<?xml version="1.0"?>
<root>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002015201</ndc>
    <ndc_label_name>Zepbound 2.5 mg/0.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002015204</ndc>
    <ndc_label_name>Zepbound 2.5 mg/0.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002024301</ndc>
    <ndc_label_name>Zepbound 5 mg/0.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002024304</ndc>
    <ndc_label_name>Zepbound 5 mg/0.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002080001</ndc>
    <ndc_label_name>Sterile Diluent for Humalog-Humulin R-Insulin Lispro injection soln</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002091155</ndc>
    <ndc_label_name>TEMPO SMART BUTTON</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002094855</ndc>
    <ndc_label_name>TEMPO WELCOME KIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002115155</ndc>
    <ndc_label_name>TEMPO REFILL KIT (WITH GAUZE)</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002120001</ndc>
    <ndc_label_name>Amyvid 10 mCi (370 MBq) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002121404</ndc>
    <ndc_label_name>Zepbound 7.5 mg/0.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002122001</ndc>
    <ndc_label_name>Tauvid 370 MBq (10 mCi) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002134004</ndc>
    <ndc_label_name>Zepbound 10 mg/0.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002142304</ndc>
    <ndc_label_name>Zepbound 12.5 mg/0.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002143301</ndc>
    <ndc_label_name>Trulicity 0.75 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002143361</ndc>
    <ndc_label_name>Trulicity 0.75 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002143380</ndc>
    <ndc_label_name>Trulicity 0.75 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002143401</ndc>
    <ndc_label_name>Trulicity 1.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002143461</ndc>
    <ndc_label_name>Trulicity 1.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002143480</ndc>
    <ndc_label_name>Trulicity 1.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002143601</ndc>
    <ndc_label_name>Emgality Pen 120 mg/mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002143611</ndc>
    <ndc_label_name>Emgality Pen 120 mg/mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002144201</ndc>
    <ndc_label_name>Omvoh 200 mg/2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002144211</ndc>
    <ndc_label_name>Omvoh 200 mg/2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002144501</ndc>
    <ndc_label_name>Taltz Autoinjector 80 mg/mL subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002144509</ndc>
    <ndc_label_name>Taltz Autoinjector (3 Pack) 80 mg/mL subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002144511</ndc>
    <ndc_label_name>Taltz Autoinjector 80 mg/mL subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002144527</ndc>
    <ndc_label_name>Taltz Autoinjector (2 Pack) 80 mg/mL subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002145701</ndc>
    <ndc_label_name>Mounjaro 15 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002145780</ndc>
    <ndc_label_name>Mounjaro 15 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002146001</ndc>
    <ndc_label_name>Mounjaro 12.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002146080</ndc>
    <ndc_label_name>Mounjaro 12.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002147101</ndc>
    <ndc_label_name>Mounjaro 10 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002147180</ndc>
    <ndc_label_name>Mounjaro 10 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002148401</ndc>
    <ndc_label_name>Mounjaro 7.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002148480</ndc>
    <ndc_label_name>Mounjaro 7.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002149501</ndc>
    <ndc_label_name>Mounjaro 5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002149580</ndc>
    <ndc_label_name>Mounjaro 5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002150601</ndc>
    <ndc_label_name>Mounjaro 2.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002150680</ndc>
    <ndc_label_name>Mounjaro 2.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002171728</ndc>
    <ndc_label_name>Inluriyo 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002171756</ndc>
    <ndc_label_name>Inluriyo 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002200204</ndc>
    <ndc_label_name>Zepbound 15 mg/0.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002223601</ndc>
    <ndc_label_name>Trulicity 3 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002223661</ndc>
    <ndc_label_name>Trulicity 3 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002223680</ndc>
    <ndc_label_name>Trulicity 3 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002237701</ndc>
    <ndc_label_name>Emgality 120 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002237711</ndc>
    <ndc_label_name>Emgality 120 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002245701</ndc>
    <ndc_label_name>Zepbound 15 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002245780</ndc>
    <ndc_label_name>Zepbound 15 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002246001</ndc>
    <ndc_label_name>Zepbound 12.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002246080</ndc>
    <ndc_label_name>Zepbound 12.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002247101</ndc>
    <ndc_label_name>Zepbound 10 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002247180</ndc>
    <ndc_label_name>Zepbound 10 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002248401</ndc>
    <ndc_label_name>Zepbound 7.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002248480</ndc>
    <ndc_label_name>Zepbound 7.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002249501</ndc>
    <ndc_label_name>Zepbound 5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002249580</ndc>
    <ndc_label_name>Zepbound 5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002250601</ndc>
    <ndc_label_name>Zepbound 2.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002250680</ndc>
    <ndc_label_name>Zepbound 2.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002298026</ndc>
    <ndc_label_name>RETEVMO 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002298060</ndc>
    <ndc_label_name>RETEVMO 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002311501</ndc>
    <ndc_label_name>Emgality 300 mg/3 mL (100 mg/mL x 3) subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002311509</ndc>
    <ndc_label_name>Emgality 300 mg/3 mL (100 mg/mL x 3) subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002311601</ndc>
    <ndc_label_name>Omvoh Pen 200 mg/2 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002311611</ndc>
    <ndc_label_name>Omvoh Pen 200 mg/2 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002318201</ndc>
    <ndc_label_name>Trulicity 4.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002318261</ndc>
    <ndc_label_name>Trulicity 4.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002318280</ndc>
    <ndc_label_name>Trulicity 4.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002322730</ndc>
    <ndc_label_name>STRATTERA 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002322830</ndc>
    <ndc_label_name>STRATTERA 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002322930</ndc>
    <ndc_label_name>STRATTERA 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002323560</ndc>
    <ndc_label_name>CYMBALTA 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002323830</ndc>
    <ndc_label_name>STRATTERA 18 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002323930</ndc>
    <ndc_label_name>STRATTERA 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002324030</ndc>
    <ndc_label_name>CYMBALTA 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002324090</ndc>
    <ndc_label_name>CYMBALTA 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002325030</ndc>
    <ndc_label_name>STRATTERA 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002325130</ndc>
    <ndc_label_name>STRATTERA 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002327030</ndc>
    <ndc_label_name>CYMBALTA 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002351101</ndc>
    <ndc_label_name>Zepbound KwikPen 15 mg/0.6 mL (60 mg/2.4 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002351111</ndc>
    <ndc_label_name>Zepbound KwikPen 15 mg/0.6 mL (60 mg/2.4 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002352201</ndc>
    <ndc_label_name>Zepbound KwikPen 12.5 mg/0.6 mL (50 mg/2.4 mL) subcutaneous pen inject</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002352211</ndc>
    <ndc_label_name>Zepbound KwikPen 12.5 mg/0.6 mL (50 mg/2.4 mL) subcutaneous pen inject</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002353301</ndc>
    <ndc_label_name>Zepbound KwikPen 10 mg/0.6 mL (40 mg/2.4 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002353311</ndc>
    <ndc_label_name>Zepbound KwikPen 10 mg/0.6 mL (40 mg/2.4 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002354401</ndc>
    <ndc_label_name>Zepbound KwikPen 7.5 mg/0.6 mL(30 mg/2.4 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002354411</ndc>
    <ndc_label_name>Zepbound KwikPen 7.5 mg/0.6 mL(30 mg/2.4 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002355501</ndc>
    <ndc_label_name>Zepbound KwikPen 5 mg/0.6 mL (20 mg/2.4 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002355511</ndc>
    <ndc_label_name>Zepbound KwikPen 5 mg/0.6 mL (20 mg/2.4 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002356601</ndc>
    <ndc_label_name>Zepbound KwikPen 2.5 mg/0.6 mL(10 mg/2.4 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002356611</ndc>
    <ndc_label_name>Zepbound KwikPen 2.5 mg/0.6 mL(10 mg/2.4 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002397760</ndc>
    <ndc_label_name>RETEVMO 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002417801</ndc>
    <ndc_label_name>Foundayo 0.8 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002417831</ndc>
    <ndc_label_name>Foundayo 0.8 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002418230</ndc>
    <ndc_label_name>Olumiant 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002418430</ndc>
    <ndc_label_name>Evista 60 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002431208</ndc>
    <ndc_label_name>Reyvow 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002446230</ndc>
    <ndc_label_name>Cialis 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002446330</ndc>
    <ndc_label_name>Cialis 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002446430</ndc>
    <ndc_label_name>Cialis 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002447930</ndc>
    <ndc_label_name>Olumiant 4 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002448354</ndc>
    <ndc_label_name>Verzenio 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002448362</ndc>
    <ndc_label_name>Verzenio 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002449101</ndc>
    <ndc_label_name>Reyvow 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002449108</ndc>
    <ndc_label_name>Reyvow 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002450301</ndc>
    <ndc_label_name>Foundayo 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002450331</ndc>
    <ndc_label_name>Foundayo 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002473230</ndc>
    <ndc_label_name>Olumiant 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002479401</ndc>
    <ndc_label_name>Foundayo 5.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002479431</ndc>
    <ndc_label_name>Foundayo 5.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002480301</ndc>
    <ndc_label_name>Foundayo 9 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002480331</ndc>
    <ndc_label_name>Foundayo 9 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002481554</ndc>
    <ndc_label_name>Verzenio 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002481562</ndc>
    <ndc_label_name>Verzenio 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002483901</ndc>
    <ndc_label_name>Foundayo 14.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002483931</ndc>
    <ndc_label_name>Foundayo 14.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002495301</ndc>
    <ndc_label_name>Foundayo 17.2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002495331</ndc>
    <ndc_label_name>Foundayo 17.2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002533754</ndc>
    <ndc_label_name>Verzenio 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002533762</ndc>
    <ndc_label_name>Verzenio 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002533763</ndc>
    <ndc_label_name>Verzenio 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002534060</ndc>
    <ndc_label_name>Retevmo 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002556260</ndc>
    <ndc_label_name>Retevmo 160 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002608260</ndc>
    <ndc_label_name>Retevmo 80 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002612060</ndc>
    <ndc_label_name>Retevmo 120 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002621654</ndc>
    <ndc_label_name>Verzenio 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002690230</ndc>
    <ndc_label_name>Jaypirca 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002702660</ndc>
    <ndc_label_name>Jaypirca 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002734901</ndc>
    <ndc_label_name>Humatrope 5 mg (15 unit) solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002751001</ndc>
    <ndc_label_name>Humalog U-100 Insulin 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002751101</ndc>
    <ndc_label_name>Humalog Mix 75-25 (U-100) Insulin 100 unit/mL subcutaneous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002751601</ndc>
    <ndc_label_name>Humalog U-100 Insulin 100 unit/mL subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002751659</ndc>
    <ndc_label_name>Humalog U-100 Insulin 100 unit/mL subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002752901</ndc>
    <ndc_label_name>Glucagon Emergency Kit 1 mg solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002753301</ndc>
    <ndc_label_name>Humalog U-100 Insulin 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002757501</ndc>
    <ndc_label_name>Omvoh 300 mg/15 mL (20 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002762301</ndc>
    <ndc_label_name>ALIMTA 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002764001</ndc>
    <ndc_label_name>ALIMTA 100 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002766901</ndc>
    <ndc_label_name>Cyramza 10 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002767801</ndc>
    <ndc_label_name>Cyramza 10 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002771201</ndc>
    <ndc_label_name>Humalog KwikPen U-200 Insulin 200 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002771227</ndc>
    <ndc_label_name>Humalog KwikPen U-200 Insulin 200 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002771401</ndc>
    <ndc_label_name>Humalog Junior KwikPen (U-100) 100 unit/mL subcutaneous half-unit pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002771459</ndc>
    <ndc_label_name>Humalog Junior KwikPen (U-100) 100 unit/mL subcutaneous half-unit pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002771501</ndc>
    <ndc_label_name>Basaglar KwikPen U-100 Insulin 100 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002771559</ndc>
    <ndc_label_name>Basaglar KwikPen U-100 Insulin 100 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002771601</ndc>
    <ndc_label_name>PORTRAZZA 800 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002771711</ndc>
    <ndc_label_name>Omvoh Pen 300mg/3mL(100mg/mL-200mg/2mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002772211</ndc>
    <ndc_label_name>Omvoh 300mg/3mL(100mg/mL-200mg/2mL) subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002772401</ndc>
    <ndc_label_name>Taltz Syringe 80 mg/mL subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002772411</ndc>
    <ndc_label_name>Taltz Syringe 80 mg/mL subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002772801</ndc>
    <ndc_label_name>Lyumjev U-100 Insulin 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002773701</ndc>
    <ndc_label_name>INSULIN LISPRO 100 UNIT/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002775201</ndc>
    <ndc_label_name>INSULIN LISPRO JR 100 UNIT/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002775205</ndc>
    <ndc_label_name>INSULIN LISPRO JR 100 UNIT/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002777201</ndc>
    <ndc_label_name>Ebglyss Pen 250 mg/2 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002777211</ndc>
    <ndc_label_name>Ebglyss Pen 250 mg/2 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002779701</ndc>
    <ndc_label_name>Ebglyss Syringe 250 mg/2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002779711</ndc>
    <ndc_label_name>Ebglyss Syringe 250 mg/2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002801101</ndc>
    <ndc_label_name>Omvoh Pen 100 mg/mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002801127</ndc>
    <ndc_label_name>OMVOH 200 MG DOSE - 2 PENS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002803101</ndc>
    <ndc_label_name>Glucagon Emergency Kit 1 mg solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002814701</ndc>
    <ndc_label_name>Humatrope 6 mg (18 unit) injection cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002814801</ndc>
    <ndc_label_name>Humatrope 12 mg (36 unit) injection cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002814901</ndc>
    <ndc_label_name>Humatrope 24 mg (72 unit) injection cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002820701</ndc>
    <ndc_label_name>Lyumjev KwikPen U-100 Insulin 100 unit/mL subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002820705</ndc>
    <ndc_label_name>Lyumjev KwikPen U-100 Insulin 100 unit/mL subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002821301</ndc>
    <ndc_label_name>Humalog Tempo Pen (U-100) Insulin 100 unit/mL subcutaneous pen, sensor</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002821305</ndc>
    <ndc_label_name>Humalog Tempo Pen (U-100) Insulin 100 unit/mL subcutaneous pen, sensor</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002821401</ndc>
    <ndc_label_name>BASAGLAR TEMPO PEN 100 UNIT/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002821405</ndc>
    <ndc_label_name>BASAGLAR TEMPO PEN 100 UNIT/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002821501</ndc>
    <ndc_label_name>Humulin R Regular U-100 Insulin 100 unit/mL injection solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002822201</ndc>
    <ndc_label_name>INSULIN LISPRO 100 UNIT/ML PEN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002822259</ndc>
    <ndc_label_name>INSULIN LISPRO 100 UNIT/ML PEN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002822801</ndc>
    <ndc_label_name>Lyumjev KwikPen U-200 Insulin 200 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002822827</ndc>
    <ndc_label_name>Lyumjev KwikPen U-200 Insulin 200 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002823301</ndc>
    <ndc_label_name>INSULIN LISPRO MIX 75-25 KWKPN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002823305</ndc>
    <ndc_label_name>INSULIN LISPRO MIX 75-25 KWKPN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002823501</ndc>
    <ndc_label_name>Lyumjev Tempo Pen (U-100) Insulin 100 unit/mL subcutaneous pen, sensor</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002823505</ndc>
    <ndc_label_name>Lyumjev Tempo Pen (U-100) Insulin 100 unit/mL subcutaneous pen, sensor</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002831501</ndc>
    <ndc_label_name>Humulin N NPH U-100 Insulin (isophane susp) 100 unit/mL subcutaneous</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002840001</ndc>
    <ndc_label_name>Forteo 20 mcg/dose (560 mcg/2.24 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002850101</ndc>
    <ndc_label_name>HUMULIN R 500 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002871501</ndc>
    <ndc_label_name>Humulin 70/30 U-100 Insulin 100 unit/mL subcutaneous suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002879701</ndc>
    <ndc_label_name>Humalog Mix 75-25 KwikPen U-100 insulin 100 unit/mL subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002879759</ndc>
    <ndc_label_name>Humalog Mix 75-25 KwikPen U-100 insulin 100 unit/mL subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002879801</ndc>
    <ndc_label_name>Humalog Mix 50-50 KwikPen U-100 Insulin 100 unit/mL subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002879859</ndc>
    <ndc_label_name>Humalog Mix 50-50 KwikPen U-100 Insulin 100 unit/mL subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002879901</ndc>
    <ndc_label_name>Humalog KwikPen (U-100) Insulin 100 unit/mL subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002879959</ndc>
    <ndc_label_name>Humalog KwikPen (U-100) Insulin 100 unit/mL subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002880301</ndc>
    <ndc_label_name>Humulin 70/30 U-100 Insulin KwikPen 100 unit/mL subcutaneous</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002880359</ndc>
    <ndc_label_name>Humulin 70/30 U-100 Insulin KwikPen 100 unit/mL subcutaneous</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002880501</ndc>
    <ndc_label_name>Humulin N NPH U-100 Insulin KwikPen 100 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002880559</ndc>
    <ndc_label_name>Humulin N NPH U-100 Insulin KwikPen 100 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002882401</ndc>
    <ndc_label_name>Humulin R U-500 (Conc) Insulin Kwikpen 500 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00002882427</ndc>
    <ndc_label_name>Humulin R U-500 (Conc) Insulin Kwikpen 500 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002887001</ndc>
    <ndc_label_name>Omvoh 100 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002887027</ndc>
    <ndc_label_name>OMVOH 200 MG DOSE - 2 SYRINGES</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002890011</ndc>
    <ndc_label_name>Taltz Syringe 20 mg/0.25 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002890501</ndc>
    <ndc_label_name>Taltz Syringe 40 mg/0.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002890511</ndc>
    <ndc_label_name>Taltz Syringe 40 mg/0.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002898001</ndc>
    <ndc_label_name>Rezvoglar KwikPen 100 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002898005</ndc>
    <ndc_label_name>Rezvoglar KwikPen 100 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002940101</ndc>
    <ndc_label_name>Kisunla 17.5 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002956001</ndc>
    <ndc_label_name>HumatroPen 6 subcutaneous pen injector device</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002956101</ndc>
    <ndc_label_name>HumatroPen 12 subcutaneous pen injector device</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002956201</ndc>
    <ndc_label_name>HumatroPen 24 subcutaneous pen injector device</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00002967801</ndc>
    <ndc_label_name>Forteo 20 mcg/dose (560 mcg/2.24 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003005060</ndc>
    <ndc_label_name>Cobenfy 50 mg-20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003010060</ndc>
    <ndc_label_name>Cobenfy 100 mg-20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003012560</ndc>
    <ndc_label_name>Cobenfy 125 mg-30 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003029305</ndc>
    <ndc_label_name>Kenalog 40 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003029320</ndc>
    <ndc_label_name>Kenalog 40 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003029328</ndc>
    <ndc_label_name>Kenalog 40 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003031505</ndc>
    <ndc_label_name>Kenalog-80  80 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003031520</ndc>
    <ndc_label_name>Kenalog-80  80 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003037113</ndc>
    <ndc_label_name>Nulojix 250 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003049420</ndc>
    <ndc_label_name>Kenalog 10 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003052411</ndc>
    <ndc_label_name>Sprycel 70 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003052711</ndc>
    <ndc_label_name>Sprycel 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003052811</ndc>
    <ndc_label_name>Sprycel 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003083050</ndc>
    <ndc_label_name>Hydrea 500 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003085222</ndc>
    <ndc_label_name>Sprycel 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003085522</ndc>
    <ndc_label_name>Sprycel 80 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003085722</ndc>
    <ndc_label_name>Sprycel 140 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003089321</ndc>
    <ndc_label_name>Eliquis 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003089331</ndc>
    <ndc_label_name>Eliquis 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003089421</ndc>
    <ndc_label_name>Eliquis 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003089431</ndc>
    <ndc_label_name>Eliquis 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003089470</ndc>
    <ndc_label_name>Eliquis 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003089511</ndc>
    <ndc_label_name>Sotyktu 6 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003089591</ndc>
    <ndc_label_name>Sotyktu 6 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003089828</ndc>
    <ndc_label_name>Eliquis Sprinkle 0.15 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003102812</ndc>
    <ndc_label_name>Eliquis 2 mg (0.5 mg x 4) tablet for oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003102828</ndc>
    <ndc_label_name>Eliquis 0.5 mg tablet for oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003102884</ndc>
    <ndc_label_name>Eliquis 1.5 mg (0.5 mg x 3) tablet for oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003110060</ndc>
    <ndc_label_name>Cobenfy 100 mg-20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003161112</ndc>
    <ndc_label_name>Baraclude 0.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003161212</ndc>
    <ndc_label_name>Baraclude 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003161412</ndc>
    <ndc_label_name>Baraclude 0.05 mg/mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003218713</ndc>
    <ndc_label_name>Orencia (with maltose) 250 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003218811</ndc>
    <ndc_label_name>Orencia 125 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003218851</ndc>
    <ndc_label_name>Orencia ClickJect 125 mg/mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003218890</ndc>
    <ndc_label_name>Orencia ClickJect 125 mg/mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003218891</ndc>
    <ndc_label_name>Orencia 125 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003229111</ndc>
    <ndc_label_name>Empliciti 300 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003232711</ndc>
    <ndc_label_name>Yervoy 50 mg/10 mL (5 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003232822</ndc>
    <ndc_label_name>Yervoy 200 mg/40 mL (5 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003256016</ndc>
    <ndc_label_name>Azactam 1 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003257016</ndc>
    <ndc_label_name>Azactam 2 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003281411</ndc>
    <ndc_label_name>Orencia 50 mg/0.4 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003281811</ndc>
    <ndc_label_name>Orencia 87.5 mg/0.7 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003312001</ndc>
    <ndc_label_name>Opdivo Qvantig 300 mg-5,000 unit/2.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003362212</ndc>
    <ndc_label_name>Reyataz 300 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003363112</ndc>
    <ndc_label_name>Reyataz 200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003363810</ndc>
    <ndc_label_name>Reyataz 50 mg oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003364111</ndc>
    <ndc_label_name>Evotaz 300 mg-150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003373413</ndc>
    <ndc_label_name>Opdivo 240 mg/24 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003375614</ndc>
    <ndc_label_name>Opdivo 120 mg/12 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003376474</ndc>
    <ndc_label_name>Eliquis DVT-PE Treatment 30-Day Starter 5 mg (74 tablets) in dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003377211</ndc>
    <ndc_label_name>Opdivo 40 mg/4 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003377412</ndc>
    <ndc_label_name>Opdivo 100 mg/10 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003404012</ndc>
    <ndc_label_name>Augtyro 40 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003404060</ndc>
    <ndc_label_name>Augtyro 40 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003416014</ndc>
    <ndc_label_name>Augtyro 160 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003416060</ndc>
    <ndc_label_name>Augtyro 160 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003452211</ndc>
    <ndc_label_name>Empliciti 400 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003520056</ndc>
    <ndc_label_name>Cobenfy Starter Pack 50 mg-20 mg/100 mg-20 mg capsules in a dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003612001</ndc>
    <ndc_label_name>Opdivo Qvantig 600 mg-10,000 unit/5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003633517</ndc>
    <ndc_label_name>Droxia 200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003633617</ndc>
    <ndc_label_name>Droxia 300 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00003633717</ndc>
    <ndc_label_name>Droxia 400 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00003712511</ndc>
    <ndc_label_name>Opdualag 240 mg-80 mg/20 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004003822</ndc>
    <ndc_label_name>VALCYTE 450 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004003909</ndc>
    <ndc_label_name>Valcyte 50 mg/mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004005832</ndc>
    <ndc_label_name>Klonopin 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004006832</ndc>
    <ndc_label_name>Klonopin 0.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004025901</ndc>
    <ndc_label_name>CellCept 250 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004025943</ndc>
    <ndc_label_name>CellCept 250 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004026001</ndc>
    <ndc_label_name>CellCept 500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004026043</ndc>
    <ndc_label_name>CellCept 500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004026129</ndc>
    <ndc_label_name>CellCept 200 mg/mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004029809</ndc>
    <ndc_label_name>CellCept Intravenous 500 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004029830</ndc>
    <ndc_label_name>CellCept Intravenous 500 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004035009</ndc>
    <ndc_label_name>Pegasys 180 mcg/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004035730</ndc>
    <ndc_label_name>Pegasys 180 mcg/0.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004038101</ndc>
    <ndc_label_name>FUZEON 90 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004038140</ndc>
    <ndc_label_name>FUZEON 90 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004040509</ndc>
    <ndc_label_name>Mircera 200 mcg/0.3 mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004080007</ndc>
    <ndc_label_name>Tamiflu 75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004080008</ndc>
    <ndc_label_name>Tamiflu 75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004080085</ndc>
    <ndc_label_name>Tamiflu 75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004080185</ndc>
    <ndc_label_name>Tamiflu 45 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004080285</ndc>
    <ndc_label_name>TAMIFLU 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004082205</ndc>
    <ndc_label_name>Tamiflu 6 mg/mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004110020</ndc>
    <ndc_label_name>XELODA 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00004110150</ndc>
    <ndc_label_name>XELODA 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005010001</ndc>
    <ndc_label_name>Trumenba 120 mcg/0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005010005</ndc>
    <ndc_label_name>Trumenba 120 mcg/0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005010010</ndc>
    <ndc_label_name>Trumenba 120 mcg/0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005200001</ndc>
    <ndc_label_name>Prevnar 20 (PF) 0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005200002</ndc>
    <ndc_label_name>Prevnar 20 (PF) 0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005200010</ndc>
    <ndc_label_name>Prevnar 20 (PF) 0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005250002</ndc>
    <ndc_label_name>FiberCon 625 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005250023</ndc>
    <ndc_label_name>FiberCon 625 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005250033</ndc>
    <ndc_label_name>FiberCon 625 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005417990</ndc>
    <ndc_label_name>Centrum Silver 0.4 mg-300 mcg-250 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005423720</ndc>
    <ndc_label_name>Centrum Kids (with vit D3, vit K) 8 mg iron-10 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005434462</ndc>
    <ndc_label_name>Centrum 9 mg iron/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005445174</ndc>
    <ndc_label_name>Centrum Complete 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005446119</ndc>
    <ndc_label_name>Centrum Silver 400 mcg-250 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005446381</ndc>
    <ndc_label_name>Centrum Silver 0.4 mg-300 mcg-250 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005446391</ndc>
    <ndc_label_name>Centrum Silver 0.4 mg-300 mcg-250 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005447060</ndc>
    <ndc_label_name>Centrum Specialist Energy 18 mg iron-400 mcg-25mcg-75mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005449860</ndc>
    <ndc_label_name>Centrum Specialist Heart 3 mg-200 mcg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005452835</ndc>
    <ndc_label_name>Centrum Chewables 8 mg iron-400 mcg-10 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005452890</ndc>
    <ndc_label_name>Centrum Chewables 8 mg iron-400 mcg-80 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005475557</ndc>
    <ndc_label_name>Centrum Women 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005475592</ndc>
    <ndc_label_name>Centrum Women 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005475652</ndc>
    <ndc_label_name>Centrum Silver Women 8 mg iron-400 mcg-50 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005475671</ndc>
    <ndc_label_name>Centrum Silver Women 8 mg iron-400 mcg-50 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005475756</ndc>
    <ndc_label_name>Centrum Men 8 mg iron-200 mcg-600 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00005475770</ndc>
    <ndc_label_name>Centrum Ultra Men's 8 mg iron-200 mcg-600 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005475850</ndc>
    <ndc_label_name>Centrum Silver Ultra Men's 300 mcg-60 mcg-600 mcg-300 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005475865</ndc>
    <ndc_label_name>Centrum Silver Men 300 mcg-60 mcg-600 mcg-300 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005475870</ndc>
    <ndc_label_name>Centrum Silver Ultra Men's 300 mcg-60 mcg-600 mcg-300 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005487460</ndc>
    <ndc_label_name>Centrum Adult 50 Plus Fresh-Fruity 120 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005550919</ndc>
    <ndc_label_name>Caltrate with Vitamin D3 600 mg-20 mcg (800 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005550924</ndc>
    <ndc_label_name>Caltrate with Vitamin D3 600 mg-20 mcg (800 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005550925</ndc>
    <ndc_label_name>Caltrate with Vitamin D3 600 mg-20 mcg (800 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005551210</ndc>
    <ndc_label_name>Caltrate-D3 Plus Minerals 300 mg-20 mcg-25 mg-0.5 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005551750</ndc>
    <ndc_label_name>Caltrate Gummy Bites 250 mg-10 mcg (400 unit) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005551795</ndc>
    <ndc_label_name>Caltrate Gummy Bites 250 mg-10 mcg (400 unit) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005555619</ndc>
    <ndc_label_name>Caltrate 600-D Plus Minerals 600 mg calcium-800 unit-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005555623</ndc>
    <ndc_label_name>Caltrate 600-D Plus Minerals 600 mg calcium-800 unit-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005556711</ndc>
    <ndc_label_name>Caltrate 600-D Minerals 600 mg (carbonate)-800 unit-40 mg chew tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005556720</ndc>
    <ndc_label_name>Caltrate 600-D Minerals 600 mg (carbonate)-800 unit-40 mg chew tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005556819</ndc>
    <ndc_label_name>Caltrate plus D  600 mg (carbonate)-20 mcg (800 unit) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00005556919</ndc>
    <ndc_label_name>Caltrate plus D  600 mg (carbonate)-20 mcg (800 unit) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006000510</ndc>
    <ndc_label_name>Belsomra 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006000513</ndc>
    <ndc_label_name>Belsomra 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006000530</ndc>
    <ndc_label_name>Belsomra 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006003201</ndc>
    <ndc_label_name>Stromectol 3 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006003220</ndc>
    <ndc_label_name>Stromectol 3 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006003299</ndc>
    <ndc_label_name>Stromectol 3 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006003310</ndc>
    <ndc_label_name>Belsomra 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006003313</ndc>
    <ndc_label_name>Belsomra 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006003330</ndc>
    <ndc_label_name>Belsomra 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006007861</ndc>
    <ndc_label_name>Janumet XR 50 mg-500 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006007862</ndc>
    <ndc_label_name>Janumet XR 50 mg-500 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006007882</ndc>
    <ndc_label_name>Janumet XR 50 mg-500 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006008061</ndc>
    <ndc_label_name>Janumet XR 50 mg-1,000 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006008062</ndc>
    <ndc_label_name>Janumet XR 50 mg-1,000 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006008082</ndc>
    <ndc_label_name>Janumet XR 50 mg-1,000 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006008131</ndc>
    <ndc_label_name>Janumet XR 100 mg-1,000 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006008154</ndc>
    <ndc_label_name>Janumet XR 100 mg-1,000 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006008182</ndc>
    <ndc_label_name>Janumet XR 100 mg-1,000 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006011201</ndc>
    <ndc_label_name>Januvia 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006011228</ndc>
    <ndc_label_name>Januvia 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006011231</ndc>
    <ndc_label_name>Januvia 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006011254</ndc>
    <ndc_label_name>Januvia 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006022101</ndc>
    <ndc_label_name>Januvia 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006022128</ndc>
    <ndc_label_name>Januvia 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006022131</ndc>
    <ndc_label_name>Januvia 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006022154</ndc>
    <ndc_label_name>Januvia 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006022761</ndc>
    <ndc_label_name>Isentress 400 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006027701</ndc>
    <ndc_label_name>Januvia 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006027728</ndc>
    <ndc_label_name>Januvia 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006027731</ndc>
    <ndc_label_name>Januvia 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006027754</ndc>
    <ndc_label_name>Januvia 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006027782</ndc>
    <ndc_label_name>Januvia 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006032510</ndc>
    <ndc_label_name>Belsomra 15 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006032513</ndc>
    <ndc_label_name>Belsomra 15 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006032530</ndc>
    <ndc_label_name>Belsomra 15 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006033510</ndc>
    <ndc_label_name>Belsomra 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006033513</ndc>
    <ndc_label_name>Belsomra 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006033530</ndc>
    <ndc_label_name>Belsomra 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006046102</ndc>
    <ndc_label_name>Emend 80 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006047361</ndc>
    <ndc_label_name>Isentress 25 mg chewable tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006047761</ndc>
    <ndc_label_name>Isentress 100 mg chewable tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006056840</ndc>
    <ndc_label_name>Zolinza 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006057561</ndc>
    <ndc_label_name>Janumet 50 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006057562</ndc>
    <ndc_label_name>Janumet 50 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006057582</ndc>
    <ndc_label_name>Janumet 50 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006057761</ndc>
    <ndc_label_name>Janumet 50 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006057762</ndc>
    <ndc_label_name>Janumet 50 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006057782</ndc>
    <ndc_label_name>Janumet 50 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006302500</ndc>
    <ndc_label_name>Zinplava 25 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006302501</ndc>
    <ndc_label_name>Zinplava 25 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006302601</ndc>
    <ndc_label_name>Keytruda 25 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006302602</ndc>
    <ndc_label_name>Keytruda 25 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006302604</ndc>
    <ndc_label_name>Keytruda 25 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006306100</ndc>
    <ndc_label_name>Emend (fosaprepitant) 150 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006306101</ndc>
    <ndc_label_name>Emend (fosaprepitant) 150 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006306601</ndc>
    <ndc_label_name>Emend 125 mg (25 mg/mL final conc.) oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006306603</ndc>
    <ndc_label_name>Emend 125 mg (25 mg/mL final conc.) oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006306901</ndc>
    <ndc_label_name>Pifeltro 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006307401</ndc>
    <ndc_label_name>Zepatier 50 mg-100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006307402</ndc>
    <ndc_label_name>Zepatier 50 mg-100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006307501</ndc>
    <ndc_label_name>Prevymis 240 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006307502</ndc>
    <ndc_label_name>Prevymis 240 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006307503</ndc>
    <ndc_label_name>Prevymis 240 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006307504</ndc>
    <ndc_label_name>Prevymis 240 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006307601</ndc>
    <ndc_label_name>Prevymis 480 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006307602</ndc>
    <ndc_label_name>Prevymis 480 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006307603</ndc>
    <ndc_label_name>Prevymis 480 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006307604</ndc>
    <ndc_label_name>Prevymis 480 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006308001</ndc>
    <ndc_label_name>Isentress HD 600 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006308301</ndc>
    <ndc_label_name>Keytruda Qlex 395 mg-4,800 unit/2.4 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006308399</ndc>
    <ndc_label_name>Keytruda Qlex 395 mg-4,800 unit/2.4 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006351659</ndc>
    <ndc_label_name>Primaxin 500 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006360301</ndc>
    <ndc_label_name>Isentress 100 mg oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006360361</ndc>
    <ndc_label_name>Isentress 100 mg oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006382210</ndc>
    <ndc_label_name>CANCIDAS IV 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006382310</ndc>
    <ndc_label_name>CANCIDAS IV 70 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006385601</ndc>
    <ndc_label_name>Recarbrio 1.25 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006385602</ndc>
    <ndc_label_name>Recarbrio 1.25 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006386203</ndc>
    <ndc_label_name>Emend 125 mg (1)-80 mg (2) capsules in a dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006404701</ndc>
    <ndc_label_name>RotaTeq Vaccine 2 mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006404702</ndc>
    <ndc_label_name>RotaTeq Vaccine 2 mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006404720</ndc>
    <ndc_label_name>RotaTeq Vaccine 2 mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006404741</ndc>
    <ndc_label_name>RotaTeq Vaccine 2 mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006409301</ndc>
    <ndc_label_name>Recombivax HB (PF) 5 mcg/0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006409302</ndc>
    <ndc_label_name>Recombivax HB (PF) 5 mcg/0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006409401</ndc>
    <ndc_label_name>Recombivax HB (PF) 10 mcg/mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006409402</ndc>
    <ndc_label_name>Recombivax HB (PF) 10 mcg/mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006409501</ndc>
    <ndc_label_name>Vaqta (PF) 25 unit/0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006409502</ndc>
    <ndc_label_name>Vaqta (PF) 25 unit/0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006409601</ndc>
    <ndc_label_name>Vaqta (PF) 50 unit/mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006409602</ndc>
    <ndc_label_name>Vaqta (PF) 50 unit/mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006411901</ndc>
    <ndc_label_name>Gardasil 9 (PF) 0.5 mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006411903</ndc>
    <ndc_label_name>Gardasil 9 (PF) 0.5 mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006412101</ndc>
    <ndc_label_name>Gardasil 9 (PF) 0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006412102</ndc>
    <ndc_label_name>Gardasil 9 (PF) 0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006417100</ndc>
    <ndc_label_name>ProQuad (PF) 10exp3-4.3-3-3.99TCID50/0.5mL subcutaneous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006417101</ndc>
    <ndc_label_name>ProQuad (PF) 10exp3-4.3-3-3.99TCID50/0.5mL subcutaneous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006417588</ndc>
    <ndc_label_name>Diluent for Merck Live Virus Vaccine syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006417589</ndc>
    <ndc_label_name>Diluent for Merck Live Virus Vaccine syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006429301</ndc>
    <ndc_label_name>Ervebo (PF)(National Stockpile) 1 mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006429302</ndc>
    <ndc_label_name>Ervebo (PF)(National Stockpile) 1 mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006430501</ndc>
    <ndc_label_name>Renflexis 100 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006430502</ndc>
    <ndc_label_name>Renflexis 100 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006430900</ndc>
    <ndc_label_name>Diluent for Merck Live Virus Vaccine</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006430901</ndc>
    <ndc_label_name>Diluent for Merck Live Virus Vaccine</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006432901</ndc>
    <ndc_label_name>Vaxneuvance (PF) 0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006432902</ndc>
    <ndc_label_name>Vaxneuvance (PF) 0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006432903</ndc>
    <ndc_label_name>Vaxneuvance (PF) 0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006434702</ndc>
    <ndc_label_name>Capvaxive 0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006434799</ndc>
    <ndc_label_name>Capvaxive 0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006468100</ndc>
    <ndc_label_name>M-M-R II (PF) 1,000-12,500 TCID50/0.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006468101</ndc>
    <ndc_label_name>M-M-R II (PF) 1,000-12,500 TCID50/0.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006482700</ndc>
    <ndc_label_name>Varivax (PF) 1,350 unit/0.5 mL subcutaneous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006482701</ndc>
    <ndc_label_name>Varivax (PF) 1,350 unit/0.5 mL subcutaneous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006483101</ndc>
    <ndc_label_name>Vaqta (PF) 25 unit/0.5 mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006483141</ndc>
    <ndc_label_name>Vaqta (PF) 25 unit/0.5 mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006483701</ndc>
    <ndc_label_name>Pneumovax-23 25 mcg/0.5 mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006483703</ndc>
    <ndc_label_name>Pneumovax-23 25 mcg/0.5 mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006484100</ndc>
    <ndc_label_name>Vaqta (PF) 50 unit/mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006484101</ndc>
    <ndc_label_name>Vaqta (PF) 50 unit/mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006484141</ndc>
    <ndc_label_name>Vaqta (PF) 50 unit/mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006489700</ndc>
    <ndc_label_name>Pedvax HIB (PF) 7.5 mcg/0.5 mL intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006489701</ndc>
    <ndc_label_name>Pedvax HIB (PF) 7.5 mcg/0.5 mL intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006494300</ndc>
    <ndc_label_name>PNEUMOVAX 23 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006494300</ndc>
    <ndc_label_name>PNEUMOVAX 23 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>True</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006494301</ndc>
    <ndc_label_name>PNEUMOVAX 23 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006494301</ndc>
    <ndc_label_name>PNEUMOVAX 23 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>True</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006498100</ndc>
    <ndc_label_name>Recombivax HB (PF) 5 mcg/0.5 mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006498101</ndc>
    <ndc_label_name>Recombivax HB (PF) 5 mcg/0.5 mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006499200</ndc>
    <ndc_label_name>Recombivax HB (PF) 40 mcg/mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006499201</ndc>
    <ndc_label_name>Recombivax HB (PF) 40 mcg/mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006499501</ndc>
    <ndc_label_name>Recombivax HB (PF) 10 mcg/mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006499541</ndc>
    <ndc_label_name>Recombivax HB (PF) 10 mcg/mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006500301</ndc>
    <ndc_label_name>Prevymis 240 mg/12 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006500302</ndc>
    <ndc_label_name>Prevymis 240 mg/12 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006500401</ndc>
    <ndc_label_name>Prevymis 480 mg/24 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006500402</ndc>
    <ndc_label_name>Prevymis 480 mg/24 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00006500701</ndc>
    <ndc_label_name>Delstrigo 100 mg-300 mg-300 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006502801</ndc>
    <ndc_label_name>Verquvo 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006502802</ndc>
    <ndc_label_name>Verquvo 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006502803</ndc>
    <ndc_label_name>Verquvo 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006502804</ndc>
    <ndc_label_name>Verquvo 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006502901</ndc>
    <ndc_label_name>Verquvo 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006502902</ndc>
    <ndc_label_name>Verquvo 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006502903</ndc>
    <ndc_label_name>Verquvo 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006502904</ndc>
    <ndc_label_name>Verquvo 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006503001</ndc>
    <ndc_label_name>Verquvo 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006503002</ndc>
    <ndc_label_name>Verquvo 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006503003</ndc>
    <ndc_label_name>Verquvo 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006503004</ndc>
    <ndc_label_name>Verquvo 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006505506</ndc>
    <ndc_label_name>Lagevrio 200 mg capsule (EUA)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006505509</ndc>
    <ndc_label_name>Lagevrio 200 mg capsule (EUA)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006506899</ndc>
    <ndc_label_name>Winrevair 45 mg subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006506999</ndc>
    <ndc_label_name>Winrevair 60 mg subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006507301</ndc>
    <ndc_label_name>Enflonsia 105 mg/0.7 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006507302</ndc>
    <ndc_label_name>Enflonsia 105 mg/0.7 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006507399</ndc>
    <ndc_label_name>Enflonsia 105 mg/0.7 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006507989</ndc>
    <ndc_label_name>Sterile Water 100 % Diluent for Winrevair injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006508089</ndc>
    <ndc_label_name>Sterile Water 100 % Diluent for Winrevair injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006508301</ndc>
    <ndc_label_name>Keytruda Qlex 790 mg-9,600 unit/4.8 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006508399</ndc>
    <ndc_label_name>Keytruda Qlex 790 mg-9,600 unit/4.8 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006508501</ndc>
    <ndc_label_name>Prevymis 120 mg oral pellets in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006508599</ndc>
    <ndc_label_name>Prevymis 120 mg oral pellets in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006508601</ndc>
    <ndc_label_name>Prevymis 20 mg oral pellets in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006508699</ndc>
    <ndc_label_name>Prevymis 20 mg oral pellets in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006508701</ndc>
    <ndc_label_name>Winrevair 90 mg (45 mg x 2) subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006508801</ndc>
    <ndc_label_name>Winrevair 120 mg (60 mg x 2) subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006509001</ndc>
    <ndc_label_name>Winrevair 45 mg subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006509101</ndc>
    <ndc_label_name>Winrevair 60 mg subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006533101</ndc>
    <ndc_label_name>Welireg 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006536303</ndc>
    <ndc_label_name>Steglatro 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006536306</ndc>
    <ndc_label_name>Steglatro 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006536403</ndc>
    <ndc_label_name>Steglatro 15 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006536406</ndc>
    <ndc_label_name>Steglatro 15 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006536703</ndc>
    <ndc_label_name>Steglujan 5 mg-100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006536706</ndc>
    <ndc_label_name>Steglujan 5 mg-100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006536803</ndc>
    <ndc_label_name>Steglujan 15 mg-100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006536806</ndc>
    <ndc_label_name>Steglujan 15 mg-100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006536903</ndc>
    <ndc_label_name>Segluromet 2.5 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006536906</ndc>
    <ndc_label_name>Segluromet 2.5 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006537003</ndc>
    <ndc_label_name>Segluromet 7.5 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006537006</ndc>
    <ndc_label_name>Segluromet 7.5 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006537303</ndc>
    <ndc_label_name>Segluromet 2.5 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006537306</ndc>
    <ndc_label_name>Segluromet 2.5 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006537403</ndc>
    <ndc_label_name>Segluromet 7.5 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006537406</ndc>
    <ndc_label_name>Segluromet 7.5 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006542302</ndc>
    <ndc_label_name>Bridion 100 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006542312</ndc>
    <ndc_label_name>Bridion 100 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006542402</ndc>
    <ndc_label_name>ANTIVENIN (LATRODECTUS) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006542505</ndc>
    <ndc_label_name>Bridion 100 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00006542515</ndc>
    <ndc_label_name>Bridion 100 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008010001</ndc>
    <ndc_label_name>Besponsa 0.9 mg(0.25 mg/mL initial concentration) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008042301</ndc>
    <ndc_label_name>ANTIVENIN MICRURUS FULVIUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008042303</ndc>
    <ndc_label_name>ANTIVENIN MICRURUS FULVIUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008083321</ndc>
    <ndc_label_name>Effexor XR 75 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008083322</ndc>
    <ndc_label_name>Effexor XR 75 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008083621</ndc>
    <ndc_label_name>Effexor XR 150 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008083622</ndc>
    <ndc_label_name>Effexor XR 150 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008083721</ndc>
    <ndc_label_name>Effexor XR 37.5 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008083722</ndc>
    <ndc_label_name>Effexor XR 37.5 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008084181</ndc>
    <ndc_label_name>Protonix 40 mg tablet,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008084381</ndc>
    <ndc_label_name>Protonix 20 mg tablet,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00008084401</ndc>
    <ndc_label_name>Protonix 40 mg granules delayed-release packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00008084402</ndc>
    <ndc_label_name>Protonix 40 mg granules delayed-release packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008092351</ndc>
    <ndc_label_name>Protonix 40 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008092355</ndc>
    <ndc_label_name>Protonix 40 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008092360</ndc>
    <ndc_label_name>Protonix 40 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008103004</ndc>
    <ndc_label_name>RAPAMUNE 1 MG/ML ORAL SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008103006</ndc>
    <ndc_label_name>RAPAMUNE 1 MG/ML ORAL SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008104005</ndc>
    <ndc_label_name>RAPAMUNE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008104010</ndc>
    <ndc_label_name>RAPAMUNE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008104105</ndc>
    <ndc_label_name>RAPAMUNE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008104110</ndc>
    <ndc_label_name>RAPAMUNE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008104205</ndc>
    <ndc_label_name>RAPAMUNE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008112312</ndc>
    <ndc_label_name>Duavee 0.45 mg-20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008112501</ndc>
    <ndc_label_name>Diluent for Torisel intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008117901</ndc>
    <ndc_label_name>Torisel 25 mg/mL (must be diluted to 10 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008121030</ndc>
    <ndc_label_name>Pristiq 25 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008121101</ndc>
    <ndc_label_name>Pristiq 50 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008121114</ndc>
    <ndc_label_name>Pristiq 50 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008121130</ndc>
    <ndc_label_name>Pristiq 50 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008122201</ndc>
    <ndc_label_name>Pristiq 100 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008122214</ndc>
    <ndc_label_name>Pristiq 100 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008122230</ndc>
    <ndc_label_name>Pristiq 100 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008400101</ndc>
    <ndc_label_name>Protonix 40 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008400110</ndc>
    <ndc_label_name>Protonix 40 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008400125</ndc>
    <ndc_label_name>Protonix 40 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008411701</ndc>
    <ndc_label_name>TRECATOR 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008451001</ndc>
    <ndc_label_name>Mylotarg 4.5 mg (1 mg/mL initial concentration) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008499019</ndc>
    <ndc_label_name>Tygacil 50 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008499020</ndc>
    <ndc_label_name>Tygacil 50 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008499419</ndc>
    <ndc_label_name>Tygacil 50 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00008499420</ndc>
    <ndc_label_name>Tygacil 50 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009000302</ndc>
    <ndc_label_name>Solu-Medrol (PF) 500 mg/4 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009000501</ndc>
    <ndc_label_name>Solu-Cortef Act-O-Vial (PF) 1,000 mg/8 mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009001103</ndc>
    <ndc_label_name>Solu-Cortef Act-O-Vial (PF) 100 mg/2 mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009001104</ndc>
    <ndc_label_name>Solu-Cortef Act-O-Vial (PF) 100 mg/2 mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009001201</ndc>
    <ndc_label_name>Cortef 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009001305</ndc>
    <ndc_label_name>Solu-Cortef Act-O-Vial (PF) 250 mg/2 mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009001306</ndc>
    <ndc_label_name>Solu-Cortef Act-O-Vial (PF) 250 mg/2 mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009001612</ndc>
    <ndc_label_name>Solu-Cortef Act-O-Vial (PF) 500 mg/4 mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009001758</ndc>
    <ndc_label_name>Halcion 0.25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009001820</ndc>
    <ndc_label_name>Solu-Medrol (PF) 1,000 mg/8 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009002001</ndc>
    <ndc_label_name>Medrol 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009002201</ndc>
    <ndc_label_name>Medrol 8 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009002901</ndc>
    <ndc_label_name>Xanax 0.25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009002902</ndc>
    <ndc_label_name>Xanax 0.25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009003101</ndc>
    <ndc_label_name>Cortef 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009003905</ndc>
    <ndc_label_name>Solu-Medrol (PF) 40 mg/mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009003906</ndc>
    <ndc_label_name>Solu-Medrol (PF) 40 mg/mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009003928</ndc>
    <ndc_label_name>Solu-Medrol (PF) 40 mg/mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009003930</ndc>
    <ndc_label_name>Solu-Medrol (PF) 40 mg/mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009003932</ndc>
    <ndc_label_name>Solu-Medrol (PF) 40 mg/mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009003933</ndc>
    <ndc_label_name>Solu-Medrol (PF) 40 mg/mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009004401</ndc>
    <ndc_label_name>Cortef 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009004703</ndc>
    <ndc_label_name>Solu-Medrol (PF) 125 mg/2 mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009004704</ndc>
    <ndc_label_name>Solu-Medrol (PF) 125 mg/2 mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009004722</ndc>
    <ndc_label_name>Solu-Medrol (PF) 125 mg/2 mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009004725</ndc>
    <ndc_label_name>Solu-Medrol (PF) 125 mg/2 mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009004726</ndc>
    <ndc_label_name>Solu-Medrol (PF) 125 mg/2 mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009004727</ndc>
    <ndc_label_name>Solu-Medrol (PF) 125 mg/2 mL solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009005101</ndc>
    <ndc_label_name>Provera 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009005501</ndc>
    <ndc_label_name>Xanax 0.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009005503</ndc>
    <ndc_label_name>Xanax 0.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009005602</ndc>
    <ndc_label_name>Medrol 4 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009005604</ndc>
    <ndc_label_name>Medrol (Pak) 4 mg tablets in a dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009005707</ndc>
    <ndc_label_name>XANAX XR 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009005907</ndc>
    <ndc_label_name>XANAX XR 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009006501</ndc>
    <ndc_label_name>Provera 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009006607</ndc>
    <ndc_label_name>Xanax XR 2 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009006807</ndc>
    <ndc_label_name>XANAX XR 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009007301</ndc>
    <ndc_label_name>Medrol 16 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009008202</ndc>
    <ndc_label_name>Camptosar 300 mg/15 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009008510</ndc>
    <ndc_label_name>Depo-Testosterone 100 mg/mL intramuscular oil</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009008601</ndc>
    <ndc_label_name>Depo-Testosterone 200 mg/mL intramuscular oil</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009008610</ndc>
    <ndc_label_name>Depo-Testosterone 200 mg/mL intramuscular oil</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009009001</ndc>
    <ndc_label_name>Xanax 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009009004</ndc>
    <ndc_label_name>Xanax 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009009401</ndc>
    <ndc_label_name>Xanax 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009010404</ndc>
    <ndc_label_name>Lincocin 300 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009010704</ndc>
    <ndc_label_name>Lincocin 300 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009011205</ndc>
    <ndc_label_name>Camptosar 100 mg/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009021501</ndc>
    <ndc_label_name>Prostin VR Pediatric 500 mcg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009021505</ndc>
    <ndc_label_name>Prostin VR Pediatric 500 mcg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009022502</ndc>
    <ndc_label_name>Cleocin HCl 150 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009026002</ndc>
    <ndc_label_name>Colestid 5 gram oral granules</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009026017</ndc>
    <ndc_label_name>Colestid 5 gram oral granules</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009027101</ndc>
    <ndc_label_name>Depo-Estradiol 5 mg/mL intramuscular oil</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009027401</ndc>
    <ndc_label_name>Depo-Medrol 20 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009028002</ndc>
    <ndc_label_name>Depo-Medrol 40 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009028003</ndc>
    <ndc_label_name>Depo-Medrol 40 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009028051</ndc>
    <ndc_label_name>Depo-Medrol 40 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009028052</ndc>
    <ndc_label_name>Depo-Medrol 40 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009028301</ndc>
    <ndc_label_name>Gelfilm implant</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009028701</ndc>
    <ndc_label_name>Provera 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009029703</ndc>
    <ndc_label_name>Gelfilm for the eye</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009030602</ndc>
    <ndc_label_name>Depo-Medrol 80 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009030612</ndc>
    <ndc_label_name>Depo-Medrol 80 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009031508</ndc>
    <ndc_label_name>GELFOAM 12-7MM SPONGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009032301</ndc>
    <ndc_label_name>Gelfoam Sponge Size 50</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009033102</ndc>
    <ndc_label_name>Cleocin HCl 75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009034201</ndc>
    <ndc_label_name>GELFOAM SIZE 100 SPONGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009034702</ndc>
    <ndc_label_name>Depo-Testosterone 100 mg/mL intramuscular oil</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009034903</ndc>
    <ndc_label_name>Gelfoam Sponge Size 200 200</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009035301</ndc>
    <ndc_label_name>Gelfoam Compressed Size 100 100 cm sponge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009039514</ndc>
    <ndc_label_name>Cleocin HCl 300 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009039605</ndc>
    <ndc_label_name>GELFOAM DENTAL SPONGE SZ 4</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009041701</ndc>
    <ndc_label_name>Depo-Testosterone 200 mg/mL intramuscular oil</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009041702</ndc>
    <ndc_label_name>Depo-Testosterone 200 mg/mL intramuscular oil</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009043304</ndc>
    <ndc_label_name>Gelfoam mucosal powder</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009043601</ndc>
    <ndc_label_name>R-Gene 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009045003</ndc>
    <ndc_label_name>Colestid 1 gram tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009069801</ndc>
    <ndc_label_name>Solu-Medrol 1,000 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009069802</ndc>
    <ndc_label_name>Solu-Medrol 1,000 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009072805</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009072809</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009074630</ndc>
    <ndc_label_name>Depo-Provera 150 mg/mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009074635</ndc>
    <ndc_label_name>Depo-Provera 150 mg/mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009075801</ndc>
    <ndc_label_name>Solu-Medrol 500 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009076004</ndc>
    <ndc_label_name>Cleocin Pediatric 75 mg/5 mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009076012</ndc>
    <ndc_label_name>Cleocin Pediatric 75 mg/5 mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009077520</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009077526</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009082501</ndc>
    <ndc_label_name>Solu-Cortef 100 mg solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009085001</ndc>
    <ndc_label_name>Solu-Medrol 2 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009085605</ndc>
    <ndc_label_name>Hemabate 250 mcg/mL intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009085608</ndc>
    <ndc_label_name>Hemabate 250 mcg/mL intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009087021</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009087026</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009090211</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009090218</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009104001</ndc>
    <ndc_label_name>Gel-Flow NT topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009104006</ndc>
    <ndc_label_name>Gel-Flow NT topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009225001</ndc>
    <ndc_label_name>Gel-Flow 5,000 unit topical syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009305101</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009305102</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009307301</ndc>
    <ndc_label_name>Depo-Medrol 40 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009307303</ndc>
    <ndc_label_name>Depo-Medrol 40 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009307322</ndc>
    <ndc_label_name>Depo-Medrol 40 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009307323</ndc>
    <ndc_label_name>Depo-Medrol 40 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009316901</ndc>
    <ndc_label_name>Prostin VR Pediatric 500 mcg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009316906</ndc>
    <ndc_label_name>Prostin VR Pediatric 500 mcg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009332901</ndc>
    <ndc_label_name>Cleocin T 1 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009335901</ndc>
    <ndc_label_name>Prepidil 0.5 mg/3 g vaginal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009344801</ndc>
    <ndc_label_name>Cleocin 2 % vaginal cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009347501</ndc>
    <ndc_label_name>Depo-Medrol 80 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009347503</ndc>
    <ndc_label_name>Depo-Medrol 80 mg/mL suspension for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009370105</ndc>
    <ndc_label_name>Caverject 20 mcg intracavernosal solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009370108</ndc>
    <ndc_label_name>Caverject 20 mcg intracavernosal solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009379401</ndc>
    <ndc_label_name>Corvert 0.1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009379422</ndc>
    <ndc_label_name>Corvert 0.1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009407303</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009407304</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009454102</ndc>
    <ndc_label_name>DETROL 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009454402</ndc>
    <ndc_label_name>DETROL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009470913</ndc>
    <ndc_label_name>Depo-SubQ provera 104 104 mg/0.65 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009499201</ndc>
    <ndc_label_name>Zyvox 600 mg/300 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009499202</ndc>
    <ndc_label_name>Zyvox 600 mg/300 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009509101</ndc>
    <ndc_label_name>Ellence 50 mg/25 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009509125</ndc>
    <ndc_label_name>Ellence 50 mg/25 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009509301</ndc>
    <ndc_label_name>Ellence 200 mg/100 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009509310</ndc>
    <ndc_label_name>Ellence 200 mg/100 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009509505</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009509506</ndc>
    <ndc_label_name>Cleocin 150 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009513601</ndc>
    <ndc_label_name>Zyvox 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009513604</ndc>
    <ndc_label_name>Zyvox 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009513701</ndc>
    <ndc_label_name>ZYVOX 200 MG/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009513704</ndc>
    <ndc_label_name>ZYVOX 200 MG/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009513802</ndc>
    <ndc_label_name>ZYVOX 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009513803</ndc>
    <ndc_label_name>ZYVOX 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009514001</ndc>
    <ndc_label_name>Zyvox 600 mg/300 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009514004</ndc>
    <ndc_label_name>Zyvox 600 mg/300 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009517502</ndc>
    <ndc_label_name>Somavert 10 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009517510</ndc>
    <ndc_label_name>Somavert 10 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009517702</ndc>
    <ndc_label_name>Somavert 15 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009517710</ndc>
    <ndc_label_name>Somavert 15 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009517902</ndc>
    <ndc_label_name>Somavert 20 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009517910</ndc>
    <ndc_label_name>Somavert 20 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009518101</ndc>
    <ndc_label_name>Caverject Impulse 10 mcg intracavernosal kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009518110</ndc>
    <ndc_label_name>Caverject 10 mcg intracavernosal syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009518201</ndc>
    <ndc_label_name>Caverject Impulse 20 mcg intracavernosal kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009518211</ndc>
    <ndc_label_name>Caverject 20 mcg intracavernosal syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009520104</ndc>
    <ndc_label_name>Somavert 25 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009520110</ndc>
    <ndc_label_name>Somavert 25 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009537604</ndc>
    <ndc_label_name>Somavert 30 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009537610</ndc>
    <ndc_label_name>Somavert 30 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00009540101</ndc>
    <ndc_label_name>Nicotrol NS 10 mg/mL nasal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009716601</ndc>
    <ndc_label_name>Somavert 10 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009716630</ndc>
    <ndc_label_name>Somavert 10 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009716801</ndc>
    <ndc_label_name>Somavert 15 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009716830</ndc>
    <ndc_label_name>Somavert 15 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009718801</ndc>
    <ndc_label_name>Somavert 20 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009718830</ndc>
    <ndc_label_name>Somavert 20 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009719901</ndc>
    <ndc_label_name>Somavert 25 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009719930</ndc>
    <ndc_label_name>Somavert 25 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009720001</ndc>
    <ndc_label_name>Somavert 30 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009720030</ndc>
    <ndc_label_name>Somavert 30 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009722401</ndc>
    <ndc_label_name>Atgam 50 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009722402</ndc>
    <ndc_label_name>Atgam 50 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009737611</ndc>
    <ndc_label_name>Depo-Provera 150 mg/mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009752903</ndc>
    <ndc_label_name>Camptosar 100 mg/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009752904</ndc>
    <ndc_label_name>Camptosar 40 mg/2 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009752905</ndc>
    <ndc_label_name>Camptosar 300 mg/15 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009752910</ndc>
    <ndc_label_name>Camptosar 40 mg/2 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009766304</ndc>
    <ndc_label_name>Aromasin 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009766705</ndc>
    <ndc_label_name>Cleocin 100 mg vaginal suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009768601</ndc>
    <ndc_label_name>Caverject 40 mcg intracavernosal solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009768604</ndc>
    <ndc_label_name>Caverject 40 mcg intracavernosal solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009780701</ndc>
    <ndc_label_name>Zyvox 600 mg/300 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00009780702</ndc>
    <ndc_label_name>Zyvox 600 mg/300 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013010110</ndc>
    <ndc_label_name>Azulfidine 500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013010130</ndc>
    <ndc_label_name>Azulfidine 500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013010250</ndc>
    <ndc_label_name>Azulfidine EN-tabs 500 mg tablet,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013010260</ndc>
    <ndc_label_name>Azulfidine EN-tabs 500 mg tablet,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013013202</ndc>
    <ndc_label_name>EMCYT 140 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013104201</ndc>
    <ndc_label_name>Estring 2 mg (7.5 mcg/24 hour) vaginal ring</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013111401</ndc>
    <ndc_label_name>Cyklokapron 1,000 mg/10 mL (100 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013111415</ndc>
    <ndc_label_name>Cyklokapron 1,000 mg/10 mL (100 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013111420</ndc>
    <ndc_label_name>Cyklokapron 1,000 mg/10 mL (100 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013111421</ndc>
    <ndc_label_name>Cyklokapron 1,000 mg/10 mL (100 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013257605</ndc>
    <ndc_label_name>Idamycin PFS 1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013257691</ndc>
    <ndc_label_name>Idamycin PFS 1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013258610</ndc>
    <ndc_label_name>Idamycin PFS 1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013258691</ndc>
    <ndc_label_name>Idamycin PFS 1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013259620</ndc>
    <ndc_label_name>Idamycin PFS 1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013259691</ndc>
    <ndc_label_name>Idamycin PFS 1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013262681</ndc>
    <ndc_label_name>Genotropin 5 mg/mL (15 unit/mL) subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013264681</ndc>
    <ndc_label_name>Genotropin 12 mg/mL (36 unit/mL) subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013264901</ndc>
    <ndc_label_name>Genotropin MiniQuick 0.2 mg/0.25 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013264902</ndc>
    <ndc_label_name>Genotropin MiniQuick 0.2 mg/0.25 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013265002</ndc>
    <ndc_label_name>Genotropin MiniQuick 0.4 mg/0.25 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013265102</ndc>
    <ndc_label_name>Genotropin MiniQuick 0.6 mg/0.25 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013265202</ndc>
    <ndc_label_name>Genotropin MiniQuick 0.8 mg/0.25 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013265302</ndc>
    <ndc_label_name>Genotropin MiniQuick 1 mg/0.25 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013265402</ndc>
    <ndc_label_name>Genotropin MiniQuick 1.2 mg/0.25 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013265502</ndc>
    <ndc_label_name>Genotropin MiniQuick 1.4 mg/0.25 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013265602</ndc>
    <ndc_label_name>Genotropin MiniQuick 1.6 mg/0.25 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013265702</ndc>
    <ndc_label_name>Genotropin MiniQuick 1.8 mg/0.25 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00013265802</ndc>
    <ndc_label_name>Genotropin MiniQuick 2 mg/0.25 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013530117</ndc>
    <ndc_label_name>MYCOBUTIN 150 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00013830304</ndc>
    <ndc_label_name>Xalatan 0.005 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00015301260</ndc>
    <ndc_label_name>BiCNU 100 mg intravenous powder for solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019086207</ndc>
    <ndc_label_name>Cysto-Conray II 17.2 % urethral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019086250</ndc>
    <ndc_label_name>Cysto-Conray II 17.2 % urethral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019095211</ndc>
    <ndc_label_name>Conray-30 30 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019095305</ndc>
    <ndc_label_name>Conray 60 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019095309</ndc>
    <ndc_label_name>Conray 60 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019095311</ndc>
    <ndc_label_name>Conray 60 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019095313</ndc>
    <ndc_label_name>Conray 60 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019095323</ndc>
    <ndc_label_name>Conray 60 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019095350</ndc>
    <ndc_label_name>Conray 60 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019112006</ndc>
    <ndc_label_name>GastroMARK 175 mcg/mL iron oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00019118827</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% (PWR INJ)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00019118881</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% (PWR INJ)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019131707</ndc>
    <ndc_label_name>MD-76 R 66-10 INFUSION BOTTLE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019131709</ndc>
    <ndc_label_name>MD-76 R 66-10 INFUSION BOTTLE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019131715</ndc>
    <ndc_label_name>MD-76 R 66-10 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132302</ndc>
    <ndc_label_name>Optiray 320 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132304</ndc>
    <ndc_label_name>Optiray 320 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132306</ndc>
    <ndc_label_name>Optiray 320 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132311</ndc>
    <ndc_label_name>Optiray 320 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132316</ndc>
    <ndc_label_name>Optiray 320 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132321</ndc>
    <ndc_label_name>Optiray 320 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132352</ndc>
    <ndc_label_name>Optiray 320 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132370</ndc>
    <ndc_label_name>Optiray 320 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132378</ndc>
    <ndc_label_name>Optiray 320 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132387</ndc>
    <ndc_label_name>Optiray 320 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132390</ndc>
    <ndc_label_name>Optiray 320 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132395</ndc>
    <ndc_label_name>Optiray 320 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132406</ndc>
    <ndc_label_name>Optiray 240 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019132411</ndc>
    <ndc_label_name>Optiray 240 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133206</ndc>
    <ndc_label_name>Optiray 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133211</ndc>
    <ndc_label_name>Optiray 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133216</ndc>
    <ndc_label_name>Optiray 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133221</ndc>
    <ndc_label_name>Optiray 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133261</ndc>
    <ndc_label_name>Optiray 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133275</ndc>
    <ndc_label_name>Optiray 300 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133290</ndc>
    <ndc_label_name>Optiray 300 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133306</ndc>
    <ndc_label_name>Optiray 350 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133311</ndc>
    <ndc_label_name>Optiray 350 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133316</ndc>
    <ndc_label_name>Optiray 350 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133321</ndc>
    <ndc_label_name>Optiray 350 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133351</ndc>
    <ndc_label_name>Optiray 350 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133352</ndc>
    <ndc_label_name>Optiray 350 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133378</ndc>
    <ndc_label_name>Optiray 350 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133387</ndc>
    <ndc_label_name>Optiray 350 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133390</ndc>
    <ndc_label_name>Optiray 350 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019133395</ndc>
    <ndc_label_name>Optiray 350 mg iodine/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019318309</ndc>
    <ndc_label_name>Conray-43 43 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019481604</ndc>
    <ndc_label_name>MD-Gastroview 66 %-10 % oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019481605</ndc>
    <ndc_label_name>MD-Gastroview 66 %-10 % oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019481606</ndc>
    <ndc_label_name>MD-Gastroview 66 %-10 % oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019905040</ndc>
    <ndc_label_name>OctreoScan 3 mCi/mL-10 mcg intravenous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00019909240</ndc>
    <ndc_label_name>TC99M SESTAMIBI PREP KIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023024004</ndc>
    <ndc_label_name>Refresh P.M. 57.3 %-42.5 % eye ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023031204</ndc>
    <ndc_label_name>Refresh Lacri-Lube 56.8 %-42.5 % eye ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023040330</ndc>
    <ndc_label_name>Refresh Plus 0.5 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023040350</ndc>
    <ndc_label_name>Refresh Plus 0.5 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023040370</ndc>
    <ndc_label_name>Refresh Plus 0.5 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023050601</ndc>
    <ndc_label_name>Refresh Classic (PF) 1.4 %-0.6 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023050650</ndc>
    <ndc_label_name>Refresh Classic (PF) 1.4 %-0.6 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023066704</ndc>
    <ndc_label_name>Refresh P.M. 57.3 %-42.5 % eye ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023079801</ndc>
    <ndc_label_name>Refresh Tears 0.5 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023079815</ndc>
    <ndc_label_name>Refresh Tears 0.5 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023114501</ndc>
    <ndc_label_name>Botox 100 unit injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023114502</ndc>
    <ndc_label_name>Botox 100 unit injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023182212</ndc>
    <ndc_label_name>Refresh Contacts eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023218105</ndc>
    <ndc_label_name>Acular 0.5 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023311010</ndc>
    <ndc_label_name>Refresh Tears PF 0.5 %-0.9 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023320502</ndc>
    <ndc_label_name>Lumigan 0.01 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023320503</ndc>
    <ndc_label_name>Lumigan 0.01 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023320505</ndc>
    <ndc_label_name>Lumigan 0.01 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023320508</ndc>
    <ndc_label_name>Lumigan 0.01 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023324015</ndc>
    <ndc_label_name>Refresh Optive 0.5 %-0.9 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023334807</ndc>
    <ndc_label_name>Ozurdex 0.7 mg intravitreal implant</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023341630</ndc>
    <ndc_label_name>Refresh Optive Sensitive (PF) 0.5 %-0.9 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023341660</ndc>
    <ndc_label_name>Refresh Optive Sensitive (PF) 0.5 %-0.9 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023350731</ndc>
    <ndc_label_name>Acuvail (PF) 0.45 % eye drops in a dropperette</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023361605</ndc>
    <ndc_label_name>Latisse 0.03 % eyelash drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023361670</ndc>
    <ndc_label_name>Latisse 0.03 % eyelash drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023378210</ndc>
    <ndc_label_name>Refresh Relieva PF 0.5 %-0.9 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023378220</ndc>
    <ndc_label_name>Refresh Relieva PF 0.5 %-0.9 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023391950</ndc>
    <ndc_label_name>Botox Cosmetic 50 unit intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023392102</ndc>
    <ndc_label_name>Botox 200 unit injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023392103</ndc>
    <ndc_label_name>Botox 200 unit injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023398810</ndc>
    <ndc_label_name>Refresh Optive Mega-3 (PF) 0.5 %-1 %-0.5 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023429105</ndc>
    <ndc_label_name>Lastacaft Once Daily Relief 0.25 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023429110</ndc>
    <ndc_label_name>Lastacaft Once Daily Relief 0.25 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023430710</ndc>
    <ndc_label_name>Refresh Optive Advanced 0.5 %-1 %-0.5 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023430720</ndc>
    <ndc_label_name>Refresh Optive Advanced 0.5 %-1 %-0.5 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023449130</ndc>
    <ndc_label_name>Refresh Optive Advanced (PF) 0.5 %-1 %-0.5 % eye drops in dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023451530</ndc>
    <ndc_label_name>Refresh Relieva PF 0.5 %-1 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023455430</ndc>
    <ndc_label_name>Refresh Celluvisc 1 % eye gel in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023530101</ndc>
    <ndc_label_name>Restasis MultiDose 0.05 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023530105</ndc>
    <ndc_label_name>Restasis MultiDose 0.05 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023545910</ndc>
    <ndc_label_name>Refresh Optive 1 %-0.9 % eye gel drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023577330</ndc>
    <ndc_label_name>Refresh Optive Mega-3 (PF) 0.5 %-1 %-0.5 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023585318</ndc>
    <ndc_label_name>DELZICOL DR 400 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023585801</ndc>
    <ndc_label_name>Liletta 20.4 mcg/24 hr (up to 8 years) 52 mg intrauterine device</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023586228</ndc>
    <ndc_label_name>Taytulla 1 mg-20 mcg (24)/75 mg (4) capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023586230</ndc>
    <ndc_label_name>Taytulla 1 mg-20 mcg (24)/75 mg (4) capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023608201</ndc>
    <ndc_label_name>Infed 50 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023608210</ndc>
    <ndc_label_name>Infed 50 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023611803</ndc>
    <ndc_label_name>Condylox 0.5 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023614230</ndc>
    <ndc_label_name>RAPAFLO 8 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023614730</ndc>
    <ndc_label_name>RAPAFLO 4 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023615004</ndc>
    <ndc_label_name>Crinone 4 % vaginal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023615005</ndc>
    <ndc_label_name>Crinone 4 % vaginal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023615108</ndc>
    <ndc_label_name>Crinone 8 % vaginal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023615109</ndc>
    <ndc_label_name>Crinone 8 % vaginal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023615301</ndc>
    <ndc_label_name>Oxytrol 3.9 mg/24 hr transdermal patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023615308</ndc>
    <ndc_label_name>Oxytrol 3.9 mg/24 hr transdermal patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023649802</ndc>
    <ndc_label_name>Ubrelvy 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023649810</ndc>
    <ndc_label_name>Ubrelvy 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023650101</ndc>
    <ndc_label_name>Ubrelvy 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023650102</ndc>
    <ndc_label_name>Ubrelvy 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023650110</ndc>
    <ndc_label_name>Ubrelvy 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023650116</ndc>
    <ndc_label_name>Ubrelvy 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023663004</ndc>
    <ndc_label_name>Refresh Relieva 0.5 %-0.9 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023663010</ndc>
    <ndc_label_name>Refresh Relieva 0.5 %-0.9 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023663208</ndc>
    <ndc_label_name>Refresh Relieva for Contacts eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023663401</ndc>
    <ndc_label_name>Refresh Relieva PF 0.5 %-0.9 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023663410</ndc>
    <ndc_label_name>Refresh Relieva PF 0.5 %-0.9 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023663420</ndc>
    <ndc_label_name>Refresh Relieva PF 0.5 %-0.9 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023695210</ndc>
    <ndc_label_name>Refresh Digital 0.5 %-1 %-0.5 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023695430</ndc>
    <ndc_label_name>Refresh Digital PF 0.5 %-1 %-0.5 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023715160</ndc>
    <ndc_label_name>Refresh Optive Mega-3 (PF) 0.5 %-1 %-0.5 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023916330</ndc>
    <ndc_label_name>Restasis 0.05 % eye drops in a dropperette</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023916360</ndc>
    <ndc_label_name>Restasis 0.05 % eye drops in a dropperette</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023917705</ndc>
    <ndc_label_name>Alphagan P 0.15 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023917710</ndc>
    <ndc_label_name>Alphagan P 0.15 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023917715</ndc>
    <ndc_label_name>Alphagan P 0.15 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023920515</ndc>
    <ndc_label_name>Refresh Liquigel 1 % eye liquid gel drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023921105</ndc>
    <ndc_label_name>Combigan 0.2 %-0.5 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023921110</ndc>
    <ndc_label_name>Combigan 0.2 %-0.5 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023921115</ndc>
    <ndc_label_name>Combigan 0.2 %-0.5 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023923201</ndc>
    <ndc_label_name>Botox Cosmetic 100 unit intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023927705</ndc>
    <ndc_label_name>Acular LS 0.4 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023932105</ndc>
    <ndc_label_name>Alphagan P 0.1 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023932110</ndc>
    <ndc_label_name>Alphagan P 0.1 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00023932115</ndc>
    <ndc_label_name>Alphagan P 0.1 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023963701</ndc>
    <ndc_label_name>Oxytrol For Women 3.9 mg/24 hour transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023963704</ndc>
    <ndc_label_name>Oxytrol For Women 3.9 mg/24 hour transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023963708</ndc>
    <ndc_label_name>Oxytrol For Women 3.9 mg/24 hour transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00023965201</ndc>
    <ndc_label_name>Durysta 10 mcg intracameral implant</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024065401</ndc>
    <ndc_label_name>Sarclisa 20 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024065601</ndc>
    <ndc_label_name>Sarclisa 20 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024101510</ndc>
    <ndc_label_name>FERGON 27 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024117190</ndc>
    <ndc_label_name>Plavix 75 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024135202</ndc>
    <ndc_label_name>Neo-Synephrine (phenylephrine) 1 % nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024159601</ndc>
    <ndc_label_name>PRIMAQUINE 26.3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024279201</ndc>
    <ndc_label_name>Ferrlecit 62.5 mg/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024279210</ndc>
    <ndc_label_name>Ferrlecit 62.5 mg/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024279401</ndc>
    <ndc_label_name>Ferrlecit 62.5 mg/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024279410</ndc>
    <ndc_label_name>Ferrlecit 62.5 mg/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024414206</ndc>
    <ndc_label_name>Multaq 400 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024414260</ndc>
    <ndc_label_name>Multaq 400 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024515006</ndc>
    <ndc_label_name>Campho-Phenique 10.8 %-4.7 % topical solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024515010</ndc>
    <ndc_label_name>Elitek 1.5 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024515011</ndc>
    <ndc_label_name>Elitek 1.5 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024515174</ndc>
    <ndc_label_name>Elitek 7.5 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024515175</ndc>
    <ndc_label_name>Elitek 7.5 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024515211</ndc>
    <ndc_label_name>Diluent For Elitek 1 mL (1.5 mg) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024515374</ndc>
    <ndc_label_name>Diluent For Elitek 5 mL (7.5 mg) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024515411</ndc>
    <ndc_label_name>Elitek 1.5 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024515574</ndc>
    <ndc_label_name>Elitek 7.5 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024540131</ndc>
    <ndc_label_name>Ambien 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024542131</ndc>
    <ndc_label_name>Ambien 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024550131</ndc>
    <ndc_label_name>Ambien CR 6.25 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024552131</ndc>
    <ndc_label_name>Ambien CR 12.5 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024576105</ndc>
    <ndc_label_name>Soliqua 100/33  100 unit-33 mcg/mL subcutaneous insulin pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024582201</ndc>
    <ndc_label_name>Diluent For Jevtana 5.7 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024582315</ndc>
    <ndc_label_name>Jevtana 60 mg/1.5 mL (must dilute to 10 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024582411</ndc>
    <ndc_label_name>Jevtana 60 mg/1.5 mL (must dilute to 10 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024583701</ndc>
    <ndc_label_name>FLOMAX 0.4 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024584001</ndc>
    <ndc_label_name>Zaltrap 100 mg/4 mL (25 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024584101</ndc>
    <ndc_label_name>Zaltrap 200 mg/8 mL (25 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024585090</ndc>
    <ndc_label_name>AVAPRO 75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024585130</ndc>
    <ndc_label_name>Avapro 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024585230</ndc>
    <ndc_label_name>Avapro 300 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024585530</ndc>
    <ndc_label_name>Avalide 150 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024585630</ndc>
    <ndc_label_name>Avalide 300 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024586001</ndc>
    <ndc_label_name>CLOLAR 20 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024586201</ndc>
    <ndc_label_name>Mozobil 24 mg/1.2 mL (20 mg/mL) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024586900</ndc>
    <ndc_label_name>Toujeo SoloStar U-300 Insulin 300 unit/mL (1.5 mL) subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024586901</ndc>
    <ndc_label_name>Toujeo SoloStar U-300 Insulin 300 unit/mL (1.5 mL) subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024586903</ndc>
    <ndc_label_name>Toujeo SoloStar U-300 Insulin 300 unit/mL (1.5 mL) subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024587100</ndc>
    <ndc_label_name>Toujeo Max U-300 SoloStar 300 unit/mL (3 mL) subcutaneous insulin pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024587101</ndc>
    <ndc_label_name>Toujeo Max U-300 SoloStar 300 unit/mL (3 mL) subcutaneous insulin pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024587102</ndc>
    <ndc_label_name>Toujeo Max U-300 SoloStar 300 unit/mL (3 mL) subcutaneous insulin pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024590801</ndc>
    <ndc_label_name>KEVZARA 150 MG/1.14 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024591001</ndc>
    <ndc_label_name>Kevzara 200 mg/1.14 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591400</ndc>
    <ndc_label_name>Dupixent 300 mg/2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591401</ndc>
    <ndc_label_name>Dupixent 300 mg/2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591402</ndc>
    <ndc_label_name>Dupixent 300 mg/2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591500</ndc>
    <ndc_label_name>Dupixent 300 mg/2 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591501</ndc>
    <ndc_label_name>Dupixent 300 mg/2 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591502</ndc>
    <ndc_label_name>Dupixent 300 mg/2 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591520</ndc>
    <ndc_label_name>Dupixent 300 mg/2 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591800</ndc>
    <ndc_label_name>Dupixent 200 mg/1.14 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591801</ndc>
    <ndc_label_name>Dupixent 200 mg/1.14 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591802</ndc>
    <ndc_label_name>Dupixent 200 mg/1.14 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591900</ndc>
    <ndc_label_name>Dupixent 200 mg/1.14 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591901</ndc>
    <ndc_label_name>Dupixent 200 mg/1.14 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591902</ndc>
    <ndc_label_name>Dupixent 200 mg/1.14 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00024591920</ndc>
    <ndc_label_name>Dupixent 200 mg/1.14 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024592001</ndc>
    <ndc_label_name>Kevzara 150 mg/1.14 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024592201</ndc>
    <ndc_label_name>Kevzara 200 mg/1.14 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024592410</ndc>
    <ndc_label_name>Admelog U-100 Insulin lispro 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024592500</ndc>
    <ndc_label_name>Admelog SoloStar U-100 Insulin lispro 100 unit/mL subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024592501</ndc>
    <ndc_label_name>Admelog SoloStar U-100 Insulin lispro 100 unit/mL subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024592505</ndc>
    <ndc_label_name>Admelog SoloStar U-100 Insulin lispro 100 unit/mL subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024592605</ndc>
    <ndc_label_name>Admelog U-100 Insulin lispro 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024592700</ndc>
    <ndc_label_name>Merilog 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024592800</ndc>
    <ndc_label_name>Merilog Solostar 100 unit/mL (3 mL) subcutaneous insulin pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00024592805</ndc>
    <ndc_label_name>Merilog Solostar 100 unit/mL (3 mL) subcutaneous insulin pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025006131</ndc>
    <ndc_label_name>Lomotil 2.5 mg-0.025 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025016608</ndc>
    <ndc_label_name>Synarel 2 mg/mL nasal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025032501</ndc>
    <ndc_label_name>Abrilada(CF) Pen 40 mg/0.8 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025032502</ndc>
    <ndc_label_name>Abrilada(CF) Pen 40 mg/0.8 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025032802</ndc>
    <ndc_label_name>Abrilada(CF) 40 mg/0.8 mL subcutaneous syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025033302</ndc>
    <ndc_label_name>Abrilada(CF) 20 mg/0.4 mL subcutaneous syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025100131</ndc>
    <ndc_label_name>Aldactone 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025103131</ndc>
    <ndc_label_name>Aldactone 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025104131</ndc>
    <ndc_label_name>Aldactone 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025138131</ndc>
    <ndc_label_name>DAYPRO 600 MG CAPLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025141160</ndc>
    <ndc_label_name>Arthrotec 50 mg-200 mcg tablet,film-coated</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025141190</ndc>
    <ndc_label_name>Arthrotec 50 mg-200 mcg tablet,film-coated</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025142160</ndc>
    <ndc_label_name>Arthrotec 75  75 mg-200 mcg tablet,film-coated</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025145134</ndc>
    <ndc_label_name>Cytotec 100 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025145160</ndc>
    <ndc_label_name>Cytotec 100 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025146131</ndc>
    <ndc_label_name>Cytotec 200 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025146160</ndc>
    <ndc_label_name>Cytotec 200 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025151501</ndc>
    <ndc_label_name>Celebrex 50 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025152031</ndc>
    <ndc_label_name>Celebrex 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025152034</ndc>
    <ndc_label_name>Celebrex 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025152051</ndc>
    <ndc_label_name>Celebrex 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025152534</ndc>
    <ndc_label_name>Celebrex 200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025152551</ndc>
    <ndc_label_name>Celebrex 200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025153001</ndc>
    <ndc_label_name>Celebrex 400 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025153002</ndc>
    <ndc_label_name>Celebrex 400 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025171001</ndc>
    <ndc_label_name>Inspra 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025172003</ndc>
    <ndc_label_name>INSPRA 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025194250</ndc>
    <ndc_label_name>FLAGYL 375 CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025273231</ndc>
    <ndc_label_name>Norpace CR 100 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025274231</ndc>
    <ndc_label_name>Norpace CR 150 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025275231</ndc>
    <ndc_label_name>Norpace 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00025276231</ndc>
    <ndc_label_name>Norpace 150 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026378225</ndc>
    <ndc_label_name>KOGENATE FS 250 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026378335</ndc>
    <ndc_label_name>KOGENATE FS 500 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026378555</ndc>
    <ndc_label_name>KOGENATE FS 1,000 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026378665</ndc>
    <ndc_label_name>KOGENATE FS 2,000 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026378775</ndc>
    <ndc_label_name>KOGENATE FS 3,000 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026382125</ndc>
    <ndc_label_name>Kovaltry 250 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026382225</ndc>
    <ndc_label_name>Kovaltry 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026382425</ndc>
    <ndc_label_name>Kovaltry 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026382650</ndc>
    <ndc_label_name>Kovaltry 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026382850</ndc>
    <ndc_label_name>Kovaltry 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026394225</ndc>
    <ndc_label_name>Jivi 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026394425</ndc>
    <ndc_label_name>Jivi 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026394625</ndc>
    <ndc_label_name>Jivi 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026394825</ndc>
    <ndc_label_name>Jivi 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026395050</ndc>
    <ndc_label_name>Jivi 4,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026395099</ndc>
    <ndc_label_name>Jivi 4,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026478201</ndc>
    <ndc_label_name>KOGENATE FS 250 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026478301</ndc>
    <ndc_label_name>KOGENATE FS 500 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026478501</ndc>
    <ndc_label_name>KOGENATE FS 1,000 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026478601</ndc>
    <ndc_label_name>KOGENATE FS 2,000 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026478701</ndc>
    <ndc_label_name>KOGENATE FS 3,000 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026482101</ndc>
    <ndc_label_name>Kovaltry 250 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026482201</ndc>
    <ndc_label_name>Kovaltry 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026482401</ndc>
    <ndc_label_name>Kovaltry 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026482601</ndc>
    <ndc_label_name>Kovaltry 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026482801</ndc>
    <ndc_label_name>Kovaltry 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026494201</ndc>
    <ndc_label_name>Jivi 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026494401</ndc>
    <ndc_label_name>Jivi 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026494601</ndc>
    <ndc_label_name>Jivi 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026494801</ndc>
    <ndc_label_name>Jivi 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026495001</ndc>
    <ndc_label_name>Jivi 4,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00026495099</ndc>
    <ndc_label_name>Jivi 4,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031034003</ndc>
    <ndc_label_name>Robitussin Medi-Soothers 5 mg-5 mg lozenges</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031034006</ndc>
    <ndc_label_name>Robitussin Medi-Soothers 5 mg-5 mg lozenges</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031034009</ndc>
    <ndc_label_name>Robitussin Medi-Soothers 5 mg-5 mg lozenges</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031034068</ndc>
    <ndc_label_name>Robitussin Cough 15 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031034074</ndc>
    <ndc_label_name>Robitussin Nighttime Cough DM 6.25 mg-15 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031034077</ndc>
    <ndc_label_name>Robitussin Cough 15 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031209448</ndc>
    <ndc_label_name>Robitussin Max Dm Day-Night 12.5 mg-30 mg/20 mL (night) oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031209466</ndc>
    <ndc_label_name>Robitussin Severe Multi-Symptom 20 mg-650 mg-400 mg/20 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031209467</ndc>
    <ndc_label_name>Robitussin Severe Multi-Symptom 20 mg-650 mg-400 mg/20 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031209469</ndc>
    <ndc_label_name>Robitussin Multi-Symptom Night 25 mg-650 mg/20 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031209499</ndc>
    <ndc_label_name>Child Robitussin Day-Night 2 mg-15 mg/10 mL(night) oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031209554</ndc>
    <ndc_label_name>Child Robitussin Honey Day-Nt 6.25 mg-15 mg/10 mL (night) oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031209581</ndc>
    <ndc_label_name>Robitussin Honey Max DM Day-Nt 12.5 mg-30 mg/20 mL (night) oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031223413</ndc>
    <ndc_label_name>Dimetapp DM Cold-Cough (PE) 1 mg-2.5 mg-5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031223419</ndc>
    <ndc_label_name>Dimetapp DM Cold-Cough (PE) 1 mg-2.5 mg-5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031223513</ndc>
    <ndc_label_name>Dimetapp Cold-Allergy (brom-PE) 1 mg-2.5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031223519</ndc>
    <ndc_label_name>Dimetapp Cold-Allergy (brom-PE) 1 mg-2.5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031224713</ndc>
    <ndc_label_name>Dimetapp Cold-Congestion 6.25 mg-2.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031224904</ndc>
    <ndc_label_name>Children Dimetapp M-S Cold-Flu 6.25 mg-2.5 mg-160 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031301850</ndc>
    <ndc_label_name>Robitussin Elderberry Max DM 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031301860</ndc>
    <ndc_label_name>Robitussin Elderberry Max DM 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031301870</ndc>
    <ndc_label_name>Child Robitussin Elderberry DM 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031865510</ndc>
    <ndc_label_name>Robitussin ER 30 mg/5 mL oral suspension,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031869312</ndc>
    <ndc_label_name>Robitussin Long-Acting 1 mg-7.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031871510</ndc>
    <ndc_label_name>Child Robitussin Cough-Chest DM 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031871513</ndc>
    <ndc_label_name>Robitussin Cough-Chest Congestion DM 5 mg-50 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031871612</ndc>
    <ndc_label_name>Robitussin Cough and Cold CF 2.5 mg-5 mg-50 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031871813</ndc>
    <ndc_label_name>Robitussin Nighttime Cough DM 3.125 mg-7.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031871818</ndc>
    <ndc_label_name>Robitussin Nighttime Cough DM 3.125 mg-7.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031871910</ndc>
    <ndc_label_name>Robitussin Cough-Chest Congestion DM 10 mg-200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031871920</ndc>
    <ndc_label_name>Robitussin Cough-Chest Congestion DM 10 mg-200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031873912</ndc>
    <ndc_label_name>Robitussin Cough-Chest Congestion DM 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031873918</ndc>
    <ndc_label_name>Robitussin Cough-Chest Congestion DM 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031873942</ndc>
    <ndc_label_name>Robitussin Cough-Chest Congestion DM 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031874220</ndc>
    <ndc_label_name>Adult Robitussin Peak Cold M-S 5 mg-10 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031874320</ndc>
    <ndc_label_name>Robitussin CoughGel 15 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875012</ndc>
    <ndc_label_name>Robitussin Cough-Sore Throat 325 mg-10 mg/10 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875018</ndc>
    <ndc_label_name>Robitussin Cough-Sore Throat 325 mg-10 mg/10 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875112</ndc>
    <ndc_label_name>Robitussin Severe Cough-Cold-Flu 10 mg-20 mg-650 mg/20 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875118</ndc>
    <ndc_label_name>Robitussin Severe Cough-Cold-Flu 10 mg-20 mg-650 mg/20 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875212</ndc>
    <ndc_label_name>Robitussin Cold-Flu Night (PE) 12.5 mg-5 mg-325 mg/10 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875218</ndc>
    <ndc_label_name>Robitussin Cold-Flu Night (PE) 12.5 mg-5 mg-325 mg/10 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875303</ndc>
    <ndc_label_name>Robitussin ER 30 mg/5 mL oral suspension,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875515</ndc>
    <ndc_label_name>Robitussin ER 30 mg/5 mL oral suspension,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875612</ndc>
    <ndc_label_name>Robitussin Honey Max DM 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875618</ndc>
    <ndc_label_name>Robitussin Honey Max DM 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875712</ndc>
    <ndc_label_name>Robitussin Cough-Chest Congestion DM 5 mg-50 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875718</ndc>
    <ndc_label_name>Robitussin Cough-Chest Congestion DM 5 mg-50 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875812</ndc>
    <ndc_label_name>Robitussin Honey Night Cough DM 3.125 mg-7.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875818</ndc>
    <ndc_label_name>Robitussin Honey Night Cough DM 3.125 mg-7.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031875912</ndc>
    <ndc_label_name>Robitussin Cough-Chest Congestion DM 5 mg-50 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031876012</ndc>
    <ndc_label_name>Robitussin Cough-Chest Congestion DM 5 mg-50 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031876212</ndc>
    <ndc_label_name>Robitussin Honey Night Cough DM 3.125 mg-7.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031876508</ndc>
    <ndc_label_name>Robitussin Max 12H Cough-Mucus 60 mg-1,200 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031876516</ndc>
    <ndc_label_name>Robitussin Max 12H Cough-Mucus 60 mg-1,200 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031877012</ndc>
    <ndc_label_name>Robitussin Honey CF Nighttime 25 mg-650 mg/20 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031877018</ndc>
    <ndc_label_name>Robitussin Honey CF Nighttime 25 mg-650 mg/20 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031877112</ndc>
    <ndc_label_name>Robitussin Honey Cgh-Flu-Sore 325 mg-10 mg/10 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00031877118</ndc>
    <ndc_label_name>Robitussin Honey Cgh-Flu-Sore 325 mg-10 mg/10 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00032004570</ndc>
    <ndc_label_name>Creon 3,000 unit-9,500 unit-15,000 unit capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00032004670</ndc>
    <ndc_label_name>Creon 6,000-19,000-30,000 unit capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00032004770</ndc>
    <ndc_label_name>Creon 12,000-38,000-60,000 unit capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00032120370</ndc>
    <ndc_label_name>Creon 3,000 unit-9,500 unit-15,000 unit capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00032120601</ndc>
    <ndc_label_name>Creon 6,000-19,000-30,000 unit capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00032121201</ndc>
    <ndc_label_name>Creon 12,000-38,000-60,000 unit capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00032122401</ndc>
    <ndc_label_name>Creon 24,000-76,000-120,000 unit capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00032263601</ndc>
    <ndc_label_name>Creon 24,000-76,000-120,000 unit capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00032263701</ndc>
    <ndc_label_name>Creon 36,000 unit-114,000 unit-180,000 unit capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00032301613</ndc>
    <ndc_label_name>Creon 36,000 unit-114,000 unit-180,000 unit capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037002207</ndc>
    <ndc_label_name>SFROWASA 4 GM/60 ML ENEMA</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037002228</ndc>
    <ndc_label_name>SFROWASA 4 GM/60 ML ENEMA</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037002260</ndc>
    <ndc_label_name>SFROWASA 4 GM/60 ML ENEMA</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037006603</ndc>
    <ndc_label_name>Rowasa rectal suspension enema 4 gram/60 mL kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037006605</ndc>
    <ndc_label_name>Rowasa rectal suspension enema 4 gram/60 mL kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037006606</ndc>
    <ndc_label_name>Rowasa 4 gram/60 mL enema</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037024523</ndc>
    <ndc_label_name>Dymista 137 mcg-50 mcg/spray nasal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037043001</ndc>
    <ndc_label_name>Felbatol 400 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037043101</ndc>
    <ndc_label_name>Felbatol 600 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037067808</ndc>
    <ndc_label_name>Gastrocrom 100 mg/5 mL oral concentrate</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037067896</ndc>
    <ndc_label_name>Gastrocrom 100 mg/5 mL oral concentrate</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037200101</ndc>
    <ndc_label_name>Soma 350 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037225010</ndc>
    <ndc_label_name>Soma 250 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037225030</ndc>
    <ndc_label_name>Soma 250 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037440101</ndc>
    <ndc_label_name>Depen Titratabs 250 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037480135</ndc>
    <ndc_label_name>Elestrin 0.87 gram/actuation (0.06%) transdermal gel pump</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037480170</ndc>
    <ndc_label_name>Elestrin 0.87 gram/actuation (0.06%) transdermal gel pump</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037601035</ndc>
    <ndc_label_name>Edluar 10 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037601093</ndc>
    <ndc_label_name>Edluar 10 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037605035</ndc>
    <ndc_label_name>Edluar 5 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037605093</ndc>
    <ndc_label_name>Edluar 5 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037632190</ndc>
    <ndc_label_name>Urelle 81 mg-10.8 mg-40.8 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037682210</ndc>
    <ndc_label_name>Proctofoam HC 1 %-1 %</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00037682315</ndc>
    <ndc_label_name>Proctofoam 1 % topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037682410</ndc>
    <ndc_label_name>Epifoam 1 %-1 % topical</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037683015</ndc>
    <ndc_label_name>Cortifoam 10 % (80 mg) rectal</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037686010</ndc>
    <ndc_label_name>Dipentum 250 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037812001</ndc>
    <ndc_label_name>MUSE 250 MCG URETHRAL SUPPOS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037812006</ndc>
    <ndc_label_name>MUSE 250 MCG URETHRAL SUPPOS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037813001</ndc>
    <ndc_label_name>MUSE 500 MCG URETHRAL SUPPOS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037813006</ndc>
    <ndc_label_name>MUSE 500 MCG URETHRAL SUPPOS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037814001</ndc>
    <ndc_label_name>MUSE 1,000 MCG URETHRAL SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00037814006</ndc>
    <ndc_label_name>MUSE 1,000 MCG URETHRAL SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00039001901</ndc>
    <ndc_label_name>CLAFORAN 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00039001910</ndc>
    <ndc_label_name>CLAFORAN 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00039002001</ndc>
    <ndc_label_name>CLAFORAN 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00039002325</ndc>
    <ndc_label_name>CLAFORAN 1 GM ADD-VANTAGE VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00039002425</ndc>
    <ndc_label_name>CLAFORAN 2 GM ADD-VANTAGE VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00043001718</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00043011718</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00043011748</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00043013410</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00043015018</ndc>
    <ndc_label_name>Gas-X 62.5 mg oral strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00043627418</ndc>
    <ndc_label_name>Gas-X Ultra-Strength 180 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00043627450</ndc>
    <ndc_label_name>Gas-X Ultra-Strength 180 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00043627520</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00043627550</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00043900572</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00045013712</ndc>
    <ndc_label_name>Imodium A-D 2 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00045016104</ndc>
    <ndc_label_name>Child's Tylenol plus Cough,Runny Nose 1 mg-5 mg-160 mg/5 mL oral susp</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00045016604</ndc>
    <ndc_label_name>Children's Tylenol 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00045018404</ndc>
    <ndc_label_name>Children's Motrin 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00045019204</ndc>
    <ndc_label_name>Children's Motrin 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00045020444</ndc>
    <ndc_label_name>Zyrtec 10 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00045022857</ndc>
    <ndc_label_name>Sudafed 30 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00045029721</ndc>
    <ndc_label_name>Tylenol 8 Hour 650 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00045040920</ndc>
    <ndc_label_name>Motrin IB 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00045048101</ndc>
    <ndc_label_name>Motrin IB 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00045066407</ndc>
    <ndc_label_name>Children's Cough-Mucus Daytime 6 gram-25 mg-1.7 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00045083821</ndc>
    <ndc_label_name>Tylenol Arthritis Pain 650 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046074905</ndc>
    <ndc_label_name>Premarin 25 mg solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046087221</ndc>
    <ndc_label_name>Premarin 0.625 mg/gram vaginal cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046110081</ndc>
    <ndc_label_name>Premarin 0.3 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046110091</ndc>
    <ndc_label_name>Premarin 0.3 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046110181</ndc>
    <ndc_label_name>Premarin 0.45 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046110281</ndc>
    <ndc_label_name>Premarin 0.625 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046110291</ndc>
    <ndc_label_name>Premarin 0.625 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046110381</ndc>
    <ndc_label_name>Premarin 0.9 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046110481</ndc>
    <ndc_label_name>Premarin 1.25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046110491</ndc>
    <ndc_label_name>Premarin 1.25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046110511</ndc>
    <ndc_label_name>Prempro 0.3 mg-1.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046110611</ndc>
    <ndc_label_name>Prempro 0.45 mg-1.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046110711</ndc>
    <ndc_label_name>Prempro 0.625 mg-2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046110811</ndc>
    <ndc_label_name>Prempro 0.625 mg-5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00046257512</ndc>
    <ndc_label_name>Premphase 0.625 mg(14)/0.625 mg-5mg(14) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049001381</ndc>
    <ndc_label_name>Unasyn 1.5 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049001383</ndc>
    <ndc_label_name>Unasyn 1.5 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049001481</ndc>
    <ndc_label_name>Unasyn 3 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049001483</ndc>
    <ndc_label_name>Unasyn 3 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049002428</ndc>
    <ndc_label_name>Unasyn 15 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049005001</ndc>
    <ndc_label_name>Zoloft 20 mg/mL oral concentrate</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049011428</ndc>
    <ndc_label_name>Eraxis(Water Diluent) 50 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049011628</ndc>
    <ndc_label_name>Eraxis(Water Diluent) 100 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049017402</ndc>
    <ndc_label_name>GLUCOTROL XL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049017403</ndc>
    <ndc_label_name>GLUCOTROL XL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049017807</ndc>
    <ndc_label_name>GLUCOTROL XL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049017808</ndc>
    <ndc_label_name>GLUCOTROL XL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049035260</ndc>
    <ndc_label_name>Geodon 20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049035460</ndc>
    <ndc_label_name>Geodon 40 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049035660</ndc>
    <ndc_label_name>Geodon 60 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049035860</ndc>
    <ndc_label_name>Geodon 80 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049042005</ndc>
    <ndc_label_name>Pfizerpen-G 5 million unit solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049042010</ndc>
    <ndc_label_name>Pfizerpen-G 5 million unit solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049043020</ndc>
    <ndc_label_name>Pfizerpen-G 20 million unit solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049052022</ndc>
    <ndc_label_name>Pfizerpen-G 5 million unit solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049052023</ndc>
    <ndc_label_name>Pfizerpen-G 5 million unit solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049052083</ndc>
    <ndc_label_name>Pfizerpen-G 5 million unit solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049052084</ndc>
    <ndc_label_name>Pfizerpen-G 5 million unit solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049053022</ndc>
    <ndc_label_name>Pfizerpen-G 20 million unit solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049053028</ndc>
    <ndc_label_name>Pfizerpen-G 20 million unit solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049204010</ndc>
    <ndc_label_name>Cardura XL 4 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049224201</ndc>
    <ndc_label_name>Eraxis(Water Diluent) 100 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00049233045</ndc>
    <ndc_label_name>Relpax 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00049233079</ndc>
    <ndc_label_name>Relpax 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00049234005</ndc>
    <ndc_label_name>Relpax 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00049234045</ndc>
    <ndc_label_name>Relpax 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00049234079</ndc>
    <ndc_label_name>Relpax 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049241010</ndc>
    <ndc_label_name>Cardura 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049251210</ndc>
    <ndc_label_name>Cardura 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049261410</ndc>
    <ndc_label_name>Cardura 4 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049271610</ndc>
    <ndc_label_name>Cardura 8 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049316044</ndc>
    <ndc_label_name>Vfend 200 mg/5 mL (40 mg/mL) oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049317030</ndc>
    <ndc_label_name>VFEND 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049318030</ndc>
    <ndc_label_name>VFEND 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049319001</ndc>
    <ndc_label_name>Vfend IV 200 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049319028</ndc>
    <ndc_label_name>Vfend IV 200 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049342030</ndc>
    <ndc_label_name>DIFLUCAN 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049342041</ndc>
    <ndc_label_name>DIFLUCAN 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049343030</ndc>
    <ndc_label_name>DIFLUCAN 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049343041</ndc>
    <ndc_label_name>DIFLUCAN 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049345019</ndc>
    <ndc_label_name>Diflucan 40 mg/mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049392001</ndc>
    <ndc_label_name>Geodon 20 mg/mL (final concentration) intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049392010</ndc>
    <ndc_label_name>Geodon 20 mg/mL (final concentration) intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049392020</ndc>
    <ndc_label_name>Geodon 20 mg/mL (final concentration) intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049392083</ndc>
    <ndc_label_name>Geodon 20 mg/mL (final concentration) intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049419001</ndc>
    <ndc_label_name>Vfend IV 200 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049490030</ndc>
    <ndc_label_name>Zoloft 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049490041</ndc>
    <ndc_label_name>Zoloft 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049491030</ndc>
    <ndc_label_name>Zoloft 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049491041</ndc>
    <ndc_label_name>Zoloft 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00049496030</ndc>
    <ndc_label_name>Zoloft 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00051846233</ndc>
    <ndc_label_name>AndroGel 20.25 mg/1.25 gram per pump act. (1.62 %) transdermal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00052031154</ndc>
    <ndc_label_name>Follistim Pen Device subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00052031301</ndc>
    <ndc_label_name>Follistim AQ 300 unit/0.36 mL subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00052031510</ndc>
    <ndc_label_name>Pregnyl 10,000 unit intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00052031601</ndc>
    <ndc_label_name>Follistim AQ 600 unit/0.72 mL subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00052032601</ndc>
    <ndc_label_name>Follistim AQ 900 unit/1.08 mL subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00052060201</ndc>
    <ndc_label_name>Tice BCG 50 mg intravesical suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00052060202</ndc>
    <ndc_label_name>Tice BCG 50 mg intravesical suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00052060301</ndc>
    <ndc_label_name>BCG VACCINE (TICE STRAIN) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00052060302</ndc>
    <ndc_label_name>BCG VACCINE (TICE STRAIN) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053009901</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053010010</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053011011</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053012012</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053013013</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053014014</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053015015</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053016016</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053017017</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053018018</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053019019</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053020020</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053021021</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053022022</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053023023</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053024024</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053025025</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053026026</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053027027</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053028028</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053029029</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053030030</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053031031</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053032032</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053033033</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053034034</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053035035</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053036036</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053037037</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053038038</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053039039</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053040040</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053041041</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053042042</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053043043</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053044044</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053045045</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053046046</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053047047</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053048048</ndc>
    <ndc_label_name>Hemgenix 1x10exp13 gc/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053720102</ndc>
    <ndc_label_name>Zemaira 1,000 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053720202</ndc>
    <ndc_label_name>Zemaira 4,000 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053720302</ndc>
    <ndc_label_name>Zemaira 5,000 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053721101</ndc>
    <ndc_label_name>Zemaira 1,000 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053721201</ndc>
    <ndc_label_name>Zemaira 4,000 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053721301</ndc>
    <ndc_label_name>Zemaira 5,000 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00053765320</ndc>
    <ndc_label_name>STERILE WATER FOR ZEMAIRA VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054000713</ndc>
    <ndc_label_name>CALCITRIOL 0.25 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054000725</ndc>
    <ndc_label_name>CALCITRIOL 0.25 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001020</ndc>
    <ndc_label_name>FLECAINIDE ACETATE 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001021</ndc>
    <ndc_label_name>FLECAINIDE ACETATE 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001025</ndc>
    <ndc_label_name>FLECAINIDE ACETATE 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001120</ndc>
    <ndc_label_name>FLECAINIDE ACETATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001121</ndc>
    <ndc_label_name>FLECAINIDE ACETATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001125</ndc>
    <ndc_label_name>FLECAINIDE ACETATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001221</ndc>
    <ndc_label_name>FLECAINIDE ACETATE 150 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001225</ndc>
    <ndc_label_name>FLECAINIDE ACETATE 150 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001720</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001729</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001820</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001825</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001829</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001920</ndc>
    <ndc_label_name>PREDNISONE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054001925</ndc>
    <ndc_label_name>PREDNISONE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054002025</ndc>
    <ndc_label_name>LITHIUM CARBONATE ER 450 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054002125</ndc>
    <ndc_label_name>LITHIUM CARBONATE ER 300 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054002129</ndc>
    <ndc_label_name>LITHIUM CARBONATE ER 300 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054002511</ndc>
    <ndc_label_name>MEFLOQUINE HCL 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054004544</ndc>
    <ndc_label_name>IPRATROPIUM 0.03% SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054004641</ndc>
    <ndc_label_name>IPRATROPIUM 0.06% SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054005746</ndc>
    <ndc_label_name>DIGOXIN 0.05 MG/ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054006258</ndc>
    <ndc_label_name>CITALOPRAM HBR 10 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054006344</ndc>
    <ndc_label_name>RISPERIDONE 1 MG/ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054006447</ndc>
    <ndc_label_name>ONDANSETRON 4 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054007725</ndc>
    <ndc_label_name>TORSEMIDE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054007729</ndc>
    <ndc_label_name>TORSEMIDE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054007928</ndc>
    <ndc_label_name>BALSALAZIDE DISODIUM 750 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054008013</ndc>
    <ndc_label_name>EXEMESTANE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054008425</ndc>
    <ndc_label_name>ZALEPLON 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054008525</ndc>
    <ndc_label_name>ZALEPLON 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054008813</ndc>
    <ndc_label_name>CALCIUM ACETATE 667 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054008826</ndc>
    <ndc_label_name>CALCIUM ACETATE 667 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054011025</ndc>
    <ndc_label_name>PERINDOPRIL ERBUMINE 2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054011125</ndc>
    <ndc_label_name>PERINDOPRIL ERBUMINE 4 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054013749</ndc>
    <ndc_label_name>GALANTAMINE 4 MG/ML ORAL SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054014025</ndc>
    <ndc_label_name>ACARBOSE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054014125</ndc>
    <ndc_label_name>ACARBOSE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054014225</ndc>
    <ndc_label_name>ACARBOSE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054016325</ndc>
    <ndc_label_name>MYCOPHENOLATE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054016329</ndc>
    <ndc_label_name>MYCOPHENOLATE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054016625</ndc>
    <ndc_label_name>MYCOPHENOLATE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054016629</ndc>
    <ndc_label_name>MYCOPHENOLATE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054017613</ndc>
    <ndc_label_name>BUPRENORPHINE 2 MG TABLET SL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054017713</ndc>
    <ndc_label_name>BUPRENORPHINE 8 MG TABLET SL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054018813</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 2-0.5MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054018913</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 8-2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054019959</ndc>
    <ndc_label_name>OXCARBAZEPINE 300 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054021025</ndc>
    <ndc_label_name>PROTRIPTYLINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054021125</ndc>
    <ndc_label_name>PROTRIPTYLINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054023025</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 400 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054023524</ndc>
    <ndc_label_name>MORPHINE SULFATE IR 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054023525</ndc>
    <ndc_label_name>MORPHINE SULFATE IR 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054023624</ndc>
    <ndc_label_name>MORPHINE SULFATE IR 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054023625</ndc>
    <ndc_label_name>MORPHINE SULFATE IR 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054023749</ndc>
    <ndc_label_name>MORPHINE SULF 10 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054023763</ndc>
    <ndc_label_name>MORPHINE SULF 10 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054023849</ndc>
    <ndc_label_name>MORPHINE SULF 20 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054023863</ndc>
    <ndc_label_name>MORPHINE SULF 20 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054024324</ndc>
    <ndc_label_name>CODEINE SULFATE 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054024424</ndc>
    <ndc_label_name>CODEINE SULFATE 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054024425</ndc>
    <ndc_label_name>CODEINE SULFATE 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054024525</ndc>
    <ndc_label_name>CODEINE SULFATE 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054024822</ndc>
    <ndc_label_name>IMATINIB MESYLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054024913</ndc>
    <ndc_label_name>IMATINIB MESYLATE 400 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054025413</ndc>
    <ndc_label_name>IRBESARTAN-HCTZ 150-12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054025422</ndc>
    <ndc_label_name>IRBESARTAN-HCTZ 150-12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054025513</ndc>
    <ndc_label_name>IRBESARTAN-HCTZ 300-12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054025522</ndc>
    <ndc_label_name>IRBESARTAN-HCTZ 300-12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054026424</ndc>
    <ndc_label_name>HYDROMORPHONE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054026425</ndc>
    <ndc_label_name>HYDROMORPHONE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054026525</ndc>
    <ndc_label_name>HYDROMORPHONE 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054027121</ndc>
    <ndc_label_name>CAPECITABINE 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054027223</ndc>
    <ndc_label_name>CAPECITABINE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054027313</ndc>
    <ndc_label_name>IMIPRAMINE PAMOATE 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054027413</ndc>
    <ndc_label_name>IMIPRAMINE PAMOATE 100 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054027513</ndc>
    <ndc_label_name>IMIPRAMINE PAMOATE 125 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054027613</ndc>
    <ndc_label_name>IMIPRAMINE PAMOATE 150 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054027803</ndc>
    <ndc_label_name>NARATRIPTAN HCL 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054027903</ndc>
    <ndc_label_name>NARATRIPTAN HCL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054028259</ndc>
    <ndc_label_name>ALENDRONATE SOD 70 MG/75 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054028325</ndc>
    <ndc_label_name>OXYMORPHONE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054028425</ndc>
    <ndc_label_name>OXYMORPHONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054029399</ndc>
    <ndc_label_name>AZELASTINE 0.1% (137 MCG) SPRY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054029513</ndc>
    <ndc_label_name>ALOSETRON HCL 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054029613</ndc>
    <ndc_label_name>ALOSETRON HCL 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054031950</ndc>
    <ndc_label_name>LINEZOLID 100 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054032656</ndc>
    <ndc_label_name>FLUTICASONE-SALMETEROL 100-50</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054032756</ndc>
    <ndc_label_name>FLUTICASONE-SALMETEROL 250-50</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054032856</ndc>
    <ndc_label_name>FLUTICASONE-SALMETEROL 500-50</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054033425</ndc>
    <ndc_label_name>CEVIMELINE HCL 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054034925</ndc>
    <ndc_label_name>PHENOXYBENZAMINE HCL 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054035625</ndc>
    <ndc_label_name>DISULFIRAM 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054037025</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054037125</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054037225</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054037325</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054037425</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054037525</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 70 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054038225</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054038325</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054038663</ndc>
    <ndc_label_name>HYDROMORPHONE 1 MG/ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054038925</ndc>
    <ndc_label_name>METHAMPHETAMINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054039041</ndc>
    <ndc_label_name>OXYCODONE HCL 5 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054039063</ndc>
    <ndc_label_name>OXYCODONE HCL 5 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054039168</ndc>
    <ndc_label_name>METHADONE 10 MG/ML ORAL CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054039268</ndc>
    <ndc_label_name>METHADONE 10 MG/ML ORAL CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054039925</ndc>
    <ndc_label_name>BEXAROTENE 75 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054040013</ndc>
    <ndc_label_name>DESVENLAFAXINE SUCCNT ER 50 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054040022</ndc>
    <ndc_label_name>DESVENLAFAXINE SUCCNT ER 50 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054040113</ndc>
    <ndc_label_name>DESVENLAFAXINE SUCCNT ER 100MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054040122</ndc>
    <ndc_label_name>DESVENLAFAXINE SUCCNT ER 100MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054040713</ndc>
    <ndc_label_name>RITONAVIR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054041313</ndc>
    <ndc_label_name>FEBUXOSTAT 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054041413</ndc>
    <ndc_label_name>FEBUXOSTAT 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054041525</ndc>
    <ndc_label_name>ETHACRYNIC ACID 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054042523</ndc>
    <ndc_label_name>RUFINAMIDE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054042623</ndc>
    <ndc_label_name>RUFINAMIDE 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054042725</ndc>
    <ndc_label_name>FLUCYTOSINE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054042825</ndc>
    <ndc_label_name>FLUCYTOSINE 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054043825</ndc>
    <ndc_label_name>LEVORPHANOL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054044949</ndc>
    <ndc_label_name>POSACONAZOLE 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054045160</ndc>
    <ndc_label_name>Centrum 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054045171</ndc>
    <ndc_label_name>Centrum 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054047021</ndc>
    <ndc_label_name>EVEROLIMUS 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054047121</ndc>
    <ndc_label_name>EVEROLIMUS 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054047221</ndc>
    <ndc_label_name>EVEROLIMUS 0.75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054048013</ndc>
    <ndc_label_name>EVEROLIMUS 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054048113</ndc>
    <ndc_label_name>EVEROLIMUS 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054048114</ndc>
    <ndc_label_name>EVEROLIMUS 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054048213</ndc>
    <ndc_label_name>EVEROLIMUS 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054049713</ndc>
    <ndc_label_name>EVEROLIMUS 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054049714</ndc>
    <ndc_label_name>EVEROLIMUS 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054050823</ndc>
    <ndc_label_name>ICOSAPENT ETHYL 1 GRAM CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054051741</ndc>
    <ndc_label_name>MORPHINE SULF 100 MG/5 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054051744</ndc>
    <ndc_label_name>MORPHINE SULF 100 MG/5 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054051750</ndc>
    <ndc_label_name>MORPHINE SULF 100 MG/5 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054052863</ndc>
    <ndc_label_name>RUFINAMIDE 40 MG/ML SUSPENSION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054053222</ndc>
    <ndc_label_name>DROXIDOPA 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054053322</ndc>
    <ndc_label_name>DROXIDOPA 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054053422</ndc>
    <ndc_label_name>DROXIDOPA 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054056150</ndc>
    <ndc_label_name>CLOBAZAM 2.5 MG/ML SUSPENSION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054057625</ndc>
    <ndc_label_name>DEFERIPRONE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054060313</ndc>
    <ndc_label_name>DESVENLAFAXINE SUCCNT ER 25 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054060421</ndc>
    <ndc_label_name>EVEROLIMUS 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054062127</ndc>
    <ndc_label_name>ICOSAPENT ETHYL 0.5 GM CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054062263</ndc>
    <ndc_label_name>DICYCLOMINE 10 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054063905</ndc>
    <ndc_label_name>METHYLERGONOVINE 0.2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054063913</ndc>
    <ndc_label_name>METHYLERGONOVINE 0.2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054065025</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAF-COD 50-300</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054065225</ndc>
    <ndc_label_name>VIGABATRIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054066025</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054066882</ndc>
    <ndc_label_name>ALVIMOPAN 12 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054070920</ndc>
    <ndc_label_name>METHADONE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054070925</ndc>
    <ndc_label_name>METHADONE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054071020</ndc>
    <ndc_label_name>METHADONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054071025</ndc>
    <ndc_label_name>METHADONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054071119</ndc>
    <ndc_label_name>DEFERIPRONE 1,000 MG TB(3X/DY)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054074287</ndc>
    <ndc_label_name>ALBUTEROL HFA 90 MCG INHALER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054074825</ndc>
    <ndc_label_name>DICYCLOMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054074831</ndc>
    <ndc_label_name>DICYCLOMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054074913</ndc>
    <ndc_label_name>PRUCALOPRIDE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054075013</ndc>
    <ndc_label_name>PRUCALOPRIDE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054075664</ndc>
    <ndc_label_name>Centrum Silver Women 8 mg iron-400 mcg-50 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054081221</ndc>
    <ndc_label_name>PYRAZINAMIDE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054081222</ndc>
    <ndc_label_name>PYRAZINAMIDE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054081225</ndc>
    <ndc_label_name>PYRAZINAMIDE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054081229</ndc>
    <ndc_label_name>PYRAZINAMIDE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054082925</ndc>
    <ndc_label_name>PROGESTERONE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054083025</ndc>
    <ndc_label_name>PROGESTERONE 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054084363</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 10-300/15</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054087949</ndc>
    <ndc_label_name>MERCAPTOPURINE 20 MG/ML SUSPEN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054090623</ndc>
    <ndc_label_name>SAPROPTERIN 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054093621</ndc>
    <ndc_label_name>TAPENTADOL ER 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054093721</ndc>
    <ndc_label_name>TAPENTADOL ER 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054093821</ndc>
    <ndc_label_name>TAPENTADOL ER 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054093921</ndc>
    <ndc_label_name>TAPENTADOL ER 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054094021</ndc>
    <ndc_label_name>TAPENTADOL ER 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054094225</ndc>
    <ndc_label_name>TAPENTADOL HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054094325</ndc>
    <ndc_label_name>TAPENTADOL HCL 75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054094525</ndc>
    <ndc_label_name>TAPENTADOL HCL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054096213</ndc>
    <ndc_label_name>ELTROMBOPAG 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054096313</ndc>
    <ndc_label_name>ELTROMBOPAG 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054096413</ndc>
    <ndc_label_name>ELTROMBOPAG 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054096513</ndc>
    <ndc_label_name>ELTROMBOPAG 75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054110058</ndc>
    <ndc_label_name>AMINOCAPROIC ACID 0.25 GRAM/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054111013</ndc>
    <ndc_label_name>AMINOCAPROIC ACID 1,000 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054195030</ndc>
    <ndc_label_name>INDOMETHACIN 50 MG SUPPOSITORY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054252625</ndc>
    <ndc_label_name>LITHIUM CARBONATE 150 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054252725</ndc>
    <ndc_label_name>LITHIUM CARBONATE 300 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054252731</ndc>
    <ndc_label_name>LITHIUM CARBONATE 300 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054253125</ndc>
    <ndc_label_name>LITHIUM CARBONATE 600 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054300001</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAF-COD 50-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054306844</ndc>
    <ndc_label_name>Alprazolam Intensol 1 mg/mL oral concentrate</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054309036</ndc>
    <ndc_label_name>BUTORPHANOL 10 MG/ML SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054311763</ndc>
    <ndc_label_name>CALCIUM CARB 1,250 MG/5 ML SUS</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054312041</ndc>
    <ndc_label_name>CALCITRIOL 1 MCG/ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054317644</ndc>
    <ndc_label_name>Dexamethasone Intensol 1 mg/mL Drops (concentrate)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054317757</ndc>
    <ndc_label_name>DEXAMETHASONE 0.5 MG/5 ML LIQ</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054317763</ndc>
    <ndc_label_name>DEXAMETHASONE 0.5 MG/5 ML LIQ</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054318544</ndc>
    <ndc_label_name>Diazepam Intensol 5 mg/mL oral concentrate</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054318863</ndc>
    <ndc_label_name>DIAZEPAM 5 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054319446</ndc>
    <ndc_label_name>DIPHENOXYLAT-ATROP 2.5-0.025/5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054327099</ndc>
    <ndc_label_name>FLUTICASONE PROP 50 MCG SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054329446</ndc>
    <ndc_label_name>FUROSEMIDE 10 MG/ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054329450</ndc>
    <ndc_label_name>FUROSEMIDE 10 MG/ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054329863</ndc>
    <ndc_label_name>FUROSEMIDE 40 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054350049</ndc>
    <ndc_label_name>LIDOCAINE 2% VISCOUS SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054350547</ndc>
    <ndc_label_name>LIDOCAINE HCL 4% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054353244</ndc>
    <ndc_label_name>Lorazepam Intensol 2 mg/mL oral concentrate</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054354563</ndc>
    <ndc_label_name>MEPERIDINE 50 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054355344</ndc>
    <ndc_label_name>Methadone Intensol 10 mg/mL oral concentrate</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054355563</ndc>
    <ndc_label_name>METHADONE 5 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054355663</ndc>
    <ndc_label_name>METHADONE 10 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054356699</ndc>
    <ndc_label_name>MIDAZOLAM HCL 2 MG/ML SYRUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054363063</ndc>
    <ndc_label_name>NAPROXEN 125 MG/5 ML SUSPEN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054372144</ndc>
    <ndc_label_name>Prednisone Intensol 5 mg/mL oral concentrate</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054372250</ndc>
    <ndc_label_name>PREDNISONE 5 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054372263</ndc>
    <ndc_label_name>PREDNISONE 5 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054372763</ndc>
    <ndc_label_name>PROPRANOLOL 20 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054373063</ndc>
    <ndc_label_name>PROPRANOLOL 40 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054414622</ndc>
    <ndc_label_name>CLOTRIMAZOLE 10 MG TROCHE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054414623</ndc>
    <ndc_label_name>CLOTRIMAZOLE 10 MG TROCHE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054417925</ndc>
    <ndc_label_name>DEXAMETHASONE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054418025</ndc>
    <ndc_label_name>DEXAMETHASONE 0.75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054418125</ndc>
    <ndc_label_name>DEXAMETHASONE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054418225</ndc>
    <ndc_label_name>DEXAMETHASONE 1.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054418325</ndc>
    <ndc_label_name>DEXAMETHASONE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054418425</ndc>
    <ndc_label_name>DEXAMETHASONE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054418625</ndc>
    <ndc_label_name>DEXAMETHASONE 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054429725</ndc>
    <ndc_label_name>FUROSEMIDE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054429731</ndc>
    <ndc_label_name>FUROSEMIDE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054429925</ndc>
    <ndc_label_name>FUROSEMIDE 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054429931</ndc>
    <ndc_label_name>FUROSEMIDE 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054430125</ndc>
    <ndc_label_name>FUROSEMIDE 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054430129</ndc>
    <ndc_label_name>FUROSEMIDE 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054449613</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054449625</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054449705</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054449710</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054449810</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054449911</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054452725</ndc>
    <ndc_label_name>LITHIUM CARBONATE 300 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054452731</ndc>
    <ndc_label_name>LITHIUM CARBONATE 300 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054453825</ndc>
    <ndc_label_name>Diskets 40 mg soluble tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054455015</ndc>
    <ndc_label_name>METHOTREXATE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054455025</ndc>
    <ndc_label_name>METHOTREXATE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054458111</ndc>
    <ndc_label_name>MERCAPTOPURINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054458127</ndc>
    <ndc_label_name>MERCAPTOPURINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054458249</ndc>
    <ndc_label_name>MERCAPTOPURINE 20 MG/ML SUSPEN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054472825</ndc>
    <ndc_label_name>PREDNISONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054472831</ndc>
    <ndc_label_name>PREDNISONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054474125</ndc>
    <ndc_label_name>PREDNISONE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054474131</ndc>
    <ndc_label_name>PREDNISONE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054474225</ndc>
    <ndc_label_name>PREDNISONE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054485825</ndc>
    <ndc_label_name>TRIAZOLAM 0.125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054485925</ndc>
    <ndc_label_name>TRIAZOLAM 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054485929</ndc>
    <ndc_label_name>TRIAZOLAM 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054814622</ndc>
    <ndc_label_name>CLOTRIMAZOLE 10 MG TROCHE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054817425</ndc>
    <ndc_label_name>DEXAMETHASONE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054817525</ndc>
    <ndc_label_name>DEXAMETHASONE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054817625</ndc>
    <ndc_label_name>DEXAMETHASONE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054817925</ndc>
    <ndc_label_name>DEXAMETHASONE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054818025</ndc>
    <ndc_label_name>DEXAMETHASONE 0.75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054818125</ndc>
    <ndc_label_name>DEXAMETHASONE 1.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054818325</ndc>
    <ndc_label_name>DEXAMETHASONE 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054829725</ndc>
    <ndc_label_name>FUROSEMIDE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054829925</ndc>
    <ndc_label_name>FUROSEMIDE 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054830125</ndc>
    <ndc_label_name>FUROSEMIDE 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054849619</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054852625</ndc>
    <ndc_label_name>LITHIUM CARBONATE 150 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054852725</ndc>
    <ndc_label_name>LITHIUM CARBONATE 300 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054852825</ndc>
    <ndc_label_name>LITHIUM CARBONATE 300 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054855025</ndc>
    <ndc_label_name>METHOTREXATE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054872425</ndc>
    <ndc_label_name>PREDNISONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054873925</ndc>
    <ndc_label_name>PREDNISONE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054874025</ndc>
    <ndc_label_name>PREDNISONE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00054962857</ndc>
    <ndc_label_name>SODIUM OXYBATE 0.5 G/ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054981725</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054981729</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054982825</ndc>
    <ndc_label_name>PREDNISONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00054982831</ndc>
    <ndc_label_name>PREDNISONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00064015008</ndc>
    <ndc_label_name>Proshield Foam/Spray Cleanser topical cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00064022002</ndc>
    <ndc_label_name>FreshNet topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065002315</ndc>
    <ndc_label_name>Miostat 0.01 % intraocular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065008515</ndc>
    <ndc_label_name>Naphcon-A 0.025 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065009265</ndc>
    <ndc_label_name>Fluorescite 500 mg/5 mL (10 %) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065019093</ndc>
    <ndc_label_name>Systane Contacts eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065019231</ndc>
    <ndc_label_name>Opti-Free PureMoist Rewetting eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065034302</ndc>
    <ndc_label_name>PHENYLEPHRINE 10% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065034904</ndc>
    <ndc_label_name>PHENYLEPHRINE 2.5% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065034905</ndc>
    <ndc_label_name>PHENYLEPHRINE 2.5% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065035604</ndc>
    <ndc_label_name>Opti-Free Replenish solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065035902</ndc>
    <ndc_label_name>Cyclomydril 0.2 %-1 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065035905</ndc>
    <ndc_label_name>Cyclomydril 0.2 %-1 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065039515</ndc>
    <ndc_label_name>Cyclogyl 0.5 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065039602</ndc>
    <ndc_label_name>Cyclogyl 1 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065039605</ndc>
    <ndc_label_name>Cyclogyl 1 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065039702</ndc>
    <ndc_label_name>Cyclogyl 2 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065039705</ndc>
    <ndc_label_name>Cyclogyl 2 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065039715</ndc>
    <ndc_label_name>Cyclogyl 2 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065040872</ndc>
    <ndc_label_name>Tears Lubricant 0.5 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065041130</ndc>
    <ndc_label_name>Betadine Ophthalmic Prep 5 % solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065041881</ndc>
    <ndc_label_name>GENTEAL TEARS 0.1%-0.3% DROP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065042636</ndc>
    <ndc_label_name>GenTeal Tears Moderate 0.1 %-0.3 %-0.2 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065042637</ndc>
    <ndc_label_name>GenTeal Tears Moderate 0.1 %-0.3 %-0.2 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065042915</ndc>
    <ndc_label_name>Systane (propylene glycol) 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065042930</ndc>
    <ndc_label_name>Systane (propylene glycol) 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065043133</ndc>
    <ndc_label_name>Systane (PF) 0.4 %-0.3 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065045407</ndc>
    <ndc_label_name>Systane Gel 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065047401</ndc>
    <ndc_label_name>Systane Gel 0.3 % eye gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065048101</ndc>
    <ndc_label_name>Systane Complete 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065048110</ndc>
    <ndc_label_name>Systane Complete 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065048111</ndc>
    <ndc_label_name>Systane Complete 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065048155</ndc>
    <ndc_label_name>Systane Complete 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065050935</ndc>
    <ndc_label_name>Systane Nighttime 94 %-3 % eye ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065051801</ndc>
    <ndc_label_name>GenTeal Tears Severe (petrolatum-mineral oil) 94 %-3 % eye ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065054301</ndc>
    <ndc_label_name>Triesence (PF) 40 mg/mL intraocular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065074114</ndc>
    <ndc_label_name>TETRACAINE 0.5% STERI-UNIT SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065079515</ndc>
    <ndc_label_name>BSS intraocular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065079550</ndc>
    <ndc_label_name>BSS intraocular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065080050</ndc>
    <ndc_label_name>BSS Plus intraocular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065080094</ndc>
    <ndc_label_name>BSS Plus intraocular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065081601</ndc>
    <ndc_label_name>Pataday Once Daily Relief 0.7 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065081604</ndc>
    <ndc_label_name>Pataday Once Daily Relief 0.7 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065081612</ndc>
    <ndc_label_name>Pataday Once Daily Relief 0.7 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065081701</ndc>
    <ndc_label_name>ATROPINE 1% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065081702</ndc>
    <ndc_label_name>ATROPINE 1% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065143105</ndc>
    <ndc_label_name>Systane Ultra 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065143121</ndc>
    <ndc_label_name>Systane Ultra 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065143128</ndc>
    <ndc_label_name>Systane Ultra 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065143131</ndc>
    <ndc_label_name>Systane Ultra 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065143141</ndc>
    <ndc_label_name>Systane Ultra 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065143205</ndc>
    <ndc_label_name>Systane Ultra (PF) 0.4 %-0.3 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065143206</ndc>
    <ndc_label_name>Systane Ultra (PF) 0.4 %-0.3 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065143302</ndc>
    <ndc_label_name>Systane Balance 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065143307</ndc>
    <ndc_label_name>Systane Balance 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065143704</ndc>
    <ndc_label_name>Systane Hydration (PF) 0.4 %-0.3 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065150782</ndc>
    <ndc_label_name>Systane Ultra (PF) 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065150792</ndc>
    <ndc_label_name>Systane Ultra (PF) 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065150928</ndc>
    <ndc_label_name>Systane Complete PF 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065150929</ndc>
    <ndc_label_name>Systane Complete PF 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065150977</ndc>
    <ndc_label_name>Systane Complete PF 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065151000</ndc>
    <ndc_label_name>Systane Hydration (PF) 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065151006</ndc>
    <ndc_label_name>Systane Hydration (PF) 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065153001</ndc>
    <ndc_label_name>Systane Complete PF 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065153004</ndc>
    <ndc_label_name>Systane Complete PF 0.6 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065179504</ndc>
    <ndc_label_name>BSS intraocular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065329003</ndc>
    <ndc_label_name>Systane PRO PF 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065329005</ndc>
    <ndc_label_name>Systane PRO PF 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065401105</ndc>
    <ndc_label_name>Zaditor 0.025 % (0.035 %) eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00065401106</ndc>
    <ndc_label_name>Zaditor 0.025 % (0.035 %) eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065414727</ndc>
    <ndc_label_name>Simbrinza 1 %-0.2 % eye drops,suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065427401</ndc>
    <ndc_label_name>Pataday Twice Daily Relief 0.1 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065805202</ndc>
    <ndc_label_name>SYSTANE LID WIPES</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065806301</ndc>
    <ndc_label_name>GenTeal Tears Moderate (PF) 0.1 %-0.3 % drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065806401</ndc>
    <ndc_label_name>GenTeal Tears Severe 0.3 % eye gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065806701</ndc>
    <ndc_label_name>GenTeal Tears Severe Gel Drops 0.4 %-0.3 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065815001</ndc>
    <ndc_label_name>Pataday Once Daily Relief 0.2 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065815003</ndc>
    <ndc_label_name>Pataday Once Daily Relief 0.2 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065859502</ndc>
    <ndc_label_name>Tryptyr 0.003 % eye drops in a dropperette</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00065930501</ndc>
    <ndc_label_name>Bion Tears (PF) 0.1 %-0.3 % drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067000548</ndc>
    <ndc_label_name>Ex-Lax (sennosides) 15 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067000709</ndc>
    <ndc_label_name>Theraflu Severe Cold Relief Night 25 mg-650 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067000710</ndc>
    <ndc_label_name>Theraflu Severe Cold Relief Day (DM) 650 mg-20 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067000711</ndc>
    <ndc_label_name>Theraflu Severe Cold Relief Day (DM) 500 mg-20 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067000712</ndc>
    <ndc_label_name>Theraflu Severe Cold-Cong Day 10 mg-325 mg-200 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067000713</ndc>
    <ndc_label_name>Theraflu Severe Cold Relief Night 25 mg-650 mg/30 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067000714</ndc>
    <ndc_label_name>Theraflu Severe Cold Day-Night 25 mg-650 mg/30 mL (night) oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067000715</ndc>
    <ndc_label_name>Theraflu Cold Relief Day-Night 25 mg-650 mg (night) powder pack</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067000720</ndc>
    <ndc_label_name>Theraflu Severe Cold Relief Day (DM) 650 mg-20 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067001624</ndc>
    <ndc_label_name>Ex-Lax Maximum Strength 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067001648</ndc>
    <ndc_label_name>Ex-Lax Maximum Strength 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067003028</ndc>
    <ndc_label_name>Benefiber Clear Sugar Free(dextrin) 3 gram/3.5 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067011701</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067011718</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067011748</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067011801</ndc>
    <ndc_label_name>Gas-X Total Relief 750 mg-250 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067011803</ndc>
    <ndc_label_name>Gas-X Total Relief 750 mg-250 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067012918</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067067430</ndc>
    <ndc_label_name>LORATADINE 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067120176</ndc>
    <ndc_label_name>Voltaren Arthritis Pain 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067120282</ndc>
    <ndc_label_name>Voltaren Arthritis Pain 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067200020</ndc>
    <ndc_label_name>Excedrin Extra Strength 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067200024</ndc>
    <ndc_label_name>Excedrin Extra Strength 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067200030</ndc>
    <ndc_label_name>Excedrin Extra Strength 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067200033</ndc>
    <ndc_label_name>Excedrin Extra Strength 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067200050</ndc>
    <ndc_label_name>Excedrin Extra Strength 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067200077</ndc>
    <ndc_label_name>Excedrin Extra Strength 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067200091</ndc>
    <ndc_label_name>Excedrin Extra Strength 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067203520</ndc>
    <ndc_label_name>Excedrin Migraine 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067203524</ndc>
    <ndc_label_name>Excedrin Migraine 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067203550</ndc>
    <ndc_label_name>Excedrin Migraine 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067203924</ndc>
    <ndc_label_name>Excedrin Migraine 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067203950</ndc>
    <ndc_label_name>Excedrin Migraine 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067203991</ndc>
    <ndc_label_name>Excedrin Migraine 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067203992</ndc>
    <ndc_label_name>Excedrin Migraine 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067204002</ndc>
    <ndc_label_name>Excedrin Migraine 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067204003</ndc>
    <ndc_label_name>Excedrin Migraine 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067204591</ndc>
    <ndc_label_name>Excedrin Tension Headache 500 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067205624</ndc>
    <ndc_label_name>Excedrin PM Headache 250 mg-250 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067205691</ndc>
    <ndc_label_name>Excedrin PM Headache 250 mg-250 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067208601</ndc>
    <ndc_label_name>4 Way 1 % nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067293340</ndc>
    <ndc_label_name>Voltaren Arthritis Pain 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067298180</ndc>
    <ndc_label_name>Theraflu Flu Relief Day-Night 2 mg-15 mg-500 mg (night) tablets</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067298190</ndc>
    <ndc_label_name>Theraflu Flu Relief Daytime 1,000 mg-30 mg/30 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067327240</ndc>
    <ndc_label_name>Theraflu Flu Relief Daytime 1,000 mg-30 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067328130</ndc>
    <ndc_label_name>Theraflu Flu Relief Day-Night 4 mg-30 mg-1,000 mg powder pack</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067328520</ndc>
    <ndc_label_name>Theraflu Flu Relief Nighttime 4 mg-30 mg-1,000 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067377610</ndc>
    <ndc_label_name>Theraflu Severe Cold Relief Day(pe-dm) 10 mg-20 mg-650 mg oral pwd pkt</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067399830</ndc>
    <ndc_label_name>Lamisil AT 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067434889</ndc>
    <ndc_label_name>Joint Comfort and Movement 100 mg-500 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067434892</ndc>
    <ndc_label_name>Joint Health-Bone Strength 600 mg-25 mcg-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067434939</ndc>
    <ndc_label_name>Theraflu Severe Cold Relief Night 12.5 mg-325 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067434942</ndc>
    <ndc_label_name>Theraflu Severe Cold Relief 325 mg-10 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067434989</ndc>
    <ndc_label_name>Theraflu Congestion Relief 0.05 % nasal mist</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067434992</ndc>
    <ndc_label_name>Theraflu Congestion Relief 0.05 % nasal mist</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067435009</ndc>
    <ndc_label_name>Theraflu-D Flu Relief Night 4 mg-60 mg-30 mg-1000 mg/30 mL oral soln</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067435014</ndc>
    <ndc_label_name>Theraflu-D Flu Relief Day 60 mg-30 mg-1,000 mg/30 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067435023</ndc>
    <ndc_label_name>Theraflu Severe Cold Relief 325 mg-10 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067435035</ndc>
    <ndc_label_name>Theraflu-D Severe Cold-Decong 60 mg-20 mg-500 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067435113</ndc>
    <ndc_label_name>Gas-X 500 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067489014</ndc>
    <ndc_label_name>NICOTINE 14 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067490014</ndc>
    <ndc_label_name>NICOTINE 21 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067609501</ndc>
    <ndc_label_name>Theraflu Nighttime PowerPod 25 mg-10 mg-650 mg oral powdr in container</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067611730</ndc>
    <ndc_label_name>Allergy Relief (loratadine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067627418</ndc>
    <ndc_label_name>Gas-X Ultra-Strength 180 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067627450</ndc>
    <ndc_label_name>Gas-X Ultra-Strength 180 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067627510</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067627520</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067627550</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067627572</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067627582</ndc>
    <ndc_label_name>Gas-X Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067627935</ndc>
    <ndc_label_name>Maalox Advanced 1,000 mg-60 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067627965</ndc>
    <ndc_label_name>Maalox Advanced 1,000 mg-60 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067627990</ndc>
    <ndc_label_name>Maalox Advanced 1,000 mg-60 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067628171</ndc>
    <ndc_label_name>Maalox Advanced 200 mg-200 mg-20 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067628212</ndc>
    <ndc_label_name>Maalox Maximum Strength 400 mg-400 mg-40 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067628301</ndc>
    <ndc_label_name>Gas-X 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067628302</ndc>
    <ndc_label_name>Gas-X 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067628614</ndc>
    <ndc_label_name>Prevacid 24Hr 15 mg capsule,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067628642</ndc>
    <ndc_label_name>Prevacid 24Hr 15 mg capsule,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067629165</ndc>
    <ndc_label_name>Maalox Advanced 1,000 mg-60 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067642606</ndc>
    <ndc_label_name>Theraflu Multi-Symptom Cold 10 mg-20 mg-500 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067680002</ndc>
    <ndc_label_name>Theraflu Severe Cold Relief Day(pe-dm) 10 mg-20 mg-650 mg oral pwd pkt</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067791606</ndc>
    <ndc_label_name>Theraflu Flu-Sore Throat 20 mg-10 mg-650 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067791706</ndc>
    <ndc_label_name>Theraflu Severe Cold Relief Day(pe-dm) 10 mg-20 mg-650 mg oral pwd pkt</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067791806</ndc>
    <ndc_label_name>THERAFLU NT SEVERE CLD-CGH PKT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067810492</ndc>
    <ndc_label_name>Excedrin Extra Strength 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067811924</ndc>
    <ndc_label_name>Excedrin Tension Headache 500 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067812708</ndc>
    <ndc_label_name>Theraflu ExpressMax Cold-Cough Day 5 mg-10 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067812808</ndc>
    <ndc_label_name>Theraflu ExpressMax Cold-Cough Night 25 mg-10 mg-650 mg/30 mL oral liq</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00067812908</ndc>
    <ndc_label_name>Theraflu ExpressMax Cold-Cough Night 25 mg-10 mg-650 mg/30 mL oral liq</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067813208</ndc>
    <ndc_label_name>Theraflu ExpressMax Severe Cold-Flu 5 mg-10 mg-325 mg-200 mg/15 mL liq</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067813620</ndc>
    <ndc_label_name>Theraflu ExpressMax Cold-Cough Day 5 mg-10 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067813720</ndc>
    <ndc_label_name>Theraflu ExpressMax Cold-Cough Night 12.5 mg-5 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067813901</ndc>
    <ndc_label_name>Excedrin Tension Headache 500 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067813902</ndc>
    <ndc_label_name>Excedrin Tension Headache 500 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067814001</ndc>
    <ndc_label_name>Ex-Lax (sennosides) 15 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067814002</ndc>
    <ndc_label_name>Ex-Lax (sennosides) 15 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067814301</ndc>
    <ndc_label_name>Perdiem Overnight Relief 15 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067815201</ndc>
    <ndc_label_name>Voltaren Arthritis Pain 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067815202</ndc>
    <ndc_label_name>Voltaren Arthritis Pain 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067815203</ndc>
    <ndc_label_name>Voltaren Arthritis Pain 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067815204</ndc>
    <ndc_label_name>Voltaren Arthritis Pain 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067815205</ndc>
    <ndc_label_name>Voltaren Arthritis Pain 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067815208</ndc>
    <ndc_label_name>Voltaren Arthritis Pain 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067815301</ndc>
    <ndc_label_name>Voltaren Arthritis Pain 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00067820601</ndc>
    <ndc_label_name>Theraflu Flu Relief Day-Night 4 mg-30 mg-1,000 mg/30 mL (nt) oral liq</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00068041830</ndc>
    <ndc_label_name>Citrucel (sucrose) oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00068042017</ndc>
    <ndc_label_name>Citrucel Sugar Free oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00068059701</ndc>
    <ndc_label_name>Rifadin 600 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00068059901</ndc>
    <ndc_label_name>Rifadin 600 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069004301</ndc>
    <ndc_label_name>HEPARIN 2,000 UNIT/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069004302</ndc>
    <ndc_label_name>HEPARIN 2,000 UNIT/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069005801</ndc>
    <ndc_label_name>HEPARIN 10,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069005802</ndc>
    <ndc_label_name>HEPARIN 10,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069005901</ndc>
    <ndc_label_name>HEPARIN 50,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069005902</ndc>
    <ndc_label_name>HEPARIN 50,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069005903</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069005904</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069010601</ndc>
    <ndc_label_name>Elelyso 200 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069013501</ndc>
    <ndc_label_name>Bosulif 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069013601</ndc>
    <ndc_label_name>Bosulif 500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069013701</ndc>
    <ndc_label_name>HEPARIN 30,000 UNIT/30 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069013703</ndc>
    <ndc_label_name>HEPARIN 30,000 UNIT/30 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069014501</ndc>
    <ndc_label_name>Inlyta 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069015111</ndc>
    <ndc_label_name>Inlyta 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069018721</ndc>
    <ndc_label_name>Ibrance 75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069018821</ndc>
    <ndc_label_name>Ibrance 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069018921</ndc>
    <ndc_label_name>Ibrance 125 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069019301</ndc>
    <ndc_label_name>Bosulif 400 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069019501</ndc>
    <ndc_label_name>Fragmin 2,500 anti-Xa unit/0.2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069019502</ndc>
    <ndc_label_name>Fragmin 2,500 anti-Xa unit/0.2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069019601</ndc>
    <ndc_label_name>Fragmin 5,000 anti-Xa unit/0.2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069019602</ndc>
    <ndc_label_name>Fragmin 5,000 anti-Xa unit/0.2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069019730</ndc>
    <ndc_label_name>Vizimpro 15 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069020601</ndc>
    <ndc_label_name>Fragmin 7,500 anti-Xa unit/0.3 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069020602</ndc>
    <ndc_label_name>Fragmin 7,500 anti-Xa unit/0.3 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069020701</ndc>
    <ndc_label_name>Abrysvo (PF) 120 mcg/0.5 mL intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069020901</ndc>
    <ndc_label_name>PROPOFOL 200 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069020910</ndc>
    <ndc_label_name>PROPOFOL 200 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069021701</ndc>
    <ndc_label_name>Fragmin 10,000 anti-Xa unit/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069021702</ndc>
    <ndc_label_name>Fragmin 10,000 anti-Xa unit/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069022001</ndc>
    <ndc_label_name>Fragmin 12,500 anti-Xa unit/0.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069022002</ndc>
    <ndc_label_name>Fragmin 12,500 anti-Xa unit/0.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069022301</ndc>
    <ndc_label_name>Fragmin 15,000 anti-Xa unit/0.6 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069022302</ndc>
    <ndc_label_name>Fragmin 15,000 anti-Xa unit/0.6 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069022701</ndc>
    <ndc_label_name>Lorbrena 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069022703</ndc>
    <ndc_label_name>Lorbrena 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069022801</ndc>
    <ndc_label_name>Fragmin 18,000 anti-Xa unit/0.72 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069022802</ndc>
    <ndc_label_name>Fragmin 18,000 anti-Xa unit/0.72 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069023101</ndc>
    <ndc_label_name>Lorbrena 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069023201</ndc>
    <ndc_label_name>Fragmin 25,000 anti-Xa unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069023401</ndc>
    <ndc_label_name>PROPOFOL 500 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069023420</ndc>
    <ndc_label_name>PROPOFOL 500 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069023530</ndc>
    <ndc_label_name>Cibinqo 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069023801</ndc>
    <ndc_label_name>Ruxience 10 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069024230</ndc>
    <ndc_label_name>Toviaz 4 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069024430</ndc>
    <ndc_label_name>Toviaz 8 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069024801</ndc>
    <ndc_label_name>PROPOFOL 1,000 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069024810</ndc>
    <ndc_label_name>PROPOFOL 1,000 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069024901</ndc>
    <ndc_label_name>Ruxience 10 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069025001</ndc>
    <ndc_label_name>Sterile Water 100 % Diluent Component for Abrysvo injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069025160</ndc>
    <ndc_label_name>Xalkori 20 mg oral pellets</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069025230</ndc>
    <ndc_label_name>Talzenna 0.1 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069025301</ndc>
    <ndc_label_name>Fragmin 2,500 anti-Xa unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069025310</ndc>
    <ndc_label_name>Fragmin 2,500 anti-Xa unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069025510</ndc>
    <ndc_label_name>DOXORUBICIN 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069027101</ndc>
    <ndc_label_name>Penbraya MenACWY Component (PF) 5 mcg/0.5 mL IM suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069027430</ndc>
    <ndc_label_name>Velsipity 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069027702</ndc>
    <ndc_label_name>DOXORUBICIN 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069028403</ndc>
    <ndc_label_name>Ibrance 75 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069028407</ndc>
    <ndc_label_name>Ibrance 75 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069029101</ndc>
    <ndc_label_name>Nivestym 300 mcg/0.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069029110</ndc>
    <ndc_label_name>Nivestym 300 mcg/0.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069029201</ndc>
    <ndc_label_name>Nivestym 480 mcg/0.8 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069029210</ndc>
    <ndc_label_name>Nivestym 480 mcg/0.8 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069029301</ndc>
    <ndc_label_name>Nivestym 300 mcg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069029310</ndc>
    <ndc_label_name>Nivestym 300 mcg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069029401</ndc>
    <ndc_label_name>Nivestym 480 mcg/1.6 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069029410</ndc>
    <ndc_label_name>Nivestym 480 mcg/1.6 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069029630</ndc>
    <ndc_label_name>Talzenna 0.25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069029701</ndc>
    <ndc_label_name>Ticovac 1.2 mcg/0.25 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069029702</ndc>
    <ndc_label_name>Ticovac 1.2 mcg/0.25 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069029860</ndc>
    <ndc_label_name>Daurismo 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069030501</ndc>
    <ndc_label_name>Trazimera 420 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069030601</ndc>
    <ndc_label_name>Trazimera 420 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069030701</ndc>
    <ndc_label_name>Bacteriostatic Water for Trazimera injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069030801</ndc>
    <ndc_label_name>Trazimera 150 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069031501</ndc>
    <ndc_label_name>Zirabev 25 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069032401</ndc>
    <ndc_label_name>Nyvepria 6 mg/0.6 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069032501</ndc>
    <ndc_label_name>Abrilada(CF) Pen 40 mg/0.8 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069032502</ndc>
    <ndc_label_name>Abrilada(CF) Pen 40 mg/0.8 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069032802</ndc>
    <ndc_label_name>Abrilada(CF) 40 mg/0.8 mL subcutaneous syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069033201</ndc>
    <ndc_label_name>Penbraya MenB Component (PF) 120 mcg/0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069033302</ndc>
    <ndc_label_name>Abrilada(CF) 20 mg/0.4 mL subcutaneous syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069033428</ndc>
    <ndc_label_name>Litfulo 50 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069033530</ndc>
    <ndc_label_name>Cibinqo 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069033621</ndc>
    <ndc_label_name>REVATIO 10 MG/ML ORAL SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069033801</ndc>
    <ndc_label_name>Revatio 10 mg/12.5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069034201</ndc>
    <ndc_label_name>Zirabev 25 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069034302</ndc>
    <ndc_label_name>DOXORUBICIN 50 MG/25 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069034401</ndc>
    <ndc_label_name>Abrysvo (PF) 120 mcg/0.5 mL intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069034405</ndc>
    <ndc_label_name>Abrysvo (PF) 120 mcg/0.5 mL intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069035330</ndc>
    <ndc_label_name>Talzenna 0.25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069035820</ndc>
    <ndc_label_name>DOXORUBICIN 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069041101</ndc>
    <ndc_label_name>Ticovac 2.4 mcg/0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069041102</ndc>
    <ndc_label_name>Ticovac 2.4 mcg/0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069041110</ndc>
    <ndc_label_name>Ticovac 2.4 mcg/0.5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069042201</ndc>
    <ndc_label_name>BEQVEZ VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069043530</ndc>
    <ndc_label_name>Cibinqo 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069045430</ndc>
    <ndc_label_name>Talzenna 0.35 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069046856</ndc>
    <ndc_label_name>Chantix 0.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069046903</ndc>
    <ndc_label_name>Chantix Continuing Month Box 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069046928</ndc>
    <ndc_label_name>Chantix Continuing Month Box 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069046956</ndc>
    <ndc_label_name>Chantix 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069047103</ndc>
    <ndc_label_name>Chantix Starting Month Box 0.5 mg (11)-1 mg (42) tablets in dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069047128</ndc>
    <ndc_label_name>Chantix Starting Month Box 0.5 mg (11)-1 mg (42) tablets in dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069048603</ndc>
    <ndc_label_name>Ibrance 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069048607</ndc>
    <ndc_label_name>Ibrance 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069050130</ndc>
    <ndc_label_name>Xeljanz XR 11 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069050230</ndc>
    <ndc_label_name>Xeljanz XR 22 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069050430</ndc>
    <ndc_label_name>Bosulif 50 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069050501</ndc>
    <ndc_label_name>Ngenla 24 mg/1.2 mL (20 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069050502</ndc>
    <ndc_label_name>Ngenla 24 mg/1.2 mL (20 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069050760</ndc>
    <ndc_label_name>Xalkori 50 mg oral pellets</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069052001</ndc>
    <ndc_label_name>Ngenla 60 mg/1.2 mL (50 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069052002</ndc>
    <ndc_label_name>Ngenla 60 mg/1.2 mL (50 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069052111</ndc>
    <ndc_label_name>Paxlovid 150 mg(6)-100 mg(5) tablets in a dose pack(Severe Renal Dose)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069054630</ndc>
    <ndc_label_name>Talzenna 0.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069055038</ndc>
    <ndc_label_name>Sutent 12.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069060001</ndc>
    <ndc_label_name>Penbraya (PF) 5 mcg-120 mcg/0.5 mL intramuscular kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069060005</ndc>
    <ndc_label_name>Penbraya (PF) 5 mcg-120 mcg/0.5 mL intramuscular kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069060010</ndc>
    <ndc_label_name>Penbraya (PF) 5 mcg-120 mcg/0.5 mL intramuscular kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069065530</ndc>
    <ndc_label_name>Talzenna 0.75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069068803</ndc>
    <ndc_label_name>Ibrance 125 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069068807</ndc>
    <ndc_label_name>Ibrance 125 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069075730</ndc>
    <ndc_label_name>Talzenna 1 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069077038</ndc>
    <ndc_label_name>Sutent 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069080901</ndc>
    <ndc_label_name>Inflectra 100 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069083038</ndc>
    <ndc_label_name>Sutent 37.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069095050</ndc>
    <ndc_label_name>VIBRAMYCIN 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069098038</ndc>
    <ndc_label_name>Sutent 50 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069100101</ndc>
    <ndc_label_name>Xeljanz 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069100201</ndc>
    <ndc_label_name>Xeljanz 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069101101</ndc>
    <ndc_label_name>Panzyga 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069101102</ndc>
    <ndc_label_name>Panzyga 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069101415</ndc>
    <ndc_label_name>Bosulif 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069102901</ndc>
    <ndc_label_name>Xeljanz 1 mg/mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069102902</ndc>
    <ndc_label_name>Xeljanz 1 mg/mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069103130</ndc>
    <ndc_label_name>Talzenna 0.1 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069106101</ndc>
    <ndc_label_name>Cutaquig 16.5 % subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069106102</ndc>
    <ndc_label_name>Cutaquig 16.5 % subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069110901</ndc>
    <ndc_label_name>Panzyga 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069110902</ndc>
    <ndc_label_name>Panzyga 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069119530</ndc>
    <ndc_label_name>Talzenna 1 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069119830</ndc>
    <ndc_label_name>Vizimpro 30 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069122401</ndc>
    <ndc_label_name>Panzyga 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069122402</ndc>
    <ndc_label_name>Panzyga 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069123530</ndc>
    <ndc_label_name>Talzenna 0.35 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069130501</ndc>
    <ndc_label_name>Retacrit 2,000 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069130510</ndc>
    <ndc_label_name>Retacrit 2,000 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069130601</ndc>
    <ndc_label_name>Retacrit 3,000 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069130610</ndc>
    <ndc_label_name>Retacrit 3,000 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069130701</ndc>
    <ndc_label_name>Retacrit 4,000 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069130710</ndc>
    <ndc_label_name>Retacrit 4,000 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069130801</ndc>
    <ndc_label_name>Retacrit 10,000 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069130810</ndc>
    <ndc_label_name>Retacrit 10,000 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069130901</ndc>
    <ndc_label_name>Retacrit 40,000 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069130904</ndc>
    <ndc_label_name>Retacrit 40,000 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069131101</ndc>
    <ndc_label_name>Retacrit 20,000 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069131110</ndc>
    <ndc_label_name>Retacrit 20,000 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069131201</ndc>
    <ndc_label_name>Panzyga 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069131202</ndc>
    <ndc_label_name>Panzyga 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069131801</ndc>
    <ndc_label_name>Retacrit 20,000 unit/2 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069131810</ndc>
    <ndc_label_name>Retacrit 20,000 unit/2 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069141501</ndc>
    <ndc_label_name>Panzyga 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069141502</ndc>
    <ndc_label_name>Panzyga 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069144204</ndc>
    <ndc_label_name>DOXORUBICIN 200 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069147601</ndc>
    <ndc_label_name>Cutaquig 16.5 % subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069147602</ndc>
    <ndc_label_name>Cutaquig 16.5 % subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069150060</ndc>
    <ndc_label_name>Xalkori 150 mg oral pellets</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069150130</ndc>
    <ndc_label_name>Talzenna 0.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069150901</ndc>
    <ndc_label_name>Cutaquig 16.5 % subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069150902</ndc>
    <ndc_label_name>Cutaquig 16.5 % subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069152068</ndc>
    <ndc_label_name>Norvasc 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069153041</ndc>
    <ndc_label_name>Norvasc 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069153068</ndc>
    <ndc_label_name>Norvasc 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069153072</ndc>
    <ndc_label_name>Norvasc 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069153130</ndc>
    <ndc_label_name>Daurismo 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069154041</ndc>
    <ndc_label_name>Norvasc 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069154068</ndc>
    <ndc_label_name>Norvasc 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069154220</ndc>
    <ndc_label_name>DOXORUBICIN 200 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069155801</ndc>
    <ndc_label_name>Panzyga 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069155802</ndc>
    <ndc_label_name>Panzyga 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069175130</ndc>
    <ndc_label_name>Talzenna 0.75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069196501</ndc>
    <ndc_label_name>Cutaquig 16.5 % subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069196502</ndc>
    <ndc_label_name>Cutaquig 16.5 % subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069197512</ndc>
    <ndc_label_name>Vyndaqel 20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069197540</ndc>
    <ndc_label_name>Vyndaqel 20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069200404</ndc>
    <ndc_label_name>BEQVEZ 4 VIAL KIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069200505</ndc>
    <ndc_label_name>BEQVEZ 5 VIAL KIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069200606</ndc>
    <ndc_label_name>BEQVEZ 6 VIAL KIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069200707</ndc>
    <ndc_label_name>BEQVEZ 7 VIAL KIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069215101</ndc>
    <ndc_label_name>Hympavzi Pen 150 mg/mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069229930</ndc>
    <ndc_label_name>Vizimpro 45 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069236201</ndc>
    <ndc_label_name>COMIRNATY 2023-24(12Y UP) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069236210</ndc>
    <ndc_label_name>COMIRNATY 2023-24(12Y UP) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069237701</ndc>
    <ndc_label_name>COMIRNATY 2023-24(12Y UP) SYRG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069237710</ndc>
    <ndc_label_name>COMIRNATY 2023-24(12Y UP) SYRG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069243201</ndc>
    <ndc_label_name>COMIRNATY 2024-25(12Y UP) SYRG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069243210</ndc>
    <ndc_label_name>COMIRNATY 2024-25(12Y UP) SYRG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069246501</ndc>
    <ndc_label_name>Abrysvo (PF) 120 mcg/0.5 mL intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069246510</ndc>
    <ndc_label_name>Abrysvo (PF) 120 mcg/0.5 mL intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069246519</ndc>
    <ndc_label_name>Abrysvo (PF) 120 mcg/0.5 mL intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069250101</ndc>
    <ndc_label_name>Comirnaty 2025-2026(5-11Y)(PF) 10 mcg/0.3 mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069250110</ndc>
    <ndc_label_name>Comirnaty 2025-2026(5-11Y)(PF) 10 mcg/0.3 mL intramuscular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069252201</ndc>
    <ndc_label_name>Elrexfio 40 mg/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069252202</ndc>
    <ndc_label_name>Elrexfio 40 mg/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069252801</ndc>
    <ndc_label_name>Comirnaty 2025-26 (12y up)(PF) 30 mcg/0.3 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069252810</ndc>
    <ndc_label_name>Comirnaty 2025-26 (12y up)(PF) 30 mcg/0.3 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069265066</ndc>
    <ndc_label_name>Procardia XL 30 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069265072</ndc>
    <ndc_label_name>Procardia XL 30 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069266066</ndc>
    <ndc_label_name>Procardia XL 60 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069266072</ndc>
    <ndc_label_name>Procardia XL 60 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069267066</ndc>
    <ndc_label_name>PROCARDIA XL 90 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069303020</ndc>
    <ndc_label_name>DOXORUBICIN 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069303120</ndc>
    <ndc_label_name>DOXORUBICIN 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069303220</ndc>
    <ndc_label_name>DOXORUBICIN 50 MG/25 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069303420</ndc>
    <ndc_label_name>DOXORUBICIN 200 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069305101</ndc>
    <ndc_label_name>ZITHROMAX 1 GM POWDER PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069305107</ndc>
    <ndc_label_name>ZITHROMAX 1 GM POWDER PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069305175</ndc>
    <ndc_label_name>ZITHROMAX 1 GM POWDER PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069306075</ndc>
    <ndc_label_name>Zithromax Z-Pak 250 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069307030</ndc>
    <ndc_label_name>Zithromax 500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069307075</ndc>
    <ndc_label_name>Zithromax TRI-PAK 500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069311019</ndc>
    <ndc_label_name>ZITHROMAX 100 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069312019</ndc>
    <ndc_label_name>Zithromax 200 mg/5 mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069313019</ndc>
    <ndc_label_name>Zithromax 200 mg/5 mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069314019</ndc>
    <ndc_label_name>Zithromax 200 mg/5 mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069315083</ndc>
    <ndc_label_name>Zithromax 500 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069315084</ndc>
    <ndc_label_name>Zithromax 500 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069322066</ndc>
    <ndc_label_name>FELDENE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069323066</ndc>
    <ndc_label_name>Feldene 20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069335825</ndc>
    <ndc_label_name>DOXORUBICIN 50 MG/25 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069350001</ndc>
    <ndc_label_name>Zavzpret 10 mg/actuation nasal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069350002</ndc>
    <ndc_label_name>Zavzpret 10 mg/actuation nasal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069400405</ndc>
    <ndc_label_name>DOXORUBICIN 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069401510</ndc>
    <ndc_label_name>DOXORUBICIN 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069402625</ndc>
    <ndc_label_name>DOXORUBICIN 50 MG/25 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069403112</ndc>
    <ndc_label_name>DOXORUBICIN 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069403701</ndc>
    <ndc_label_name>DOXORUBICIN 200 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069406101</ndc>
    <ndc_label_name>Zithromax 250 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069406189</ndc>
    <ndc_label_name>Zithromax 250 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069419068</ndc>
    <ndc_label_name>Revatio 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069420030</ndc>
    <ndc_label_name>Viagra 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069420505</ndc>
    <ndc_label_name>DOXORUBICIN 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069421030</ndc>
    <ndc_label_name>Viagra 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069421066</ndc>
    <ndc_label_name>Viagra 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069422030</ndc>
    <ndc_label_name>Viagra 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069422066</ndc>
    <ndc_label_name>Viagra 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069449401</ndc>
    <ndc_label_name>Elrexfio 40 mg/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069449402</ndc>
    <ndc_label_name>Elrexfio 40 mg/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069504506</ndc>
    <ndc_label_name>Paxlovid 300 mg (150 mg x 2)-100 mg tablets in a dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069504530</ndc>
    <ndc_label_name>Paxlovid 300 mg (150 mg x 2)-100 mg tablets in a dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069531702</ndc>
    <ndc_label_name>Paxlovid 150 mg-100 mg tablets in a dose pack (Moderate Renal Dose)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069531720</ndc>
    <ndc_label_name>Paxlovid 150 mg-100 mg tablets in a dose pack (Moderate Renal Dose)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069532103</ndc>
    <ndc_label_name>Paxlovid 300 mg (150 mg x 2)-100 mg tablets in a dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069532130</ndc>
    <ndc_label_name>Paxlovid 300 mg (150 mg x 2)-100 mg tablets in a dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069541066</ndc>
    <ndc_label_name>VISTARIL 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069543402</ndc>
    <ndc_label_name>Paxlovid 150 mg-100 mg tablets in a dose pack (Moderate Renal Dose)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069543420</ndc>
    <ndc_label_name>Paxlovid 150 mg-100 mg tablets in a dose pack (Moderate Renal Dose)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069545011</ndc>
    <ndc_label_name>Paxlovid 150 mg(6)-100 mg(5) tablets in a dose pack(Severe Renal Dose)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069547101</ndc>
    <ndc_label_name>Cerebyx 100 mg PE/2 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069547102</ndc>
    <ndc_label_name>Cerebyx 100 mg PE/2 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069547401</ndc>
    <ndc_label_name>Cerebyx 500 mg PE/10 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069547402</ndc>
    <ndc_label_name>Cerebyx 500 mg PE/10 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069562905</ndc>
    <ndc_label_name>DOXORUBICIN 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069580060</ndc>
    <ndc_label_name>Tikosyn 125 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069580061</ndc>
    <ndc_label_name>Tikosyn 125 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069581060</ndc>
    <ndc_label_name>Tikosyn 250 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069581061</ndc>
    <ndc_label_name>Tikosyn 250 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069582060</ndc>
    <ndc_label_name>Tikosyn 500 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069582061</ndc>
    <ndc_label_name>Tikosyn 500 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069588624</ndc>
    <ndc_label_name>LEDERLE LEUCOVORIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00069588699</ndc>
    <ndc_label_name>LEDERLE LEUCOVORIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069600102</ndc>
    <ndc_label_name>Cerebyx 100 mg PE/2 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069600110</ndc>
    <ndc_label_name>Cerebyx 500 mg PE/10 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069600121</ndc>
    <ndc_label_name>Cerebyx 500 mg PE/10 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069600125</ndc>
    <ndc_label_name>Cerebyx 100 mg PE/2 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069600201</ndc>
    <ndc_label_name>Octagam 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069600202</ndc>
    <ndc_label_name>Octagam 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069611101</ndc>
    <ndc_label_name>Octagam 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069611102</ndc>
    <ndc_label_name>Octagam 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069618030</ndc>
    <ndc_label_name>Caduet 5 mg-10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069623701</ndc>
    <ndc_label_name>Octagam 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069623702</ndc>
    <ndc_label_name>Octagam 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069632330</ndc>
    <ndc_label_name>Caduet 5 mg-20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069633901</ndc>
    <ndc_label_name>Octagam 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069633902</ndc>
    <ndc_label_name>Octagam 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069655001</ndc>
    <ndc_label_name>Octagam 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069655002</ndc>
    <ndc_label_name>Octagam 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069656530</ndc>
    <ndc_label_name>Caduet 5 mg-40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069674730</ndc>
    <ndc_label_name>Caduet 5 mg-80 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069723230</ndc>
    <ndc_label_name>Caduet 10 mg-20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069747630</ndc>
    <ndc_label_name>Caduet 10 mg-80 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069765430</ndc>
    <ndc_label_name>Caduet 10 mg-40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069781030</ndc>
    <ndc_label_name>Caduet 10 mg-10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069814020</ndc>
    <ndc_label_name>Xalkori 250 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069814120</ndc>
    <ndc_label_name>Xalkori 200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069840001</ndc>
    <ndc_label_name>Octagam 5 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069840002</ndc>
    <ndc_label_name>Octagam 5 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069842501</ndc>
    <ndc_label_name>Octagam 5 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069842502</ndc>
    <ndc_label_name>Octagam 5 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069845101</ndc>
    <ndc_label_name>Octagam 5 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069845102</ndc>
    <ndc_label_name>Octagam 5 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069847601</ndc>
    <ndc_label_name>Octagam 5 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069847602</ndc>
    <ndc_label_name>Octagam 5 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069873001</ndc>
    <ndc_label_name>Vyndamax 61 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00069873030</ndc>
    <ndc_label_name>Vyndamax 61 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071000724</ndc>
    <ndc_label_name>Dilantin Infatabs 50 mg chewable tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071000740</ndc>
    <ndc_label_name>Dilantin Infatabs 50 mg chewable tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071015623</ndc>
    <ndc_label_name>Lipitor 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071015723</ndc>
    <ndc_label_name>Lipitor 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071022323</ndc>
    <ndc_label_name>ACCURETIC 20-25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071023724</ndc>
    <ndc_label_name>Zarontin 250 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071035060</ndc>
    <ndc_label_name>Nardil 15 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071036924</ndc>
    <ndc_label_name>Dilantin Extended 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071036932</ndc>
    <ndc_label_name>Dilantin Extended 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071036940</ndc>
    <ndc_label_name>Dilantin Extended 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071040124</ndc>
    <ndc_label_name>Neurontin 800 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071041724</ndc>
    <ndc_label_name>Nitrostat 0.3 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071041813</ndc>
    <ndc_label_name>Nitrostat 0.4 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071041824</ndc>
    <ndc_label_name>Nitrostat 0.4 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071041924</ndc>
    <ndc_label_name>Nitrostat 0.6 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071051324</ndc>
    <ndc_label_name>Neurontin 600 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00071052524</ndc>
    <ndc_label_name>Celontin 300 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071052723</ndc>
    <ndc_label_name>ACCUPRIL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071053023</ndc>
    <ndc_label_name>ACCUPRIL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071053223</ndc>
    <ndc_label_name>ACCUPRIL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071053523</ndc>
    <ndc_label_name>ACCUPRIL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071073720</ndc>
    <ndc_label_name>Lopid 600 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071073730</ndc>
    <ndc_label_name>Lopid 600 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071080324</ndc>
    <ndc_label_name>Neurontin 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071080524</ndc>
    <ndc_label_name>Neurontin 300 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071080624</ndc>
    <ndc_label_name>Neurontin 400 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071101268</ndc>
    <ndc_label_name>Lyrica 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071101341</ndc>
    <ndc_label_name>Lyrica 50 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071101368</ndc>
    <ndc_label_name>Lyrica 50 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071101441</ndc>
    <ndc_label_name>Lyrica 75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071101468</ndc>
    <ndc_label_name>Lyrica 75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071101541</ndc>
    <ndc_label_name>Lyrica 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071101568</ndc>
    <ndc_label_name>Lyrica 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071101641</ndc>
    <ndc_label_name>Lyrica 150 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071101668</ndc>
    <ndc_label_name>Lyrica 150 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071101768</ndc>
    <ndc_label_name>Lyrica 200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071101868</ndc>
    <ndc_label_name>Lyrica 300 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071101968</ndc>
    <ndc_label_name>Lyrica 225 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071102001</ndc>
    <ndc_label_name>Lyrica 20 mg/mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071102601</ndc>
    <ndc_label_name>Lyrica CR 82.5 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071102701</ndc>
    <ndc_label_name>Lyrica CR 165 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071102901</ndc>
    <ndc_label_name>Lyrica CR 330 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071201247</ndc>
    <ndc_label_name>Neurontin 250 mg/5 mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071221435</ndc>
    <ndc_label_name>Dilantin-125 125 mg/5 mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071241819</ndc>
    <ndc_label_name>Zarontin 250 mg/5 mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071311223</ndc>
    <ndc_label_name>ACCURETIC 10-12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071374066</ndc>
    <ndc_label_name>Dilantin 30 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00071521223</ndc>
    <ndc_label_name>ACCURETIC 20-12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074003807</ndc>
    <ndc_label_name>Orilissa 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074003828</ndc>
    <ndc_label_name>Orilissa 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074003914</ndc>
    <ndc_label_name>Orilissa 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074003956</ndc>
    <ndc_label_name>Orilissa 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074012402</ndc>
    <ndc_label_name>Humira(CF) Pen 80 mg/0.8 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074012403</ndc>
    <ndc_label_name>Humira(CF) Pen Crohn's-Ulc Colitis-Hid Sup Strt 80 mg/0.8 mL subcut kt</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074012474</ndc>
    <ndc_label_name>Humira(CF) Pen 80 mg/0.8 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074024001</ndc>
    <ndc_label_name>Pedialyte oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074024302</ndc>
    <ndc_label_name>Humira(CF) 40 mg/0.4 mL subcutaneous syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074024501</ndc>
    <ndc_label_name>Pedialyte Freezer Pops oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074050101</ndc>
    <ndc_label_name>Vyalev 12 mg-240 mg/mL continuous subcutaneous infusion solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074055402</ndc>
    <ndc_label_name>Humira(CF) Pen 40 mg/0.4 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074055471</ndc>
    <ndc_label_name>Humira(CF) Pen 40 mg/0.4 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074056111</ndc>
    <ndc_label_name>Venclexta 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074056114</ndc>
    <ndc_label_name>Venclexta 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074056607</ndc>
    <ndc_label_name>Venclexta 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074056611</ndc>
    <ndc_label_name>Venclexta 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074057611</ndc>
    <ndc_label_name>Venclexta 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074057622</ndc>
    <ndc_label_name>Venclexta 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074057630</ndc>
    <ndc_label_name>Venclexta 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074057928</ndc>
    <ndc_label_name>Venclexta Starting Pack 10 mg-50 mg-100 mg tablets in a dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074061602</ndc>
    <ndc_label_name>Humira(CF) 20 mg/0.2 mL subcutaneous syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074081702</ndc>
    <ndc_label_name>Humira(CF) 10 mg/0.1 mL subcutaneous syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074101756</ndc>
    <ndc_label_name>Oriahnn 300-1-0.5 mg(AM)/300 mg(PM) capsules</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074104004</ndc>
    <ndc_label_name>Survanta 25 mg/mL intratracheal suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074104008</ndc>
    <ndc_label_name>Survanta 25 mg/mL intratracheal suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074104328</ndc>
    <ndc_label_name>Rinvoq 45 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074104401</ndc>
    <ndc_label_name>Emrelis 20 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074105001</ndc>
    <ndc_label_name>Skyrizi 150 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074105501</ndc>
    <ndc_label_name>Emrelis 100 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074106501</ndc>
    <ndc_label_name>Skyrizi 180 mg/1.2 mL (150 mg/mL) subcutaneous wearable injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074106601</ndc>
    <ndc_label_name>Skyrizi 180 mg/1.2 mL (150 mg/mL) subcutaneous wearable injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074106901</ndc>
    <ndc_label_name>Skyrizi 360 mg/2.4 mL (150 mg/mL) subcutaneous wearable injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074107001</ndc>
    <ndc_label_name>Skyrizi 360 mg/2.4 mL (150 mg/mL) subcutaneous wearable injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074153903</ndc>
    <ndc_label_name>Humira(CF) Pen Ps-Uv-Adol HS 80 mg/0.8 mL(1)-40 mg/0.4 mL(2)subcut kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074157521</ndc>
    <ndc_label_name>Kaletra 100 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074165801</ndc>
    <ndc_label_name>Zemplar 5 mcg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074165805</ndc>
    <ndc_label_name>Zemplar 5 mcg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074210001</ndc>
    <ndc_label_name>Skyrizi 150 mg/mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074210803</ndc>
    <ndc_label_name>Lupron Depot-Ped 7.5 mg (Ped) intramuscular kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074228203</ndc>
    <ndc_label_name>Lupron Depot-Ped 11.25 mg intramuscular kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074230630</ndc>
    <ndc_label_name>Rinvoq 15 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074230670</ndc>
    <ndc_label_name>Rinvoq 15 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074231030</ndc>
    <ndc_label_name>Rinvoq 30 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074232001</ndc>
    <ndc_label_name>Rinvoq LQ 1 mg/mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074234030</ndc>
    <ndc_label_name>Norvir 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074244003</ndc>
    <ndc_label_name>Lupron Depot-Ped 15 mg intramuscular kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074260028</ndc>
    <ndc_label_name>Mavyret 50 mg-20 mg oral pellets in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074260521</ndc>
    <ndc_label_name>Kaletra 200 mg-50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074262501</ndc>
    <ndc_label_name>Mavyret 100 mg-40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074262504</ndc>
    <ndc_label_name>Mavyret 100 mg-40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074262528</ndc>
    <ndc_label_name>Mavyret 100 mg-40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074262584</ndc>
    <ndc_label_name>Mavyret 100 mg-40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074300860</ndc>
    <ndc_label_name>Kaletra 100 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074301207</ndc>
    <ndc_label_name>Duopa 4.63 mg-20 mg/mL suspension in j-tube pump</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074310832</ndc>
    <ndc_label_name>Gengraf 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074310932</ndc>
    <ndc_label_name>Gengraf 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074316190</ndc>
    <ndc_label_name>TRILIPIX DR 45 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074316290</ndc>
    <ndc_label_name>TRILIPIX DR 135 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074317390</ndc>
    <ndc_label_name>TRICOR 48 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074334603</ndc>
    <ndc_label_name>Lupron Depot 22.5 mg (3 month) intramuscular syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074339930</ndc>
    <ndc_label_name>Norvir 100 mg oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074347303</ndc>
    <ndc_label_name>Lupron Depot 45 mg (6 Month) intramuscular syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074357501</ndc>
    <ndc_label_name>Lupron Depot-Ped 45 mg intramuscular syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074364103</ndc>
    <ndc_label_name>Lupron Depot 3.75 mg intramuscular syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074364171</ndc>
    <ndc_label_name>Lupron Depot 3.75 mg intramuscular syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074364203</ndc>
    <ndc_label_name>Lupron Depot 7.5 mg intramuscular syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074366303</ndc>
    <ndc_label_name>Lupron Depot 11.25 mg (3 month) intramuscular syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074368303</ndc>
    <ndc_label_name>Lupron Depot 30 mg (4 month) intramuscular syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074372719</ndc>
    <ndc_label_name>Synthroid 137 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074372772</ndc>
    <ndc_label_name>Synthroid 137 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074372790</ndc>
    <ndc_label_name>Synthroid 137 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074377903</ndc>
    <ndc_label_name>Lupron Depot-Ped 11.25 mg (3 month) intramuscular syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074379902</ndc>
    <ndc_label_name>Humira 40 mg/0.8 mL subcutaneous syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074387801</ndc>
    <ndc_label_name>Emblaveo 2 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074387810</ndc>
    <ndc_label_name>Emblaveo 2 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074395646</ndc>
    <ndc_label_name>Kaletra 400 mg-100 mg/5 mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074401412</ndc>
    <ndc_label_name>Kaletra 200 mg-50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074433901</ndc>
    <ndc_label_name>Humira Pen 40 mg/0.8 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074433902</ndc>
    <ndc_label_name>Humira Pen 40 mg/0.8 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074433974</ndc>
    <ndc_label_name>Humira Pen 40 mg/0.8 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074434119</ndc>
    <ndc_label_name>Synthroid 25 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074434172</ndc>
    <ndc_label_name>Synthroid 25 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074434190</ndc>
    <ndc_label_name>Synthroid 25 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074445604</ndc>
    <ndc_label_name>Ultane 99.97 % inhalation liquid</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074445651</ndc>
    <ndc_label_name>Ultane 99.97 % inhalation liquid</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074455211</ndc>
    <ndc_label_name>Synthroid 50 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074455219</ndc>
    <ndc_label_name>Synthroid 50 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074455272</ndc>
    <ndc_label_name>Synthroid 50 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074455290</ndc>
    <ndc_label_name>Synthroid 50 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074463701</ndc>
    <ndc_label_name>Zemplar 2 mcg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074501501</ndc>
    <ndc_label_name>Skyrizi 60 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074517530</ndc>
    <ndc_label_name>Pedialyte oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074518211</ndc>
    <ndc_label_name>Synthroid 75 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074518219</ndc>
    <ndc_label_name>Synthroid 75 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074518272</ndc>
    <ndc_label_name>Synthroid 75 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074518290</ndc>
    <ndc_label_name>Synthroid 75 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074549820</ndc>
    <ndc_label_name>Pedialyte Singles oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074611413</ndc>
    <ndc_label_name>Depakote Sprinkles 125 mg capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074647032</ndc>
    <ndc_label_name>Pedialyte oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074647132</ndc>
    <ndc_label_name>Pedialyte oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074659419</ndc>
    <ndc_label_name>Synthroid 88 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074659472</ndc>
    <ndc_label_name>Synthroid 88 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074659490</ndc>
    <ndc_label_name>Synthroid 88 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074662411</ndc>
    <ndc_label_name>Synthroid 100 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074662419</ndc>
    <ndc_label_name>Synthroid 100 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074662472</ndc>
    <ndc_label_name>Synthroid 100 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074662490</ndc>
    <ndc_label_name>Synthroid 100 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074706811</ndc>
    <ndc_label_name>Synthroid 125 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074706819</ndc>
    <ndc_label_name>Synthroid 125 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074706872</ndc>
    <ndc_label_name>Synthroid 125 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074706890</ndc>
    <ndc_label_name>Synthroid 125 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074706911</ndc>
    <ndc_label_name>Synthroid 150 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074706919</ndc>
    <ndc_label_name>Synthroid 150 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074706972</ndc>
    <ndc_label_name>Synthroid 150 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074706990</ndc>
    <ndc_label_name>Synthroid 150 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074707019</ndc>
    <ndc_label_name>Synthroid 175 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074707090</ndc>
    <ndc_label_name>Synthroid 175 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074709404</ndc>
    <ndc_label_name>Qulipta 60 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074709430</ndc>
    <ndc_label_name>Qulipta 60 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074709530</ndc>
    <ndc_label_name>Qulipta 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00074709630</ndc>
    <ndc_label_name>Qulipta 30 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074709802</ndc>
    <ndc_label_name>Vuity 1.25 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074709804</ndc>
    <ndc_label_name>Vuity 1.25 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074709806</ndc>
    <ndc_label_name>Vuity 1.25 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074714811</ndc>
    <ndc_label_name>Synthroid 200 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074714819</ndc>
    <ndc_label_name>Synthroid 200 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074714890</ndc>
    <ndc_label_name>Synthroid 200 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074714919</ndc>
    <ndc_label_name>Synthroid 300 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074714990</ndc>
    <ndc_label_name>Synthroid 300 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074726950</ndc>
    <ndc_label_name>GENGRAF 100 MG/ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074732513</ndc>
    <ndc_label_name>Depakote 125 mg tablet,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074732613</ndc>
    <ndc_label_name>Depakote 250 mg tablet,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074732713</ndc>
    <ndc_label_name>Depakote 500 mg tablet,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074740113</ndc>
    <ndc_label_name>Depakote ER 250 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074740213</ndc>
    <ndc_label_name>Depakote ER 500 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074903630</ndc>
    <ndc_label_name>Zemplar 1 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074903730</ndc>
    <ndc_label_name>Zemplar 2 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074929619</ndc>
    <ndc_label_name>Synthroid 112 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074929672</ndc>
    <ndc_label_name>Synthroid 112 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074929690</ndc>
    <ndc_label_name>Synthroid 112 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00074969403</ndc>
    <ndc_label_name>Lupron Depot-Ped 30 mg (3 month) intramuscular syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075062001</ndc>
    <ndc_label_name>Lovenox 40 mg/0.4 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075062040</ndc>
    <ndc_label_name>Lovenox 40 mg/0.4 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075062101</ndc>
    <ndc_label_name>Lovenox 60 mg/0.6 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075062160</ndc>
    <ndc_label_name>Lovenox 60 mg/0.6 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075062201</ndc>
    <ndc_label_name>Lovenox 80 mg/0.8 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075062280</ndc>
    <ndc_label_name>Lovenox 80 mg/0.8 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075062300</ndc>
    <ndc_label_name>Lovenox 100 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075062303</ndc>
    <ndc_label_name>Lovenox 100 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075062401</ndc>
    <ndc_label_name>Lovenox 30 mg/0.3 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075062430</ndc>
    <ndc_label_name>Lovenox 30 mg/0.3 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075062603</ndc>
    <ndc_label_name>Lovenox 300 mg/3 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075291200</ndc>
    <ndc_label_name>Lovenox 120 mg/0.8 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075291201</ndc>
    <ndc_label_name>Lovenox 120 mg/0.8 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075291500</ndc>
    <ndc_label_name>Lovenox 150 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075291501</ndc>
    <ndc_label_name>Lovenox 150 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075801301</ndc>
    <ndc_label_name>Lovenox 30 mg/0.3 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075801310</ndc>
    <ndc_label_name>Lovenox 30 mg/0.3 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075801401</ndc>
    <ndc_label_name>Lovenox 40 mg/0.4 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075801410</ndc>
    <ndc_label_name>Lovenox 40 mg/0.4 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075801601</ndc>
    <ndc_label_name>Lovenox 60 mg/0.6 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075801610</ndc>
    <ndc_label_name>Lovenox 60 mg/0.6 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075801801</ndc>
    <ndc_label_name>Lovenox 80 mg/0.8 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075801810</ndc>
    <ndc_label_name>Lovenox 80 mg/0.8 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075802001</ndc>
    <ndc_label_name>Lovenox 100 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075802010</ndc>
    <ndc_label_name>Lovenox 100 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075802201</ndc>
    <ndc_label_name>Lovenox 120 mg/0.8 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075802210</ndc>
    <ndc_label_name>Lovenox 120 mg/0.8 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075802501</ndc>
    <ndc_label_name>Lovenox 150 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075802510</ndc>
    <ndc_label_name>Lovenox 150 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00075803001</ndc>
    <ndc_label_name>Lovenox 300 mg/3 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078010901</ndc>
    <ndc_label_name>Sandimmune 250 mg/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078010961</ndc>
    <ndc_label_name>Sandimmune 250 mg/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078011022</ndc>
    <ndc_label_name>SANDIMMUNE 100 MG/ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078018001</ndc>
    <ndc_label_name>Sandostatin 50 mcg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078018061</ndc>
    <ndc_label_name>Sandostatin 50 mcg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078018101</ndc>
    <ndc_label_name>Sandostatin 100 mcg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078018161</ndc>
    <ndc_label_name>Sandostatin 100 mcg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078018201</ndc>
    <ndc_label_name>Sandostatin 500 mcg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078018261</ndc>
    <ndc_label_name>Sandostatin 500 mcg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078024015</ndc>
    <ndc_label_name>Sandimmune 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078024061</ndc>
    <ndc_label_name>Sandimmune 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078024115</ndc>
    <ndc_label_name>Sandimmune 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078024161</ndc>
    <ndc_label_name>Sandimmune 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078024615</ndc>
    <ndc_label_name>Neoral 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078024661</ndc>
    <ndc_label_name>Neoral 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078024815</ndc>
    <ndc_label_name>Neoral 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078024861</ndc>
    <ndc_label_name>Neoral 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078024915</ndc>
    <ndc_label_name>Femara 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078027422</ndc>
    <ndc_label_name>Neoral 100 mg/mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078031434</ndc>
    <ndc_label_name>Diovan HCT 80 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078031534</ndc>
    <ndc_label_name>Diovan HCT 160 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078033184</ndc>
    <ndc_label_name>Simulect 20 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078033705</ndc>
    <ndc_label_name>Trileptal 300 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078034342</ndc>
    <ndc_label_name>Vivelle-Dot 0.0375 mg/24 hr transdermal patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078034442</ndc>
    <ndc_label_name>Vivelle-Dot 0.05 mg/24 hr transdermal patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078034542</ndc>
    <ndc_label_name>Vivelle-Dot 0.075 mg/24 hr transdermal patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078034642</ndc>
    <ndc_label_name>Vivelle-Dot 0.1 mg/24 hr transdermal patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078035415</ndc>
    <ndc_label_name>Lescol XL 80 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078035752</ndc>
    <ndc_label_name>Trileptal 300 mg/5 mL (60 mg/mL) oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078035834</ndc>
    <ndc_label_name>Diovan 80 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078035934</ndc>
    <ndc_label_name>Diovan 160 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078036034</ndc>
    <ndc_label_name>Diovan 320 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078036405</ndc>
    <ndc_label_name>Lotrel 10 mg-20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078036542</ndc>
    <ndc_label_name>Vivelle-Dot 0.025 mg/24 hr transdermal patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078036562</ndc>
    <ndc_label_name>Vivelle-Dot 0.025 mg/24 hr transdermal patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078037005</ndc>
    <ndc_label_name>RITALIN LA 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078037105</ndc>
    <ndc_label_name>RITALIN LA 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078037205</ndc>
    <ndc_label_name>RITALIN LA 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078037905</ndc>
    <ndc_label_name>Lotrel 10 mg-40 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078038005</ndc>
    <ndc_label_name>Focalin 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078038105</ndc>
    <ndc_label_name>Focalin 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078038205</ndc>
    <ndc_label_name>Focalin 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078038334</ndc>
    <ndc_label_name>Diovan HCT 160 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078038566</ndc>
    <ndc_label_name>Myfortic 180 mg tablet,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078038666</ndc>
    <ndc_label_name>Myfortic 360 mg tablet,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078039361</ndc>
    <ndc_label_name>Simulect 10 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078040134</ndc>
    <ndc_label_name>Gleevec 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078040505</ndc>
    <ndc_label_name>Lotrel 5 mg-10 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078040605</ndc>
    <ndc_label_name>Lotrel 5 mg-20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078041420</ndc>
    <ndc_label_name>Zortress 0.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078041461</ndc>
    <ndc_label_name>Zortress 0.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078041520</ndc>
    <ndc_label_name>Zortress 0.75 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078041561</ndc>
    <ndc_label_name>Zortress 0.75 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078041720</ndc>
    <ndc_label_name>Zortress 0.25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078041761</ndc>
    <ndc_label_name>Zortress 0.25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078042220</ndc>
    <ndc_label_name>Zortress 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078042261</ndc>
    <ndc_label_name>Zortress 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078042315</ndc>
    <ndc_label_name>Diovan 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078042405</ndc>
    <ndc_label_name>RITALIN LA 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078043005</ndc>
    <ndc_label_name>Focalin XR 5 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078043105</ndc>
    <ndc_label_name>Focalin XR 10 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078043205</ndc>
    <ndc_label_name>Focalin XR 20 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078043305</ndc>
    <ndc_label_name>Focalin XR 30 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078043405</ndc>
    <ndc_label_name>Focalin XR 40 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078043561</ndc>
    <ndc_label_name>Reclast 5 mg/100 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078043905</ndc>
    <ndc_label_name>Ritalin 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078044005</ndc>
    <ndc_label_name>Ritalin 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078044105</ndc>
    <ndc_label_name>Ritalin 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078045605</ndc>
    <ndc_label_name>Trileptal 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078045705</ndc>
    <ndc_label_name>Trileptal 600 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078046761</ndc>
    <ndc_label_name>Desferal 500 mg solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078046791</ndc>
    <ndc_label_name>Desferal 500 mg solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078046815</ndc>
    <ndc_label_name>Exjade 125 mg dispersible tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078046915</ndc>
    <ndc_label_name>Exjade 250 mg dispersible tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078047015</ndc>
    <ndc_label_name>Exjade 500 mg dispersible tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078047134</ndc>
    <ndc_label_name>Diovan HCT 320 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078047234</ndc>
    <ndc_label_name>Diovan HCT 320 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078048815</ndc>
    <ndc_label_name>Exforge 5 mg-160 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078048915</ndc>
    <ndc_label_name>Exforge 10 mg-160 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078049015</ndc>
    <ndc_label_name>Exforge 5 mg-320 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078049115</ndc>
    <ndc_label_name>Exforge 10 mg-320 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078049305</ndc>
    <ndc_label_name>Focalin XR 15 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078050115</ndc>
    <ndc_label_name>Exelon Patch 4.6 mg/24 hour transdermal</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078050161</ndc>
    <ndc_label_name>Exelon Patch 4.6 mg/24 hour transdermal</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078050215</ndc>
    <ndc_label_name>Exelon Patch 9.5 mg/24 hour transdermal</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078050261</ndc>
    <ndc_label_name>Exelon Patch 9.5 mg/24 hour transdermal</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078050315</ndc>
    <ndc_label_name>Exelon Patch 13.3 mg/24 hour transdermal</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078050361</ndc>
    <ndc_label_name>Exelon Patch 13.3 mg/24 hour transdermal</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078050883</ndc>
    <ndc_label_name>Tegretol 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078050905</ndc>
    <ndc_label_name>Tegretol 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078051005</ndc>
    <ndc_label_name>Tegretol XR 100 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078051105</ndc>
    <ndc_label_name>Tegretol XR 200 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078051205</ndc>
    <ndc_label_name>Tegretol XR 400 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078052651</ndc>
    <ndc_label_name>Tasigna 200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078052687</ndc>
    <ndc_label_name>Tasigna 200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078055915</ndc>
    <ndc_label_name>Exforge HCT 5 mg-160 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078056015</ndc>
    <ndc_label_name>Exforge HCT 5 mg-160 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078056115</ndc>
    <ndc_label_name>Exforge HCT 10 mg-160 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078056215</ndc>
    <ndc_label_name>Exforge HCT 10 mg-160 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078056315</ndc>
    <ndc_label_name>Exforge HCT 10 mg-320 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078056651</ndc>
    <ndc_label_name>Afinitor 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078056661</ndc>
    <ndc_label_name>Afinitor 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078056751</ndc>
    <ndc_label_name>Afinitor 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078056761</ndc>
    <ndc_label_name>Afinitor 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078056845</ndc>
    <ndc_label_name>Coartem 20 mg-120 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078059251</ndc>
    <ndc_label_name>Tasigna 150 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078059287</ndc>
    <ndc_label_name>Tasigna 150 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078059451</ndc>
    <ndc_label_name>Afinitor 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078059461</ndc>
    <ndc_label_name>Afinitor 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078060715</ndc>
    <ndc_label_name>Gilenya 0.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078060789</ndc>
    <ndc_label_name>Gilenya 0.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078060805</ndc>
    <ndc_label_name>Focalin XR 25 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078060905</ndc>
    <ndc_label_name>Focalin XR 35 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078062051</ndc>
    <ndc_label_name>Afinitor 7.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078062061</ndc>
    <ndc_label_name>Afinitor 7.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078062651</ndc>
    <ndc_label_name>Afinitor Disperz 2 mg tablet for oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078062661</ndc>
    <ndc_label_name>Afinitor Disperz 2 mg tablet for oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078062751</ndc>
    <ndc_label_name>Afinitor Disperz 3 mg tablet for oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078062761</ndc>
    <ndc_label_name>Afinitor Disperz 3 mg tablet for oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078062851</ndc>
    <ndc_label_name>Afinitor Disperz 5 mg tablet for oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078062861</ndc>
    <ndc_label_name>Afinitor Disperz 5 mg tablet for oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078063019</ndc>
    <ndc_label_name>Tobi Podhaler 28 mg capsule with inhalation device</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078063941</ndc>
    <ndc_label_name>Cosentyx Pen 300 mg/2 pens (150 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078063968</ndc>
    <ndc_label_name>Cosentyx Pen 150 mg/mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078063997</ndc>
    <ndc_label_name>Cosentyx 150 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078063998</ndc>
    <ndc_label_name>Cosentyx 300 mg/2 Syringes (150 mg/mL) subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078064515</ndc>
    <ndc_label_name>Odomzo 200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078064913</ndc>
    <ndc_label_name>Gleevec 400 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078064926</ndc>
    <ndc_label_name>Gleevec 400 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078064930</ndc>
    <ndc_label_name>Gleevec 400 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078065415</ndc>
    <ndc_label_name>Jadenu 90 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078065515</ndc>
    <ndc_label_name>Jadenu 180 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078065615</ndc>
    <ndc_label_name>Jadenu 360 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078065920</ndc>
    <ndc_label_name>Entresto 24 mg-26 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078065967</ndc>
    <ndc_label_name>Entresto 24 mg-26 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078066913</ndc>
    <ndc_label_name>Arzerra 100 mg/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078066961</ndc>
    <ndc_label_name>Arzerra 100 mg/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078067119</ndc>
    <ndc_label_name>Tykerb 250 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078067201</ndc>
    <ndc_label_name>Hycamtin 0.25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078067301</ndc>
    <ndc_label_name>Hycamtin 1 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078068166</ndc>
    <ndc_label_name>Tafinlar 75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078068266</ndc>
    <ndc_label_name>Tafinlar 50 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078068361</ndc>
    <ndc_label_name>Arranon 5 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078068415</ndc>
    <ndc_label_name>Promacta 12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078068515</ndc>
    <ndc_label_name>Promacta 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078068615</ndc>
    <ndc_label_name>Promacta 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078068655</ndc>
    <ndc_label_name>Promacta 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078068715</ndc>
    <ndc_label_name>Promacta 75 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078069061</ndc>
    <ndc_label_name>Arzerra 1,000 mg/50 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078069484</ndc>
    <ndc_label_name>Zykadia 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078069620</ndc>
    <ndc_label_name>Entresto 97 mg-103 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078069667</ndc>
    <ndc_label_name>Entresto 97 mg-103 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078069719</ndc>
    <ndc_label_name>Promacta 25 mg oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078069723</ndc>
    <ndc_label_name>Promacta 25 mg oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078069761</ndc>
    <ndc_label_name>Promacta 25 mg oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078069802</ndc>
    <ndc_label_name>Rydapt 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078069819</ndc>
    <ndc_label_name>Rydapt 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078069851</ndc>
    <ndc_label_name>Rydapt 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078069899</ndc>
    <ndc_label_name>Rydapt 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078070151</ndc>
    <ndc_label_name>Piqray 200 mg/day (200 mg x 1) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078070184</ndc>
    <ndc_label_name>Piqray 200 mg/day (200 mg x 1) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078070802</ndc>
    <ndc_label_name>Piqray 300 mg/day (150 mg x 2) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078070851</ndc>
    <ndc_label_name>Piqray 300 mg/day (150 mg x 2) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078070890</ndc>
    <ndc_label_name>Piqray 300 mg/day (150 mg x 2) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078070891</ndc>
    <ndc_label_name>Piqray 300 mg/day (150 mg x 2) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078070956</ndc>
    <ndc_label_name>Tabrecta 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078071315</ndc>
    <ndc_label_name>Jadenu Sprinkle 180 mg oral granules in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078071319</ndc>
    <ndc_label_name>Jadenu Sprinkle 180 mg oral granules in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078071502</ndc>
    <ndc_label_name>Piqray 250 mg/day (200 mg x 1 and 50 mg x 1) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078071561</ndc>
    <ndc_label_name>Piqray 250 mg/day (200 mg x 1 and 50 mg x 1) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078071591</ndc>
    <ndc_label_name>Piqray 250 mg/day (200 mg x 1 and 50 mg x 1) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078071594</ndc>
    <ndc_label_name>Piqray 250 mg/day (200 mg x 1 and 50 mg x 1) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078071656</ndc>
    <ndc_label_name>Tabrecta 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078072015</ndc>
    <ndc_label_name>Jadenu Sprinkle 360 mg oral granules in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078072019</ndc>
    <ndc_label_name>Jadenu Sprinkle 360 mg oral granules in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078072210</ndc>
    <ndc_label_name>Azopt 1 % eye drops,suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078072215</ndc>
    <ndc_label_name>Azopt 1 % eye drops,suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078072715</ndc>
    <ndc_label_name>Jadenu Sprinkle 90 mg oral granules in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078072719</ndc>
    <ndc_label_name>Jadenu Sprinkle 90 mg oral granules in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078072910</ndc>
    <ndc_label_name>Betoptic S 0.25 % eye drops,suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078072915</ndc>
    <ndc_label_name>Betoptic S 0.25 % eye drops,suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078073461</ndc>
    <ndc_label_name>Ilaris (PF) 150 mg/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078073610</ndc>
    <ndc_label_name>ALOMIDE 0.1% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078074303</ndc>
    <ndc_label_name>Ilevro 0.3 % eye drops,suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078077101</ndc>
    <ndc_label_name>MAXITROL EYE OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078077720</ndc>
    <ndc_label_name>Entresto 49 mg-51 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078077767</ndc>
    <ndc_label_name>Entresto 49 mg-51 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078077803</ndc>
    <ndc_label_name>Nevanac 0.1 % eye drops,suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078079061</ndc>
    <ndc_label_name>Sandostatin LAR Depot 10 mg intramuscular susp,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078079205</ndc>
    <ndc_label_name>Maxitrol 3.5 mg/mL-10,000 unit/mL-0.1% eye drops,suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078079761</ndc>
    <ndc_label_name>Sandostatin LAR Depot 20 mg intramuscular susp,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078080461</ndc>
    <ndc_label_name>Sandostatin LAR Depot 30 mg intramuscular susp,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078081181</ndc>
    <ndc_label_name>Sandostatin LAR Depot 10 mg intramuscular susp,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078081301</ndc>
    <ndc_label_name>Tobrex 0.3 % eye ointment</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078081881</ndc>
    <ndc_label_name>Sandostatin LAR Depot 20 mg intramuscular susp,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078082581</ndc>
    <ndc_label_name>Sandostatin LAR Depot 30 mg intramuscular susp,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078082760</ndc>
    <ndc_label_name>Beovu 6 mg/0.05 mL intravitreal syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078084101</ndc>
    <ndc_label_name>Ciloxan 0.3 % eye ointment</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078084619</ndc>
    <ndc_label_name>Kymriah 0.2 x 10exp6 to 2.5 x 10exp8 cell intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078085526</ndc>
    <ndc_label_name>Cipro HC 0.2 %-1 % ear drops,suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078086001</ndc>
    <ndc_label_name>Kisqali 200 mg/day (200 mg x 1) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078086225</ndc>
    <ndc_label_name>Durezol 0.05 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078086714</ndc>
    <ndc_label_name>Kisqali 400 mg/day (200 mg x 2) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078086742</ndc>
    <ndc_label_name>Kisqali 400 mg/day (200 mg x 2) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078087421</ndc>
    <ndc_label_name>Kisqali 600 mg/day (200 mg x 3) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078087463</ndc>
    <ndc_label_name>Kisqali 600 mg/day (200 mg x 3) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078087601</ndc>
    <ndc_label_name>TobraDex 0.3 %-0.1 % eye ointment</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078088361</ndc>
    <ndc_label_name>Adakveo 10 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078088821</ndc>
    <ndc_label_name>Kisqali 200 mg/day (200 mg x 1) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078089514</ndc>
    <ndc_label_name>Kisqali 400 mg/day (200 mg x 2) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078089778</ndc>
    <ndc_label_name>Triesence (PF) 40 mg/mL intraocular suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078090221</ndc>
    <ndc_label_name>Kisqali 600 mg/day (200 mg x 3) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078090961</ndc>
    <ndc_label_name>KISQALI FEMARA 200 MG CO-PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078091105</ndc>
    <ndc_label_name>Xiidra 5 % eye drops in a dropperette</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078091112</ndc>
    <ndc_label_name>Xiidra 5 % eye drops in a dropperette</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078091661</ndc>
    <ndc_label_name>KISQALI FEMARA 400 MG CO-PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078092361</ndc>
    <ndc_label_name>KISQALI FEMARA 600 MG CO-PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078092525</ndc>
    <ndc_label_name>Maxidex 0.1 % eye drops,suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078093791</ndc>
    <ndc_label_name>Egaten 250 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078093926</ndc>
    <ndc_label_name>Vigamox 0.5 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078094625</ndc>
    <ndc_label_name>Travatan Z 0.004 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078094640</ndc>
    <ndc_label_name>Travatan Z 0.004 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078095166</ndc>
    <ndc_label_name>Tasigna 50 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078095819</ndc>
    <ndc_label_name>Kymriah 0.6 x 10exp8 to 6 x10exp8 cell intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078096589</ndc>
    <ndc_label_name>Gilenya 0.25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078097219</ndc>
    <ndc_label_name>Promacta 12.5 mg oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078097223</ndc>
    <ndc_label_name>Promacta 12.5 mg oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078097261</ndc>
    <ndc_label_name>Promacta 12.5 mg oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078097912</ndc>
    <ndc_label_name>Mayzent Starter Pack (for 2 mg maint dose) 0.25 mg (12 tabs) tablets</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078097950</ndc>
    <ndc_label_name>Mayzent 0.25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078097989</ndc>
    <ndc_label_name>Mayzent Starter Pack (for 1 mg maint dose) 0.25 mg (7 tabs) tablets</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078098615</ndc>
    <ndc_label_name>Mayzent 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078098645</ndc>
    <ndc_label_name>Mayzent 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078100060</ndc>
    <ndc_label_name>Leqvio 284 mg/1.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078100098</ndc>
    <ndc_label_name>Leqvio 284 mg/1.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078100768</ndc>
    <ndc_label_name>Kesimpta Pen 20 mg/0.4 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00078100798</ndc>
    <ndc_label_name>Kesimpta Pen 20 mg/0.4 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078101415</ndc>
    <ndc_label_name>Mayzent 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078102151</ndc>
    <ndc_label_name>Vijoice 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078102184</ndc>
    <ndc_label_name>Vijoice 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078102851</ndc>
    <ndc_label_name>Vijoice 125 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078102884</ndc>
    <ndc_label_name>Vijoice 125 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078103502</ndc>
    <ndc_label_name>Vijoice 250 mg/day(200 mg x 1 and 50 mg x 1) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078103561</ndc>
    <ndc_label_name>Vijoice 250 mg/day(200 mg x 1 and 50 mg x 1) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078105697</ndc>
    <ndc_label_name>Cosentyx 75 mg/0.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078107068</ndc>
    <ndc_label_name>Cosentyx UnoReady Pen 300 mg/2 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078107096</ndc>
    <ndc_label_name>Cosentyx UnoReady Pen 300 mg/2 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078107766</ndc>
    <ndc_label_name>Votrient 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078109120</ndc>
    <ndc_label_name>Scemblix 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078109820</ndc>
    <ndc_label_name>Scemblix 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078110515</ndc>
    <ndc_label_name>Mekinist 0.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078111215</ndc>
    <ndc_label_name>Mekinist 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078115421</ndc>
    <ndc_label_name>Tafinlar 10 mg tablet for oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078116147</ndc>
    <ndc_label_name>Mekinist 0.05 mg/mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078116861</ndc>
    <ndc_label_name>Cosentyx 25 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078117519</ndc>
    <ndc_label_name>Vijoice 50 mg oral granules in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078117551</ndc>
    <ndc_label_name>Vijoice 50 mg oral granules in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078118920</ndc>
    <ndc_label_name>Fabhalta 200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078119620</ndc>
    <ndc_label_name>Scemblix 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078121761</ndc>
    <ndc_label_name>Pluvicto 27 mCi/mL (1,000 MBq/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078122461</ndc>
    <ndc_label_name>Locametz 25 mcg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078123120</ndc>
    <ndc_label_name>Entresto Sprinkle 6 mg-6 mg oral pellet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078123820</ndc>
    <ndc_label_name>Entresto Sprinkle 15 mg-16 mg oral pellet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078142015</ndc>
    <ndc_label_name>Vanrafia 0.75 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00078148320</ndc>
    <ndc_label_name>Rhapsido 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00081073794</ndc>
    <ndc_label_name>Neosporin Plus Pain Relief 3.5 mg-10,000 unit-10 mg/gram topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00081079888</ndc>
    <ndc_label_name>Polysporin 500 unit-10,000 unit/gram topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00085052201</ndc>
    <ndc_label_name>Coricidin HBP Cold and Flu 2 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00085052202</ndc>
    <ndc_label_name>Coricidin HBP Cold and Flu 2 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00085096315</ndc>
    <ndc_label_name>Lotrimin AF (clotrimazole) 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00085126001</ndc>
    <ndc_label_name>Gyne-Lotrimin 2 % vaginal cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00085132801</ndc>
    <ndc_label_name>NOXAFIL 40 MG/ML SUSPENSION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00085138101</ndc>
    <ndc_label_name>Temodar 100 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00085222401</ndc>
    <ndc_label_name>Noxafil 300 mg oral suspension,delayed release in a packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00085222402</ndc>
    <ndc_label_name>Noxafil 300 mg oral suspension,delayed release in a packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00085410025</ndc>
    <ndc_label_name>Complex 15 topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00085411508</ndc>
    <ndc_label_name>Complex 15 lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00085432402</ndc>
    <ndc_label_name>NOXAFIL DR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00085433101</ndc>
    <ndc_label_name>Noxafil 300 mg/16.7 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087020125</ndc>
    <ndc_label_name>Enfamil A.R. 2.5-5.1-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087020142</ndc>
    <ndc_label_name>Enfamil A.R. 2.5-5.1-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087020165</ndc>
    <ndc_label_name>Enfamil A.R. 2.5-5.1-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087036701</ndc>
    <ndc_label_name>Pregestimil 2.8-5.6-10.2 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087036721</ndc>
    <ndc_label_name>Pregestimil 2.8-5.6-10.2 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00087040203</ndc>
    <ndc_label_name>Poly-Vi-Sol 250 mcg-50 mg-10 mcg/mL oral drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00087040303</ndc>
    <ndc_label_name>Tri-Vi-Sol 250 mcg-50 mg-10 mcg/mL oral drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00087040501</ndc>
    <ndc_label_name>Poly-Vi-Sol with Iron 11 mg iron/mL oral drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087042541</ndc>
    <ndc_label_name>Product 3232A 22 g-33 g-14.8 mg/100 g oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087049801</ndc>
    <ndc_label_name>Nutramigen DHA-ARA 2.8 gram-5.3 gram-10.3 gram/100 kcal oral conc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087049811</ndc>
    <ndc_label_name>Nutramigen DHA-ARA 2.8 gram-5.3 gram-10.3 gram/100 kcal oral conc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087074002</ndc>
    <ndc_label_name>Fer-In-Sol 15 mg iron (75 mg)/mL oral drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087086644</ndc>
    <ndc_label_name>D-Vi-Sol 10 mcg/mL (400 unit/mL) oral drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087119541</ndc>
    <ndc_label_name>Enfamil ProSobee LIPIL oral concentrate</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087121401</ndc>
    <ndc_label_name>Enfamil Prosobee 2.5 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087121441</ndc>
    <ndc_label_name>Enfamil Prosobee 2.5 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087121442</ndc>
    <ndc_label_name>Enfamil Prosobee 2.5 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087121447</ndc>
    <ndc_label_name>Enfamil Prosobee 2.5 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087123901</ndc>
    <ndc_label_name>Nutramigen with Enflora LGG 2.8 g-5.3 g-10.3 g/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087123905</ndc>
    <ndc_label_name>Nutramigen with Enflora LGG 2.8 g-5.3 g-10.3 g/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087123941</ndc>
    <ndc_label_name>Nutramigen with Enflora LGG 2.8 g-5.3 g-10.3 g/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087123945</ndc>
    <ndc_label_name>Nutramigen with Enflora LGG 2.8 g-5.3 g-10.3 g/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087134541</ndc>
    <ndc_label_name>Enfamil Water oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087134641</ndc>
    <ndc_label_name>Enfamil Glucose 5 % oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087136542</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087136560</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087136561</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087136567</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087136641</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087136741</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral concentrate</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087143301</ndc>
    <ndc_label_name>Pregestimil 2.8-5.6 gram/100 kcal (5 oz) oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087143341</ndc>
    <ndc_label_name>Pregestimil 2.8-5.6 gram/100 kcal (5 oz) oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087143401</ndc>
    <ndc_label_name>Pregestimil 2.8-5.6 gram/100 kcal (4.2oz) oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087143441</ndc>
    <ndc_label_name>Pregestimil 2.8-5.6 gram/100 kcal (4.2oz) oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087143741</ndc>
    <ndc_label_name>Nutramigen DHA-ARA 2.8-5.3-10.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087144941</ndc>
    <ndc_label_name>Enfamil ProSobee LIPIL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087145341</ndc>
    <ndc_label_name>Enfamil A.R. 2.5 gram-5.1 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087146341</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.55 gram-7.5 kcal/5 mL oral liquid pack</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087146441</ndc>
    <ndc_label_name>Enfamil Gentlease 2.3 gram-5.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087146701</ndc>
    <ndc_label_name>Enfagrow Toddler Next Step Non-GMO 6 gram-160 kcal/36 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087146741</ndc>
    <ndc_label_name>Enfagrow Toddler Next Step Non-GMO 6 gram-160 kcal/36 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087201448</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.275 gram-3.5 kcal/0.71 gram oral pwd pk</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510003</ndc>
    <ndc_label_name>Phenyl-Free 2 PKU 22 gram-410 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510010</ndc>
    <ndc_label_name>Phenyl-Free 2HP PKU 40 gram-390 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510015</ndc>
    <ndc_label_name>BCAD 2  24 gram-410 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510018</ndc>
    <ndc_label_name>PFD 2 400 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510022</ndc>
    <ndc_label_name>OA2 Powder 21 gram-410 kcal/100 gram oral</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510024</ndc>
    <ndc_label_name>Tyros 2, 22 gram-410 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510027</ndc>
    <ndc_label_name>HCY 2  22 gram-410 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510029</ndc>
    <ndc_label_name>WND 2 8.2 g-410 kcal/100 g oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510069</ndc>
    <ndc_label_name>Enfamil Gentlease 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510096</ndc>
    <ndc_label_name>Enfamil A.R. 2.5-5.1-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510107</ndc>
    <ndc_label_name>Enfamil Gentlease 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510172</ndc>
    <ndc_label_name>Phenyl-Free 1 16.2 gram-500 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510178</ndc>
    <ndc_label_name>PFD Toddler 530 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510179</ndc>
    <ndc_label_name>PFD Toddler 530 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510184</ndc>
    <ndc_label_name>BCAD 1 16.2 g-500 kcal/100 g oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510188</ndc>
    <ndc_label_name>GA Powder 15.1 g-500 kcal/100 g oral</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510191</ndc>
    <ndc_label_name>TYROS 1 16.7 g-500 kcal/100 g oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510196</ndc>
    <ndc_label_name>LMD Powder 16.2 gram-500 kcal/100 gram oral</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510199</ndc>
    <ndc_label_name>OA 1 Powder 15.7 g-500 kcal/100 g oral</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510202</ndc>
    <ndc_label_name>HCY 1 Powder 16.2 g-500 kcal/100 g oral</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510205</ndc>
    <ndc_label_name>WND 1 6.5 g-500 kcal/100 g oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510242</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510341</ndc>
    <ndc_label_name>Enfamil Gentlease 2.3 gram-5.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510480</ndc>
    <ndc_label_name>PurAmino DHA-ARA 2.8-5.3-10.6 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510517</ndc>
    <ndc_label_name>Nutramigen DHA-ARA 2.8-5.3-10.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510523</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral liq</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510524</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral liq</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510525</ndc>
    <ndc_label_name>Enfaport 3.5-5.5-10 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510734</ndc>
    <ndc_label_name>Nutramigen Toddler Enflora-LGG 2.5 gram-4.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087510735</ndc>
    <ndc_label_name>Nutramigen Toddler Enflora-LGG 2.5 gram-4.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511132</ndc>
    <ndc_label_name>Enfamil Reguline 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511133</ndc>
    <ndc_label_name>Enfamil Reguline 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511157</ndc>
    <ndc_label_name>Enfamil Reguline 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511158</ndc>
    <ndc_label_name>Enfamil Reguline 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511413</ndc>
    <ndc_label_name>Enfagrow Toddler Non-Gmo 6 gram-160 kcal/36 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00087511503</ndc>
    <ndc_label_name>Enfamil Enfalyte oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511562</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral liq</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511563</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral liq</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511564</ndc>
    <ndc_label_name>Nutramigen DHA-ARA 2.8-5.3-10.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511565</ndc>
    <ndc_label_name>Nutramigen DHA-ARA 2.8-5.3-10.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511568</ndc>
    <ndc_label_name>Enfamil Premature 24 3.3 gram-5 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511570</ndc>
    <ndc_label_name>Enfamil Premature 20 3.3 gram-5 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511572</ndc>
    <ndc_label_name>Enfamil Premature 30 3.3 gram-5 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511574</ndc>
    <ndc_label_name>Enfamil Premature 24 3.6 gram-5 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511728</ndc>
    <ndc_label_name>Portagen 16.5 gram-470 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511748</ndc>
    <ndc_label_name>Enfamil Enspire Infant Formula 2.1 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511751</ndc>
    <ndc_label_name>Enfagrow NeuroPro Toddler Non-GMO 0.03 gram-0.7 kcal/mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511752</ndc>
    <ndc_label_name>Enfagrow NeuroPro Toddler Non-GMO 0.03 gram-0.7 kcal/mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511961</ndc>
    <ndc_label_name>Enfagrow NeuroPro Toddler Non-GMO 0.03 gram-0.7 kcal/mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511963</ndc>
    <ndc_label_name>Enfagrow NeuroPro Toddler Non-GMO 0.03 gram-0.7 kcal/mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511976</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511977</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511978</ndc>
    <ndc_label_name>Enfamil Gentlease 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087511979</ndc>
    <ndc_label_name>Enfamil Gentlease 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512105</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512106</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512107</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512108</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512109</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512110</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512111</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512112</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512113</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3-5.3 gram/100 kcal oral pwdr pkt</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512114</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3-5.3 gram/100 kcal oral pwdr pkt</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512117</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512118</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512119</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512120</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512121</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512122</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512125</ndc>
    <ndc_label_name>Enfamil Gentlease 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512126</ndc>
    <ndc_label_name>Enfamil Gentlease 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512127</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512128</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512129</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512131</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512133</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512134</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512141</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512143</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512154</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512155</ndc>
    <ndc_label_name>Enfamil Infant 2 gram-5.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512203</ndc>
    <ndc_label_name>Enfamil NeuroPro EnfaCare Non-GMO 2.8 gram-5.3 gram/100 kcal liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512205</ndc>
    <ndc_label_name>Enfamil NeuroPro EnfaCare Non-GMO 2.8 gram-5.3 gram/100 kcal liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512206</ndc>
    <ndc_label_name>Enfamil NeuroPro EnfaCare Non-GMO 2.8 gram-5.3 gram/100 kcal oral pwdr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512207</ndc>
    <ndc_label_name>Enfamil NeuroPro EnfaCare Non-GMO 2.8 gram-5.3 gram/100 kcal oral pwdr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512208</ndc>
    <ndc_label_name>Enfamil NeuroPro EnfaCare Non-GMO 2.8 gram-5.3 gram/100 kcal oral pwdr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512209</ndc>
    <ndc_label_name>Enfamil NeuroPro EnfaCare Non-GMO 2.8 gram-5.3 gram/100 kcal oral pwdr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512222</ndc>
    <ndc_label_name>Nutramigen with probiotic LGG 2.8 g-5.3 g-10.3 g/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512223</ndc>
    <ndc_label_name>Nutramigen with probiotic LGG 2.8 g-5.3 g-10.3 g/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512244</ndc>
    <ndc_label_name>PurAmino Jr 13.7 gram-490 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512245</ndc>
    <ndc_label_name>PurAmino Jr 13.7 gram-490 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512246</ndc>
    <ndc_label_name>PurAmino Jr 13.7 gram-490 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512247</ndc>
    <ndc_label_name>PurAmino Jr 13.7 gram-490 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512353</ndc>
    <ndc_label_name>Enfamil Enspire Gentlease 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512354</ndc>
    <ndc_label_name>Enfamil Enspire Gentlease 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512355</ndc>
    <ndc_label_name>Enfamil Enspire Gentlease 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512356</ndc>
    <ndc_label_name>Enfamil Enspire Gentlease 2.3 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512364</ndc>
    <ndc_label_name>Enfamil Prosobee 2.5 gram-5.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512365</ndc>
    <ndc_label_name>Enfamil Prosobee 2.5 gram-5.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512452</ndc>
    <ndc_label_name>Enfamil NeuroPro Sensitive Non-GMO 2.2-5.3-10.9 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512453</ndc>
    <ndc_label_name>Enfamil NeuroPro Sensitive Non-GMO 2.2-5.3-10.9 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512454</ndc>
    <ndc_label_name>Enfamil NeuroPro Sensitive Non-GMO 2.2-5.3-10.9 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512455</ndc>
    <ndc_label_name>Enfamil NeuroPro Sensitive Non-GMO 2.2-5.3-10.9 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512529</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.42 gram-7.5 kcal/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512530</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.42 gram-7.5 kcal/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512531</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.56 gram-7.5 kcal/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512532</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.56 gram-7.5 kcal/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512542</ndc>
    <ndc_label_name>Enfagrow Premium Toddler 6 gram-160 kcal/36 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512611</ndc>
    <ndc_label_name>Enfamil DHA-ARA Supplement 20 mg-40 mg/0.5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512612</ndc>
    <ndc_label_name>Enfamil DHA-ARA Supplement 20 mg-40 mg/0.5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512622</ndc>
    <ndc_label_name>Enfamil Dual Probiotics-Vit D 2.5 billion cell-10 mcg/6 drops oral</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512642</ndc>
    <ndc_label_name>Enfamil A.R. 2.5-5.1-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512643</ndc>
    <ndc_label_name>Enfamil A.R. 2.5-5.1-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512682</ndc>
    <ndc_label_name>Enfamil Enspire Optimum Non-GMO 2.1 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512683</ndc>
    <ndc_label_name>Enfamil Enspire Optimum Non-GMO 2.1 gram-5.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512731</ndc>
    <ndc_label_name>Enfamil NeuroPro EnfaCare Non-GMO 2.8 gram-5.3 gram/100 kcal liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512740</ndc>
    <ndc_label_name>D-Vi-Sol 10 mcg/mL (400 unit/mL) oral drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512748</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512749</ndc>
    <ndc_label_name>Enfamil NeuroPro Non-GMO 2.1-5.3-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512750</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512751</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512879</ndc>
    <ndc_label_name>Enfamil NeuroPro EnfaCare Non-GMO 2.8 gram-5.3 gram/100 kcal oral pwdr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512880</ndc>
    <ndc_label_name>Enfamil NeuroPro EnfaCare Non-GMO 2.8 gram-5.3 gram/100 kcal oral pwdr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512903</ndc>
    <ndc_label_name>Enfagrow Toddler Gentlease Non-GMO 5 gram-180 kcal/36 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512904</ndc>
    <ndc_label_name>Enfagrow Toddler Gentlease Non-GMO 5 gram-180 kcal/36 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512988</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.42 gram-7.5 kcal/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512989</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.42 gram-7.5 kcal/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512990</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.56 gram-7.5 kcal/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087512991</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.56 gram-7.5 kcal/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087513147</ndc>
    <ndc_label_name>Nutramigen DHA-ARA 2.8-5.3-10.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087513148</ndc>
    <ndc_label_name>Nutramigen DHA-ARA 2.8-5.3-10.3 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087513167</ndc>
    <ndc_label_name>Enfagrow Toddler Non-Gmo 6 gram-160 kcal/36 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087513168</ndc>
    <ndc_label_name>Enfagrow Premium Toddler 6 gram-160 kcal/36 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087513478</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.56 gram-7.5 kcal/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087513479</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.56 gram-7.5 kcal/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087513480</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.42 gram-7.5 kcal/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087513481</ndc>
    <ndc_label_name>Enfamil Human Milk Fortifier 0.42 gram-7.5 kcal/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00087869247</ndc>
    <ndc_label_name>Enfagrow Toddler Next Step 6 gram-160 kcal/36 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00088117112</ndc>
    <ndc_label_name>GAVISCON LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00088117312</ndc>
    <ndc_label_name>Gaviscon Extra Strength 254 mg-237.5 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00088117447</ndc>
    <ndc_label_name>Gaviscon Extra Strength 160 mg-105 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00088210201</ndc>
    <ndc_label_name>Priftin 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00088210224</ndc>
    <ndc_label_name>Priftin 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00088216030</ndc>
    <ndc_label_name>Arava 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00088216130</ndc>
    <ndc_label_name>Arava 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00088221900</ndc>
    <ndc_label_name>Lantus Solostar U-100 Insulin 100 unit/mL (3 mL) subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00088221901</ndc>
    <ndc_label_name>Lantus Solostar U-100 Insulin 100 unit/mL (3 mL) subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00088221905</ndc>
    <ndc_label_name>Lantus Solostar U-100 Insulin 100 unit/mL (3 mL) subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00088222033</ndc>
    <ndc_label_name>Lantus U-100 Insulin 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00088222034</ndc>
    <ndc_label_name>Lantus U-100 Insulin 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00088250033</ndc>
    <ndc_label_name>Apidra U-100 Insulin 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00088250200</ndc>
    <ndc_label_name>Apidra SoloStar U-100 Insulin 100 unit/mL subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00088250205</ndc>
    <ndc_label_name>Apidra SoloStar U-100 Insulin 100 unit/mL subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093001006</ndc>
    <ndc_label_name>TOLTERODINE TARTRATE 1 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093001701</ndc>
    <ndc_label_name>MOEXIPRIL HCL 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093001805</ndc>
    <ndc_label_name>TOLTERODINE TARTRATE 2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093001806</ndc>
    <ndc_label_name>TOLTERODINE TARTRATE 2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093005101</ndc>
    <ndc_label_name>CARVEDILOL 3.125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093005105</ndc>
    <ndc_label_name>CARVEDILOL 3.125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093005301</ndc>
    <ndc_label_name>BUSPIRONE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093005305</ndc>
    <ndc_label_name>BUSPIRONE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093005401</ndc>
    <ndc_label_name>BUSPIRONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093005405</ndc>
    <ndc_label_name>BUSPIRONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093005801</ndc>
    <ndc_label_name>TRAMADOL HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093005805</ndc>
    <ndc_label_name>TRAMADOL HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093007301</ndc>
    <ndc_label_name>ZOLPIDEM TARTRATE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093007401</ndc>
    <ndc_label_name>ZOLPIDEM TARTRATE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093009001</ndc>
    <ndc_label_name>EPITOL 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093010901</ndc>
    <ndc_label_name>CARBAMAZEPINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093010910</ndc>
    <ndc_label_name>CARBAMAZEPINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093013501</ndc>
    <ndc_label_name>CARVEDILOL 6.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093013505</ndc>
    <ndc_label_name>CARVEDILOL 6.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093026215</ndc>
    <ndc_label_name>FLUOCINONIDE 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093026230</ndc>
    <ndc_label_name>FLUOCINONIDE 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093026292</ndc>
    <ndc_label_name>FLUOCINONIDE 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093026315</ndc>
    <ndc_label_name>Fluocinonide-E 0.05 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093026330</ndc>
    <ndc_label_name>Fluocinonide-E 0.05 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093026392</ndc>
    <ndc_label_name>Fluocinonide-E 0.05 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093026415</ndc>
    <ndc_label_name>FLUOCINONIDE 0.05% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093026430</ndc>
    <ndc_label_name>FLUOCINONIDE 0.05% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093026492</ndc>
    <ndc_label_name>FLUOCINONIDE 0.05% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093030801</ndc>
    <ndc_label_name>CLEMASTINE FUM 2.68 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093031101</ndc>
    <ndc_label_name>LOPERAMIDE 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093031105</ndc>
    <ndc_label_name>LOPERAMIDE 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093031401</ndc>
    <ndc_label_name>KETOROLAC 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093031801</ndc>
    <ndc_label_name>DILTIAZEM 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093031805</ndc>
    <ndc_label_name>DILTIAZEM 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093031901</ndc>
    <ndc_label_name>DILTIAZEM 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093031905</ndc>
    <ndc_label_name>DILTIAZEM 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093032001</ndc>
    <ndc_label_name>DILTIAZEM 90 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093032101</ndc>
    <ndc_label_name>DILTIAZEM 120 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093057606</ndc>
    <ndc_label_name>LOVASTATIN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093057610</ndc>
    <ndc_label_name>LOVASTATIN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093071101</ndc>
    <ndc_label_name>FLURBIPROFEN 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093071105</ndc>
    <ndc_label_name>FLURBIPROFEN 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093075201</ndc>
    <ndc_label_name>ATENOLOL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093075210</ndc>
    <ndc_label_name>ATENOLOL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093075301</ndc>
    <ndc_label_name>ATENOLOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093075305</ndc>
    <ndc_label_name>ATENOLOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093075601</ndc>
    <ndc_label_name>PIROXICAM 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093075701</ndc>
    <ndc_label_name>PIROXICAM 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093075705</ndc>
    <ndc_label_name>PIROXICAM 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093077110</ndc>
    <ndc_label_name>PRAVASTATIN SODIUM 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093077198</ndc>
    <ndc_label_name>PRAVASTATIN SODIUM 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093077801</ndc>
    <ndc_label_name>CARBAMAZEPINE 100 MG TAB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093078701</ndc>
    <ndc_label_name>ATENOLOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093078710</ndc>
    <ndc_label_name>ATENOLOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093081001</ndc>
    <ndc_label_name>NORTRIPTYLINE HCL 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093081005</ndc>
    <ndc_label_name>NORTRIPTYLINE HCL 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093081101</ndc>
    <ndc_label_name>NORTRIPTYLINE HCL 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093081105</ndc>
    <ndc_label_name>NORTRIPTYLINE HCL 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093081201</ndc>
    <ndc_label_name>NORTRIPTYLINE HCL 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093081205</ndc>
    <ndc_label_name>NORTRIPTYLINE HCL 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093081301</ndc>
    <ndc_label_name>NORTRIPTYLINE HCL 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093081305</ndc>
    <ndc_label_name>NORTRIPTYLINE HCL 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093083201</ndc>
    <ndc_label_name>CLONAZEPAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093083205</ndc>
    <ndc_label_name>CLONAZEPAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093092606</ndc>
    <ndc_label_name>LOVASTATIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093092610</ndc>
    <ndc_label_name>LOVASTATIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093092806</ndc>
    <ndc_label_name>LOVASTATIN 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093092810</ndc>
    <ndc_label_name>LOVASTATIN 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093094801</ndc>
    <ndc_label_name>DICLOFENAC POT 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093094805</ndc>
    <ndc_label_name>DICLOFENAC POT 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093098301</ndc>
    <ndc_label_name>NYSTATIN 500,000 UNIT ORAL TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093100301</ndc>
    <ndc_label_name>BUSPIRONE HCL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093100305</ndc>
    <ndc_label_name>BUSPIRONE HCL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093100501</ndc>
    <ndc_label_name>NAPROXEN DR 375 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093100505</ndc>
    <ndc_label_name>NAPROXEN DR 375 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093100601</ndc>
    <ndc_label_name>NAPROXEN DR 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093100605</ndc>
    <ndc_label_name>NAPROXEN DR 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093101042</ndc>
    <ndc_label_name>MUPIROCIN 2% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093102406</ndc>
    <ndc_label_name>NEFAZODONE HCL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093102506</ndc>
    <ndc_label_name>NEFAZODONE HCL 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093102606</ndc>
    <ndc_label_name>NEFAZODONE HCL 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093106001</ndc>
    <ndc_label_name>SOTALOL 120 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093106101</ndc>
    <ndc_label_name>SOTALOL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093106201</ndc>
    <ndc_label_name>SOTALOL 160 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093106301</ndc>
    <ndc_label_name>SOTALOL 240 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093107701</ndc>
    <ndc_label_name>CEFPROZIL 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093107853</ndc>
    <ndc_label_name>CEFPROZIL 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093108701</ndc>
    <ndc_label_name>CEFACLOR ER 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093110616</ndc>
    <ndc_label_name>TERIPARATIDE 560MCG/2.24ML PEN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093111801</ndc>
    <ndc_label_name>ETODOLAC ER 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093112201</ndc>
    <ndc_label_name>ETODOLAC ER 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093112589</ndc>
    <ndc_label_name>ABIRATERONE ACETATE 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093113556</ndc>
    <ndc_label_name>ACITRETIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093113656</ndc>
    <ndc_label_name>ACITRETIN 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093113856</ndc>
    <ndc_label_name>ACITRETIN 17.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093117201</ndc>
    <ndc_label_name>PENICILLIN VK 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093117210</ndc>
    <ndc_label_name>PENICILLIN VK 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093117401</ndc>
    <ndc_label_name>PENICILLIN VK 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093117410</ndc>
    <ndc_label_name>PENICILLIN VK 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093117701</ndc>
    <ndc_label_name>NEOMYCIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093171201</ndc>
    <ndc_label_name>WARFARIN SODIUM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093171210</ndc>
    <ndc_label_name>WARFARIN SODIUM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093171301</ndc>
    <ndc_label_name>WARFARIN SODIUM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093171310</ndc>
    <ndc_label_name>WARFARIN SODIUM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093171401</ndc>
    <ndc_label_name>WARFARIN SODIUM 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093171410</ndc>
    <ndc_label_name>WARFARIN SODIUM 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093171501</ndc>
    <ndc_label_name>WARFARIN SODIUM 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093171601</ndc>
    <ndc_label_name>WARFARIN SODIUM 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093171610</ndc>
    <ndc_label_name>WARFARIN SODIUM 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093171801</ndc>
    <ndc_label_name>WARFARIN SODIUM 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093172001</ndc>
    <ndc_label_name>WARFARIN SODIUM 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093172101</ndc>
    <ndc_label_name>WARFARIN SODIUM 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093172110</ndc>
    <ndc_label_name>WARFARIN SODIUM 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093172301</ndc>
    <ndc_label_name>WARFARIN SODIUM 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093192006</ndc>
    <ndc_label_name>CYCLOBENZAPRINE ER 15 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093192106</ndc>
    <ndc_label_name>CYCLOBENZAPRINE ER 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093202623</ndc>
    <ndc_label_name>AZITHROMYCIN 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093202631</ndc>
    <ndc_label_name>AZITHROMYCIN 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093202694</ndc>
    <ndc_label_name>AZITHROMYCIN 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093202723</ndc>
    <ndc_label_name>AZITHROMYCIN 100 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093206301</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093206406</ndc>
    <ndc_label_name>CILOSTAZOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093206450</ndc>
    <ndc_label_name>CILOSTAZOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093206506</ndc>
    <ndc_label_name>CILOSTAZOL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093206701</ndc>
    <ndc_label_name>DOXAZOSIN MESYLATE 8 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093206801</ndc>
    <ndc_label_name>DOXAZOSIN MESYLATE 4 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093206901</ndc>
    <ndc_label_name>DOXAZOSIN MESYLATE 2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093207001</ndc>
    <ndc_label_name>DOXAZOSIN MESYLATE 1 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093214028</ndc>
    <ndc_label_name>Tri-Lo-Sprintec 0.18 mg/0.215 mg/0.25 mg-0.025 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093214062</ndc>
    <ndc_label_name>Tri-Lo-Sprintec 0.18 mg/0.215 mg/0.25 mg-0.025 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093216519</ndc>
    <ndc_label_name>NALOXONE HCL 4 MG NASAL SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093216568</ndc>
    <ndc_label_name>NALOXONE HCL 4 MG NASAL SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093217801</ndc>
    <ndc_label_name>LIOTHYRONINE SOD 25 MCG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093217901</ndc>
    <ndc_label_name>LIOTHYRONINE SOD 5 MCG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093218001</ndc>
    <ndc_label_name>LIOTHYRONINE SOD 50 MCG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093220301</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093220305</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093220310</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093220401</ndc>
    <ndc_label_name>METOCLOPRAMIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093220405</ndc>
    <ndc_label_name>METOCLOPRAMIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093221001</ndc>
    <ndc_label_name>SUCRALFATE 1 GM TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093221005</ndc>
    <ndc_label_name>SUCRALFATE 1 GM TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093221098</ndc>
    <ndc_label_name>SUCRALFATE 1 GM TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093223801</ndc>
    <ndc_label_name>CEPHALEXIN 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093224001</ndc>
    <ndc_label_name>CEPHALEXIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093226301</ndc>
    <ndc_label_name>AMOXICILLIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093226401</ndc>
    <ndc_label_name>AMOXICILLIN 875 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093226701</ndc>
    <ndc_label_name>AMOXICILLIN 125 MG TAB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093226801</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG TAB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093227034</ndc>
    <ndc_label_name>AMOX-CLAV 200-28.5 MG TAB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093227234</ndc>
    <ndc_label_name>AMOX-CLAV 400-57 MG TAB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093227434</ndc>
    <ndc_label_name>AMOX-CLAV 500-125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093227534</ndc>
    <ndc_label_name>AMOX-CLAV 875-125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093227773</ndc>
    <ndc_label_name>AMOX-CLAV 200-28.5 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093227973</ndc>
    <ndc_label_name>AMOX-CLAV 400-57 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093240101</ndc>
    <ndc_label_name>HYDROXYCHLOROQUINE 200 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093300256</ndc>
    <ndc_label_name>QUININE SULFATE 324 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093300819</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093300893</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093300919</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 30 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093300993</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 30 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093301630</ndc>
    <ndc_label_name>TADALAFIL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093301665</ndc>
    <ndc_label_name>TADALAFIL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093301730</ndc>
    <ndc_label_name>TADALAFIL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093301765</ndc>
    <ndc_label_name>TADALAFIL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093306056</ndc>
    <ndc_label_name>RASAGILINE MESYLATE 0.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093306156</ndc>
    <ndc_label_name>RASAGILINE MESYLATE 1 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093306619</ndc>
    <ndc_label_name>ICATIBANT 30 MG/3 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093306634</ndc>
    <ndc_label_name>ICATIBANT 30 MG/3 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093306693</ndc>
    <ndc_label_name>ICATIBANT 30 MG/3 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093309819</ndc>
    <ndc_label_name>RISEDRONATE SODIUM 35 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093309829</ndc>
    <ndc_label_name>RISEDRONATE SODIUM 35 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093309844</ndc>
    <ndc_label_name>RISEDRONATE SODIUM 35 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093309956</ndc>
    <ndc_label_name>RISEDRONATE SODIUM 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093310056</ndc>
    <ndc_label_name>RISEDRONATE SODIUM 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093310701</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093310705</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093310901</ndc>
    <ndc_label_name>AMOXICILLIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093310905</ndc>
    <ndc_label_name>AMOXICILLIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093310906</ndc>
    <ndc_label_name>AMOXICILLIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093310953</ndc>
    <ndc_label_name>AMOXICILLIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093312228</ndc>
    <ndc_label_name>Jinteli 1 mg-5 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093312242</ndc>
    <ndc_label_name>Jinteli 1 mg-5 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093312298</ndc>
    <ndc_label_name>Jinteli 1 mg-5 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093312301</ndc>
    <ndc_label_name>DICLOXACILLIN 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093312501</ndc>
    <ndc_label_name>DICLOXACILLIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093312701</ndc>
    <ndc_label_name>DISOPYRAMIDE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093312901</ndc>
    <ndc_label_name>DISOPYRAMIDE 150 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093313331</ndc>
    <ndc_label_name>IMIQUIMOD 3.75% CREAM PUMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093313482</ndc>
    <ndc_label_name>Camrese 0.15 mg-30 mcg (84)/10 mcg(7) tablets,3 month dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093313491</ndc>
    <ndc_label_name>Camrese 0.15 mg-30 mcg (84)/10 mcg(7) tablets,3 month dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093314501</ndc>
    <ndc_label_name>CEPHALEXIN 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093314505</ndc>
    <ndc_label_name>CEPHALEXIN 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093314701</ndc>
    <ndc_label_name>CEPHALEXIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093314705</ndc>
    <ndc_label_name>CEPHALEXIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093316006</ndc>
    <ndc_label_name>CEFDINIR 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093317431</ndc>
    <ndc_label_name>ALBUTEROL HFA 90 MCG INHALER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093318620</ndc>
    <ndc_label_name>PENCICLOVIR 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093319601</ndc>
    <ndc_label_name>CEFADROXIL 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093319653</ndc>
    <ndc_label_name>CEFADROXIL 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093321201</ndc>
    <ndc_label_name>CLONAZEPAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093321205</ndc>
    <ndc_label_name>CLONAZEPAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093321301</ndc>
    <ndc_label_name>CLONAZEPAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093321305</ndc>
    <ndc_label_name>CLONAZEPAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093321915</ndc>
    <ndc_label_name>KETOCONAZOLE 2% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093321930</ndc>
    <ndc_label_name>KETOCONAZOLE 2% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093321992</ndc>
    <ndc_label_name>KETOCONAZOLE 2% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093322308</ndc>
    <ndc_label_name>ESTRADIOL 10 MCG VAGINAL INSRT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093322319</ndc>
    <ndc_label_name>ESTRADIOL 10 MCG VAGINAL INSRT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093322397</ndc>
    <ndc_label_name>ESTRADIOL 10 MCG VAGINAL INSRT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093323401</ndc>
    <ndc_label_name>SULFASALAZINE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093323405</ndc>
    <ndc_label_name>SULFASALAZINE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093323410</ndc>
    <ndc_label_name>SULFASALAZINE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093323921</ndc>
    <ndc_label_name>BUPRENORPHINE 7.5 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093323940</ndc>
    <ndc_label_name>BUPRENORPHINE 7.5 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093324101</ndc>
    <ndc_label_name>BISOPROLOL-HCTZ 2.5-6.25 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093324201</ndc>
    <ndc_label_name>BISOPROLOL-HCTZ 5-6.25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093324356</ndc>
    <ndc_label_name>BISOPROLOL-HCTZ 10-6.25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093330101</ndc>
    <ndc_label_name>TRAMADOL HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093330105</ndc>
    <ndc_label_name>TRAMADOL HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093330416</ndc>
    <ndc_label_name>Reclipsen (28) 0.15 mg-0.03 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093330428</ndc>
    <ndc_label_name>Reclipsen (28) 0.15 mg-0.03 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342001</ndc>
    <ndc_label_name>CYCLOBENZAPRINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342101</ndc>
    <ndc_label_name>CYCLOBENZAPRINE 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342201</ndc>
    <ndc_label_name>CYCLOBENZAPRINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342205</ndc>
    <ndc_label_name>CYCLOBENZAPRINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342210</ndc>
    <ndc_label_name>CYCLOBENZAPRINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342501</ndc>
    <ndc_label_name>LORAZEPAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342505</ndc>
    <ndc_label_name>LORAZEPAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342510</ndc>
    <ndc_label_name>LORAZEPAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342601</ndc>
    <ndc_label_name>LORAZEPAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342605</ndc>
    <ndc_label_name>LORAZEPAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342610</ndc>
    <ndc_label_name>LORAZEPAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342701</ndc>
    <ndc_label_name>LORAZEPAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342705</ndc>
    <ndc_label_name>LORAZEPAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342710</ndc>
    <ndc_label_name>LORAZEPAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342810</ndc>
    <ndc_label_name>TACROLIMUS 0.03% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342830</ndc>
    <ndc_label_name>TACROLIMUS 0.03% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342892</ndc>
    <ndc_label_name>TACROLIMUS 0.03% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342910</ndc>
    <ndc_label_name>TACROLIMUS 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342930</ndc>
    <ndc_label_name>TACROLIMUS 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093342992</ndc>
    <ndc_label_name>TACROLIMUS 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093354143</ndc>
    <ndc_label_name>ESTRADIOL 0.01% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093354256</ndc>
    <ndc_label_name>ATOMOXETINE HCL 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093354356</ndc>
    <ndc_label_name>ATOMOXETINE HCL 18 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093354456</ndc>
    <ndc_label_name>ATOMOXETINE HCL 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093354556</ndc>
    <ndc_label_name>ATOMOXETINE HCL 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093354656</ndc>
    <ndc_label_name>ATOMOXETINE HCL 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093354756</ndc>
    <ndc_label_name>ATOMOXETINE HCL 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093354856</ndc>
    <ndc_label_name>ATOMOXETINE HCL 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093356026</ndc>
    <ndc_label_name>PEG3350 100-7.5-2.691-1.01-5.9</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093360782</ndc>
    <ndc_label_name>FLUTICASONE-SALMETEROL 55-14</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093360882</ndc>
    <ndc_label_name>FLUTICASONE-SALMETEROL 113-14</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093360982</ndc>
    <ndc_label_name>FLUTICASONE-SALMETEROL 232-14</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093363020</ndc>
    <ndc_label_name>ACYCLOVIR 5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093365522</ndc>
    <ndc_label_name>METHYLERGONOVINE 0.2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093365528</ndc>
    <ndc_label_name>METHYLERGONOVINE 0.2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093365621</ndc>
    <ndc_label_name>BUPRENORPHINE 5 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093365640</ndc>
    <ndc_label_name>BUPRENORPHINE 5 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093365721</ndc>
    <ndc_label_name>BUPRENORPHINE 10 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093365740</ndc>
    <ndc_label_name>BUPRENORPHINE 10 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093365821</ndc>
    <ndc_label_name>BUPRENORPHINE 15 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093365840</ndc>
    <ndc_label_name>BUPRENORPHINE 15 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093365921</ndc>
    <ndc_label_name>BUPRENORPHINE 20 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093365940</ndc>
    <ndc_label_name>BUPRENORPHINE 20 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093372750</ndc>
    <ndc_label_name>DICLOFENAC EPOLAMINE 1.3% PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093372755</ndc>
    <ndc_label_name>DICLOFENAC EPOLAMINE 1.3% PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093375004</ndc>
    <ndc_label_name>TOBRAMYCIN 300 MG/4 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093375028</ndc>
    <ndc_label_name>TOBRAMYCIN 300 MG/4 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093375063</ndc>
    <ndc_label_name>TOBRAMYCIN 300 MG/4 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093400028</ndc>
    <ndc_label_name>Vestura (28) 3 mg-0.02 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093400062</ndc>
    <ndc_label_name>Vestura (28) 3 mg-0.02 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093405953</ndc>
    <ndc_label_name>CEFADROXIL 1 GM TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093406106</ndc>
    <ndc_label_name>FORMOTEROL 20 MCG/2 ML NEB VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093406119</ndc>
    <ndc_label_name>FORMOTEROL 20 MCG/2 ML NEB VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093406130</ndc>
    <ndc_label_name>FORMOTEROL 20 MCG/2 ML NEB VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093406701</ndc>
    <ndc_label_name>PRAZOSIN 1 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093406710</ndc>
    <ndc_label_name>PRAZOSIN 1 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093406801</ndc>
    <ndc_label_name>PRAZOSIN 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093406810</ndc>
    <ndc_label_name>PRAZOSIN 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093406901</ndc>
    <ndc_label_name>PRAZOSIN 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093406905</ndc>
    <ndc_label_name>PRAZOSIN 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093406952</ndc>
    <ndc_label_name>PRAZOSIN 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093408563</ndc>
    <ndc_label_name>TOBRAMYCIN 300 MG/5 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093412573</ndc>
    <ndc_label_name>PENICILLIN VK 125 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093412574</ndc>
    <ndc_label_name>PENICILLIN VK 125 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093412773</ndc>
    <ndc_label_name>PENICILLIN VK 250 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093412774</ndc>
    <ndc_label_name>PENICILLIN VK 250 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093413664</ndc>
    <ndc_label_name>CEFDINIR 125 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093413673</ndc>
    <ndc_label_name>CEFDINIR 125 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093413764</ndc>
    <ndc_label_name>CEFDINIR 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093413773</ndc>
    <ndc_label_name>CEFDINIR 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093414545</ndc>
    <ndc_label_name>LEVALBUTEROL 0.31 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093414556</ndc>
    <ndc_label_name>LEVALBUTEROL 0.31 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093414645</ndc>
    <ndc_label_name>LEVALBUTEROL 0.63 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093414656</ndc>
    <ndc_label_name>LEVALBUTEROL 0.63 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093414719</ndc>
    <ndc_label_name>LEVALBUTEROL CONC 1.25 MG/0.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093414756</ndc>
    <ndc_label_name>LEVALBUTEROL CONC 1.25 MG/0.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093414845</ndc>
    <ndc_label_name>LEVALBUTEROL 1.25 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093414856</ndc>
    <ndc_label_name>LEVALBUTEROL 1.25 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093415573</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093415579</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093415580</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093416073</ndc>
    <ndc_label_name>AMOXICILLIN 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093416076</ndc>
    <ndc_label_name>AMOXICILLIN 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093416078</ndc>
    <ndc_label_name>AMOXICILLIN 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093416173</ndc>
    <ndc_label_name>AMOXICILLIN 400 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093416176</ndc>
    <ndc_label_name>AMOXICILLIN 400 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093416178</ndc>
    <ndc_label_name>AMOXICILLIN 400 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093417573</ndc>
    <ndc_label_name>CEPHALEXIN 125 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093417574</ndc>
    <ndc_label_name>CEPHALEXIN 125 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093417773</ndc>
    <ndc_label_name>CEPHALEXIN 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093417774</ndc>
    <ndc_label_name>CEPHALEXIN 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093500256</ndc>
    <ndc_label_name>OLMSRTN-AMLDPN-HCTZ 40-10-25MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093500356</ndc>
    <ndc_label_name>OLMSRTN-AMLDPN-HCTZ 40-10-12.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093500456</ndc>
    <ndc_label_name>OLMSRTN-AMLDPN-HCTZ 40-5-25 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093500556</ndc>
    <ndc_label_name>OLMSRTN-AMLDPN-HCTZ 20-5-12.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093500656</ndc>
    <ndc_label_name>OLMSRTN-AMLDPN-HCTZ 40-5-12.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093503056</ndc>
    <ndc_label_name>TIAGABINE HCL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093503156</ndc>
    <ndc_label_name>TIAGABINE HCL 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093504501</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 25 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093504601</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 35 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093505610</ndc>
    <ndc_label_name>ATORVASTATIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093505698</ndc>
    <ndc_label_name>ATORVASTATIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093505705</ndc>
    <ndc_label_name>ATORVASTATIN 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093505798</ndc>
    <ndc_label_name>ATORVASTATIN 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093505810</ndc>
    <ndc_label_name>ATORVASTATIN 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093505898</ndc>
    <ndc_label_name>ATORVASTATIN 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093505910</ndc>
    <ndc_label_name>ATORVASTATIN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093505998</ndc>
    <ndc_label_name>ATORVASTATIN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093506001</ndc>
    <ndc_label_name>HYDROXYZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093506005</ndc>
    <ndc_label_name>HYDROXYZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093506101</ndc>
    <ndc_label_name>HYDROXYZINE HCL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093506105</ndc>
    <ndc_label_name>HYDROXYZINE HCL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093506110</ndc>
    <ndc_label_name>HYDROXYZINE HCL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093506201</ndc>
    <ndc_label_name>HYDROXYZINE HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093506205</ndc>
    <ndc_label_name>HYDROXYZINE HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093515001</ndc>
    <ndc_label_name>MOEXIPRIL HCL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093520005</ndc>
    <ndc_label_name>BUSPIRONE HCL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093520006</ndc>
    <ndc_label_name>BUSPIRONE HCL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093523456</ndc>
    <ndc_label_name>EFAVIR-EMTRI-TENOF 600-200-300</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093524519</ndc>
    <ndc_label_name>OLANZAPINE ODT 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093524565</ndc>
    <ndc_label_name>OLANZAPINE ODT 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093524619</ndc>
    <ndc_label_name>OLANZAPINE ODT 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093524665</ndc>
    <ndc_label_name>OLANZAPINE ODT 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093524719</ndc>
    <ndc_label_name>OLANZAPINE ODT 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093524765</ndc>
    <ndc_label_name>OLANZAPINE ODT 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093524819</ndc>
    <ndc_label_name>OLANZAPINE ODT 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093524865</ndc>
    <ndc_label_name>OLANZAPINE ODT 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093526018</ndc>
    <ndc_label_name>ALMOTRIPTAN MALATE 6.25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093526019</ndc>
    <ndc_label_name>ALMOTRIPTAN MALATE 6.25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093526119</ndc>
    <ndc_label_name>ALMOTRIPTAN MALATE 12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093526129</ndc>
    <ndc_label_name>ALMOTRIPTAN MALATE 12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093529501</ndc>
    <ndc_label_name>METHYLPHENIDATE CD 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093529601</ndc>
    <ndc_label_name>METHYLPHENIDATE CD 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093529701</ndc>
    <ndc_label_name>METHYLPHENIDATE CD 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093532828</ndc>
    <ndc_label_name>Junel Fe 24 1 mg-20 mcg (24)/75 mg (4) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093532862</ndc>
    <ndc_label_name>Junel Fe 24 1 mg-20 mcg (24)/75 mg (4) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093534156</ndc>
    <ndc_label_name>SILDENAFIL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093534201</ndc>
    <ndc_label_name>SILDENAFIL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093534256</ndc>
    <ndc_label_name>SILDENAFIL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093534301</ndc>
    <ndc_label_name>SILDENAFIL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093534356</ndc>
    <ndc_label_name>SILDENAFIL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093534601</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(LA) 20MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093534701</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(LA) 30MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093534801</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(LA) 40MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093537601</ndc>
    <ndc_label_name>CLOZAPINE ODT 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093537619</ndc>
    <ndc_label_name>CLOZAPINE ODT 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093537684</ndc>
    <ndc_label_name>CLOZAPINE ODT 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093537701</ndc>
    <ndc_label_name>CLOZAPINE ODT 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093537719</ndc>
    <ndc_label_name>CLOZAPINE ODT 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093537784</ndc>
    <ndc_label_name>CLOZAPINE ODT 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093541601</ndc>
    <ndc_label_name>CLOZAPINE ODT 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093541701</ndc>
    <ndc_label_name>CLOZAPINE ODT 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093541719</ndc>
    <ndc_label_name>CLOZAPINE ODT 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093541784</ndc>
    <ndc_label_name>CLOZAPINE ODT 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093541901</ndc>
    <ndc_label_name>CLOZAPINE ODT 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093541919</ndc>
    <ndc_label_name>CLOZAPINE ODT 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093541984</ndc>
    <ndc_label_name>CLOZAPINE ODT 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093542088</ndc>
    <ndc_label_name>CABERGOLINE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093545528</ndc>
    <ndc_label_name>Mimvey 1 mg-0.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093545542</ndc>
    <ndc_label_name>Mimvey 1 mg-0.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093550356</ndc>
    <ndc_label_name>OLANZAPINE-FLUOXETINE 3-25 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093550456</ndc>
    <ndc_label_name>OLANZAPINE-FLUOXETINE 6-25 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093550556</ndc>
    <ndc_label_name>OLANZAPINE-FLUOXETINE 6-50 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093550656</ndc>
    <ndc_label_name>OLANZAPINE-FLUOXETINE 12-25 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093550756</ndc>
    <ndc_label_name>OLANZAPINE-FLUOXETINE 12-50 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093551798</ndc>
    <ndc_label_name>SILDENAFIL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093552606</ndc>
    <ndc_label_name>ATAZANAVIR SULFATE 150 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093552706</ndc>
    <ndc_label_name>ATAZANAVIR SULFATE 200 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093552856</ndc>
    <ndc_label_name>ATAZANAVIR SULFATE 300 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093553756</ndc>
    <ndc_label_name>ESZOPICLONE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093553801</ndc>
    <ndc_label_name>ESZOPICLONE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093553901</ndc>
    <ndc_label_name>ESZOPICLONE 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093555001</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093555101</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 10 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093555201</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 15 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093555301</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 20 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093555401</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 30 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093556201</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 40 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093557101</ndc>
    <ndc_label_name>ERYTHROMYCIN 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093557156</ndc>
    <ndc_label_name>ERYTHROMYCIN 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093557201</ndc>
    <ndc_label_name>ERYTHROMYCIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093557256</ndc>
    <ndc_label_name>ERYTHROMYCIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093590786</ndc>
    <ndc_label_name>MESALAMINE DR 400 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093593854</ndc>
    <ndc_label_name>LANTHANUM CARB 500 MG TAB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093593898</ndc>
    <ndc_label_name>LANTHANUM CARB 500 MG TAB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093593985</ndc>
    <ndc_label_name>LANTHANUM CARB 750 MG TAB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093593998</ndc>
    <ndc_label_name>LANTHANUM CARB 750 MG TAB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093594040</ndc>
    <ndc_label_name>LANTHANUM CARB 1,000 MG TB CHW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093594098</ndc>
    <ndc_label_name>LANTHANUM CARB 1,000 MG TB CHW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093595506</ndc>
    <ndc_label_name>ARFORMOTEROL 15 MCG/2 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093595511</ndc>
    <ndc_label_name>ARFORMOTEROL 15 MCG/2 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093595519</ndc>
    <ndc_label_name>ARFORMOTEROL 15 MCG/2 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093595545</ndc>
    <ndc_label_name>ARFORMOTEROL 15 MCG/2 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093595556</ndc>
    <ndc_label_name>ARFORMOTEROL 15 MCG/2 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093598519</ndc>
    <ndc_label_name>EPINEPHRINE 0.15 MG AUTO-INJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093598527</ndc>
    <ndc_label_name>EPINEPHRINE 0.15 MG AUTO-INJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093598619</ndc>
    <ndc_label_name>EPINEPHRINE 0.3 MG AUTO-INJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093598627</ndc>
    <ndc_label_name>EPINEPHRINE 0.3 MG AUTO-INJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093603182</ndc>
    <ndc_label_name>Rivelsa 0.15 mg-20 mcg/0.15 mg-25 mcg tablets,3 month dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093603191</ndc>
    <ndc_label_name>Rivelsa 0.15 mg-20 mcg/0.15 mg-25 mcg tablets,3 month dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093614882</ndc>
    <ndc_label_name>Camrese Lo 0.1 mg-20 mcg (84)/10 mcg (7) tablets,3 month dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093614891</ndc>
    <ndc_label_name>Camrese Lo 0.1 mg-20 mcg (84)/10 mcg (7) tablets,3 month dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093645056</ndc>
    <ndc_label_name>ESOMEPRAZOLE MAG DR 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093645098</ndc>
    <ndc_label_name>ESOMEPRAZOLE MAG DR 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093645156</ndc>
    <ndc_label_name>ESOMEPRAZOLE MAG DR 40 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093645198</ndc>
    <ndc_label_name>ESOMEPRAZOLE MAG DR 40 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093681519</ndc>
    <ndc_label_name>BUDESONIDE 0.25 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093681545</ndc>
    <ndc_label_name>BUDESONIDE 0.25 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093681555</ndc>
    <ndc_label_name>BUDESONIDE 0.25 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093681573</ndc>
    <ndc_label_name>BUDESONIDE 0.25 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093681619</ndc>
    <ndc_label_name>BUDESONIDE 0.5 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093681645</ndc>
    <ndc_label_name>BUDESONIDE 0.5 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093681655</ndc>
    <ndc_label_name>BUDESONIDE 0.5 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093681673</ndc>
    <ndc_label_name>BUDESONIDE 0.5 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093681719</ndc>
    <ndc_label_name>BUDESONIDE 1 MG/2 ML INH SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093681745</ndc>
    <ndc_label_name>BUDESONIDE 1 MG/2 ML INH SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093681773</ndc>
    <ndc_label_name>BUDESONIDE 1 MG/2 ML INH SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093711306</ndc>
    <ndc_label_name>NEFAZODONE HCL 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093716305</ndc>
    <ndc_label_name>TOLTERODINE TART ER 2 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093716356</ndc>
    <ndc_label_name>TOLTERODINE TART ER 2 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093716398</ndc>
    <ndc_label_name>TOLTERODINE TART ER 2 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093716405</ndc>
    <ndc_label_name>TOLTERODINE TART ER 4 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093716456</ndc>
    <ndc_label_name>TOLTERODINE TART ER 4 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093716498</ndc>
    <ndc_label_name>TOLTERODINE TART ER 4 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093717201</ndc>
    <ndc_label_name>ETODOLAC ER 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093717801</ndc>
    <ndc_label_name>NEFAZODONE HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093719801</ndc>
    <ndc_label_name>FLUOXETINE HCL 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093719805</ndc>
    <ndc_label_name>FLUOXETINE HCL 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093719856</ndc>
    <ndc_label_name>FLUOXETINE HCL 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093720110</ndc>
    <ndc_label_name>PRAVASTATIN SODIUM 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093720198</ndc>
    <ndc_label_name>PRAVASTATIN SODIUM 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093720210</ndc>
    <ndc_label_name>PRAVASTATIN SODIUM 40 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093720298</ndc>
    <ndc_label_name>PRAVASTATIN SODIUM 40 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093727105</ndc>
    <ndc_label_name>PIOGLITAZONE HCL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093727156</ndc>
    <ndc_label_name>PIOGLITAZONE HCL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093727198</ndc>
    <ndc_label_name>PIOGLITAZONE HCL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093727205</ndc>
    <ndc_label_name>PIOGLITAZONE HCL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093727256</ndc>
    <ndc_label_name>PIOGLITAZONE HCL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093727298</ndc>
    <ndc_label_name>PIOGLITAZONE HCL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093727305</ndc>
    <ndc_label_name>PIOGLITAZONE HCL 45 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093727356</ndc>
    <ndc_label_name>PIOGLITAZONE HCL 45 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093727398</ndc>
    <ndc_label_name>PIOGLITAZONE HCL 45 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093729001</ndc>
    <ndc_label_name>RALOXIFENE HCL 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093729056</ndc>
    <ndc_label_name>RALOXIFENE HCL 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093729501</ndc>
    <ndc_label_name>CARVEDILOL 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093729505</ndc>
    <ndc_label_name>CARVEDILOL 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093729601</ndc>
    <ndc_label_name>CARVEDILOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093729605</ndc>
    <ndc_label_name>CARVEDILOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093731405</ndc>
    <ndc_label_name>CLOPIDOGREL 75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093731456</ndc>
    <ndc_label_name>CLOPIDOGREL 75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093733401</ndc>
    <ndc_label_name>MYCOPHENOLATE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093733405</ndc>
    <ndc_label_name>MYCOPHENOLATE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093735056</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093735156</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093735201</ndc>
    <ndc_label_name>CALCITRIOL 0.25 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093735301</ndc>
    <ndc_label_name>CALCITRIOL 0.5 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093735505</ndc>
    <ndc_label_name>FINASTERIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093735556</ndc>
    <ndc_label_name>FINASTERIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093735598</ndc>
    <ndc_label_name>FINASTERIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093736710</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 50-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093736756</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 50-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093736798</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 50-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093736810</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 100-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093736856</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 100-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093736898</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 100-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093736910</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 100-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093736956</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 100-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093736998</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 100-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093738405</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 37.5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093738456</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 37.5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093738498</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 37.5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093738505</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093738556</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093738598</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093738605</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 150 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093738656</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 150 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093738698</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 150 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093738756</ndc>
    <ndc_label_name>MOXIFLOXACIN HCL 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093739286</ndc>
    <ndc_label_name>NIACIN ER 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093739386</ndc>
    <ndc_label_name>NIACIN ER 750 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093739398</ndc>
    <ndc_label_name>NIACIN ER 750 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093739486</ndc>
    <ndc_label_name>NIACIN ER 1,000 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093739498</ndc>
    <ndc_label_name>NIACIN ER 1,000 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093744201</ndc>
    <ndc_label_name>FLUVASTATIN SODIUM 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093744256</ndc>
    <ndc_label_name>FLUVASTATIN SODIUM 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093744301</ndc>
    <ndc_label_name>FLUVASTATIN SODIUM 40 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093744356</ndc>
    <ndc_label_name>FLUVASTATIN SODIUM 40 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093744601</ndc>
    <ndc_label_name>FLUVASTATIN ER 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093744656</ndc>
    <ndc_label_name>FLUVASTATIN ER 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093745501</ndc>
    <ndc_label_name>GLIPIZIDE-METFORMIN 2.5-250 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093745601</ndc>
    <ndc_label_name>GLIPIZIDE-METFORMIN 2.5-500 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093745701</ndc>
    <ndc_label_name>GLIPIZIDE-METFORMIN 5-500 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093747119</ndc>
    <ndc_label_name>RIZATRIPTAN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093747143</ndc>
    <ndc_label_name>RIZATRIPTAN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093747219</ndc>
    <ndc_label_name>RIZATRIPTAN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093747243</ndc>
    <ndc_label_name>RIZATRIPTAN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093747306</ndc>
    <ndc_label_name>CAPECITABINE 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093747489</ndc>
    <ndc_label_name>CAPECITABINE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093751631</ndc>
    <ndc_label_name>FLUTICASONE-SALMETEROL 500-50</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093751731</ndc>
    <ndc_label_name>FLUTICASONE-SALMETEROL 100-50</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093751831</ndc>
    <ndc_label_name>FLUTICASONE-SALMETEROL 250-50</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093753656</ndc>
    <ndc_label_name>ANASTROZOLE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093762056</ndc>
    <ndc_label_name>LETROZOLE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093762998</ndc>
    <ndc_label_name>IMATINIB MESYLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093763056</ndc>
    <ndc_label_name>IMATINIB MESYLATE 400 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093765256</ndc>
    <ndc_label_name>VARDENAFIL HCL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093765356</ndc>
    <ndc_label_name>VARDENAFIL HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093765456</ndc>
    <ndc_label_name>VARDENAFIL HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093765556</ndc>
    <ndc_label_name>VARDENAFIL HCL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093766256</ndc>
    <ndc_label_name>ERLOTINIB HCL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093766356</ndc>
    <ndc_label_name>ERLOTINIB HCL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093766456</ndc>
    <ndc_label_name>ERLOTINIB HCL 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093767901</ndc>
    <ndc_label_name>ETONOGESTREL-EE VAGINAL RING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093767902</ndc>
    <ndc_label_name>ETONOGESTREL-EE VAGINAL RING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093770198</ndc>
    <ndc_label_name>LEVOCETIRIZINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093770456</ndc>
    <ndc_label_name>EMTRICITABINE-TENOFV 200-300MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093776619</ndc>
    <ndc_label_name>EVEROLIMUS 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093776624</ndc>
    <ndc_label_name>EVEROLIMUS 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093776719</ndc>
    <ndc_label_name>EVEROLIMUS 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093776724</ndc>
    <ndc_label_name>EVEROLIMUS 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093776819</ndc>
    <ndc_label_name>EVEROLIMUS 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093776824</ndc>
    <ndc_label_name>EVEROLIMUS 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093776919</ndc>
    <ndc_label_name>EVEROLIMUS 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093776924</ndc>
    <ndc_label_name>EVEROLIMUS 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093777113</ndc>
    <ndc_label_name>RISEDRONATE SODIUM 150 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093777119</ndc>
    <ndc_label_name>RISEDRONATE SODIUM 150 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093777179</ndc>
    <ndc_label_name>RISEDRONATE SODIUM 150 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093786519</ndc>
    <ndc_label_name>FENTANYL CITRATE OTFC 200 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093786565</ndc>
    <ndc_label_name>FENTANYL CITRATE OTFC 200 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093786619</ndc>
    <ndc_label_name>FENTANYL CITRATE OTFC 400 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093786665</ndc>
    <ndc_label_name>FENTANYL CITRATE OTFC 400 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093786719</ndc>
    <ndc_label_name>FENTANYL CITRATE OTFC 600 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093786765</ndc>
    <ndc_label_name>FENTANYL CITRATE OTFC 600 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093786819</ndc>
    <ndc_label_name>FENTANYL CITRATE OTFC 800 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093786865</ndc>
    <ndc_label_name>FENTANYL CITRATE OTFC 800 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093786919</ndc>
    <ndc_label_name>FENTANYL CIT OTFC 1,200 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093786965</ndc>
    <ndc_label_name>FENTANYL CIT OTFC 1,200 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093787019</ndc>
    <ndc_label_name>FENTANYL CIT OTFC 1,600 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093787065</ndc>
    <ndc_label_name>FENTANYL CIT OTFC 1,600 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093790901</ndc>
    <ndc_label_name>TIOPRONIN 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093803401</ndc>
    <ndc_label_name>GLYBURIDE MICRO 1.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093803501</ndc>
    <ndc_label_name>GLYBURIDE MICRO 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093803505</ndc>
    <ndc_label_name>GLYBURIDE MICRO 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093803601</ndc>
    <ndc_label_name>GLYBURIDE MICRO 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093807256</ndc>
    <ndc_label_name>TIAGABINE HCL 12 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093807316</ndc>
    <ndc_label_name>KELNOR 1-50 TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093807328</ndc>
    <ndc_label_name>KELNOR 1-50 TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093807656</ndc>
    <ndc_label_name>TIAGABINE HCL 16 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093810798</ndc>
    <ndc_label_name>IBUPROFEN-FAMOTIDIN 800-26.6MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093811756</ndc>
    <ndc_label_name>FAMCICLOVIR 125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093811856</ndc>
    <ndc_label_name>FAMCICLOVIR 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093811956</ndc>
    <ndc_label_name>FAMCICLOVIR 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093816201</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093816301</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 200 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093816401</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 300 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093816501</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 400 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093816601</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093818064</ndc>
    <ndc_label_name>OSELTAMIVIR 6 MG/ML SUSPENSION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093819201</ndc>
    <ndc_label_name>CIMETIDINE 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093819205</ndc>
    <ndc_label_name>CIMETIDINE 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093819928</ndc>
    <ndc_label_name>SUNITINIB MALATE 12.5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093820401</ndc>
    <ndc_label_name>CIMETIDINE 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093820405</ndc>
    <ndc_label_name>CIMETIDINE 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093821028</ndc>
    <ndc_label_name>Finzala 1 mg-20 mcg (24)/75 mg (4) chewable tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093821062</ndc>
    <ndc_label_name>Finzala 1 mg-20 mcg (24)/75 mg (4) chewable tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093822428</ndc>
    <ndc_label_name>SUNITINIB MALATE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093822928</ndc>
    <ndc_label_name>SUNITINIB MALATE 37.5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093823128</ndc>
    <ndc_label_name>SUNITINIB MALATE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093823256</ndc>
    <ndc_label_name>IRBESARTAN-HCTZ 300-12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093823298</ndc>
    <ndc_label_name>IRBESARTAN-HCTZ 300-12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093823856</ndc>
    <ndc_label_name>IRBESARTAN-HCTZ 150-12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093823898</ndc>
    <ndc_label_name>IRBESARTAN-HCTZ 150-12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093830501</ndc>
    <ndc_label_name>CIMETIDINE 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093831018</ndc>
    <ndc_label_name>ELETRIPTAN HBR 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093831019</ndc>
    <ndc_label_name>ELETRIPTAN HBR 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093831118</ndc>
    <ndc_label_name>ELETRIPTAN HBR 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093831119</ndc>
    <ndc_label_name>ELETRIPTAN HBR 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093834201</ndc>
    <ndc_label_name>GLYBURIDE 1.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093834301</ndc>
    <ndc_label_name>GLYBURIDE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093834305</ndc>
    <ndc_label_name>GLYBURIDE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093834310</ndc>
    <ndc_label_name>GLYBURIDE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093834398</ndc>
    <ndc_label_name>GLYBURIDE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093834401</ndc>
    <ndc_label_name>GLYBURIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093834405</ndc>
    <ndc_label_name>GLYBURIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093834410</ndc>
    <ndc_label_name>GLYBURIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093834498</ndc>
    <ndc_label_name>GLYBURIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093867574</ndc>
    <ndc_label_name>AMOX-CLAV 600-42.9 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093867575</ndc>
    <ndc_label_name>AMOX-CLAV 600-42.9 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093867578</ndc>
    <ndc_label_name>AMOX-CLAV 600-42.9 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093873901</ndc>
    <ndc_label_name>MEXILETINE 150 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093874001</ndc>
    <ndc_label_name>MEXILETINE 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093874101</ndc>
    <ndc_label_name>MEXILETINE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093901819</ndc>
    <ndc_label_name>CYCLOSPORINE MODIFIED 25 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093901865</ndc>
    <ndc_label_name>CYCLOSPORINE MODIFIED 25 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093901919</ndc>
    <ndc_label_name>CYCLOSPORINE MODIFIED 50 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093901965</ndc>
    <ndc_label_name>CYCLOSPORINE MODIFIED 50 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093902019</ndc>
    <ndc_label_name>CYCLOSPORINE MODIFIED 100 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093902065</ndc>
    <ndc_label_name>CYCLOSPORINE MODIFIED 100 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093914701</ndc>
    <ndc_label_name>VENLAFAXINE HCL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093914801</ndc>
    <ndc_label_name>VENLAFAXINE HCL 37.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093914901</ndc>
    <ndc_label_name>VENLAFAXINE HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093915701</ndc>
    <ndc_label_name>VENLAFAXINE HCL 75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093916301</ndc>
    <ndc_label_name>VENLAFAXINE HCL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093922201</ndc>
    <ndc_label_name>DIFLUNISAL 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093922205</ndc>
    <ndc_label_name>DIFLUNISAL 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093922206</ndc>
    <ndc_label_name>DIFLUNISAL 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093922489</ndc>
    <ndc_label_name>MESALAMINE ER 0.375 GRAM CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093929019</ndc>
    <ndc_label_name>CLONAZEPAM 0.125 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093929067</ndc>
    <ndc_label_name>CLONAZEPAM 0.125 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093929119</ndc>
    <ndc_label_name>CLONAZEPAM 0.25 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093929167</ndc>
    <ndc_label_name>CLONAZEPAM 0.25 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093929219</ndc>
    <ndc_label_name>CLONAZEPAM 0.5 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093929267</ndc>
    <ndc_label_name>CLONAZEPAM 0.5 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093929319</ndc>
    <ndc_label_name>CLONAZEPAM 1 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093929367</ndc>
    <ndc_label_name>CLONAZEPAM 1 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093929419</ndc>
    <ndc_label_name>CLONAZEPAM 2 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093929467</ndc>
    <ndc_label_name>CLONAZEPAM 2 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093936401</ndc>
    <ndc_label_name>GLYBURIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093936405</ndc>
    <ndc_label_name>GLYBURIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093936410</ndc>
    <ndc_label_name>GLYBURIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093943301</ndc>
    <ndc_label_name>GLYBURIDE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093943305</ndc>
    <ndc_label_name>GLYBURIDE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093947753</ndc>
    <ndc_label_name>GLYBURIDE 1.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093960995</ndc>
    <ndc_label_name>DOXEPIN 5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00093961413</ndc>
    <ndc_label_name>SILVER NITRATE 0.5% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093970101</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 10-100 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093970105</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 10-100 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093970201</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 25-100 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093970205</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 25-100 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093970210</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 25-100 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093970301</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 25-250 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093970305</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 25-250 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00093970310</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 25-250 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00095300001</ndc>
    <ndc_label_name>BUPAP 50 MG-300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096070735</ndc>
    <ndc_label_name>Drysol Dab-O-Matic 20 % topical solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096070737</ndc>
    <ndc_label_name>Drysol 20 % topical solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096070760</ndc>
    <ndc_label_name>Drysol Dab-O-Matic 20 % topical solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096070935</ndc>
    <ndc_label_name>Xerac AC 6.25 % topical solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096070960</ndc>
    <ndc_label_name>Xerac AC 6.25 % topical solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096072004</ndc>
    <ndc_label_name>DML Forte topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096072145</ndc>
    <ndc_label_name>DML Facial Moisturizer topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00096072208</ndc>
    <ndc_label_name>DML lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00096072216</ndc>
    <ndc_label_name>DML lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096072408</ndc>
    <ndc_label_name>Aquanil Skin Cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096072416</ndc>
    <ndc_label_name>Aquanil Skin Cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096073204</ndc>
    <ndc_label_name>Aquanil HC 1 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096073508</ndc>
    <ndc_label_name>DHS Zinc 2 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096073516</ndc>
    <ndc_label_name>DHS Zinc 2 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096073608</ndc>
    <ndc_label_name>DHS Tar Gel 0.5 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096073704</ndc>
    <ndc_label_name>DHS Tar 0.5 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096073708</ndc>
    <ndc_label_name>DHS Tar 0.5 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00096073804</ndc>
    <ndc_label_name>DHS Sal 3 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00111070752</ndc>
    <ndc_label_name>COVID-19 At-Home Test kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00111070772</ndc>
    <ndc_label_name>COVID-19 At-Home Test kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113001940</ndc>
    <ndc_label_name>Severe Cold-Flu Nighttime 6.25 mg-5 mg-10 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113002026</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113002562</ndc>
    <ndc_label_name>Pain Relief (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113002571</ndc>
    <ndc_label_name>Pain Relief (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113002578</ndc>
    <ndc_label_name>Pain Relief (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113002802</ndc>
    <ndc_label_name>24 Hour Allergy Relief 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113002808</ndc>
    <ndc_label_name>24 Hour Allergy Relief 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113002809</ndc>
    <ndc_label_name>24 Hour Allergy Relief 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113002925</ndc>
    <ndc_label_name>GS NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113002960</ndc>
    <ndc_label_name>GS NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113002971</ndc>
    <ndc_label_name>GS NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113003263</ndc>
    <ndc_label_name>Dual Action Complete 10 mg-800 mg-165 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113005058</ndc>
    <ndc_label_name>Ibuprofen PM 200 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113005060</ndc>
    <ndc_label_name>Ibuprofen PM 200 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113005253</ndc>
    <ndc_label_name>GS SLEEP TIME 25 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113005267</ndc>
    <ndc_label_name>GS SLEEP TIME 25 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113005306</ndc>
    <ndc_label_name>GS NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113005452</ndc>
    <ndc_label_name>Suphedrine 12 Hour 120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113005662</ndc>
    <ndc_label_name>Nighttime Cold-Flu 6.25 mg-15 mg-325 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113005673</ndc>
    <ndc_label_name>Nighttime Cold-Flu 6.25 mg-15 mg-325 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113005705</ndc>
    <ndc_label_name>Infant's Ibuprofen 50 mg/1.25 mL oral drops,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113005803</ndc>
    <ndc_label_name>GS OMEPRAZOLE-BICARB 20-1,100</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113006126</ndc>
    <ndc_label_name>Adult Tussin Chest Congestion 100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113006134</ndc>
    <ndc_label_name>Adult Tussin Chest Congestion 100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113007471</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113007478</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113008100</ndc>
    <ndc_label_name>Miconazole-3  200 mg-2 % (9 gram) vaginal kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113008464</ndc>
    <ndc_label_name>First Aid Antibiotic 3.5 mg-400 unit-5,000 unit/gram topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113008753</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) - Anti-Gas 2 mg-125 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113008762</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) - Anti-Gas 2 mg-125 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113009423</ndc>
    <ndc_label_name>Nasal Decongestant (phenylephrine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113009468</ndc>
    <ndc_label_name>Nasal Decongestant (phenylephrine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113009489</ndc>
    <ndc_label_name>Nasal Decongestant (phenylephrine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113009691</ndc>
    <ndc_label_name>Flu-Severe Cold-Cough Daytime 10 mg-20 mg-650 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113010862</ndc>
    <ndc_label_name>Complete Lice Treatment 4 %-0.33 %-0.5 % topical kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113011655</ndc>
    <ndc_label_name>GS LANSOPRAZOLE DR 15 MG ODT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113011701</ndc>
    <ndc_label_name>GS LANSOPRAZOLE DR 15 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113011702</ndc>
    <ndc_label_name>GS LANSOPRAZOLE DR 15 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113011703</ndc>
    <ndc_label_name>GS LANSOPRAZOLE DR 15 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113014165</ndc>
    <ndc_label_name>Acid Reducer (famotidine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113014762</ndc>
    <ndc_label_name>All Day Allergy-D 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113016110</ndc>
    <ndc_label_name>Infants' Pain and Fever 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113016626</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113016634</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113017025</ndc>
    <ndc_label_name>GS NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113017060</ndc>
    <ndc_label_name>GS NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113017071</ndc>
    <ndc_label_name>GS NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113018630</ndc>
    <ndc_label_name>Sleep Time 50 mg/30 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113018640</ndc>
    <ndc_label_name>Sleep Time 50 mg/30 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113018816</ndc>
    <ndc_label_name>Hemorrhoidal(phenyleph-min oil-petrolat)0.25 %-14 %-74.9 % rectal oint</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113018926</ndc>
    <ndc_label_name>Children's All Day Allergy (cetirizine) 1 mg/mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113019402</ndc>
    <ndc_label_name>Acid Reducer (famotidine) 20 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113019471</ndc>
    <ndc_label_name>Acid Reducer (famotidine) 20 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113020625</ndc>
    <ndc_label_name>GS NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113021226</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113021429</ndc>
    <ndc_label_name>Miconazole-7  2 % vaginal cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113022453</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113022462</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113022491</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113022771</ndc>
    <ndc_label_name>Pain Relief (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113027468</ndc>
    <ndc_label_name>GS ASPIRIN 81 MG CHEWABLE TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113027953</ndc>
    <ndc_label_name>Hemorrhoidal (phenyleph-cocoa) 0.25 %-88.44 % rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113029827</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG LIQUID GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113029858</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG LIQUID GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113030410</ndc>
    <ndc_label_name>Nasal Spray (oxymetazoline) 0.05 %</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113030601</ndc>
    <ndc_label_name>ClearLax 17 gram/dose oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113030602</ndc>
    <ndc_label_name>ClearLax 17 gram/dose oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113030603</ndc>
    <ndc_label_name>ClearLax 17 gram/dose oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113032365</ndc>
    <ndc_label_name>Lubricating Plus 0.5 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113033534</ndc>
    <ndc_label_name>Nighttime Cold-Flu Relief 6.25 mg-15 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113034405</ndc>
    <ndc_label_name>GS NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113037462</ndc>
    <ndc_label_name>Migraine Formula 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113037478</ndc>
    <ndc_label_name>Migraine Formula 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113037926</ndc>
    <ndc_label_name>Children's Allergy (diphenhydramine) 12.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113038428</ndc>
    <ndc_label_name>Cough DM ER 30 mg/5 mL oral suspension,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113038810</ndc>
    <ndc_label_name>No Drip 0.05 % nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113040378</ndc>
    <ndc_label_name>Pain Relief (acetaminophen) 325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113042225</ndc>
    <ndc_label_name>GS NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113042654</ndc>
    <ndc_label_name>Tioconazole-1 6.5 % vaginal ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113042865</ndc>
    <ndc_label_name>Gas Relief (simethicone) 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113043162</ndc>
    <ndc_label_name>Sleep Aid (diphenhydramine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113043262</ndc>
    <ndc_label_name>Nasal Decongestant (pseudoephedrine) 30 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113043771</ndc>
    <ndc_label_name>Pain Relief PM 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113044164</ndc>
    <ndc_label_name>Sleep Aid (doxylamine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113044173</ndc>
    <ndc_label_name>Sleep Aid (doxylamine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113044301</ndc>
    <ndc_label_name>Nasal Allergy 55 mcg spray aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113045660</ndc>
    <ndc_label_name>GS NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113046708</ndc>
    <ndc_label_name>GS ASPIRIN 81 MG CHEWABLE TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113046768</ndc>
    <ndc_label_name>GS ASPIRIN 81 MG CHEWABLE TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113047962</ndc>
    <ndc_label_name>Allergy Relief (diphenhydramine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113047978</ndc>
    <ndc_label_name>Allergy Relief (diphenhydramine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113047979</ndc>
    <ndc_label_name>Allergy Relief (diphenhydramine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113048462</ndc>
    <ndc_label_name>Pain Relief (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113048471</ndc>
    <ndc_label_name>Pain Relief (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113048478</ndc>
    <ndc_label_name>Pain Relief (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113048485</ndc>
    <ndc_label_name>Pain Relief Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113048490</ndc>
    <ndc_label_name>Pain Relief (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113050326</ndc>
    <ndc_label_name>Children's All Day Allergy (cetirizine) 1 mg/mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113051771</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113052055</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG ODT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113052074</ndc>
    <ndc_label_name>GS OMEPRAZOLE DR 20 MG ODT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113053260</ndc>
    <ndc_label_name>GS NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113053278</ndc>
    <ndc_label_name>GS NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113054164</ndc>
    <ndc_label_name>Anti-Itch (hydrocortisone) 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113054478</ndc>
    <ndc_label_name>Arthritis Pain Relief (acetaminophen) ER 650 mg tablet,extend release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113057826</ndc>
    <ndc_label_name>Tussin DM 10 mg-100 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113060334</ndc>
    <ndc_label_name>Severe Cold-Flu (phenylephrine) 5 mg-10 mg-325 mg-200 mg/15 mL liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113060340</ndc>
    <ndc_label_name>Severe Cold-Flu (phenylephrine) 5 mg-10 mg-325 mg-200 mg/15 mL liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113060462</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113060471</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113060478</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113060490</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113060826</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113061239</ndc>
    <ndc_label_name>Allergy Relief (loratadine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113061246</ndc>
    <ndc_label_name>Allergy Relief (loratadine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113061260</ndc>
    <ndc_label_name>Allergy Relief (loratadine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113061265</ndc>
    <ndc_label_name>Allergy Relief (loratadine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113061275</ndc>
    <ndc_label_name>Allergy Relief (loratadine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113061288</ndc>
    <ndc_label_name>Allergy Relief (loratadine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113062264</ndc>
    <ndc_label_name>Itch Relief 2 %-0.1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113064762</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113064771</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113064778</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113064810</ndc>
    <ndc_label_name>Nasal Four 1 % spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113065634</ndc>
    <ndc_label_name>Daytime Cold-Flu 5 mg-10 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113065772</ndc>
    <ndc_label_name>Gas Relief Ultra Strength 180 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113066026</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113066834</ndc>
    <ndc_label_name>NightTime Cough 6.25 mg-15 mg/15 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113067126</ndc>
    <ndc_label_name>Children's Allergy Relief (loratadine) 5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113068526</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113070326</ndc>
    <ndc_label_name>Tussin CF (PE-DM-guaif) 5 mg-10 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113070334</ndc>
    <ndc_label_name>Tussin CF (PE-DM-guaif) 5 mg-10 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113073402</ndc>
    <ndc_label_name>GS NICOTINE 2 MG MINI LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113079830</ndc>
    <ndc_label_name>Hair Regrowth Treatment 5 % topical solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113081266</ndc>
    <ndc_label_name>Mucus DM Max ER 60 mg-1,200 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113081710</ndc>
    <ndc_label_name>Sinus Nasal Spray 0.05 %</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113082529</ndc>
    <ndc_label_name>Miconazole-7  2 % vaginal cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113083926</ndc>
    <ndc_label_name>GS CHILD MUCUS RELIEF M-S COLD</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113084795</ndc>
    <ndc_label_name>Aller-Ease 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113086626</ndc>
    <ndc_label_name>Lice Killing 0.33 %-4 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113087305</ndc>
    <ndc_label_name>GS NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113089726</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113089734</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113089801</ndc>
    <ndc_label_name>GS ESOMEPRAZOLE MAG DR 20 MG</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113089802</ndc>
    <ndc_label_name>GS ESOMEPRAZOLE MAG DR 20 MG</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113089803</ndc>
    <ndc_label_name>GS ESOMEPRAZOLE MAG DR 20 MG</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113090162</ndc>
    <ndc_label_name>GS NAPROXEN SOD 220 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113090175</ndc>
    <ndc_label_name>GS NAPROXEN SOD 220 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113091530</ndc>
    <ndc_label_name>GS OMEPRAZOLE DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113091555</ndc>
    <ndc_label_name>GS OMEPRAZOLE DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113091574</ndc>
    <ndc_label_name>GS OMEPRAZOLE DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113092726</ndc>
    <ndc_label_name>Tussin DM Max 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113092734</ndc>
    <ndc_label_name>Tussin DM Max 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113094424</ndc>
    <ndc_label_name>Hemorrhoidal Cream 0.25 %-1 % rectal</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113094610</ndc>
    <ndc_label_name>Infants' Pain and Fever 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113095702</ndc>
    <ndc_label_name>GS NICOTINE 4 MG MINI LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113095760</ndc>
    <ndc_label_name>GS NICOTINE 4 MG MINI LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113095821</ndc>
    <ndc_label_name>Children's Cough DM ER 30 mg/5 mL oral suspension,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113095828</ndc>
    <ndc_label_name>Children's Cough DM ER 30 mg/5 mL oral suspension,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113097364</ndc>
    <ndc_label_name>Anti-Itch (hydrocortisone) 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113098726</ndc>
    <ndc_label_name>Children's Cold and Cough (PE) 1 mg-2.5 mg-5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113111401</ndc>
    <ndc_label_name>GS LANSOPRAZOLE DR 15 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113111402</ndc>
    <ndc_label_name>GS LANSOPRAZOLE DR 15 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113111403</ndc>
    <ndc_label_name>GS LANSOPRAZOLE DR 15 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113118901</ndc>
    <ndc_label_name>Arthritis Pain (diclofenac) 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113118903</ndc>
    <ndc_label_name>Arthritis Pain (diclofenac) 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113121285</ndc>
    <ndc_label_name>GS IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113164526</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 1 mg/7.5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113172001</ndc>
    <ndc_label_name>Nasonex 24hr Allergy 50 mcg/actuation nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113172002</ndc>
    <ndc_label_name>Nasonex 24hr Allergy 50 mcg/actuation nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113172011</ndc>
    <ndc_label_name>Nasonex 24hr Allergy 50 mcg/actuation nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113172526</ndc>
    <ndc_label_name>Tussin DM 5 mg-50 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113172534</ndc>
    <ndc_label_name>Tussin DM 5 mg-50 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113191016</ndc>
    <ndc_label_name>Lice Killing (permethrin) 1 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113200268</ndc>
    <ndc_label_name>Mucus D 60 mg-600 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113200289</ndc>
    <ndc_label_name>Mucus D 60 mg-600 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113200312</ndc>
    <ndc_label_name>Option-2  1.5 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113200760</ndc>
    <ndc_label_name>Allergy and Congestion Relief 5 mg-120 mg tablet,extend release 12 hr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113201760</ndc>
    <ndc_label_name>Sinus 12 Hour 120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113202358</ndc>
    <ndc_label_name>Mucus Relief ER 600 mg tablet, extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113202360</ndc>
    <ndc_label_name>Mucus Relief ER 600 mg tablet, extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113214762</ndc>
    <ndc_label_name>All Day Allergy-D 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113221949</ndc>
    <ndc_label_name>Mucus DM 30 mg-600 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113222462</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113246162</ndc>
    <ndc_label_name>GS IBUPROFEN 100 MG CHEW TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113403262</ndc>
    <ndc_label_name>Sleep Aid (doxylamine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113403267</ndc>
    <ndc_label_name>Sleep Aid (doxylamine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113407774</ndc>
    <ndc_label_name>Mucus Relief ER 1,200 mg tablet, extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113436862</ndc>
    <ndc_label_name>GS NAPROXEN SOD 220 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113436875</ndc>
    <ndc_label_name>GS NAPROXEN SOD 220 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113436878</ndc>
    <ndc_label_name>GS NAPROXEN SOD 220 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113436879</ndc>
    <ndc_label_name>GS NAPROXEN SOD 220 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113530016</ndc>
    <ndc_label_name>Dual Action Pain Reliever 125 mg-250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113530068</ndc>
    <ndc_label_name>Dual Action Pain Reliever 125 mg-250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113600203</ndc>
    <ndc_label_name>Prevacid 24Hr 15 mg capsule,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113601926</ndc>
    <ndc_label_name>Child Cough-Cold (bromphen-DM) 2 mg-10 mg/10 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113611703</ndc>
    <ndc_label_name>Prevacid 24Hr 15 mg capsule,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113777760</ndc>
    <ndc_label_name>Allergy Relief D12 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113810025</ndc>
    <ndc_label_name>GS NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113810101</ndc>
    <ndc_label_name>Opill 0.075 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113810103</ndc>
    <ndc_label_name>Opill 0.075 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113810104</ndc>
    <ndc_label_name>Opill 0.075 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113810106</ndc>
    <ndc_label_name>Opill 0.075 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113817501</ndc>
    <ndc_label_name>Arthritis Pain (diclofenac) 1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113830768</ndc>
    <ndc_label_name>Mucus D 60 mg-600 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113860025</ndc>
    <ndc_label_name>GS NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113891162</ndc>
    <ndc_label_name>Mucus D 120 mg-1,200 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113895926</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00113900422</ndc>
    <ndc_label_name>Allergy Relief D-24hr 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113945813</ndc>
    <ndc_label_name>All Day Allergy (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113945839</ndc>
    <ndc_label_name>All Day Allergy (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00113945866</ndc>
    <ndc_label_name>All Day Allergy (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115107001</ndc>
    <ndc_label_name>DIPYRIDAMOLE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115107101</ndc>
    <ndc_label_name>DIPYRIDAMOLE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115107201</ndc>
    <ndc_label_name>DIPYRIDAMOLE 75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115124808</ndc>
    <ndc_label_name>CARVEDILOL ER 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115124908</ndc>
    <ndc_label_name>CARVEDILOL ER 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115125008</ndc>
    <ndc_label_name>CARVEDILOL ER 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115125108</ndc>
    <ndc_label_name>CARVEDILOL ER 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115132019</ndc>
    <ndc_label_name>COLESEVELAM 625 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115132510</ndc>
    <ndc_label_name>FENOFIBRIC ACID DR 135 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115136529</ndc>
    <ndc_label_name>SEVELAMER 0.8 GM POWDER PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115136530</ndc>
    <ndc_label_name>SEVELAMER 0.8 GM POWDER PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115136629</ndc>
    <ndc_label_name>SEVELAMER 2.4 GM POWDER PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115136630</ndc>
    <ndc_label_name>SEVELAMER 2.4 GM POWDER PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115140408</ndc>
    <ndc_label_name>PYRIDOSTIGMINE ER 180 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115140801</ndc>
    <ndc_label_name>METHYLTESTOSTERONE 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115143613</ndc>
    <ndc_label_name>CYCLOBENZAPRINE ER 15 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115143713</ndc>
    <ndc_label_name>CYCLOBENZAPRINE ER 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115148601</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115148701</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115148801</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 15 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115148901</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115149001</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115149101</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115152210</ndc>
    <ndc_label_name>FENOFIBRATE 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115152310</ndc>
    <ndc_label_name>FENOFIBRATE 120 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115155410</ndc>
    <ndc_label_name>FENOFIBRIC ACID DR 45 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115155510</ndc>
    <ndc_label_name>FENOFIBRIC ACID DR 135 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115164301</ndc>
    <ndc_label_name>NITROFURANTOIN MCR 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115164501</ndc>
    <ndc_label_name>NITROFURANTOIN MCR 100 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115165901</ndc>
    <ndc_label_name>PROPRANOLOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115165903</ndc>
    <ndc_label_name>PROPRANOLOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115166001</ndc>
    <ndc_label_name>PROPRANOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115166003</ndc>
    <ndc_label_name>PROPRANOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115166101</ndc>
    <ndc_label_name>PROPRANOLOL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115166103</ndc>
    <ndc_label_name>PROPRANOLOL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115166201</ndc>
    <ndc_label_name>PROPRANOLOL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115166202</ndc>
    <ndc_label_name>PROPRANOLOL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115168774</ndc>
    <ndc_label_name>BUDESONIDE 0.25 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115168776</ndc>
    <ndc_label_name>BUDESONIDE 0.25 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115168974</ndc>
    <ndc_label_name>BUDESONIDE 0.5 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115168976</ndc>
    <ndc_label_name>BUDESONIDE 0.5 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115169301</ndc>
    <ndc_label_name>PROPRANOLOL 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115169430</ndc>
    <ndc_label_name>EPINEPHRINE 0.3 MG AUTO-INJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115169449</ndc>
    <ndc_label_name>EPINEPHRINE 0.3 MG AUTO-INJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115169530</ndc>
    <ndc_label_name>EPINEPHRINE 0.15 MG AUTO-INJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115169549</ndc>
    <ndc_label_name>EPINEPHRINE 0.15 MG AUTO-INJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115169606</ndc>
    <ndc_label_name>HYDROCORTISONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115169701</ndc>
    <ndc_label_name>HYDROCORTISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115170001</ndc>
    <ndc_label_name>HYDROCORTISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115170901</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 25 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115171001</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 35 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115172401</ndc>
    <ndc_label_name>GRISEOFULVIN ULTRA 125 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115172501</ndc>
    <ndc_label_name>GRISEOFULVIN ULTRA 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115173601</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(CD) 10MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115173701</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(CD) 20MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115173801</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(CD) 30MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115173901</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(CD) 40MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115174001</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(CD) 50MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115174101</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(CD) 60MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115174501</ndc>
    <ndc_label_name>METAXALONE 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115175008</ndc>
    <ndc_label_name>ACITRETIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115175108</ndc>
    <ndc_label_name>ACITRETIN 17.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115175308</ndc>
    <ndc_label_name>ACITRETIN 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115175701</ndc>
    <ndc_label_name>CYPROHEPTADINE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115180001</ndc>
    <ndc_label_name>METHYLPHENIDATE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115180101</ndc>
    <ndc_label_name>METHYLPHENIDATE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115180201</ndc>
    <ndc_label_name>METHYLPHENIDATE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115180301</ndc>
    <ndc_label_name>HYDROXYZINE PAM 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115180302</ndc>
    <ndc_label_name>HYDROXYZINE PAM 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115180401</ndc>
    <ndc_label_name>HYDROXYZINE PAM 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115180402</ndc>
    <ndc_label_name>HYDROXYZINE PAM 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115191101</ndc>
    <ndc_label_name>RIMANTADINE HCL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115202310</ndc>
    <ndc_label_name>NITROFURANTOIN MCR 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115261101</ndc>
    <ndc_label_name>TERBUTALINE SULFATE 2.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115262201</ndc>
    <ndc_label_name>TERBUTALINE SULFATE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115279006</ndc>
    <ndc_label_name>CHLOROQUINE PH 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115351101</ndc>
    <ndc_label_name>PYRIDOSTIGMINE BR 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115441101</ndc>
    <ndc_label_name>DANTROLENE SODIUM 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115442201</ndc>
    <ndc_label_name>DANTROLENE SODIUM 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115443301</ndc>
    <ndc_label_name>DANTROLENE SODIUM 100 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115521116</ndc>
    <ndc_label_name>COLESTIPOL HCL 1 GM TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115521218</ndc>
    <ndc_label_name>COLESTIPOL HCL GRANULES PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115521229</ndc>
    <ndc_label_name>COLESTIPOL HCL GRANULES PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115521302</ndc>
    <ndc_label_name>COLESTIPOL HCL GRANULES</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115551110</ndc>
    <ndc_label_name>FENOFIBRATE 54 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115552202</ndc>
    <ndc_label_name>FENOFIBRATE 160 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115552210</ndc>
    <ndc_label_name>FENOFIBRATE 160 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115592201</ndc>
    <ndc_label_name>PILOCARPINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115701009</ndc>
    <ndc_label_name>CHLOROQUINE PH 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115703301</ndc>
    <ndc_label_name>FLUDROCORTISONE 0.1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115703302</ndc>
    <ndc_label_name>FLUDROCORTISONE 0.1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115703701</ndc>
    <ndc_label_name>Methitest 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115991801</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115991901</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 10 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115992001</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 15 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115992101</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 20 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115992201</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 30 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115993076</ndc>
    <ndc_label_name>LEVALBUTEROL 0.31 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115993078</ndc>
    <ndc_label_name>LEVALBUTEROL 0.31 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115993176</ndc>
    <ndc_label_name>LEVALBUTEROL 0.63 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115993178</ndc>
    <ndc_label_name>LEVALBUTEROL 0.63 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115993276</ndc>
    <ndc_label_name>LEVALBUTEROL 1.25 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00115993278</ndc>
    <ndc_label_name>LEVALBUTEROL 1.25 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115993901</ndc>
    <ndc_label_name>LAMOTRIGINE ODT 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115994001</ndc>
    <ndc_label_name>LAMOTRIGINE ODT 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115994101</ndc>
    <ndc_label_name>LAMOTRIGINE ODT 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00115994201</ndc>
    <ndc_label_name>LAMOTRIGINE ODT 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00116102104</ndc>
    <ndc_label_name>Dyna-Hex 2 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116106032</ndc>
    <ndc_label_name>Dyna-Hex 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116106101</ndc>
    <ndc_label_name>Dyna-Hex 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116106104</ndc>
    <ndc_label_name>Dyna-Hex 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116106108</ndc>
    <ndc_label_name>Dyna-Hex 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116106116</ndc>
    <ndc_label_name>Dyna-Hex 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116106118</ndc>
    <ndc_label_name>Dyna-Hex 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116106132</ndc>
    <ndc_label_name>Dyna-Hex 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116106140</ndc>
    <ndc_label_name>Dyna-Hex 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116200104</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12% RINSE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116200105</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12%  15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116200106</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12%  15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116200107</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12%  15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116200115</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12% RINSE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116200116</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12% RINSE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00116299404</ndc>
    <ndc_label_name>Scrub Care Exidine 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116400508</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116400511</ndc>
    <ndc_label_name>LACTULOSE 20 GM/30 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116400515</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116400516</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116400530</ndc>
    <ndc_label_name>LACTULOSE 20 GM/30 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116400532</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116400540</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116400541</ndc>
    <ndc_label_name>LACTULOSE 20 GM/30 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116401010</ndc>
    <ndc_label_name>AMANTADINE 100 MG/10 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116401016</ndc>
    <ndc_label_name>AMANTADINE 50 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116401041</ndc>
    <ndc_label_name>AMANTADINE 100 MG/10 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116402316</ndc>
    <ndc_label_name>PROMETHAZINE 6.25 MG/5 ML SYRP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00116402416</ndc>
    <ndc_label_name>PROMETHAZINE-DM 6.25-15 MG/5ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00116402550</ndc>
    <ndc_label_name>LIDOCAINE HCL 4% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121043130</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121048900</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 12.5MG/5ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121048905</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 12.5MG/5ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121050405</ndc>
    <ndc_label_name>ACETAMINOP-CODEINE 120-12 MG/5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121050440</ndc>
    <ndc_label_name>ACETAMINOP-CODEINE 120-12 MG/5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121053005</ndc>
    <ndc_label_name>FERROUS SULF 300 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121057708</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121057716</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121057732</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121058104</ndc>
    <ndc_label_name>HALOPERIDOL LAC 2 MG/ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121058105</ndc>
    <ndc_label_name>HALOPERIDOL LAC 10 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121058115</ndc>
    <ndc_label_name>HALOPERIDOL LAC 2 MG/ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121059500</ndc>
    <ndc_label_name>SOD CITRATE-CITRIC ACID CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121059515</ndc>
    <ndc_label_name>SOD CITRATE-CITRIC ACID CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121059516</ndc>
    <ndc_label_name>SOD CITRATE-CITRIC ACID SOLN</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121059530</ndc>
    <ndc_label_name>SOD CITRATE-CITRIC ACID SOLN</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121063800</ndc>
    <ndc_label_name>GUAIFENESIN-DM 100-10 MG/5 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121063805</ndc>
    <ndc_label_name>GUAIFENESIN-DM 100-10 MG/5 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121064610</ndc>
    <ndc_label_name>AMANTADINE 100 MG/10 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121064616</ndc>
    <ndc_label_name>AMANTADINE 50 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121065304</ndc>
    <ndc_label_name>FLUPHENAZINE 5 MG/ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121065402</ndc>
    <ndc_label_name>FLUPHENAZINE 2.5 MG/5 ML ELIX</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121065416</ndc>
    <ndc_label_name>FLUPHENAZINE 2.5 MG/5 ML ELIX</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121065700</ndc>
    <ndc_label_name>ACETAMINOPHEN 160 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121065705</ndc>
    <ndc_label_name>ACETAMINOPHEN 160 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121065816</ndc>
    <ndc_label_name>TRIHEXYPHENIDYL 2 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121067016</ndc>
    <ndc_label_name>ETHOSUXIMIDE 250 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121067516</ndc>
    <ndc_label_name>VALPROIC ACID 250 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121067585</ndc>
    <ndc_label_name>VALPROIC ACID 250 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121067616</ndc>
    <ndc_label_name>POTASSIUM CIT-CITRIC ACID SOLN</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121067716</ndc>
    <ndc_label_name>Tricitrates 550 mg-500 mg-334 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121067816</ndc>
    <ndc_label_name>NORTRIPTYLINE 10 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121072104</ndc>
    <ndc_label_name>FLUOXETINE 20 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121072208</ndc>
    <ndc_label_name>senna 176 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121075908</ndc>
    <ndc_label_name>PREDNISOLONE 15 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121076616</ndc>
    <ndc_label_name>CALCIUM CARB 1,250 MG/5 ML SUS</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121077001</ndc>
    <ndc_label_name>LORAZEPAM 2 MG/ML ORAL CONCENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121077308</ndc>
    <ndc_label_name>PREDNISOLONE 10 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121077504</ndc>
    <ndc_label_name>GUAIFEN-CODEINE 100-10 MG/5 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121077516</ndc>
    <ndc_label_name>GUAIFEN-CODEINE 100-10 MG/5 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121077708</ndc>
    <ndc_label_name>PREDNISOLONE 20 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121079916</ndc>
    <ndc_label_name>LEVETIRACETAM 100 MG/ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121082016</ndc>
    <ndc_label_name>THEOPHYLLINE 80 MG/15 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121082515</ndc>
    <ndc_label_name>MORPHINE SULF 100 MG/5 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121082601</ndc>
    <ndc_label_name>OXYCODONE HCL 100 MG/5 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121083300</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121083305</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121085320</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP 20 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121085340</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP 20 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121085416</ndc>
    <ndc_label_name>Sulfatrim 200 mg-40 mg/5 mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121086500</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 12.5MG/5ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121086505</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 12.5MG/5ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121086800</ndc>
    <ndc_label_name>NYSTATIN 500,000 UNIT/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121086802</ndc>
    <ndc_label_name>NYSTATIN 100,000 UNIT/ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121086805</ndc>
    <ndc_label_name>NYSTATIN 500,000 UNIT/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121086816</ndc>
    <ndc_label_name>NYSTATIN 100,000 UNIT/ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121086850</ndc>
    <ndc_label_name>NYSTATIN 500,000 UNIT/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121087316</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121087332</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121087404</ndc>
    <ndc_label_name>CETIRIZINE HCL 1 MG/ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121087416</ndc>
    <ndc_label_name>CETIRIZINE HCL 1 MG/ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121088251</ndc>
    <ndc_label_name>ONDANSETRON 4 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121088508</ndc>
    <ndc_label_name>PREDNISOLONE 15 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121088516</ndc>
    <ndc_label_name>PREDNISOLONE 15 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121089020</ndc>
    <ndc_label_name>VANCOMYCIN HCL 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121089105</ndc>
    <ndc_label_name>FELBAMATE 600 MG/5 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121089120</ndc>
    <ndc_label_name>FELBAMATE 600 MG/5 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121089300</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12%  15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121089315</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12%  15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121089340</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12%  15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121090405</ndc>
    <ndc_label_name>MORPHINE SULF 10 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121090494</ndc>
    <ndc_label_name>MORPHINE SULF 10 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121091400</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121091405</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121092616</ndc>
    <ndc_label_name>Promethazine VC 6.25 mg-5 mg/5 mL oral syrup</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121093304</ndc>
    <ndc_label_name>BROMPHEN-PSE-DM 2-30-10 MG/5ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121093316</ndc>
    <ndc_label_name>BROMPHEN-PSE-DM 2-30-10 MG/5ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121093505</ndc>
    <ndc_label_name>DOCUSATE SODIUM 50 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121093540</ndc>
    <ndc_label_name>DOCUSATE SODIUM 50 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121094000</ndc>
    <ndc_label_name>Milk Of Magnesia Concentrated 2,400 mg/10 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121094010</ndc>
    <ndc_label_name>Milk Of Magnesia Concentrated 2,400 mg/10 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121094205</ndc>
    <ndc_label_name>PHENOBARBITAL 20 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121094216</ndc>
    <ndc_label_name>PHENOBARBITAL 20 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121094250</ndc>
    <ndc_label_name>PHENOBARBITAL 20 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121094816</ndc>
    <ndc_label_name>POTASSIUM CL 10% (20 MEQ/15ML)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121095003</ndc>
    <ndc_label_name>LIDOCAINE 2% VISCOUS SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121095608</ndc>
    <ndc_label_name>ATOVAQUONE 750 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121096501</ndc>
    <ndc_label_name>LACTULOSE 10 GM PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121096530</ndc>
    <ndc_label_name>LACTULOSE 10 GM PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121096600</ndc>
    <ndc_label_name>Children's Acetaminophen 160 mg/5 mL (5 mL) oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121096605</ndc>
    <ndc_label_name>Children's Acetaminophen 160 mg/5 mL (5 mL) oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121097001</ndc>
    <ndc_label_name>LIDOCAINE PAIN RELIEF 4% PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121097005</ndc>
    <ndc_label_name>LIDOCAINE PAIN RELIEF 4% PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121097030</ndc>
    <ndc_label_name>LIDOCAINE PAIN RELIEF 4% PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121097251</ndc>
    <ndc_label_name>LIDOCAINE HCL 4% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121097400</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121097410</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121097440</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121097450</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121097494</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121097610</ndc>
    <ndc_label_name>Cefotan 1 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121097655</ndc>
    <ndc_label_name>Cefotan 1 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121097710</ndc>
    <ndc_label_name>Cefotan 2 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121097755</ndc>
    <ndc_label_name>Cefotan 2 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121097800</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 25 MG/10ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121097810</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 25 MG/10ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121100230</ndc>
    <ndc_label_name>LIDOCAINE-PRILOCAINE CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121100812</ndc>
    <ndc_label_name>ACETAMIN-CODEIN 300-30 MG/12.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121100840</ndc>
    <ndc_label_name>ACETAMIN-CODEIN 300-30 MG/12.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121101205</ndc>
    <ndc_label_name>LACOSAMIDE 50 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121101295</ndc>
    <ndc_label_name>LACOSAMIDE 50 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121101605</ndc>
    <ndc_label_name>ATOVAQUONE 750 MG/5ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121101618</ndc>
    <ndc_label_name>ATOVAQUONE 750 MG/5ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121101642</ndc>
    <ndc_label_name>ATOVAQUONE 750 MG/5ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121101830</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 2-0.5MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121101930</ndc>
    <ndc_label_name>BUPRENORPHINE 2 MG TABLET SL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121102200</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121102205</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121102508</ndc>
    <ndc_label_name>CIMETIDINE 300 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121102716</ndc>
    <ndc_label_name>LITHIUM 8 MEQ/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121103416</ndc>
    <ndc_label_name>HYDROXYZINE 10 MG/5 ML SYRUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121103555</ndc>
    <ndc_label_name>LINCOMYCIN HCL 3 GM/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121103800</ndc>
    <ndc_label_name>MEGESTROL 400 MG/10ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121103810</ndc>
    <ndc_label_name>MEGESTROL 400 MG/10ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121103840</ndc>
    <ndc_label_name>MEGESTROL 400 MG/10ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121104516</ndc>
    <ndc_label_name>NYSTATIN 100,000 UNIT/ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121104700</ndc>
    <ndc_label_name>ACETAMINOPHEN 160 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121104705</ndc>
    <ndc_label_name>ACETAMINOPHEN 160 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121105355</ndc>
    <ndc_label_name>LEUPROLIDE 2WK 14 MG/2.8 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121106716</ndc>
    <ndc_label_name>GABAPENTIN 250 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121107016</ndc>
    <ndc_label_name>PROMETHAZINE-DM 6.25-15 MG/5ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121107255</ndc>
    <ndc_label_name>OLANZAPINE 10 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121107410</ndc>
    <ndc_label_name>BRIVARACETAM 10 MG/ML ORAL SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121107502</ndc>
    <ndc_label_name>BRIVARACETAM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121107555</ndc>
    <ndc_label_name>BRIVARACETAM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121107601</ndc>
    <ndc_label_name>MUPIROCIN 2% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121107650</ndc>
    <ndc_label_name>MUPIROCIN 2% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121107701</ndc>
    <ndc_label_name>BENZOCAINE 20% SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121107725</ndc>
    <ndc_label_name>BENZOCAINE 20% SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121115400</ndc>
    <ndc_label_name>LACTULOSE 20 GM/30 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121115406</ndc>
    <ndc_label_name>LACTULOSE 20 GM/30 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121115430</ndc>
    <ndc_label_name>LACTULOSE 20 GM/30 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121115440</ndc>
    <ndc_label_name>LACTULOSE 20 GM/30 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121119000</ndc>
    <ndc_label_name>SOD CITRATE-CITRIC ACID CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121119030</ndc>
    <ndc_label_name>SOD CITRATE-CITRIC ACID CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121127600</ndc>
    <ndc_label_name>GUAIFENESIN-DM 200-20 MG/10 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121127610</ndc>
    <ndc_label_name>GUAIFENESIN-DM 200-20 MG/10 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121131400</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG/10.15 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121131411</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG/10.15 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121135000</ndc>
    <ndc_label_name>VALPROIC ACID 500 MG/10 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121135010</ndc>
    <ndc_label_name>VALPROIC ACID 500 MG/10 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121148800</ndc>
    <ndc_label_name>GUAIFENESIN 200 MG/10 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121148810</ndc>
    <ndc_label_name>GUAIFENESIN 200 MG/10 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121154410</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 5-217/10</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121154440</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 5-217/10</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121155010</ndc>
    <ndc_label_name>GUAIFEN-CODEINE 200-20 MG/10ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121155040</ndc>
    <ndc_label_name>GUAIFEN-CODEINE 200-20 MG/10ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121157610</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/10 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121159810</ndc>
    <ndc_label_name>LEVETIRACETAM 1,000MG/10ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121159820</ndc>
    <ndc_label_name>LEVETIRACETAM 1,000MG/10ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121166600</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121166610</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121168015</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121169610</ndc>
    <ndc_label_name>CITALOPRAM HBR 20 MG/10 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121169640</ndc>
    <ndc_label_name>CITALOPRAM HBR 20 MG/10 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121173000</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 25 MG/10ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121173010</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 25 MG/10ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121174400</ndc>
    <ndc_label_name>GUAIFENESIN 100MG/5ML SOLN CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121174405</ndc>
    <ndc_label_name>GUAIFENESIN 100MG/5ML SOLN CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121174410</ndc>
    <ndc_label_name>GUAIFENESIN 100 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121174415</ndc>
    <ndc_label_name>GUAIFENESIN 100 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121176030</ndc>
    <ndc_label_name>MAG-AL 200 mg-200 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121176130</ndc>
    <ndc_label_name>Mag-Al Plus 200 mg-200 mg-20 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121176230</ndc>
    <ndc_label_name>Mag-Al Plus Extra Strength 400 mg-400 mg-40 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121177505</ndc>
    <ndc_label_name>GUAIFEN-CODEINE 100-10 MG/5 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121177540</ndc>
    <ndc_label_name>GUAIFEN-CODEINE 100-10 MG/5 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121178100</ndc>
    <ndc_label_name>Children's Acetaminophen 160 mg/5 mL (5 mL) oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121178105</ndc>
    <ndc_label_name>Children's Acetaminophen 160 mg/5 mL (5 mL) oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121182800</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121182810</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121185416</ndc>
    <ndc_label_name>PROMETHAZINE 6.25 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121187000</ndc>
    <ndc_label_name>DOCUSATE SOD 100 MG/10 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121187010</ndc>
    <ndc_label_name>DOCUSATE SOD 100 MG/10 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121188200</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG/10.15 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121188211</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG/10.15 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121188294</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG/10.15 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121188407</ndc>
    <ndc_label_name>PHENOBARBITAL 30 MG/7.5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121188450</ndc>
    <ndc_label_name>PHENOBARBITAL 30 MG/7.5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121189600</ndc>
    <ndc_label_name>POTASSIUM CL10%(40MEQ/30ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121189630</ndc>
    <ndc_label_name>POTASSIUM CL10%(40MEQ/30ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121189640</ndc>
    <ndc_label_name>POTASSIUM CL10%(40MEQ/30ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121189650</ndc>
    <ndc_label_name>POTASSIUM CL10%(40MEQ/30ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121193001</ndc>
    <ndc_label_name>LACTULOSE 20 GM PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121193030</ndc>
    <ndc_label_name>LACTULOSE 20 GM PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121197100</ndc>
    <ndc_label_name>ACETAMINOPHEN 650MG/20.3ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121197121</ndc>
    <ndc_label_name>ACETAMINOPHEN 650MG/20.3ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121202410</ndc>
    <ndc_label_name>LACOSAMIDE 100 MG/10 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121202495</ndc>
    <ndc_label_name>LACOSAMIDE 100 MG/10 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121203630</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 8-2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121203830</ndc>
    <ndc_label_name>BUPRENORPHINE 8 MG TABLET SL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121204400</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121204410</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121209400</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG/10.15 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121209411</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG/10.15 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121210602</ndc>
    <ndc_label_name>LEUPROLIDE 2WK 14 MG/2.8 ML KT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121213406</ndc>
    <ndc_label_name>GABAPENTIN 300 MG/6ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121213440</ndc>
    <ndc_label_name>GABAPENTIN 300 MG/6ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121223200</ndc>
    <ndc_label_name>GUAIFENESIN 300 MG/15 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121223215</ndc>
    <ndc_label_name>GUAIFENESIN 300 MG/15 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121231615</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMN 7.5-325/15</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121231650</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMN 7.5-325/15</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121252030</ndc>
    <ndc_label_name>POTASSIUM CL10%(40MEQ/30ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121282321</ndc>
    <ndc_label_name>ACETAMINOPHEN 650MG/20.3ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121282394</ndc>
    <ndc_label_name>ACETAMINOPHEN 650MG/20.3ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121282615</ndc>
    <ndc_label_name>PHENOBARBITAL 60 MG/15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121282650</ndc>
    <ndc_label_name>PHENOBARBITAL 60 MG/15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121284716</ndc>
    <ndc_label_name>POTASSIUM CL 20% (40 MEQ/15ML)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121303615</ndc>
    <ndc_label_name>LACOSAMIDE 150 MG/15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121303695</ndc>
    <ndc_label_name>LACOSAMIDE 150 MG/15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121314100</ndc>
    <ndc_label_name>ACETAMINOPHEN 650MG/20.3ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121314121</ndc>
    <ndc_label_name>ACETAMINOPHEN 650MG/20.3ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121402705</ndc>
    <ndc_label_name>LITHIUM 8 MEQ/5 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121402794</ndc>
    <ndc_label_name>LITHIUM 8 MEQ/5 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121404874</ndc>
    <ndc_label_name>LACOSAMIDE 200 MG/20 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121404895</ndc>
    <ndc_label_name>LACOSAMIDE 200 MG/20 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121406705</ndc>
    <ndc_label_name>GABAPENTIN 250 MG/5ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121406740</ndc>
    <ndc_label_name>GABAPENTIN 250 MG/5ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121457706</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121457715</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121457740</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121467500</ndc>
    <ndc_label_name>VALPROIC ACID 250 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121467505</ndc>
    <ndc_label_name>VALPROIC ACID 250 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121467540</ndc>
    <ndc_label_name>VALPROIC ACID 250 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121472105</ndc>
    <ndc_label_name>FLUOXETINE 20 MG/5 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121472215</ndc>
    <ndc_label_name>senna 176 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121475905</ndc>
    <ndc_label_name>PREDNISOLONE 15MG/5ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121475950</ndc>
    <ndc_label_name>PREDNISOLONE 15MG/5ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121476605</ndc>
    <ndc_label_name>CALCIUM CARB 1,250 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121477205</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 2.5-108/5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121477240</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 2.5-108/5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121478505</ndc>
    <ndc_label_name>NYSTATIN 500,000 UNIT/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121478535</ndc>
    <ndc_label_name>NYSTATIN 500,000 UNIT/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121479905</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121479940</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121479950</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121482015</ndc>
    <ndc_label_name>THEOPHYLLINE 80 MG/15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121482040</ndc>
    <ndc_label_name>THEOPHYLLINE 80 MG/15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121482225</ndc>
    <ndc_label_name>HYDROXYZINE 50 MG/25 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121482705</ndc>
    <ndc_label_name>OXYCODONE HCL 5 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121482740</ndc>
    <ndc_label_name>OXYCODONE HCL 5 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121482750</ndc>
    <ndc_label_name>OXYCODONE HCL 5 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121483905</ndc>
    <ndc_label_name>OXYCODONE HCL 5 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121483940</ndc>
    <ndc_label_name>OXYCODONE HCL 5 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121494800</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121494815</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121494840</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121494850</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121494880</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121494894</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121495015</ndc>
    <ndc_label_name>LIDOCAINE 2% VISCOUS 15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121495040</ndc>
    <ndc_label_name>LIDOCAINE 2% VISCOUS 15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121495505</ndc>
    <ndc_label_name>MORPHINE SULF 10 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00121495594</ndc>
    <ndc_label_name>MORPHINE SULF 10 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121496705</ndc>
    <ndc_label_name>SENNA 8.8 MG/5 ML SYRUP CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00121496740</ndc>
    <ndc_label_name>SENNA 8.8 MG/5 ML SYRUP CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126001661</ndc>
    <ndc_label_name>PreviDent 5000 Dry Mouth 1.1 % dental paste</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126002292</ndc>
    <ndc_label_name>PreviDent 5000 Enamel Protect 1.1 %-5 % dental paste</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126003316</ndc>
    <ndc_label_name>PreviDent 0.2 % dental solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00126003516</ndc>
    <ndc_label_name>Periogard 0.12 % mouthwash</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126007061</ndc>
    <ndc_label_name>PreviDent 5000 Sensitive 1.1 %-5 % dental paste</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126007292</ndc>
    <ndc_label_name>PreviDent 5000 Booster Plus 1.1 % dental paste</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126007492</ndc>
    <ndc_label_name>PreviDent 5000 Booster Plus 1.1 % dental paste</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00126008008</ndc>
    <ndc_label_name>Peroxyl 1.5 % mucosal solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126008802</ndc>
    <ndc_label_name>PreviDent 1.1 % gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00126013516</ndc>
    <ndc_label_name>Phos-Flur 0.02 % fluoride (0.044 % sodium fluoride) dental solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00126013816</ndc>
    <ndc_label_name>Phos-Flur 0.02 % fluoride (0.044 % sodium fluoride) dental solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00126013916</ndc>
    <ndc_label_name>Phos-Flur 0.02 % fluoride (0.044 % sodium fluoride) dental solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00126016593</ndc>
    <ndc_label_name>Gel-Kam 0.4 % dental</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126017916</ndc>
    <ndc_label_name>PreviDent 0.2 % dental solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00126019293</ndc>
    <ndc_label_name>Gel-Kam 0.4 % dental</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00126027216</ndc>
    <ndc_label_name>Periogard 0.12 % mouthwash</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126028666</ndc>
    <ndc_label_name>PreviDent 5000 Plus 1.1 % cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126028733</ndc>
    <ndc_label_name>PreviDent 5000 Plus 1.1 % cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126028766</ndc>
    <ndc_label_name>PreviDent 5000 Plus 1.1 % cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126028802</ndc>
    <ndc_label_name>PreviDent 1.1 % gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126028992</ndc>
    <ndc_label_name>PreviDent 5000 Ortho Defense 1.1 % dental paste</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00126031192</ndc>
    <ndc_label_name>PreviDent Kids 1.1 % dental paste</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00127136677</ndc>
    <ndc_label_name>Lobana Peri-Garde topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00127136688</ndc>
    <ndc_label_name>Lobana Peri-Garde topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00127154006</ndc>
    <ndc_label_name>Lobana Body lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00127154012</ndc>
    <ndc_label_name>Lobana Body lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00127154016</ndc>
    <ndc_label_name>Lobana Body lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00127166016</ndc>
    <ndc_label_name>Pheneen topical solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00127178606</ndc>
    <ndc_label_name>Surgel topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00127178612</ndc>
    <ndc_label_name>Surgel topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00127178616</ndc>
    <ndc_label_name>Surgel topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00127303612</ndc>
    <ndc_label_name>Lobana Bath oil</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00127330202</ndc>
    <ndc_label_name>Ta-Poff topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00131181067</ndc>
    <ndc_label_name>Vimpat 200 mg/20 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00131247735</ndc>
    <ndc_label_name>Vimpat 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00131247760</ndc>
    <ndc_label_name>Vimpat 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00131247835</ndc>
    <ndc_label_name>Vimpat 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00131247860</ndc>
    <ndc_label_name>Vimpat 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00131247935</ndc>
    <ndc_label_name>Vimpat 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00131247960</ndc>
    <ndc_label_name>Vimpat 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00131248035</ndc>
    <ndc_label_name>Vimpat 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00131248060</ndc>
    <ndc_label_name>Vimpat 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00131541072</ndc>
    <ndc_label_name>Vimpat 10 mg/mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132000036</ndc>
    <ndc_label_name>Phazyme 500 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132000046</ndc>
    <ndc_label_name>Fleet Mineral Oil 50 % oral emulsion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132000047</ndc>
    <ndc_label_name>Fleet Bisacodyl 5 mg tablet,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132000048</ndc>
    <ndc_label_name>Fleet Docusate 100 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132000050</ndc>
    <ndc_label_name>Fleet Mini (bisacodyl) 10 mg/30 mL enema</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132000106</ndc>
    <ndc_label_name>Pedia-Lax Stool Softener 50 mg/15 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00132000206</ndc>
    <ndc_label_name>Phazyme 180 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00132000211</ndc>
    <ndc_label_name>Phazyme 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00132000214</ndc>
    <ndc_label_name>Phazyme 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00132000215</ndc>
    <ndc_label_name>Phazyme 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132000507</ndc>
    <ndc_label_name>PHAZYME GAS AND ACID CHEW TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00132000508</ndc>
    <ndc_label_name>Phazyme 180 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132000655</ndc>
    <ndc_label_name>Pedia-Lax (mag hydroxide) 400 mg (170 mg magnesium) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132002011</ndc>
    <ndc_label_name>Fleet Enema Extra 19 gram-7 gram/197 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132007900</ndc>
    <ndc_label_name>Fleet Glycerin (Adult) rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132007912</ndc>
    <ndc_label_name>Fleet Glycerin (Adult) rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132007924</ndc>
    <ndc_label_name>Fleet Glycerin (Adult) rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132007950</ndc>
    <ndc_label_name>Fleet Glycerin (Adult) rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132010624</ndc>
    <ndc_label_name>Pedia-Lax Stool Softener 50 mg/15 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00132011946</ndc>
    <ndc_label_name>Fleet Enema 19 gram-7 gram/118 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132018582</ndc>
    <ndc_label_name>Fleet Glycerin Laxative 5.4 gram/5.4 mL rectal solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132019012</ndc>
    <ndc_label_name>Pedia-Lax 2.8 gram/2.7 mL rectal solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00132020140</ndc>
    <ndc_label_name>Fleet Enema 19 gram-7 gram/118 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00132020142</ndc>
    <ndc_label_name>Fleet Enema 19 gram-7 gram/118 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00132020145</ndc>
    <ndc_label_name>Fleet Enema 19 gram-7 gram/118 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132020220</ndc>
    <ndc_label_name>Fleet Pediatric 9.5 gram-3.5 gram/59 mL enema</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00132021112</ndc>
    <ndc_label_name>Phazyme 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132030140</ndc>
    <ndc_label_name>Fleet Mineral Oil enema</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132065501</ndc>
    <ndc_label_name>Pedia-Lax (mag hydroxide) 400 mg (170 mg magnesium) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132070336</ndc>
    <ndc_label_name>Fleet Bisacodyl 10 mg/30 mL enema</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00132874302</ndc>
    <ndc_label_name>Summer's Eve Douche 0.3 %</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007003</ndc>
    <ndc_label_name>Tums 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007027</ndc>
    <ndc_label_name>Tums 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007048</ndc>
    <ndc_label_name>Tums 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007127</ndc>
    <ndc_label_name>Tums 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007148</ndc>
    <ndc_label_name>Tums 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007401</ndc>
    <ndc_label_name>Tums E-X 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007406</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007407</ndc>
    <ndc_label_name>Tums E-X 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007422</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007424</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007425</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007446</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135007625</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135008969</ndc>
    <ndc_label_name>Citrucel (sucrose) oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135008971</ndc>
    <ndc_label_name>Citrucel (sucrose) oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135009070</ndc>
    <ndc_label_name>Citrucel Sugar Free oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135009074</ndc>
    <ndc_label_name>Citrucel Sugar Free oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135009075</ndc>
    <ndc_label_name>Citrucel Sugar Free oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135009441</ndc>
    <ndc_label_name>GAVISCON LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135009541</ndc>
    <ndc_label_name>Gaviscon Extra Strength 254 mg-237.5 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135009826</ndc>
    <ndc_label_name>Gaviscon Extra Strength 160 mg-105 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135011814</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135011883</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135014001</ndc>
    <ndc_label_name>Tums E-X 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135014003</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135014502</ndc>
    <ndc_label_name>Nicoderm CQ 21 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135015405</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135015501</ndc>
    <ndc_label_name>Tums 320 mg calcium (750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135015707</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135015710</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135015711</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135015807</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135015810</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135015811</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135017802</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135017803</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135017808</ndc>
    <ndc_label_name>Tums E-X 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135018002</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135018014</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135018102</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135018105</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135018107</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135018114</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135018301</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019401</ndc>
    <ndc_label_name>Nicoderm CQ 21 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019402</ndc>
    <ndc_label_name>Nicoderm CQ 21 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019403</ndc>
    <ndc_label_name>Nicoderm CQ 21 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019405</ndc>
    <ndc_label_name>Nicoderm CQ 21 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019408</ndc>
    <ndc_label_name>Nicoderm CQ 21 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019502</ndc>
    <ndc_label_name>Nicoderm CQ 14 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019503</ndc>
    <ndc_label_name>Nicoderm CQ 14 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019505</ndc>
    <ndc_label_name>Nicoderm CQ 14 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019508</ndc>
    <ndc_label_name>Nicoderm CQ 14 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019602</ndc>
    <ndc_label_name>Nicoderm CQ 7 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019605</ndc>
    <ndc_label_name>Nicoderm CQ 7 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019608</ndc>
    <ndc_label_name>Nicoderm CQ 7 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019901</ndc>
    <ndc_label_name>Citrucel 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019902</ndc>
    <ndc_label_name>Citrucel 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135019907</ndc>
    <ndc_label_name>Citrucel 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135020001</ndc>
    <ndc_label_name>Abreva 10 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135020003</ndc>
    <ndc_label_name>Abreva 10 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135020005</ndc>
    <ndc_label_name>Abreva 10 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135020006</ndc>
    <ndc_label_name>Abreva 10 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135022503</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135022602</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135022603</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135022801</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135022905</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135023004</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135023005</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135023501</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135023502</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135024102</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135024105</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135024106</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135024108</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135024202</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135024205</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135024206</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135024208</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135024302</ndc>
    <ndc_label_name>Tums Extra Strength Smoothies 300 mg (as carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135024502</ndc>
    <ndc_label_name>Tums Extra Strength Smoothies 300 mg (as carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135024601</ndc>
    <ndc_label_name>Tums Extra Strength Smoothies 300 mg (as carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135024602</ndc>
    <ndc_label_name>Tums Extra Strength Smoothies 300 mg (as carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135024605</ndc>
    <ndc_label_name>Tums Extra Strength Smoothies 300 mg (as carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135030001</ndc>
    <ndc_label_name>Abreva 10 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135035503</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135043003</ndc>
    <ndc_label_name>Gaviscon Extra Strength 160 mg-105 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135045601</ndc>
    <ndc_label_name>Tums Extra Strength Smoothies 300 mg (as carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135045603</ndc>
    <ndc_label_name>Tums Extra Strength Smoothies 300 mg (as carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135045605</ndc>
    <ndc_label_name>Tums Extra Strength Smoothies 300 mg (as carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135046101</ndc>
    <ndc_label_name>Alli 60 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135046102</ndc>
    <ndc_label_name>Alli 60 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135046105</ndc>
    <ndc_label_name>Alli 60 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135046106</ndc>
    <ndc_label_name>Alli 60 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135046601</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135046602</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135046605</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135046608</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135046702</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135046705</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135046708</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135046901</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135047401</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135047402</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135047403</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135047405</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135047408</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135047418</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135047501</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135047502</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135047503</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135047505</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135047508</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135050802</ndc>
    <ndc_label_name>Nicorette 2 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135050803</ndc>
    <ndc_label_name>Nicorette 2 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135050804</ndc>
    <ndc_label_name>Nicorette 2 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135050902</ndc>
    <ndc_label_name>Nicorette 4 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135050903</ndc>
    <ndc_label_name>Nicorette 4 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135050904</ndc>
    <ndc_label_name>Nicorette 4 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051001</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051002</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051003</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051005</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051006</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051007</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051101</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051102</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051105</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051106</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051107</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051201</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051205</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051301</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051305</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051403</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051404</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135051503</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135052202</ndc>
    <ndc_label_name>Tums Freshers 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135052203</ndc>
    <ndc_label_name>Tums Freshers 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135053202</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135053203</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135053302</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135054103</ndc>
    <ndc_label_name>Tums Freshers 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135056001</ndc>
    <ndc_label_name>Tums Ultra 470 mg (as calcium carbonate 1,177 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135056002</ndc>
    <ndc_label_name>Tums Ultra 470 mg (as calcium carbonate 1,177 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135057401</ndc>
    <ndc_label_name>Gaviscon Extra Strength 254 mg-237.5 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135057602</ndc>
    <ndc_label_name>Flonase Allergy Relief 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135057603</ndc>
    <ndc_label_name>Flonase Allergy Relief 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135057604</ndc>
    <ndc_label_name>Flonase Allergy Relief 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135057614</ndc>
    <ndc_label_name>Flonase Allergy Relief 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135057615</ndc>
    <ndc_label_name>Flonase Allergy Relief 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135057616</ndc>
    <ndc_label_name>Flonase Allergy Relief 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135057617</ndc>
    <ndc_label_name>Flonase Allergy Relief 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135057801</ndc>
    <ndc_label_name>Flonase Headache-Allergy Relief 2 mg-5 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135057802</ndc>
    <ndc_label_name>Flonase Headache-Allergy Relief 2 mg-5 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135057803</ndc>
    <ndc_label_name>Flonase Headache-Allergy Relief 2 mg-5 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135058201</ndc>
    <ndc_label_name>Children's Flonase Allergy Relief 50 mcg/actuation nasal spray,susp</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135058202</ndc>
    <ndc_label_name>Children's Flonase Allergy Relief 50 mcg/actuation nasal spray,susp</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135058204</ndc>
    <ndc_label_name>Children's Flonase Allergy Relief 50 mcg/actuation nasal spray,susp</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135060601</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135060602</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135060604</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135061101</ndc>
    <ndc_label_name>Tums 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135061502</ndc>
    <ndc_label_name>Flonase Sensimist 27.5 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135061503</ndc>
    <ndc_label_name>Flonase Sensimist 27.5 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135061504</ndc>
    <ndc_label_name>Flonase Sensimist 27.5 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135061505</ndc>
    <ndc_label_name>Flonase Sensimist 27.5 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135061506</ndc>
    <ndc_label_name>Flonase Sensimist 27.5 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135061601</ndc>
    <ndc_label_name>Children's Flonase Sensimist 27.5 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135062501</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135062502</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135062601</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135062602</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135063501</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135063502</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135063601</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135063602</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135100001</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135100002</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135132601</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135132603</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00135132801</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135150001</ndc>
    <ndc_label_name>Nicorette 4 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135150002</ndc>
    <ndc_label_name>Nicorette 4 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135280001</ndc>
    <ndc_label_name>Nicorette 2 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135280002</ndc>
    <ndc_label_name>Nicorette 2 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135805081</ndc>
    <ndc_label_name>Nicorette 2 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00135806081</ndc>
    <ndc_label_name>Nicorette 4 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00140000401</ndc>
    <ndc_label_name>Valium 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00140000501</ndc>
    <ndc_label_name>Valium 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143117101</ndc>
    <ndc_label_name>CAPTOPRIL 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143117110</ndc>
    <ndc_label_name>CAPTOPRIL 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143117201</ndc>
    <ndc_label_name>CAPTOPRIL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143117210</ndc>
    <ndc_label_name>CAPTOPRIL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143117301</ndc>
    <ndc_label_name>CAPTOPRIL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143117310</ndc>
    <ndc_label_name>CAPTOPRIL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143117401</ndc>
    <ndc_label_name>CAPTOPRIL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143122701</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143122710</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143124001</ndc>
    <ndc_label_name>DIGOXIN 125 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143124010</ndc>
    <ndc_label_name>DIGOXIN 125 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143124101</ndc>
    <ndc_label_name>DIGOXIN 250 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143124110</ndc>
    <ndc_label_name>DIGOXIN 250 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143145501</ndc>
    <ndc_label_name>PHENOBARBITAL 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143145505</ndc>
    <ndc_label_name>PHENOBARBITAL 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143145801</ndc>
    <ndc_label_name>PHENOBARBITAL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143145805</ndc>
    <ndc_label_name>PHENOBARBITAL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143149501</ndc>
    <ndc_label_name>PHENOBARBITAL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143149505</ndc>
    <ndc_label_name>PHENOBARBITAL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143150001</ndc>
    <ndc_label_name>PHENOBARBITAL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143150005</ndc>
    <ndc_label_name>PHENOBARBITAL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143176901</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143176910</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143177101</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143177110</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143177201</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143177210</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143211205</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143211250</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143301801</ndc>
    <ndc_label_name>COLCHICINE 0.6 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143301810</ndc>
    <ndc_label_name>COLCHICINE 0.6 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143301830</ndc>
    <ndc_label_name>COLCHICINE 0.6 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143314150</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143314250</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143900501</ndc>
    <ndc_label_name>TESTOSTERONE CYP 2,000 MG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143900601</ndc>
    <ndc_label_name>ACETAZOLAMIDE SOD 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143902201</ndc>
    <ndc_label_name>FULVESTRANT 250 MG/5 ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143902202</ndc>
    <ndc_label_name>FULVESTRANT 250 MG/5 ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143908401</ndc>
    <ndc_label_name>DOXORUBICIN 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143908501</ndc>
    <ndc_label_name>DOXORUBICIN 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143908601</ndc>
    <ndc_label_name>DOXORUBICIN 50 MG/25 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143908701</ndc>
    <ndc_label_name>DOXORUBICIN 200 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143908801</ndc>
    <ndc_label_name>DOXORUBICIN 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143908901</ndc>
    <ndc_label_name>DOXORUBICIN 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143909001</ndc>
    <ndc_label_name>DOXORUBICIN 50 MG/25 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143909101</ndc>
    <ndc_label_name>DOXORUBICIN 200 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143909201</ndc>
    <ndc_label_name>DOXORUBICIN 10 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143909301</ndc>
    <ndc_label_name>DOXORUBICIN 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143909401</ndc>
    <ndc_label_name>METHYLENE BLUE 50 MG/10ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143909405</ndc>
    <ndc_label_name>METHYLENE BLUE 50 MG/10ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143909801</ndc>
    <ndc_label_name>BORTEZOMIB 3.5 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143912801</ndc>
    <ndc_label_name>GENTAMICIN 80 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143912825</ndc>
    <ndc_label_name>GENTAMICIN 80 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143913501</ndc>
    <ndc_label_name>MITOMYCIN 20 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143913601</ndc>
    <ndc_label_name>MITOMYCIN 40 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143913901</ndc>
    <ndc_label_name>CEFAZOLIN 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143913925</ndc>
    <ndc_label_name>CEFAZOLIN 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143914001</ndc>
    <ndc_label_name>CEFAZOLIN 3 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143914025</ndc>
    <ndc_label_name>CEFAZOLIN 3 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143914101</ndc>
    <ndc_label_name>DOBUTAMINE 250 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143914110</ndc>
    <ndc_label_name>DOBUTAMINE 250 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143914401</ndc>
    <ndc_label_name>LIRAGLUTIDE 18 MG/3 ML PEN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143914402</ndc>
    <ndc_label_name>LIRAGLUTIDE 2-PAK 18 MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143914403</ndc>
    <ndc_label_name>LIRAGLUTIDE 3-PAK 18 MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143915001</ndc>
    <ndc_label_name>Combogesic IV 300 mg-1,000 mg/100 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143915010</ndc>
    <ndc_label_name>Combogesic IV 300 mg-1,000 mg/100 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143915201</ndc>
    <ndc_label_name>VANCOMYCIN HCL 1.25 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143915210</ndc>
    <ndc_label_name>VANCOMYCIN HCL 1.25 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143915301</ndc>
    <ndc_label_name>VANCOMYCIN HCL 1.5 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143915310</ndc>
    <ndc_label_name>VANCOMYCIN HCL 1.5 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143915501</ndc>
    <ndc_label_name>FUROSEMIDE 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143915525</ndc>
    <ndc_label_name>FUROSEMIDE 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143915601</ndc>
    <ndc_label_name>FUROSEMIDE 40 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143915610</ndc>
    <ndc_label_name>FUROSEMIDE 40 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143915701</ndc>
    <ndc_label_name>FUROSEMIDE 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143915710</ndc>
    <ndc_label_name>FUROSEMIDE 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143915801</ndc>
    <ndc_label_name>FUROSEMIDE 500 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143915901</ndc>
    <ndc_label_name>FUROSEMIDE 1,000 MG/100 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143916001</ndc>
    <ndc_label_name>CISATRACURIUM 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143916010</ndc>
    <ndc_label_name>CISATRACURIUM 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143916101</ndc>
    <ndc_label_name>VANCOMYCIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143916110</ndc>
    <ndc_label_name>VANCOMYCIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143916125</ndc>
    <ndc_label_name>VANCOMYCIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143916201</ndc>
    <ndc_label_name>VANCOMYCIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143916210</ndc>
    <ndc_label_name>VANCOMYCIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143916301</ndc>
    <ndc_label_name>VANCOMYCIN HCL 5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143916401</ndc>
    <ndc_label_name>VANCOMYCIN HCL 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143916501</ndc>
    <ndc_label_name>Enoby 60 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143916601</ndc>
    <ndc_label_name>Xtrenbo 120 mg/1.7 mL (70 mg/mL) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143916701</ndc>
    <ndc_label_name>ERIBULIN MESYLATE 1 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143916801</ndc>
    <ndc_label_name>Starjemza 45 mg/0.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143916901</ndc>
    <ndc_label_name>Starjemza 45 mg/0.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143917001</ndc>
    <ndc_label_name>Starjemza 90 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143917101</ndc>
    <ndc_label_name>Starjemza 130 mg/26 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143917201</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 200 MG/20 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143917210</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 200 MG/20 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143917301</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% 400 MG/20 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143917310</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% 400 MG/20 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143918001</ndc>
    <ndc_label_name>CALCIUM GLUC 1,000 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143918025</ndc>
    <ndc_label_name>CALCIUM GLUC 1,000 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143918301</ndc>
    <ndc_label_name>LABETALOL HCL 20 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143918310</ndc>
    <ndc_label_name>LABETALOL HCL 20 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143918401</ndc>
    <ndc_label_name>CALCIUM GLUC 5,000 MG/50 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143918425</ndc>
    <ndc_label_name>CALCIUM GLUC 5,000 MG/50 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143918501</ndc>
    <ndc_label_name>CALCIUM GLUC 10,000 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143918520</ndc>
    <ndc_label_name>CALCIUM GLUC 10,000 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143919201</ndc>
    <ndc_label_name>FOSCARNET 6,000 MG/250 ML BTTL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143919501</ndc>
    <ndc_label_name>ROPIVACAINE 0.2% 200 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143919524</ndc>
    <ndc_label_name>ROPIVACAINE 0.2% 200 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143919601</ndc>
    <ndc_label_name>ROPIVACAINE 0.2% 400 MG/200 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143919612</ndc>
    <ndc_label_name>ROPIVACAINE 0.2% 400 MG/200 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143919701</ndc>
    <ndc_label_name>ROPIVACAINE 0.5% 500 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143919724</ndc>
    <ndc_label_name>ROPIVACAINE 0.5% 500 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143919801</ndc>
    <ndc_label_name>DEXMEDETOMIDINE 1000MCG/250-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143919810</ndc>
    <ndc_label_name>DEXMEDETOMIDINE 1000MCG/250-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143919901</ndc>
    <ndc_label_name>OLANZAPINE 10 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143920401</ndc>
    <ndc_label_name>DOCETAXEL 20 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143920501</ndc>
    <ndc_label_name>DOCETAXEL 80 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143920901</ndc>
    <ndc_label_name>CHLOROPROCAINE 2% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143920910</ndc>
    <ndc_label_name>CHLOROPROCAINE 2% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143921001</ndc>
    <ndc_label_name>CHLOROPROCAINE 3% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143921010</ndc>
    <ndc_label_name>CHLOROPROCAINE 3% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143921701</ndc>
    <ndc_label_name>IDARUBICIN HCL 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143921801</ndc>
    <ndc_label_name>IDARUBICIN HCL 10 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143921901</ndc>
    <ndc_label_name>IDARUBICIN HCL 20 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143923201</ndc>
    <ndc_label_name>VECURONIUM 20 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143923210</ndc>
    <ndc_label_name>VECURONIUM 20 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143923301</ndc>
    <ndc_label_name>BENZTROPINE 2 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143923305</ndc>
    <ndc_label_name>BENZTROPINE 2 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143923401</ndc>
    <ndc_label_name>VECURONIUM 10 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143923410</ndc>
    <ndc_label_name>VECURONIUM 10 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143924001</ndc>
    <ndc_label_name>BLEOMYCIN SULFATE 15 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143924101</ndc>
    <ndc_label_name>BLEOMYCIN SULFATE 30 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143924501</ndc>
    <ndc_label_name>DACARBAZINE 200 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143924510</ndc>
    <ndc_label_name>DACARBAZINE 200 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143924701</ndc>
    <ndc_label_name>DEXRAZOXANE 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143924801</ndc>
    <ndc_label_name>DEXRAZOXANE 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143924920</ndc>
    <ndc_label_name>AMOX-CLAV 875-125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143925001</ndc>
    <ndc_label_name>ROCURONIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143925010</ndc>
    <ndc_label_name>ROCURONIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143925101</ndc>
    <ndc_label_name>ROCURONIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143925110</ndc>
    <ndc_label_name>ROCURONIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143925201</ndc>
    <ndc_label_name>DOPAMINE 200 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143925225</ndc>
    <ndc_label_name>DOPAMINE 200 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143925401</ndc>
    <ndc_label_name>DOPAMINE 400 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143925425</ndc>
    <ndc_label_name>DOPAMINE 400 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143926001</ndc>
    <ndc_label_name>MESNA 1 GRAM/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143926101</ndc>
    <ndc_label_name>CEFAZOLIN 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143926110</ndc>
    <ndc_label_name>CEFAZOLIN 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143926201</ndc>
    <ndc_label_name>CEFAZOLIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143926225</ndc>
    <ndc_label_name>CEFAZOLIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143926301</ndc>
    <ndc_label_name>ROPIVACAINE 0.2% 40 MG/20 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143926310</ndc>
    <ndc_label_name>ROPIVACAINE 0.2% 40 MG/20 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143926401</ndc>
    <ndc_label_name>ROPIVACAINE 0.5% 150 MG/30 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143926410</ndc>
    <ndc_label_name>ROPIVACAINE 0.5% 150 MG/30 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143926501</ndc>
    <ndc_label_name>ROPIVACAINE 0.75% 150 MG/20 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143926510</ndc>
    <ndc_label_name>ROPIVACAINE 0.75% 150 MG/20 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143926601</ndc>
    <ndc_label_name>ROPIVACAINE 1% 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143926610</ndc>
    <ndc_label_name>ROPIVACAINE 1% 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143926701</ndc>
    <ndc_label_name>CLINDAMYCIN 300 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143926801</ndc>
    <ndc_label_name>CLINDAMYCIN 600 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143926901</ndc>
    <ndc_label_name>CLINDAMYCIN 900 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143927301</ndc>
    <ndc_label_name>DIHYDROERGOTAMINE 1 MG/ML AMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143927310</ndc>
    <ndc_label_name>DIHYDROERGOTAMINE 1 MG/ML AMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143927701</ndc>
    <ndc_label_name>Adriamycin 50 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143927901</ndc>
    <ndc_label_name>MITOMYCIN 20 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143928001</ndc>
    <ndc_label_name>MITOMYCIN 40 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143928101</ndc>
    <ndc_label_name>LEVETIRACETAM-NACL 500 MG/100</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143928110</ndc>
    <ndc_label_name>LEVETIRACETAM-NACL 500 MG/100</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143928201</ndc>
    <ndc_label_name>LEVETIRACETAM-NACL 1,000MG/100</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143928210</ndc>
    <ndc_label_name>LEVETIRACETAM-NACL 1,000MG/100</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143928301</ndc>
    <ndc_label_name>LEVETIRACETAM-NACL 1,500MG/100</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143928310</ndc>
    <ndc_label_name>LEVETIRACETAM-NACL 1,500MG/100</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143928401</ndc>
    <ndc_label_name>PANTOPRAZOLE SODIUM 40 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143928410</ndc>
    <ndc_label_name>PANTOPRAZOLE SODIUM 40 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143928501</ndc>
    <ndc_label_name>AMOXICILLIN 875 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143928520</ndc>
    <ndc_label_name>AMOXICILLIN 875 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143928801</ndc>
    <ndc_label_name>ARGATROBAN 250 MG/2.5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143928901</ndc>
    <ndc_label_name>ESTRADIOL VALERATE 50 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143929001</ndc>
    <ndc_label_name>ESTRADIOL VALERATE 100 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143929101</ndc>
    <ndc_label_name>ESTRADIOL VALERATE 200 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143929201</ndc>
    <ndc_label_name>THIOTEPA 100 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143929501</ndc>
    <ndc_label_name>HALOPERIDOL DEC 100 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143929601</ndc>
    <ndc_label_name>HALOPERIDOL DEC 500 MG/5 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143929701</ndc>
    <ndc_label_name>DANTROLENE SODIUM 20 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143929801</ndc>
    <ndc_label_name>SOD FER GLUC CPLX 62.5 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143929810</ndc>
    <ndc_label_name>SOD FER GLUC CPLX 62.5 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143929901</ndc>
    <ndc_label_name>GANCICLOVIR 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143929910</ndc>
    <ndc_label_name>GANCICLOVIR 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143930001</ndc>
    <ndc_label_name>PANTOPRAZOLE SODIUM 40 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143930010</ndc>
    <ndc_label_name>PANTOPRAZOLE SODIUM 40 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143930601</ndc>
    <ndc_label_name>IDARUBICIN HCL 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143930701</ndc>
    <ndc_label_name>IDARUBICIN HCL 10 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143930801</ndc>
    <ndc_label_name>IDARUBICIN HCL 20 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143930901</ndc>
    <ndc_label_name>THIOTEPA 15 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143931001</ndc>
    <ndc_label_name>ETOMIDATE 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143931010</ndc>
    <ndc_label_name>ETOMIDATE 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143931101</ndc>
    <ndc_label_name>ETOMIDATE 40 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143931110</ndc>
    <ndc_label_name>ETOMIDATE 40 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143931501</ndc>
    <ndc_label_name>LEVOFLOXACIN 250 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143931524</ndc>
    <ndc_label_name>LEVOFLOXACIN 250 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143931601</ndc>
    <ndc_label_name>LEVOFLOXACIN 500 MG/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143931624</ndc>
    <ndc_label_name>LEVOFLOXACIN 500 MG/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143931701</ndc>
    <ndc_label_name>LEVOFLOXACIN 750 MG/150 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143931724</ndc>
    <ndc_label_name>LEVOFLOXACIN 750 MG/150 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143931801</ndc>
    <ndc_label_name>NOREPINEPHRINE 4 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143931810</ndc>
    <ndc_label_name>NOREPINEPHRINE 4 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143932001</ndc>
    <ndc_label_name>LABETALOL HCL 100 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143932601</ndc>
    <ndc_label_name>MILRINONE LACT 20 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143932610</ndc>
    <ndc_label_name>MILRINONE LACT 20 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143932801</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143932810</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143932901</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143932910</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933001</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933010</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933101</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933110</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933201</ndc>
    <ndc_label_name>BUPIVACAINE 0.75% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933210</ndc>
    <ndc_label_name>BUPIVACAINE 0.75% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933301</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933310</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933401</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933410</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933501</ndc>
    <ndc_label_name>BUPIVACAINE 0.75% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933510</ndc>
    <ndc_label_name>BUPIVACAINE 0.75% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933801</ndc>
    <ndc_label_name>SUCCINYLCHOLINE 200 MG/10 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143933825</ndc>
    <ndc_label_name>SUCCINYLCHOLINE 200 MG/10 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143934001</ndc>
    <ndc_label_name>GEMCITABINE 200 MG/5.26 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143934101</ndc>
    <ndc_label_name>GEMCITABINE 1 GRAM/26.3 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143934201</ndc>
    <ndc_label_name>GEMCITABINE 2 GRAM/52.6 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143935501</ndc>
    <ndc_label_name>VANCOMYCIN HCL 750 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143935510</ndc>
    <ndc_label_name>VANCOMYCIN HCL 750 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143935701</ndc>
    <ndc_label_name>VANCOMYCIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143935710</ndc>
    <ndc_label_name>VANCOMYCIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143935801</ndc>
    <ndc_label_name>VANCOMYCIN HCL 5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143935901</ndc>
    <ndc_label_name>VANCOMYCIN HCL 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143936101</ndc>
    <ndc_label_name>MICAFUNGIN 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143936201</ndc>
    <ndc_label_name>MICAFUNGIN 100 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143936301</ndc>
    <ndc_label_name>LABETALOL 100 MG/100 ML-NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143936310</ndc>
    <ndc_label_name>LABETALOL 100 MG/100 ML-NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143936401</ndc>
    <ndc_label_name>LABETALOL 200 MG/200 ML-NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143936410</ndc>
    <ndc_label_name>LABETALOL 200 MG/200 ML-NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143936501</ndc>
    <ndc_label_name>LABETALOL 300 MG/300 ML-NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143936510</ndc>
    <ndc_label_name>LABETALOL 300 MG/300 ML-NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143936601</ndc>
    <ndc_label_name>LABETALOL 200MG/200ML-DEXTROSE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143936610</ndc>
    <ndc_label_name>LABETALOL 200MG/200ML-DEXTROSE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143936701</ndc>
    <ndc_label_name>METHOTREXATE 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143936801</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 200 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143937301</ndc>
    <ndc_label_name>MILRINONE LACT 10 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143937310</ndc>
    <ndc_label_name>MILRINONE LACT 10 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143937401</ndc>
    <ndc_label_name>MILRINONE LACT 20 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143937410</ndc>
    <ndc_label_name>MILRINONE LACT 20 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143937501</ndc>
    <ndc_label_name>TERBUTALINE SULF 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143937510</ndc>
    <ndc_label_name>TERBUTALINE SULF 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143937601</ndc>
    <ndc_label_name>ETOPOSIDE 100 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143937701</ndc>
    <ndc_label_name>ARGATROBAN 50 MG/50ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143937801</ndc>
    <ndc_label_name>DAPTOMYCIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143937901</ndc>
    <ndc_label_name>MIDAZOLAM 50 MG/50 ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143937910</ndc>
    <ndc_label_name>MIDAZOLAM 50 MG/50 ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143938001</ndc>
    <ndc_label_name>MIDAZOLAM 100MG/100ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143938010</ndc>
    <ndc_label_name>MIDAZOLAM 100MG/100ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143938101</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143938110</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143938201</ndc>
    <ndc_label_name>CEFEPIME HCL 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143938210</ndc>
    <ndc_label_name>CEFEPIME HCL 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143938301</ndc>
    <ndc_label_name>CEFEPIME HCL 2 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143938310</ndc>
    <ndc_label_name>CEFEPIME HCL 2 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143938401</ndc>
    <ndc_label_name>FOSAPREPITANT 150 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143938501</ndc>
    <ndc_label_name>DECITABINE 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143938601</ndc>
    <ndc_label_name>ACETAMINOPHEN 1000MG/100ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143938610</ndc>
    <ndc_label_name>ACETAMINOPHEN 1000MG/100ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143938701</ndc>
    <ndc_label_name>TRIAMCINOLONE ACET 40 MG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143938725</ndc>
    <ndc_label_name>TRIAMCINOLONE ACET 40 MG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143939101</ndc>
    <ndc_label_name>REMIFENTANIL 1 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143939110</ndc>
    <ndc_label_name>REMIFENTANIL 1 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143939201</ndc>
    <ndc_label_name>REMIFENTANIL 2 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143939210</ndc>
    <ndc_label_name>REMIFENTANIL 2 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143939301</ndc>
    <ndc_label_name>REMIFENTANIL 5 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143939310</ndc>
    <ndc_label_name>REMIFENTANIL 5 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143939401</ndc>
    <ndc_label_name>GEMCITABINE HCL 200 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143939601</ndc>
    <ndc_label_name>CISATRACURIUM 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143939701</ndc>
    <ndc_label_name>CISATRACURIUM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143939710</ndc>
    <ndc_label_name>CISATRACURIUM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143939801</ndc>
    <ndc_label_name>ERTAPENEM 1 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143939810</ndc>
    <ndc_label_name>ERTAPENEM 1 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143942801</ndc>
    <ndc_label_name>FOSAPREPITANT 150 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143942901</ndc>
    <ndc_label_name>ERTAPENEM 1 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143942910</ndc>
    <ndc_label_name>ERTAPENEM 1 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143943001</ndc>
    <ndc_label_name>MEROPENEM IV 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143943010</ndc>
    <ndc_label_name>MEROPENEM IV 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143943101</ndc>
    <ndc_label_name>MEROPENEM IV 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143943110</ndc>
    <ndc_label_name>MEROPENEM IV 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143943301</ndc>
    <ndc_label_name>ACETYLCYSTEINE 6 GRAM/30 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143943304</ndc>
    <ndc_label_name>ACETYLCYSTEINE 6 GRAM/30 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143944201</ndc>
    <ndc_label_name>CARBOPROST 250 MCG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143944210</ndc>
    <ndc_label_name>CARBOPROST 250 MCG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143944301</ndc>
    <ndc_label_name>COLISTIMETHATE 150 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143944312</ndc>
    <ndc_label_name>COLISTIMETHATE 150 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143944401</ndc>
    <ndc_label_name>DAPTOMYCIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143944501</ndc>
    <ndc_label_name>DAPTOMYCIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143945501</ndc>
    <ndc_label_name>DAPTOMYCIN 350 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143946101</ndc>
    <ndc_label_name>POLYMYXIN B SULFATE VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143946110</ndc>
    <ndc_label_name>POLYMYXIN B SULFATE VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143946501</ndc>
    <ndc_label_name>DAPTOMYCIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143946601</ndc>
    <ndc_label_name>Tyzavan 1.25 gram/250 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143946606</ndc>
    <ndc_label_name>Tyzavan 1.25 gram/250 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143946701</ndc>
    <ndc_label_name>Tyzavan 1.75 gram/350 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143946706</ndc>
    <ndc_label_name>Tyzavan 1.75 gram/350 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143946801</ndc>
    <ndc_label_name>Tyzavan 750 mg/150 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143946812</ndc>
    <ndc_label_name>Tyzavan 750 mg/150 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143946901</ndc>
    <ndc_label_name>Tyzavan 1.5 gram/300 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143946906</ndc>
    <ndc_label_name>Tyzavan 1.5 gram/300 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143947001</ndc>
    <ndc_label_name>Tyzavan 2 gram/400 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143947006</ndc>
    <ndc_label_name>Tyzavan 2 gram/400 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143947101</ndc>
    <ndc_label_name>Tyzavan 500 mg/100 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143947112</ndc>
    <ndc_label_name>Tyzavan 500 mg/100 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143947201</ndc>
    <ndc_label_name>Tyzavan 1 gram/200 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143947212</ndc>
    <ndc_label_name>Tyzavan 1 gram/200 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143950101</ndc>
    <ndc_label_name>HALOPERIDOL LAC 5 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143950125</ndc>
    <ndc_label_name>HALOPERIDOL LAC 5 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143950201</ndc>
    <ndc_label_name>HALOPERIDOL LAC 50 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143950301</ndc>
    <ndc_label_name>ACETAZOLAMIDE SOD 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143950401</ndc>
    <ndc_label_name>CISPLATIN 50 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143950501</ndc>
    <ndc_label_name>CISPLATIN 100 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143950601</ndc>
    <ndc_label_name>ETOMIDATE 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143950610</ndc>
    <ndc_label_name>ETOMIDATE 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143950701</ndc>
    <ndc_label_name>ETOMIDATE 40 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143950710</ndc>
    <ndc_label_name>ETOMIDATE 40 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143950801</ndc>
    <ndc_label_name>KETAMINE 500 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143950810</ndc>
    <ndc_label_name>KETAMINE 500 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143950901</ndc>
    <ndc_label_name>KETAMINE 500 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143950910</ndc>
    <ndc_label_name>KETAMINE 500 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143951001</ndc>
    <ndc_label_name>ETOPOSIDE 100 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143951101</ndc>
    <ndc_label_name>ETOPOSIDE 500 MG/25 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143951201</ndc>
    <ndc_label_name>ETOPOSIDE 1,000 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143951301</ndc>
    <ndc_label_name>PALONOSETRON 0.25 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143951401</ndc>
    <ndc_label_name>DROPERIDOL 5 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143951425</ndc>
    <ndc_label_name>DROPERIDOL 5 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143951501</ndc>
    <ndc_label_name>DROPERIDOL 2.5 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143951525</ndc>
    <ndc_label_name>DROPERIDOL 2.5 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143951901</ndc>
    <ndc_label_name>METHOTREXATE 50 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143951910</ndc>
    <ndc_label_name>METHOTREXATE 50 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143952501</ndc>
    <ndc_label_name>DEXMEDETOMIDIN 400MCG/100ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143952510</ndc>
    <ndc_label_name>DEXMEDETOMIDIN 400MCG/100ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143952601</ndc>
    <ndc_label_name>DEXMEDETOMIDINE 200MCG/50ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143952610</ndc>
    <ndc_label_name>DEXMEDETOMIDINE 200MCG/50ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143952901</ndc>
    <ndc_label_name>FLUPHENAZINE DEC 125 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143953001</ndc>
    <ndc_label_name>IFOSFAMIDE 3 GM/60 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143953101</ndc>
    <ndc_label_name>IFOSFAMIDE 1 GM/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143953201</ndc>
    <ndc_label_name>DEXMEDETOMIDINE 200 MCG/2 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143953225</ndc>
    <ndc_label_name>DEXMEDETOMIDINE 200 MCG/2 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143953301</ndc>
    <ndc_label_name>ALLOPURINOL SODIUM 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143953401</ndc>
    <ndc_label_name>LINEZOLID 600 MG/300 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143953410</ndc>
    <ndc_label_name>LINEZOLID 600 MG/300 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143954201</ndc>
    <ndc_label_name>NICARDIPINE 25 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143954210</ndc>
    <ndc_label_name>NICARDIPINE 25 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143955001</ndc>
    <ndc_label_name>DAUNORUBICIN 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143955101</ndc>
    <ndc_label_name>DAUNORUBICIN 20 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143955110</ndc>
    <ndc_label_name>DAUNORUBICIN 20 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143955201</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 350 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143955301</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 200 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143955401</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 100 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143955501</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143955801</ndc>
    <ndc_label_name>LEVOLEUCOVORIN 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143955901</ndc>
    <ndc_label_name>ARGATROBAN 50 MG/50ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143956401</ndc>
    <ndc_label_name>PHENTOLAMINE 5 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143956410</ndc>
    <ndc_label_name>PHENTOLAMINE 5 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143956501</ndc>
    <ndc_label_name>THIOTEPA 15 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143956601</ndc>
    <ndc_label_name>AZATHIOPRINE SOD 100 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143956701</ndc>
    <ndc_label_name>CEFUROXIME SOD 1.5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143956725</ndc>
    <ndc_label_name>CEFUROXIME SOD 1.5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143956801</ndc>
    <ndc_label_name>CEFUROXIME SOD 750 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143956825</ndc>
    <ndc_label_name>CEFUROXIME SOD 750 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143956901</ndc>
    <ndc_label_name>CEFUROXIME SOD 7.5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143957001</ndc>
    <ndc_label_name>SOD FER GLUC CPLX 62.5 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143957010</ndc>
    <ndc_label_name>SOD FER GLUC CPLX 62.5 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143957501</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143957510</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143957701</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143957710</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143958301</ndc>
    <ndc_label_name>IRINOTECAN HCL 100 MG/5 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143959401</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% 100 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143959425</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% 100 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143959501</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 50 MG/5 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143959525</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 50 MG/5 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143959601</ndc>
    <ndc_label_name>PARICALCITOL 10 MCG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143959721</ndc>
    <ndc_label_name>ABIRATERONE ACETATE 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143960601</ndc>
    <ndc_label_name>AZACITIDINE 100 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143961901</ndc>
    <ndc_label_name>CYANOCOBALAMIN 30,000 MCG/30ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143961910</ndc>
    <ndc_label_name>CYANOCOBALAMIN 30,000 MCG/30ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143962001</ndc>
    <ndc_label_name>CYANOCOBALAMIN 10,000 MCG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143962010</ndc>
    <ndc_label_name>CYANOCOBALAMIN 10,000 MCG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143962101</ndc>
    <ndc_label_name>CYANOCOBALAMIN 1,000 MCG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143962125</ndc>
    <ndc_label_name>CYANOCOBALAMIN 1,000 MCG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143962201</ndc>
    <ndc_label_name>LABETALOL HCL 100 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143962301</ndc>
    <ndc_label_name>LABETALOL HCL 200 MG/40 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143963301</ndc>
    <ndc_label_name>NICARDIPIN 40MG/200ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143963310</ndc>
    <ndc_label_name>NICARDIPIN 40MG/200ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143963401</ndc>
    <ndc_label_name>NICARDIPIN 20MG/200ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143963410</ndc>
    <ndc_label_name>NICARDIPIN 20MG/200ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143963701</ndc>
    <ndc_label_name>VALPROATE SOD 500 MG/5 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143963710</ndc>
    <ndc_label_name>VALPROATE SOD 500 MG/5 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143963801</ndc>
    <ndc_label_name>SUMATRIPTAN 6 MG/0.5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143963805</ndc>
    <ndc_label_name>SUMATRIPTAN 6 MG/0.5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143965901</ndc>
    <ndc_label_name>TESTOSTERONE CYP 200 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143966001</ndc>
    <ndc_label_name>METOPROLOL TART 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143966010</ndc>
    <ndc_label_name>METOPROLOL TART 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143967301</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143967325</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143967401</ndc>
    <ndc_label_name>ARGATROBAN 250 MG/2.5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143967801</ndc>
    <ndc_label_name>CEFTRIAXONE 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143967901</ndc>
    <ndc_label_name>GLYCOPYRROLATE 4 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143967910</ndc>
    <ndc_label_name>GLYCOPYRROLATE 4 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143968001</ndc>
    <ndc_label_name>GLYCOPYRROLATE 1 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143968025</ndc>
    <ndc_label_name>GLYCOPYRROLATE 1 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143968101</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.4 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143968125</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.4 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143968201</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143968225</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143968301</ndc>
    <ndc_label_name>FLUMAZENIL 1 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143968310</ndc>
    <ndc_label_name>FLUMAZENIL 1 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143968401</ndc>
    <ndc_label_name>FLUMAZENIL 0.5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143968410</ndc>
    <ndc_label_name>FLUMAZENIL 0.5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143968901</ndc>
    <ndc_label_name>NICARDIPINE 25 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143968910</ndc>
    <ndc_label_name>NICARDIPINE 25 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143970101</ndc>
    <ndc_label_name>IRINOTECAN HCL 100 MG/5 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143970201</ndc>
    <ndc_label_name>IRINOTECAN HCL 40 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143970801</ndc>
    <ndc_label_name>MILRINONE LACT 50 MG/50 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143970901</ndc>
    <ndc_label_name>MILRINONE LACT 20 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143970910</ndc>
    <ndc_label_name>MILRINONE LACT 20 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143971001</ndc>
    <ndc_label_name>MILRINONE LACT 10 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143971010</ndc>
    <ndc_label_name>MILRINONE LACT 10 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143971801</ndc>
    <ndc_label_name>MILRINONE-D5W 40 MG/200 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143971810</ndc>
    <ndc_label_name>MILRINONE-D5W 40 MG/200 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143971901</ndc>
    <ndc_label_name>MILRINONE-D5W 20 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143971910</ndc>
    <ndc_label_name>MILRINONE-D5W 20 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143972001</ndc>
    <ndc_label_name>LEVOFLOXACIN 750 MG/150 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143972024</ndc>
    <ndc_label_name>LEVOFLOXACIN 750 MG/150 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143972101</ndc>
    <ndc_label_name>LEVOFLOXACIN 500 MG/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143972124</ndc>
    <ndc_label_name>LEVOFLOXACIN 500 MG/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143972201</ndc>
    <ndc_label_name>LEVOFLOXACIN 250 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143972224</ndc>
    <ndc_label_name>LEVOFLOXACIN 250 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143972301</ndc>
    <ndc_label_name>CLONIDINE 5,000 MCG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143972401</ndc>
    <ndc_label_name>CLONIDINE 1,000 MCG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143972501</ndc>
    <ndc_label_name>PROGESTERONE 500 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143972601</ndc>
    <ndc_label_name>TESTOSTERONE CYP 2,000 MG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143972901</ndc>
    <ndc_label_name>BENZTROPINE 2 MG/2 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143972905</ndc>
    <ndc_label_name>BENZTROPINE 2 MG/2 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143974401</ndc>
    <ndc_label_name>GRANISETRON HCL 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143974410</ndc>
    <ndc_label_name>GRANISETRON HCL 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143974501</ndc>
    <ndc_label_name>GRANISETRON HCL 4 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143974505</ndc>
    <ndc_label_name>GRANISETRON HCL 4 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143974601</ndc>
    <ndc_label_name>TERBUTALINE SULF 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143974610</ndc>
    <ndc_label_name>TERBUTALINE SULF 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143975001</ndc>
    <ndc_label_name>TESTOSTERON ENAN 1,000 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143975301</ndc>
    <ndc_label_name>METHYLPREDNISOLONE SS 40 MG VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143975325</ndc>
    <ndc_label_name>METHYLPREDNISOLONE SS 40 MG VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143975401</ndc>
    <ndc_label_name>METHYLPREDNISOLONE SS 125 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143975425</ndc>
    <ndc_label_name>METHYLPREDNISOLONE SS 125 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143978301</ndc>
    <ndc_label_name>FLUMAZENIL 1 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143978310</ndc>
    <ndc_label_name>FLUMAZENIL 1 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143978401</ndc>
    <ndc_label_name>FLUMAZENIL 0.5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143978410</ndc>
    <ndc_label_name>FLUMAZENIL 0.5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143978501</ndc>
    <ndc_label_name>VALPROATE SOD 500 MG/5 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143978510</ndc>
    <ndc_label_name>VALPROATE SOD 500 MG/5 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143978601</ndc>
    <ndc_label_name>ENALAPRILAT 2.5 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143978610</ndc>
    <ndc_label_name>ENALAPRILAT 2.5 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143978701</ndc>
    <ndc_label_name>ENALAPRILAT 1.25 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143978710</ndc>
    <ndc_label_name>ENALAPRILAT 1.25 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143980250</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143980305</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143980350</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143983001</ndc>
    <ndc_label_name>METHOTREXATE 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143983601</ndc>
    <ndc_label_name>PENICILLIN VK 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143983610</ndc>
    <ndc_label_name>PENICILLIN VK 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143983701</ndc>
    <ndc_label_name>PENICILLIN VK 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143983710</ndc>
    <ndc_label_name>PENICILLIN VK 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143985001</ndc>
    <ndc_label_name>METHYLPREDNISOLONE SS 500 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143985101</ndc>
    <ndc_label_name>METHYLPREDNISOLONE SS 1 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985201</ndc>
    <ndc_label_name>LEVOCARNITINE 1 GM/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985210</ndc>
    <ndc_label_name>LEVOCARNITINE 1 GM/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985316</ndc>
    <ndc_label_name>AMOX-CLAV 600-42.9 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985324</ndc>
    <ndc_label_name>AMOX-CLAV 600-42.9 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985375</ndc>
    <ndc_label_name>AMOX-CLAV 600-42.9 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985601</ndc>
    <ndc_label_name>CEFTRIAXONE 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985625</ndc>
    <ndc_label_name>CEFTRIAXONE 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985701</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985725</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985801</ndc>
    <ndc_label_name>CEFTRIAXONE 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985825</ndc>
    <ndc_label_name>CEFTRIAXONE 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985901</ndc>
    <ndc_label_name>CEFTRIAXONE 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143985925</ndc>
    <ndc_label_name>CEFTRIAXONE 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143987101</ndc>
    <ndc_label_name>CLADRIBINE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143987201</ndc>
    <ndc_label_name>PROPRANOLOL 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143987210</ndc>
    <ndc_label_name>PROPRANOLOL 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143987301</ndc>
    <ndc_label_name>METOPROLOL TART 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143987325</ndc>
    <ndc_label_name>METOPROLOL TART 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143987501</ndc>
    <ndc_label_name>AMIODARONE 150 MG/3 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143987525</ndc>
    <ndc_label_name>AMIODARONE 150 MG/3 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143987610</ndc>
    <ndc_label_name>CEFOXITIN 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143987701</ndc>
    <ndc_label_name>CEFOXITIN 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143987725</ndc>
    <ndc_label_name>CEFOXITIN 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143987801</ndc>
    <ndc_label_name>CEFOXITIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143987825</ndc>
    <ndc_label_name>CEFOXITIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143988601</ndc>
    <ndc_label_name>AMOXICILLIN 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143988650</ndc>
    <ndc_label_name>AMOXICILLIN 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143988675</ndc>
    <ndc_label_name>AMOXICILLIN 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143988701</ndc>
    <ndc_label_name>AMOXICILLIN 400 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143988750</ndc>
    <ndc_label_name>AMOXICILLIN 400 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143988775</ndc>
    <ndc_label_name>AMOXICILLIN 400 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143988801</ndc>
    <ndc_label_name>AMOXICILLIN 125 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143988815</ndc>
    <ndc_label_name>AMOXICILLIN 125 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143988880</ndc>
    <ndc_label_name>AMOXICILLIN 125 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143988901</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143988915</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143988980</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143992390</ndc>
    <ndc_label_name>CEFAZOLIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143992490</ndc>
    <ndc_label_name>CEFAZOLIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143992701</ndc>
    <ndc_label_name>CIPROFLOXACIN HCL 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143992801</ndc>
    <ndc_label_name>CIPROFLOXACIN HCL 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143992950</ndc>
    <ndc_label_name>CIPROFLOXACIN HCL 750 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143993905</ndc>
    <ndc_label_name>AMOXICILLIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143997722</ndc>
    <ndc_label_name>CEFUROXIME SOD 1.5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143997790</ndc>
    <ndc_label_name>CEFUROXIME SOD 1.5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143997922</ndc>
    <ndc_label_name>CEFUROXIME SOD 750 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00143997990</ndc>
    <ndc_label_name>CEFUROXIME SOD 750 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143998101</ndc>
    <ndc_label_name>AMOX-CLAV 200-28.5 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143998150</ndc>
    <ndc_label_name>AMOX-CLAV 200-28.5 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143998175</ndc>
    <ndc_label_name>AMOX-CLAV 200-28.5 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143998201</ndc>
    <ndc_label_name>AMOX-CLAV 400-57 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143998250</ndc>
    <ndc_label_name>AMOX-CLAV 400-57 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143998275</ndc>
    <ndc_label_name>AMOX-CLAV 400-57 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143998303</ndc>
    <ndc_label_name>CEFAZOLIN 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00143998391</ndc>
    <ndc_label_name>CEFAZOLIN 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00145007160</ndc>
    <ndc_label_name>Veltin 1.2 %-0.025 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00149000128</ndc>
    <ndc_label_name>Pepto-Bismol Ultra 525 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168000215</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168000315</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.025% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168000380</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.025% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168000415</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168000416</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168000480</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168000580</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.025% OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168000615</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168000616</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168000680</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168001516</ndc>
    <ndc_label_name>HYDROCORTISONE 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168001531</ndc>
    <ndc_label_name>HYDROCORTISONE 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168002016</ndc>
    <ndc_label_name>HYDROCORTISONE 1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168002031</ndc>
    <ndc_label_name>HYDROCORTISONE 1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168003315</ndc>
    <ndc_label_name>BETAMETHASONE VALER 0.1% OINTM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168003346</ndc>
    <ndc_label_name>BETAMETHASONE VALER 0.1% OINTM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168004015</ndc>
    <ndc_label_name>BETAMETHASONE VA 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168004046</ndc>
    <ndc_label_name>BETAMETHASONE VA 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168004160</ndc>
    <ndc_label_name>BETAMETHASONE VA 0.1% LOTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168005515</ndc>
    <ndc_label_name>BETAMETHASONE DP 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168005546</ndc>
    <ndc_label_name>BETAMETHASONE DP 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168005615</ndc>
    <ndc_label_name>BETAMETHASONE DP 0.05% OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168005646</ndc>
    <ndc_label_name>BETAMETHASONE DP 0.05% OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168005760</ndc>
    <ndc_label_name>BETAMETHASONE DP 0.05% LOT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168005960</ndc>
    <ndc_label_name>FLUOCINOLONE 0.01% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168006415</ndc>
    <ndc_label_name>FLUOCINOLONE 0.025% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168006460</ndc>
    <ndc_label_name>FLUOCINOLONE 0.025% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168008016</ndc>
    <ndc_label_name>HYDROCORTISONE 2.5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168008031</ndc>
    <ndc_label_name>HYDROCORTISONE 2.5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168009915</ndc>
    <ndc_label_name>KETOCONAZOLE 2% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168009930</ndc>
    <ndc_label_name>KETOCONAZOLE 2% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168009960</ndc>
    <ndc_label_name>KETOCONAZOLE 2% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168012691</ndc>
    <ndc_label_name>Swim Ear 95 %-5 % drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168013460</ndc>
    <ndc_label_name>FLUOCINONIDE 0.05% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168014616</ndc>
    <ndc_label_name>HYDROCORTISONE 2.5% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168014630</ndc>
    <ndc_label_name>HYDROCORTISONE 2.5% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168016315</ndc>
    <ndc_label_name>CLOBETASOL 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168016330</ndc>
    <ndc_label_name>CLOBETASOL 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168016346</ndc>
    <ndc_label_name>CLOBETASOL 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168016360</ndc>
    <ndc_label_name>CLOBETASOL 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168020130</ndc>
    <ndc_label_name>CLINDAMYCIN PH 1% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168020160</ndc>
    <ndc_label_name>CLINDAMYCIN PH 1% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168020230</ndc>
    <ndc_label_name>CLINDAMYCIN PH 1% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168020260</ndc>
    <ndc_label_name>CLINDAMYCIN PH 1% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168020360</ndc>
    <ndc_label_name>CLINDAMYCIN PHOSP 1% LOTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168020437</ndc>
    <ndc_label_name>LIDOCAINE 5% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168025815</ndc>
    <ndc_label_name>CLOTRIMAZOLE-BETAMETHASONE CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168025846</ndc>
    <ndc_label_name>CLOTRIMAZOLE-BETAMETHASONE CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168026315</ndc>
    <ndc_label_name>ALCLOMETASONE DIPRO 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168026345</ndc>
    <ndc_label_name>ALCLOMETASONE DIPRO 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168026360</ndc>
    <ndc_label_name>ALCLOMETASONE DIPRO 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168026515</ndc>
    <ndc_label_name>BETAMETHASONE DP AUG 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168026730</ndc>
    <ndc_label_name>BETAMETHASONE DP AUG 0.05% LOT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168026760</ndc>
    <ndc_label_name>BETAMETHASONE DP AUG 0.05% LOT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168026815</ndc>
    <ndc_label_name>BETAMETHASONE DP AUG 0.05% OIN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168026850</ndc>
    <ndc_label_name>BETAMETHASONE DP AUG 0.05% OIN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168026950</ndc>
    <ndc_label_name>CLOBETASOL 0.05% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168027740</ndc>
    <ndc_label_name>CLINDAMYCIN 2% VAGINAL CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168029315</ndc>
    <ndc_label_name>CLOBETASOL 0.05% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168029330</ndc>
    <ndc_label_name>CLOBETASOL 0.05% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168029360</ndc>
    <ndc_label_name>CLOBETASOL 0.05% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168030115</ndc>
    <ndc_label_name>CLOBETASOL EMOLLIENT 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168030130</ndc>
    <ndc_label_name>CLOBETASOL EMOLLIENT 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168030160</ndc>
    <ndc_label_name>CLOBETASOL EMOLLIENT 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168032346</ndc>
    <ndc_label_name>METRONIDAZOLE 0.75% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168033215</ndc>
    <ndc_label_name>FLUTICASONE PROP 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168033230</ndc>
    <ndc_label_name>FLUTICASONE PROP 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168034646</ndc>
    <ndc_label_name>TERCONAZOLE 0.4% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168034720</ndc>
    <ndc_label_name>TERCONAZOLE 0.8% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168035705</ndc>
    <ndc_label_name>LIDOCAINE-PRILOCAINE CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168035730</ndc>
    <ndc_label_name>LIDOCAINE-PRILOCAINE CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168035755</ndc>
    <ndc_label_name>LIDOCAINE-PRILOCAINE CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168035756</ndc>
    <ndc_label_name>LIDOCAINE-PRILOCAINE CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168035830</ndc>
    <ndc_label_name>OXICONAZOLE NITRATE 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168035860</ndc>
    <ndc_label_name>OXICONAZOLE NITRATE 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168035890</ndc>
    <ndc_label_name>OXICONAZOLE NITRATE 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168038360</ndc>
    <ndc_label_name>METRONIDAZOLE 0.75% LOTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168041060</ndc>
    <ndc_label_name>PREDNICARBATE 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168041630</ndc>
    <ndc_label_name>TACROLIMUS 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168041660</ndc>
    <ndc_label_name>TACROLIMUS 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168041699</ndc>
    <ndc_label_name>TACROLIMUS 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168041730</ndc>
    <ndc_label_name>TACROLIMUS 0.03% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168041760</ndc>
    <ndc_label_name>TACROLIMUS 0.03% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00168041799</ndc>
    <ndc_label_name>TACROLIMUS 0.03% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00168042446</ndc>
    <ndc_label_name>ADAPALENE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169170430</ndc>
    <ndc_label_name>Ozempic 4 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169170930</ndc>
    <ndc_label_name>Ozempic 9 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169171530</ndc>
    <ndc_label_name>Ozempic 1.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169183302</ndc>
    <ndc_label_name>Novolin R Regular U-100 Insulin 100 unit/mL injection solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169183311</ndc>
    <ndc_label_name>Novolin R Regular U-100 Insulin 100 unit/mL injection solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169183402</ndc>
    <ndc_label_name>Novolin N NPH U-100 Insulin isophane 100 unit/mL subcutaneous susp</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169183411</ndc>
    <ndc_label_name>Novolin N NPH U-100 Insulin isophane 100 unit/mL subcutaneous susp</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169183702</ndc>
    <ndc_label_name>Novolin 70/30 U-100 Insulin 100 unit/mL subcutaneous suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169183711</ndc>
    <ndc_label_name>Novolin 70/30 U-100 Insulin 100 unit/mL subcutaneous suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169185189</ndc>
    <ndc_label_name>Novofine 32 32 gauge x 1/4" needle</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169185459</ndc>
    <ndc_label_name>Novopen Echo subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169185550</ndc>
    <ndc_label_name>NovoFine Plus 32 gauge x 1/6" needle</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169191201</ndc>
    <ndc_label_name>ZEGALOGUE 0.6 MG/0.6ML AUTOINJ</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169191202</ndc>
    <ndc_label_name>ZEGALOGUE 0.6 MG/0.6ML AUTOINJ</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169191301</ndc>
    <ndc_label_name>ZEGALOGUE 0.6 MG/0.6 ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169191302</ndc>
    <ndc_label_name>ZEGALOGUE 0.6 MG/0.6 ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169200190</ndc>
    <ndc_label_name>Diluting Medium for Novolog injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169203011</ndc>
    <ndc_label_name>Sogroya 10 mg/1.5 mL (6.7 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169203511</ndc>
    <ndc_label_name>Sogroya 5 mg/1.5 mL (3.3 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169203711</ndc>
    <ndc_label_name>Sogroya 15 mg/1.5 mL (10 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169208015</ndc>
    <ndc_label_name>Alhemo Pen 150 mg/1.5 mL (100 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169208103</ndc>
    <ndc_label_name>Alhemo Pen 300 mg/3 mL (100 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169208415</ndc>
    <ndc_label_name>Alhemo Pen 60 mg/1.5 mL (40 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169210011</ndc>
    <ndc_label_name>Novolog U-100 Insulin aspart 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169210112</ndc>
    <ndc_label_name>Novolog FlexPen U-100 Insulin aspart 100 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169210125</ndc>
    <ndc_label_name>Novolog FlexPen U-100 Insulin aspart 100 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169220011</ndc>
    <ndc_label_name>Novolog Mix 70-30 U-100 Insulin 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169220125</ndc>
    <ndc_label_name>Novolog Mix 70-30 FlexPen U-100 Insulin 100 unit/mL subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169255013</ndc>
    <ndc_label_name>Tresiba FlexTouch U-200 insulin 200 unit/mL (3 mL) subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169255097</ndc>
    <ndc_label_name>Tresiba FlexTouch U-200 insulin 200 unit/mL (3 mL) subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169266015</ndc>
    <ndc_label_name>Tresiba FlexTouch U-100 insulin 100 unit/mL (3 mL) subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169266097</ndc>
    <ndc_label_name>Tresiba FlexTouch U-100 insulin 100 unit/mL (3 mL) subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169266211</ndc>
    <ndc_label_name>Tresiba U-100 Insulin 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169280015</ndc>
    <ndc_label_name>Saxenda 3 mg/0.5 mL (18 mg/3 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169291115</ndc>
    <ndc_label_name>Xultophy 100/3.6  100 unit-3.6 mg/mL (3 mL) subcutaneous insulin pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169300301</ndc>
    <ndc_label_name>Novolin R FlexPen 100 unit/mL (3 mL) subcutaneous insulin pen</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169300312</ndc>
    <ndc_label_name>Novolin R FlexPen 100 unit/mL (3 mL) subcutaneous insulin pen</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169300315</ndc>
    <ndc_label_name>Novolin R FlexPen 100 unit/mL (3 mL) subcutaneous insulin pen</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169300325</ndc>
    <ndc_label_name>Novolin R FlexPen 100 unit/mL (3 mL) subcutaneous insulin pen</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169300415</ndc>
    <ndc_label_name>Novolin N FlexPen 100 unit/mL (3 mL) subcutaneous insulin pen</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169300425</ndc>
    <ndc_label_name>Novolin N FlexPen 100 unit/mL (3 mL) subcutaneous insulin pen</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169300701</ndc>
    <ndc_label_name>Novolin 70-30 FlexPen U-100 Insulin 100 unit/mL (70-30) subcutaneous</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169300712</ndc>
    <ndc_label_name>Novolin 70-30 FlexPen U-100 Insulin 100 unit/mL (70-30) subcutaneous</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169300715</ndc>
    <ndc_label_name>Novolin 70-30 FlexPen U-100 Insulin 100 unit/mL (70-30) subcutaneous</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169300725</ndc>
    <ndc_label_name>Novolin 70-30 FlexPen U-100 Insulin 100 unit/mL (70-30) subcutaneous</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169320111</ndc>
    <ndc_label_name>Fiasp U-100 Insulin 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169320415</ndc>
    <ndc_label_name>Fiasp FlexTouch U-100 Insulin 100 unit/mL (3 mL) subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169320511</ndc>
    <ndc_label_name>Fiasp Penfill U-100 Insulin 100 unit/mL (3 mL) subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169320515</ndc>
    <ndc_label_name>Fiasp Penfill U-100 Insulin 100 unit/mL (3 mL) subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169320611</ndc>
    <ndc_label_name>Fiasp Pumpcart 100 unit/mL (1.6 mL) subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169320615</ndc>
    <ndc_label_name>Fiasp Pumpcart 100 unit/mL (1.6 mL) subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169330312</ndc>
    <ndc_label_name>Novolog PenFill U-100 Insulin aspart 100 unit/mL subcutaneous cartridg</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169368512</ndc>
    <ndc_label_name>Novolog Mix 70-30 U-100 Insulin 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169368712</ndc>
    <ndc_label_name>LEVEMIR 100 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169369619</ndc>
    <ndc_label_name>Novolog Mix 70-30 FlexPen U-100 Insulin 100 unit/mL subcutaneous pen</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169406012</ndc>
    <ndc_label_name>Victoza 2-Pak 0.6 mg/0.1 mL (18 mg/3 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169406013</ndc>
    <ndc_label_name>Victoza 3-Pak 0.6 mg/0.1 mL (18 mg/3 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169413001</ndc>
    <ndc_label_name>Ozempic 1 mg/dose (4 mg/3 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169413013</ndc>
    <ndc_label_name>Ozempic 1 mg/dose (4 mg/3 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169418103</ndc>
    <ndc_label_name>Ozempic 0.25 mg or 0.5 mg (2 mg/3 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169418113</ndc>
    <ndc_label_name>Ozempic 0.25 mg or 0.5 mg (2 mg/3 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169418197</ndc>
    <ndc_label_name>Ozempic 0.25 mg or 0.5 mg (2 mg/3 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169430330</ndc>
    <ndc_label_name>Rybelsus 3 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169430399</ndc>
    <ndc_label_name>Rybelsus 3 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169430730</ndc>
    <ndc_label_name>Rybelsus 7 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169431430</ndc>
    <ndc_label_name>Rybelsus 14 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169440431</ndc>
    <ndc_label_name>Wegovy 4 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169440931</ndc>
    <ndc_label_name>Wegovy 9 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169441531</ndc>
    <ndc_label_name>Wegovy 1.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169441592</ndc>
    <ndc_label_name>Wegovy 1.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169442531</ndc>
    <ndc_label_name>Wegovy 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169450101</ndc>
    <ndc_label_name>Wegovy 1 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169450114</ndc>
    <ndc_label_name>Wegovy 1 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169450501</ndc>
    <ndc_label_name>Wegovy 0.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169450514</ndc>
    <ndc_label_name>Wegovy 0.5 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169451701</ndc>
    <ndc_label_name>Wegovy 1.7 mg/0.75 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169451714</ndc>
    <ndc_label_name>Wegovy 1.7 mg/0.75 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169452401</ndc>
    <ndc_label_name>Wegovy 2.4 mg/0.75 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169452414</ndc>
    <ndc_label_name>Wegovy 2.4 mg/0.75 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169452501</ndc>
    <ndc_label_name>Wegovy 0.25 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169452514</ndc>
    <ndc_label_name>Wegovy 0.25 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169452590</ndc>
    <ndc_label_name>Wegovy 0.25 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169452594</ndc>
    <ndc_label_name>Wegovy 0.25 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169457201</ndc>
    <ndc_label_name>Wegovy HD 7.2 mg/0.75 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169457214</ndc>
    <ndc_label_name>Wegovy HD 7.2 mg/0.75 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169477211</ndc>
    <ndc_label_name>Ozempic 2 mg/dose (8 mg/3 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169477212</ndc>
    <ndc_label_name>Ozempic 2 mg/dose (8 mg/3 mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169517603</ndc>
    <ndc_label_name>Vagifem 10 mcg vaginal tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169517604</ndc>
    <ndc_label_name>Vagifem 10 mcg vaginal tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169530610</ndc>
    <ndc_label_name>Rivfloza 160 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169530708</ndc>
    <ndc_label_name>Rivfloza 128 mg/0.8 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169530801</ndc>
    <ndc_label_name>Rivfloza 80 mg/0.5 mL (160 mg/mL) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169633910</ndc>
    <ndc_label_name>Novolog FlexPen U-100 Insulin aspart 100 unit/mL (3 mL) subcutaneous</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169643210</ndc>
    <ndc_label_name>LEVEMIR FLEXPEN 100 UNIT/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169643255</ndc>
    <ndc_label_name>LEVEMIR FLEXPEN 100 UNIT/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169700093</ndc>
    <ndc_label_name>STERILE WATER FOR TRETTEN VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169701198</ndc>
    <ndc_label_name>Diluent For Novoseven RT subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169701298</ndc>
    <ndc_label_name>Diluent For Novoseven RT subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169701301</ndc>
    <ndc_label_name>Tretten 2,500 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169701598</ndc>
    <ndc_label_name>Diluent For Novoseven RT subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169701898</ndc>
    <ndc_label_name>Diluent For Novoseven RT subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169706515</ndc>
    <ndc_label_name>GLUCAGEN 1 MG HYPOKIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169711311</ndc>
    <ndc_label_name>Tretten 2,500 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169720101</ndc>
    <ndc_label_name>Novoseven RT 1 mg (1,000 mcg) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169720201</ndc>
    <ndc_label_name>Novoseven RT 2 mg (2,000 mcg) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169720501</ndc>
    <ndc_label_name>Novoseven RT 5 mg (5,000 mcg) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169720801</ndc>
    <ndc_label_name>Novoseven RT 8 mg (8,000 mcg) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169721111</ndc>
    <ndc_label_name>Novoseven RT 1 mg (1,000 mcg) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169721211</ndc>
    <ndc_label_name>Novoseven RT 2 mg (2,000 mcg) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169721511</ndc>
    <ndc_label_name>Novoseven RT 5 mg (5,000 mcg) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169721811</ndc>
    <ndc_label_name>Novoseven RT 8 mg (8,000 mcg) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169750111</ndc>
    <ndc_label_name>Novolog U-100 Insulin aspart 100 unit/mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169770321</ndc>
    <ndc_label_name>NORDITROPIN FLEXPRO 30 MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169770421</ndc>
    <ndc_label_name>Norditropin FlexPro 5 mg/1.5 mL (3.3 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169770521</ndc>
    <ndc_label_name>Norditropin FlexPro 10 mg/1.5 mL (6.7 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00169770821</ndc>
    <ndc_label_name>Norditropin FlexPro 15 mg/1.5 mL (10 mg/mL) subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169781001</ndc>
    <ndc_label_name>Novoeight 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169781501</ndc>
    <ndc_label_name>Novoeight 1,500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169782001</ndc>
    <ndc_label_name>Novoeight 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169782501</ndc>
    <ndc_label_name>Novoeight 250 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169783001</ndc>
    <ndc_label_name>Novoeight 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169785001</ndc>
    <ndc_label_name>Novoeight 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169790101</ndc>
    <ndc_label_name>Rebinyn 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169790201</ndc>
    <ndc_label_name>Rebinyn 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169790301</ndc>
    <ndc_label_name>Rebinyn 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169790501</ndc>
    <ndc_label_name>Rebinyn 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169791111</ndc>
    <ndc_label_name>Rebinyn 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169792211</ndc>
    <ndc_label_name>Rebinyn 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169793311</ndc>
    <ndc_label_name>Rebinyn 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169795511</ndc>
    <ndc_label_name>Rebinyn 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169810001</ndc>
    <ndc_label_name>Esperoct 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169810111</ndc>
    <ndc_label_name>Esperoct 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169815001</ndc>
    <ndc_label_name>Esperoct 1,500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169815111</ndc>
    <ndc_label_name>Esperoct 1,500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169820001</ndc>
    <ndc_label_name>Esperoct 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169820111</ndc>
    <ndc_label_name>Esperoct 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169830001</ndc>
    <ndc_label_name>Esperoct 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169830111</ndc>
    <ndc_label_name>Esperoct 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169840001</ndc>
    <ndc_label_name>Esperoct 4,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169840111</ndc>
    <ndc_label_name>Esperoct 4,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169850001</ndc>
    <ndc_label_name>Esperoct 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00169850111</ndc>
    <ndc_label_name>Esperoct 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172208360</ndc>
    <ndc_label_name>HYDROCHLOROTHIAZIDE 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172208380</ndc>
    <ndc_label_name>HYDROCHLOROTHIAZIDE 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172208960</ndc>
    <ndc_label_name>HYDROCHLOROTHIAZIDE 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172208980</ndc>
    <ndc_label_name>HYDROCHLOROTHIAZIDE 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172344460</ndc>
    <ndc_label_name>HYDROCHLOROTHIAZIDE 12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172344480</ndc>
    <ndc_label_name>HYDROCHLOROTHIAZIDE 12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172376170</ndc>
    <ndc_label_name>LISINOPRIL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172392560</ndc>
    <ndc_label_name>DIAZEPAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172392570</ndc>
    <ndc_label_name>DIAZEPAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172392660</ndc>
    <ndc_label_name>DIAZEPAM 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172392670</ndc>
    <ndc_label_name>DIAZEPAM 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172392680</ndc>
    <ndc_label_name>DIAZEPAM 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172392760</ndc>
    <ndc_label_name>DIAZEPAM 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172392770</ndc>
    <ndc_label_name>DIAZEPAM 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172392780</ndc>
    <ndc_label_name>DIAZEPAM 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172409660</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172409680</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172409760</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172409780</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172572860</ndc>
    <ndc_label_name>FAMOTIDINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172572870</ndc>
    <ndc_label_name>FAMOTIDINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172572880</ndc>
    <ndc_label_name>FAMOTIDINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172572960</ndc>
    <ndc_label_name>FAMOTIDINE 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172572970</ndc>
    <ndc_label_name>FAMOTIDINE 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00172640605</ndc>
    <ndc_label_name>CROMOLYN 20 MG/2 ML NEB SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00172640649</ndc>
    <ndc_label_name>CROMOLYN 20 MG/2 ML NEB SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00172731320</ndc>
    <ndc_label_name>CYCLOSPORINE MODIFIED 100MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173013555</ndc>
    <ndc_label_name>Wellbutrin SR 150 mg tablet, 12 hr sustained-release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173047800</ndc>
    <ndc_label_name>Imitrex STATdose Refill 6 mg/0.5 mL subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173047900</ndc>
    <ndc_label_name>Imitrex STATdose Pen 6 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173051700</ndc>
    <ndc_label_name>Flolan 0.5 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173051900</ndc>
    <ndc_label_name>Flolan 1.5 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173052100</ndc>
    <ndc_label_name>Serevent Diskus 50 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173052600</ndc>
    <ndc_label_name>Lamictal 5 mg chewable dispersible tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173052700</ndc>
    <ndc_label_name>Lamictal 25 mg chewable dispersible tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173054700</ndc>
    <ndc_label_name>Mepron 750 mg/5 mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173056504</ndc>
    <ndc_label_name>Valtrex 1 gram tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173056510</ndc>
    <ndc_label_name>Valtrex 1 gram tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173059402</ndc>
    <ndc_label_name>Lamictal Starter (Orange) Kit 25 mg (42)-100 mg (7) tablets, dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173063302</ndc>
    <ndc_label_name>Lamictal 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173063310</ndc>
    <ndc_label_name>Lamictal Starter (Blue) Kit 25 mg (35) tablets in a dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173064255</ndc>
    <ndc_label_name>Lamictal 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173064360</ndc>
    <ndc_label_name>Lamictal 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173064460</ndc>
    <ndc_label_name>Lamictal 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173066518</ndc>
    <ndc_label_name>Mepron 750 mg/5 mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173067501</ndc>
    <ndc_label_name>Malarone 250 mg-100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173067502</ndc>
    <ndc_label_name>Malarone 250 mg-100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173067601</ndc>
    <ndc_label_name>Malarone Pediatric 62.5 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173068101</ndc>
    <ndc_label_name>Relenza Diskhaler 5 mg/actuation powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173068122</ndc>
    <ndc_label_name>Relenza Diskhaler 5 mg/actuation powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173068220</ndc>
    <ndc_label_name>Ventolin HFA 90 mcg/actuation aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173068224</ndc>
    <ndc_label_name>Ventolin HFA 90 mcg/actuation aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173069500</ndc>
    <ndc_label_name>Advair Diskus 100 mcg-50 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173069504</ndc>
    <ndc_label_name>Advair Diskus 100 mcg-50 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173069600</ndc>
    <ndc_label_name>Advair Diskus 250 mcg-50 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173069604</ndc>
    <ndc_label_name>Advair Diskus 250 mcg-50 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173069700</ndc>
    <ndc_label_name>Advair Diskus 500 mcg-50 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173069704</ndc>
    <ndc_label_name>Advair Diskus 500 mcg-50 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173071520</ndc>
    <ndc_label_name>Advair HFA 45 mcg-21 mcg/actuation aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173071522</ndc>
    <ndc_label_name>Advair HFA 45 mcg-21 mcg/actuation aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173071620</ndc>
    <ndc_label_name>Advair HFA 115 mcg-21 mcg/actuation aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173071622</ndc>
    <ndc_label_name>Advair HFA 115 mcg-21 mcg/actuation aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173071720</ndc>
    <ndc_label_name>Advair HFA 230 mcg-21 mcg/actuation aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173071722</ndc>
    <ndc_label_name>Advair HFA 230 mcg-21 mcg/actuation aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173072200</ndc>
    <ndc_label_name>Wellbutrin SR 200 mg tablet, 12 hr sustained-release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173073500</ndc>
    <ndc_label_name>Imitrex 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173073601</ndc>
    <ndc_label_name>Imitrex 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173073701</ndc>
    <ndc_label_name>Imitrex 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173073900</ndc>
    <ndc_label_name>Imitrex STATdose Pen 4 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173073902</ndc>
    <ndc_label_name>Imitrex STATdose Refill 4 mg/0.5 mL subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173075400</ndc>
    <ndc_label_name>Lamictal XR 25 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173075500</ndc>
    <ndc_label_name>Lamictal XR 50 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173075600</ndc>
    <ndc_label_name>Lamictal XR 100 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173075700</ndc>
    <ndc_label_name>Lamictal XR 200 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173075800</ndc>
    <ndc_label_name>Lamictal XR Starter (Blue) 25 mg (21)-50 mg (7) tablet,extend release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173075900</ndc>
    <ndc_label_name>Lamictal XR Starter (Green) 50 mg(14)-100 mg(14)-200 mg(7) tab,ext.rel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173076000</ndc>
    <ndc_label_name>Lamictal XR Starter (Orange) 25 mg(14)-50 mg(14)-100 mg(7) tab,ext.rel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173076100</ndc>
    <ndc_label_name>Lamictal XR 300 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173077202</ndc>
    <ndc_label_name>Lamictal ODT 25 mg disintegrating tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173077402</ndc>
    <ndc_label_name>Lamictal ODT 50 mg disintegrating tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173077602</ndc>
    <ndc_label_name>Lamictal ODT 100 mg disintegrating tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173077702</ndc>
    <ndc_label_name>Lamictal ODT 200 mg disintegrating tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173077800</ndc>
    <ndc_label_name>Lamictal ODT Starter(Orange) 25 mg(14)-50 mg(14)-100 mg(7) tab,disint</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173077900</ndc>
    <ndc_label_name>Lamictal ODT Starter (Blue) 25 mg (21)-50 mg (7) tablet,disintegrating</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173078000</ndc>
    <ndc_label_name>Lamictal ODT Starter (Green) 50 mg (42)-100 mg (14) tablet,disintegrat</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173078100</ndc>
    <ndc_label_name>Lamictal XR 250 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173080913</ndc>
    <ndc_label_name>Jalyn 0.5 mg-0.4 mg capsule, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173080959</ndc>
    <ndc_label_name>Jalyn 0.5 mg-0.4 mg capsule, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173081728</ndc>
    <ndc_label_name>Lamictal Starter (Green) Kit 25 mg (84)-100 mg (14) tablets, dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173085701</ndc>
    <ndc_label_name>pH 12 Diluent for Flolan intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173085702</ndc>
    <ndc_label_name>pH 12 Diluent for Flolan intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173085910</ndc>
    <ndc_label_name>Breo Ellipta 100 mcg-25 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173085914</ndc>
    <ndc_label_name>Breo Ellipta 100 mcg-25 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173086906</ndc>
    <ndc_label_name>Anoro Ellipta 62.5 mcg-25 mcg/actuation powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173086910</ndc>
    <ndc_label_name>Anoro Ellipta 62.5 mcg-25 mcg/actuation powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173086961</ndc>
    <ndc_label_name>Anoro Ellipta 62.5 mcg-25 mcg/actuation powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173087306</ndc>
    <ndc_label_name>Incruse Ellipta 62.5 mcg/actuation powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173087310</ndc>
    <ndc_label_name>Incruse Ellipta 62.5 mcg/actuation powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173087410</ndc>
    <ndc_label_name>Arnuity Ellipta 100 mcg/actuation powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173087414</ndc>
    <ndc_label_name>Arnuity Ellipta 100 mcg/actuation powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173087610</ndc>
    <ndc_label_name>Arnuity Ellipta 200 mcg/actuation powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173087614</ndc>
    <ndc_label_name>Arnuity Ellipta 200 mcg/actuation powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173088101</ndc>
    <ndc_label_name>Nucala 100 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173088161</ndc>
    <ndc_label_name>Nucala 100 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173088210</ndc>
    <ndc_label_name>Breo Ellipta 200 mcg-25 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173088214</ndc>
    <ndc_label_name>Breo Ellipta 200 mcg-25 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173088710</ndc>
    <ndc_label_name>Trelegy Ellipta 100 mcg-62.5 mcg-25 mcg powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173088714</ndc>
    <ndc_label_name>Trelegy Ellipta 100 mcg-62.5 mcg-25 mcg powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173088761</ndc>
    <ndc_label_name>Trelegy Ellipta 100 mcg-62.5 mcg-25 mcg powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00173088810</ndc>
    <ndc_label_name>Arnuity Ellipta 50 mcg/actuation powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173088939</ndc>
    <ndc_label_name>Krintafel 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173089201</ndc>
    <ndc_label_name>Nucala 100 mg/mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173089242</ndc>
    <ndc_label_name>Nucala 100 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173089261</ndc>
    <ndc_label_name>Nucala 100 mg/mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173089310</ndc>
    <ndc_label_name>Trelegy Ellipta 200 mcg-62.5 mcg-25 mcg powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173089314</ndc>
    <ndc_label_name>Trelegy Ellipta 200 mcg-62.5 mcg-25 mcg powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173089361</ndc>
    <ndc_label_name>Trelegy Ellipta 200 mcg-62.5 mcg-25 mcg powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173089713</ndc>
    <ndc_label_name>JESDUVROQ 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173089803</ndc>
    <ndc_label_name>Jemperli 50 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173090313</ndc>
    <ndc_label_name>JESDUVROQ 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173090442</ndc>
    <ndc_label_name>Nucala 40 mg/0.4 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173090613</ndc>
    <ndc_label_name>JESDUVROQ 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173090913</ndc>
    <ndc_label_name>Zejula 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173091113</ndc>
    <ndc_label_name>JESDUVROQ 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173091213</ndc>
    <ndc_label_name>Zejula 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173091261</ndc>
    <ndc_label_name>Zejula 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173091301</ndc>
    <ndc_label_name>Blenrep 70 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173091413</ndc>
    <ndc_label_name>JESDUVROQ 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173091513</ndc>
    <ndc_label_name>Zejula 300 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173091561</ndc>
    <ndc_label_name>Zejula 300 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173091610</ndc>
    <ndc_label_name>Breo Ellipta 50 mcg-25 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173092238</ndc>
    <ndc_label_name>Blujepa 750 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173092245</ndc>
    <ndc_label_name>Blujepa 750 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173092742</ndc>
    <ndc_label_name>Exdensur 100 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173093308</ndc>
    <ndc_label_name>Valtrex 500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173093310</ndc>
    <ndc_label_name>Valtrex 500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00173094755</ndc>
    <ndc_label_name>Wellbutrin SR 100 mg tablet, 12 hr sustained-release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178031430</ndc>
    <ndc_label_name>POTASSIUM IODIDE 65 MG/ML SOLN</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178032003</ndc>
    <ndc_label_name>Thera-Gesic 15 %-1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178033003</ndc>
    <ndc_label_name>Dr. Smith's Diaper 10 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178045501</ndc>
    <ndc_label_name>Texacort 2.5 % topical solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178046002</ndc>
    <ndc_label_name>AVAR-E GREEN EMOLLIENT CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178046502</ndc>
    <ndc_label_name>AVAR-E LS CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178047002</ndc>
    <ndc_label_name>Avar-E 10 %-5 % (w/w) topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178047508</ndc>
    <ndc_label_name>Avar LS 10 %-2 % topical cleanser</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178048008</ndc>
    <ndc_label_name>Avar 10 %-5 % (w/w) topical cleanser</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178048508</ndc>
    <ndc_label_name>OVACE PLUS 10% SHAMPOO</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178049012</ndc>
    <ndc_label_name>OVACE PLUS WASH 10% CLNSNG GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178049502</ndc>
    <ndc_label_name>OVACE PLUS 10% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178049906</ndc>
    <ndc_label_name>OVACE 10% WASH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178050001</ndc>
    <ndc_label_name>Lithostat 250 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178055001</ndc>
    <ndc_label_name>Oncovite tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178060001</ndc>
    <ndc_label_name>UROCIT-K SR 5 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178061001</ndc>
    <ndc_label_name>Urocit-K 10 10 mEq (1,080 mg) tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178061501</ndc>
    <ndc_label_name>Urocit-K 15 15 mEq (1,620 mg) tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178062002</ndc>
    <ndc_label_name>OVACE PLUS 9.8% LOTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178063016</ndc>
    <ndc_label_name>OVACE PLUS 10% WASH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178074001</ndc>
    <ndc_label_name>URIBEL CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178074501</ndc>
    <ndc_label_name>Uribel Tabs 81.6 mg-0.12 mg-10.8 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178083230</ndc>
    <ndc_label_name>CITRANATAL B-CALM COMBO PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178089630</ndc>
    <ndc_label_name>CITRANATAL MEDLEY SOFTGEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178090001</ndc>
    <ndc_label_name>Thiola 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178090190</ndc>
    <ndc_label_name>Thiola EC 300 mg tablet,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00178090201</ndc>
    <ndc_label_name>Thiola EC 100 mg tablet,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179801230</ndc>
    <ndc_label_name>BACITRACIN ZN 500 UNIT/GM OINT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179801430</ndc>
    <ndc_label_name>CLOTRIMAZOLE 1% TOPICAL CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179801630</ndc>
    <ndc_label_name>HYDROCORTISONE-ALOE 0.5% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179801730</ndc>
    <ndc_label_name>MICONAZOLE 2% TOPICAL CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179801930</ndc>
    <ndc_label_name>TOLNAFTATE 1% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179802902</ndc>
    <ndc_label_name>NIACIN 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179803160</ndc>
    <ndc_label_name>Vision Formula (with lutein) 300 mcg-200 mg-27 mg-2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179803212</ndc>
    <ndc_label_name>Vision Formula(A-C-E-Zn-Se-Cu) 1,000 unit-60 mg-30 unit tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179803330</ndc>
    <ndc_label_name>Men's Pack 0.4 mg-250 mcg oral pack</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179803430</ndc>
    <ndc_label_name>Women's Daily Pack 400 mcg-800 mg-10 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179803501</ndc>
    <ndc_label_name>FOLIC ACID 1,000 MCG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179803612</ndc>
    <ndc_label_name>MAG-OXIDE MAGNESIUM 200 MG TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179804612</ndc>
    <ndc_label_name>GLUCOSAMINE-CHONDROITIN TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179804712</ndc>
    <ndc_label_name>Men's Daily Formula 400 mcg-20 mcg-300 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179804912</ndc>
    <ndc_label_name>OMEGA-3 FISH OIL 1,200 MG SFGL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179805002</ndc>
    <ndc_label_name>FOLIC ACID 800 MCG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179805190</ndc>
    <ndc_label_name>LUTEIN 6 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179805202</ndc>
    <ndc_label_name>VITAMIN E 100 UNIT SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179805301</ndc>
    <ndc_label_name>FERROUS GLUCONATE 324 MG TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179805401</ndc>
    <ndc_label_name>FERROUS SULFATE 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179805602</ndc>
    <ndc_label_name>CALCIUM CIT 315-VIT D3 250 CPT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179805802</ndc>
    <ndc_label_name>VITAMIN B-12 1,000 MCG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179805912</ndc>
    <ndc_label_name>Adults 50 Plus 0.4 mg-300 mcg-250 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179806102</ndc>
    <ndc_label_name>VITAMIN B-6 100 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179806312</ndc>
    <ndc_label_name>Adults' Daily Formula 18 mg iron-25 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179806490</ndc>
    <ndc_label_name>Prenatal Multivitamins 28 mg iron-800 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179806512</ndc>
    <ndc_label_name>Women's Daily Formula 18 mg iron-400 mcg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179806612</ndc>
    <ndc_label_name>Women's 50 Plus Daily Formula 400 mcg-500 mg calcium-20 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179806712</ndc>
    <ndc_label_name>Men's 50 Plus Daily Formula 400 mcg-20 mcg-370 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179810442</ndc>
    <ndc_label_name>OMEPRAZOLE MAG DR 20.6 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179815001</ndc>
    <ndc_label_name>BISACODYL EC 5 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179815601</ndc>
    <ndc_label_name>senna 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179830201</ndc>
    <ndc_label_name>CETIRIZINE HCL 5 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179831301</ndc>
    <ndc_label_name>PSEUDOEPHEDRINE 30 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179831550</ndc>
    <ndc_label_name>PSEUDOEPHEDRINE 60 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179831701</ndc>
    <ndc_label_name>LORATADINE 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179831730</ndc>
    <ndc_label_name>LORATADINE 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179832530</ndc>
    <ndc_label_name>FEXOFENADINE HCL 180 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179840702</ndc>
    <ndc_label_name>B Complex w-Vit C 18 mg-10 mg-45 mg-5 mg-250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179840902</ndc>
    <ndc_label_name>CALCIUM-MAGNESIUM-ZINC TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179842118</ndc>
    <ndc_label_name>FISH OIL 1,200 MG FISH OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179842712</ndc>
    <ndc_label_name>MELATONIN 3 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179870260</ndc>
    <ndc_label_name>BENZOYL PEROXIDE 5% GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179870360</ndc>
    <ndc_label_name>BENZOYL PEROXIDE 10% GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179870405</ndc>
    <ndc_label_name>BENZOYL PEROXIDE 10% WASH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179870505</ndc>
    <ndc_label_name>BENZOYL PEROXIDE 5% WASH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179870730</ndc>
    <ndc_label_name>Double Antibiotic (bacitrcn zn) 500 unit-10,000 unit/gram top ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179871030</ndc>
    <ndc_label_name>HYDROCORTISONE 1% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00179871130</ndc>
    <ndc_label_name>HYDROCORTISONE 1% OINTMENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179871530</ndc>
    <ndc_label_name>TERBINAFINE 1% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00179872402</ndc>
    <ndc_label_name>Silicone Scar Therapy Gel Strip 1.4" X 6" topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185002201</ndc>
    <ndc_label_name>ORPHENADRINE ER 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185005501</ndc>
    <ndc_label_name>METOLAZONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185012201</ndc>
    <ndc_label_name>NITROFURANTOIN MONO-MCR 100 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185012210</ndc>
    <ndc_label_name>NITROFURANTOIN MONO-MCR 100 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185012801</ndc>
    <ndc_label_name>BUMETANIDE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185012805</ndc>
    <ndc_label_name>BUMETANIDE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185012901</ndc>
    <ndc_label_name>BUMETANIDE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185012905</ndc>
    <ndc_label_name>BUMETANIDE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185013001</ndc>
    <ndc_label_name>BUMETANIDE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185013005</ndc>
    <ndc_label_name>BUMETANIDE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185021101</ndc>
    <ndc_label_name>BENAZEPRIL-HCTZ 20-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185023601</ndc>
    <ndc_label_name>BENAZEPRIL-HCTZ 5-6.25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185027701</ndc>
    <ndc_label_name>BENAZEPRIL-HCTZ 20-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185032501</ndc>
    <ndc_label_name>BENAZEPRIL-HCTZ 10-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185067401</ndc>
    <ndc_label_name>HYDROXYZINE PAM 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185067405</ndc>
    <ndc_label_name>HYDROXYZINE PAM 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185067601</ndc>
    <ndc_label_name>HYDROXYZINE PAM 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185067605</ndc>
    <ndc_label_name>HYDROXYZINE PAM 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185084201</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185085301</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185209801</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMINE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185209901</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185505001</ndc>
    <ndc_label_name>METOLAZONE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00185560001</ndc>
    <ndc_label_name>METOLAZONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00186037020</ndc>
    <ndc_label_name>Symbicort 160 mcg-4.5 mcg/actuation HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00186037028</ndc>
    <ndc_label_name>Symbicort 160 mcg-4.5 mcg/actuation HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00186037060</ndc>
    <ndc_label_name>Symbicort 160 mcg-4.5 mcg/actuation HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00186037220</ndc>
    <ndc_label_name>Symbicort 80 mcg-4.5 mcg/actuation HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00186037228</ndc>
    <ndc_label_name>Symbicort 80 mcg-4.5 mcg/actuation HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00186077660</ndc>
    <ndc_label_name>Brilinta 60 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00186077739</ndc>
    <ndc_label_name>Brilinta 90 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00186077760</ndc>
    <ndc_label_name>Brilinta 90 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186091765</ndc>
    <ndc_label_name>Pulmicort Flexhaler 90 mcg/actuation breath activated</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186198804</ndc>
    <ndc_label_name>Pulmicort 0.25 mg/2 mL suspension for nebulization</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186198904</ndc>
    <ndc_label_name>Pulmicort 0.5 mg/2 mL suspension for nebulization</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186199004</ndc>
    <ndc_label_name>Pulmicort 1 mg/2 mL suspension for nebulization</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186401001</ndc>
    <ndc_label_name>Nexium Packet 10 mg granules delayed release for susp</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186402001</ndc>
    <ndc_label_name>Nexium Packet 20 mg granules delayed release for susp</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186402501</ndc>
    <ndc_label_name>Nexium Packet 2.5 mg granules delayed release for susp</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186404001</ndc>
    <ndc_label_name>Nexium Packet 40 mg granules delayed release for susp</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186405001</ndc>
    <ndc_label_name>Nexium Packet 5 mg granules delayed release for susp</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186502031</ndc>
    <ndc_label_name>Nexium 20 mg capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186502054</ndc>
    <ndc_label_name>Nexium 20 mg capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186504031</ndc>
    <ndc_label_name>Nexium 40 mg capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00186504054</ndc>
    <ndc_label_name>Nexium 40 mg capsule,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187000201</ndc>
    <ndc_label_name>Bryhali 0.01 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187000260</ndc>
    <ndc_label_name>Bryhali 0.01 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187000400</ndc>
    <ndc_label_name>Siliq 210 mg/1.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187000402</ndc>
    <ndc_label_name>Siliq 210 mg/1.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187000503</ndc>
    <ndc_label_name>Altreno 0.05 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187000520</ndc>
    <ndc_label_name>Altreno 0.05 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187000545</ndc>
    <ndc_label_name>Altreno 0.05 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187000625</ndc>
    <ndc_label_name>Cabtreo 0.15 %-3.1 %-1.2 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187000714</ndc>
    <ndc_label_name>VIRAZOLE 6 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187001050</ndc>
    <ndc_label_name>Ammonul 10 %-10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187001345</ndc>
    <ndc_label_name>HYLATOPICPLUS CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187006301</ndc>
    <ndc_label_name>Ativan 0.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187006401</ndc>
    <ndc_label_name>Ativan 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187006410</ndc>
    <ndc_label_name>Ativan 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187006501</ndc>
    <ndc_label_name>Ativan 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187014030</ndc>
    <ndc_label_name>Vasotec 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187014090</ndc>
    <ndc_label_name>Vasotec 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187014130</ndc>
    <ndc_label_name>Vasotec 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187014190</ndc>
    <ndc_label_name>Vasotec 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187014210</ndc>
    <ndc_label_name>Vasotec 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187014230</ndc>
    <ndc_label_name>Vasotec 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187014290</ndc>
    <ndc_label_name>Vasotec 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187014310</ndc>
    <ndc_label_name>Vasotec 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187014330</ndc>
    <ndc_label_name>Vasotec 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187014390</ndc>
    <ndc_label_name>Vasotec 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187014601</ndc>
    <ndc_label_name>Vaseretic 10 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187015201</ndc>
    <ndc_label_name>Isordil Titradose 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187019201</ndc>
    <ndc_label_name>Isordil 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187024501</ndc>
    <ndc_label_name>Migranal 0.5 mg/pump act. (4 mg/mL) nasal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187024503</ndc>
    <ndc_label_name>Migranal 0.5 mg/pump act. (4 mg/mL) nasal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187045301</ndc>
    <ndc_label_name>Zelapar 1.25 mg disintegrating tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187045302</ndc>
    <ndc_label_name>Zelapar 1.25 mg disintegrating tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187065301</ndc>
    <ndc_label_name>Duobrii 0.01 %-0.045 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187073007</ndc>
    <ndc_label_name>Wellbutrin XL 150 mg 24 hr tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187073030</ndc>
    <ndc_label_name>Wellbutrin XL 150 mg 24 hr tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187073090</ndc>
    <ndc_label_name>Wellbutrin XL 150 mg 24 hr tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187073107</ndc>
    <ndc_label_name>Wellbutrin XL 300 mg 24 hr tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187073130</ndc>
    <ndc_label_name>Wellbutrin XL 300 mg 24 hr tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187077147</ndc>
    <ndc_label_name>Cardizem 30 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187077247</ndc>
    <ndc_label_name>Cardizem 60 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187079247</ndc>
    <ndc_label_name>Cardizem 120 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187079530</ndc>
    <ndc_label_name>Cardizem CD 120 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187079542</ndc>
    <ndc_label_name>Cardizem CD 120 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187079630</ndc>
    <ndc_label_name>Cardizem CD 180 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187079642</ndc>
    <ndc_label_name>Cardizem CD 180 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187079730</ndc>
    <ndc_label_name>Cardizem CD 240 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187079742</ndc>
    <ndc_label_name>Cardizem CD 240 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187079830</ndc>
    <ndc_label_name>Cardizem CD 300 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187079842</ndc>
    <ndc_label_name>Cardizem CD 300 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187079942</ndc>
    <ndc_label_name>Cardizem CD 360 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187093801</ndc>
    <ndc_label_name>Tasmar 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187099395</ndc>
    <ndc_label_name>Zovirax 5 % topical ointment</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187099445</ndc>
    <ndc_label_name>Zovirax 5 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187141616</ndc>
    <ndc_label_name>Ionil T 1 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187149825</ndc>
    <ndc_label_name>Timoptic Ocudose (PF) 0.25 % eye drops in a dropperette</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187204530</ndc>
    <ndc_label_name>Cardizem LA 120 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187204590</ndc>
    <ndc_label_name>Cardizem LA 120 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187204630</ndc>
    <ndc_label_name>Cardizem LA 180 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187204690</ndc>
    <ndc_label_name>Cardizem LA 180 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187204730</ndc>
    <ndc_label_name>Cardizem LA 240 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187204790</ndc>
    <ndc_label_name>Cardizem LA 240 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187204830</ndc>
    <ndc_label_name>Cardizem LA 300 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187204890</ndc>
    <ndc_label_name>Cardizem LA 300 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187204930</ndc>
    <ndc_label_name>Cardizem LA 360 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187204990</ndc>
    <ndc_label_name>Cardizem LA 360 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187205030</ndc>
    <ndc_label_name>Cardizem LA 420 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187205090</ndc>
    <ndc_label_name>Cardizem LA 420 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187209845</ndc>
    <ndc_label_name>Arazlo 0.045 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187212010</ndc>
    <ndc_label_name>Syprine 250 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187261230</ndc>
    <ndc_label_name>Tiazac 120 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187261290</ndc>
    <ndc_label_name>Tiazac 120 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187261330</ndc>
    <ndc_label_name>Tiazac 180 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187261390</ndc>
    <ndc_label_name>Tiazac 180 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187261430</ndc>
    <ndc_label_name>Tiazac 240 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187261490</ndc>
    <ndc_label_name>Tiazac 240 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187261530</ndc>
    <ndc_label_name>Tiazac 300 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187261590</ndc>
    <ndc_label_name>Tiazac 300 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187261630</ndc>
    <ndc_label_name>Tiazac 360 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187261690</ndc>
    <ndc_label_name>Tiazac 360 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187261730</ndc>
    <ndc_label_name>Tiazac 420 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187261790</ndc>
    <ndc_label_name>Tiazac 420 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187301030</ndc>
    <ndc_label_name>Mestinon 60 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187301220</ndc>
    <ndc_label_name>Mestinon 60 mg/5 mL oral syrup</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187301330</ndc>
    <ndc_label_name>Mestinon Timespan 180 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187305035</ndc>
    <ndc_label_name>Onexton 1.2 % (1 % base)-3.75 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187305050</ndc>
    <ndc_label_name>Onexton 1.2 % (1 % base)-3.75 % topical gel with pump</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187320447</ndc>
    <ndc_label_name>Efudex 5 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187355410</ndc>
    <ndc_label_name>Ancobon 250 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187355510</ndc>
    <ndc_label_name>Ancobon 500 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187410010</ndc>
    <ndc_label_name>Librax (with clidinium) 5 mg-2.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187430305</ndc>
    <ndc_label_name>AMYTAL SODIUM 0.5 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187442010</ndc>
    <ndc_label_name>Pepcid 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187442030</ndc>
    <ndc_label_name>Pepcid 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187444010</ndc>
    <ndc_label_name>Pepcid 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187444030</ndc>
    <ndc_label_name>Pepcid 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187510001</ndc>
    <ndc_label_name>ELIDEL 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187510102</ndc>
    <ndc_label_name>ELIDEL 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187510203</ndc>
    <ndc_label_name>ELIDEL 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187510401</ndc>
    <ndc_label_name>Xerese 5 %-1 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187511045</ndc>
    <ndc_label_name>BIAFINE EMULSION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187511090</ndc>
    <ndc_label_name>BIAFINE EMULSION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187511560</ndc>
    <ndc_label_name>Ertaczo 2 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187514020</ndc>
    <ndc_label_name>RETIN-A MICRO 0.1% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187514045</ndc>
    <ndc_label_name>RETIN-A MICRO 0.1% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187514050</ndc>
    <ndc_label_name>RETIN-A MICRO PUMP 0.1% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187514420</ndc>
    <ndc_label_name>RETIN-A MICRO 0.04% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187514445</ndc>
    <ndc_label_name>RETIN-A MICRO 0.04% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187514450</ndc>
    <ndc_label_name>RETIN-A MICRO PUMP 0.04% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187514650</ndc>
    <ndc_label_name>Retin-A Micro Pump 0.06 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187514850</ndc>
    <ndc_label_name>Retin-A Micro Pump 0.08 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187515020</ndc>
    <ndc_label_name>Renova 0.02 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187515040</ndc>
    <ndc_label_name>Renova 0.02 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187515044</ndc>
    <ndc_label_name>Renova 0.02 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187515060</ndc>
    <ndc_label_name>Renova 0.02 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187516020</ndc>
    <ndc_label_name>Retin-A 0.025 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187516045</ndc>
    <ndc_label_name>Retin-A 0.025 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187516220</ndc>
    <ndc_label_name>Retin-A 0.05 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187516245</ndc>
    <ndc_label_name>Retin-A 0.05 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187516420</ndc>
    <ndc_label_name>Retin-A 0.1 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187516445</ndc>
    <ndc_label_name>Retin-A 0.1 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187517015</ndc>
    <ndc_label_name>Retin-A 0.025 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187517045</ndc>
    <ndc_label_name>Retin-A 0.025 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187517215</ndc>
    <ndc_label_name>Retin-A 0.01 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187517245</ndc>
    <ndc_label_name>Retin-A 0.01 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187519804</ndc>
    <ndc_label_name>Klaron 10 % lotion (suspension)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187520030</ndc>
    <ndc_label_name>Carac 0.5 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187520260</ndc>
    <ndc_label_name>Noritate 1 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187520546</ndc>
    <ndc_label_name>Benzamycin 3 %-5 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187540004</ndc>
    <ndc_label_name>Jublia 10 % topical solution, applicator</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187540008</ndc>
    <ndc_label_name>Jublia 10 % topical solution, applicator</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187552560</ndc>
    <ndc_label_name>Targretin 1 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187552675</ndc>
    <ndc_label_name>Targretin 75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187560015</ndc>
    <ndc_label_name>Visudyne 15 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187581007</ndc>
    <ndc_label_name>Aplenzin 174 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187581030</ndc>
    <ndc_label_name>Aplenzin 174 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187581107</ndc>
    <ndc_label_name>Aplenzin 348 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187581130</ndc>
    <ndc_label_name>Aplenzin 348 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187581207</ndc>
    <ndc_label_name>Aplenzin 522 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00187581230</ndc>
    <ndc_label_name>Aplenzin 522 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193148901</ndc>
    <ndc_label_name>Breeze 2 Control Solution, Normal</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193149001</ndc>
    <ndc_label_name>Breeze 2 Control Solution, Low</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193149101</ndc>
    <ndc_label_name>Breeze 2 Control Solution, High</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00193280221</ndc>
    <ndc_label_name>Diastix strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00193280250</ndc>
    <ndc_label_name>Diastix strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00193288021</ndc>
    <ndc_label_name>Ketostix strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00193288050</ndc>
    <ndc_label_name>Ketostix strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00193288221</ndc>
    <ndc_label_name>Keto-Diastix strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00193288250</ndc>
    <ndc_label_name>Keto-Diastix strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193596531</ndc>
    <ndc_label_name>Fingerstix Lancets</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193602021</ndc>
    <ndc_label_name>Microlet Next Lancet 28 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193620101</ndc>
    <ndc_label_name>Contour Next Link kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193620301</ndc>
    <ndc_label_name>Contour Next Link kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193626201</ndc>
    <ndc_label_name>Contour Next Link 2.4 kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193654621</ndc>
    <ndc_label_name>Microlet Lancet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193656801</ndc>
    <ndc_label_name>Single-Let misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193658621</ndc>
    <ndc_label_name>Microlet Lancet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193660601</ndc>
    <ndc_label_name>Microlet 2 Lancing Device kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193670201</ndc>
    <ndc_label_name>Microlet Next Lancing Device kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193703601</ndc>
    <ndc_label_name>Contour Plus Blue Meter</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193707025</ndc>
    <ndc_label_name>Contour Test Strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193708050</ndc>
    <ndc_label_name>Contour Test Strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193709021</ndc>
    <ndc_label_name>Contour Test Strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193710901</ndc>
    <ndc_label_name>Contour Control Solution, Normal</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193711001</ndc>
    <ndc_label_name>Contour Control Solution, Low</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193711101</ndc>
    <ndc_label_name>Contour Control Solution, High</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193718901</ndc>
    <ndc_label_name>Contour Meter</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193725201</ndc>
    <ndc_label_name>Contour Next EZ Meter</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193727735</ndc>
    <ndc_label_name>Contour Next Test Strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193727870</ndc>
    <ndc_label_name>Contour Next Test Strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193730850</ndc>
    <ndc_label_name>Contour Next Test Strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193731025</ndc>
    <ndc_label_name>Contour Next Test Strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193731150</ndc>
    <ndc_label_name>Contour Next Test Strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193731221</ndc>
    <ndc_label_name>Contour Next Test Strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193731310</ndc>
    <ndc_label_name>Contour Next Test Strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193731401</ndc>
    <ndc_label_name>Contour Next Level 2 Control Solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193731501</ndc>
    <ndc_label_name>Contour Next Level 1 Control Solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193737701</ndc>
    <ndc_label_name>Contour Next Meter</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193737901</ndc>
    <ndc_label_name>Contour Next Glucose Meter kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193738301</ndc>
    <ndc_label_name>Contour Next Gen Meter kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193755301</ndc>
    <ndc_label_name>Contour Next EZ Meter</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193758450</ndc>
    <ndc_label_name>Contour Plus Test Strip</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193781801</ndc>
    <ndc_label_name>Contour Next One Meter</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193782501</ndc>
    <ndc_label_name>Contour Next One Meter</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier/>
    <ndc>00193782801</ndc>
    <ndc_label_name>Contour Next One Meter kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>True</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193792201</ndc>
    <ndc_label_name>Contour Next Gen Meter</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193954501</ndc>
    <ndc_label_name>Contour Meter kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193955601</ndc>
    <ndc_label_name>Contour Meter</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193962801</ndc>
    <ndc_label_name>Contour Next EZ Meter kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00193967430</ndc>
    <ndc_label_name>Breeze 2 Test Strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00206886001</ndc>
    <ndc_label_name>Zosyn 2.25 gram/50 mL in dextrose (iso-osmotic) intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00206886002</ndc>
    <ndc_label_name>Zosyn 2.25 gram/50 mL in dextrose (iso-osmotic) intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00206886101</ndc>
    <ndc_label_name>Zosyn 3.375 gram/50 mL in dextrose (iso-osmotic) intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00206886102</ndc>
    <ndc_label_name>Zosyn 3.375 gram/50 mL in dextrose (iso-osmotic) intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00206886201</ndc>
    <ndc_label_name>Zosyn 4.5 gram/100 mL in dextrose (iso-osmotic) intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00206886202</ndc>
    <ndc_label_name>Zosyn 4.5 gram/100 mL in dextrose (iso-osmotic) intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00220099962</ndc>
    <ndc_label_name>Enterade Advanced Oncology 230 mg-95 mg-5 kcal/237 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223004007</ndc>
    <ndc_label_name>IV 3000 2 3/8" X 2 3/4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223007638</ndc>
    <ndc_label_name>Allevyn 8" X 8" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223041521</ndc>
    <ndc_label_name>Allevyn 6" X 6" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223041532</ndc>
    <ndc_label_name>Allevyn 8" X 8" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223041585</ndc>
    <ndc_label_name>Allevyn 8" X 8" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223041680</ndc>
    <ndc_label_name>Allevyn Adhesive Dressing 9" X 9"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223042672</ndc>
    <ndc_label_name>Allevyn Heel 4 1/2" X 5 1/2" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223042675</ndc>
    <ndc_label_name>Allevyn Sacrum 9" X 9" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223043840</ndc>
    <ndc_label_name>Allevyn Adhesive Dressing 7" X 7"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223043858</ndc>
    <ndc_label_name>Allevyn Adhesive Dressing 3" X 3"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223043859</ndc>
    <ndc_label_name>Allevyn Adhesive Dressing 5" X 5"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223043860</ndc>
    <ndc_label_name>Allevyn Adhesive Dressing 7" X 7"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223043861</ndc>
    <ndc_label_name>Allevyn 2" X 2" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223043862</ndc>
    <ndc_label_name>Allevyn 4" X 4" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223043864</ndc>
    <ndc_label_name>Allevyn 8" X 8" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223043869</ndc>
    <ndc_label_name>Allevyn Tracheostomy Dressing 3.5" X 3.5"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223044151</ndc>
    <ndc_label_name>Allevyn Sacrum 6 3/4" X 6 3/4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223044165</ndc>
    <ndc_label_name>Cica-Care Adhesive Silicone 5" X 6" topical sheets</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045011</ndc>
    <ndc_label_name>Cuticerin Dressing 8" X 16"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045014</ndc>
    <ndc_label_name>Cuticerin Dressing 3" X 8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045017</ndc>
    <ndc_label_name>Cuticerin Dressing 3" X 3"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045020</ndc>
    <ndc_label_name>Cuticerin Dressing 3" X 3"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045023</ndc>
    <ndc_label_name>Cuticerin Dressing 3" X 8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045139</ndc>
    <ndc_label_name>Cutinova Hydro Dressing 4" X 4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045142</ndc>
    <ndc_label_name>Cutinova Hydro Dressing 6" X 8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045145</ndc>
    <ndc_label_name>Cutinova Hydro Dressing 2" X 2 3/8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045290</ndc>
    <ndc_label_name>Allevyn Thin Dressing 2" X 2 3/8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045293</ndc>
    <ndc_label_name>Allevyn Thin Dressing 4" X 4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045296</ndc>
    <ndc_label_name>Allevyn Thin Dressing 6" X 8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045429</ndc>
    <ndc_label_name>Allevyn Plus Adhesive 5" X 5" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045432</ndc>
    <ndc_label_name>Allevyn Plus Adhesive 7" X 7" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045435</ndc>
    <ndc_label_name>Allevyn Plus Adhesive 5" X 9" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045637</ndc>
    <ndc_label_name>Cuticerin Dressing 4" X 4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045658</ndc>
    <ndc_label_name>Cuticerin Dressing 3" X 8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045659</ndc>
    <ndc_label_name>Acticoat Moisture Control 2" X 2" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045662</ndc>
    <ndc_label_name>Acticoat Moisture Control 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045665</ndc>
    <ndc_label_name>Acticoat Moisture Control 4" X 8" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045958</ndc>
    <ndc_label_name>Acticoat Surgical Dressing 4" X 4 3/4"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045959</ndc>
    <ndc_label_name>Acticoat Surgical Dressing 4" X 8"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045960</ndc>
    <ndc_label_name>Acticoat Surgical Dressing 4" X 10"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045979</ndc>
    <ndc_label_name>Allevyn Ag Adhesive 5 %-3" X 3" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045982</ndc>
    <ndc_label_name>Allevyn Ag Adhesive 5 %-5" X 5" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045985</ndc>
    <ndc_label_name>Allevyn Ag Adhesive 5 %-7" X 7" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045994</ndc>
    <ndc_label_name>Allevyn Ag 5 %-2" X 2" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223045997</ndc>
    <ndc_label_name>Allevyn Ag 5 %-4" X 4" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046000</ndc>
    <ndc_label_name>Allevyn Ag 5 %-6" X 6" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046003</ndc>
    <ndc_label_name>Allevyn Ag 5 %-8" X 8" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046392</ndc>
    <ndc_label_name>Allevyn Gentle Border 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046409</ndc>
    <ndc_label_name>Allevyn Gentle Border 3" X 3" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046415</ndc>
    <ndc_label_name>Allevyn Gentle Border 5" X 5" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046417</ndc>
    <ndc_label_name>Allevyn Gentle Border 7" X 7" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046525</ndc>
    <ndc_label_name>Allevyn Gentle Border Heel 9" X 9 1/8" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046546</ndc>
    <ndc_label_name>Allevyn Ag Gentle Dressing 5 %-2" X 2"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046549</ndc>
    <ndc_label_name>Allevyn Ag Gentle Dressing 5 %-4" X 4"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046555</ndc>
    <ndc_label_name>Allevyn Ag Gentle Dressing 5 %-6" X 6"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046558</ndc>
    <ndc_label_name>Allevyn Ag Gentle Dressing 5 %-8" X 8"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046692</ndc>
    <ndc_label_name>Durafiber Dressing 2" X 2"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046695</ndc>
    <ndc_label_name>Durafiber Dressing 4" X 4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046698</ndc>
    <ndc_label_name>Durafiber Dressing 6" X 6"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046704</ndc>
    <ndc_label_name>Durafiber Dressing 3/4" X 18"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223046819</ndc>
    <ndc_label_name>Acticoat Surgical Dressing 4" X 13 3/4"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223047545</ndc>
    <ndc_label_name>Allevyn Gentle Border Lite 2" X 2" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223047548</ndc>
    <ndc_label_name>Allevyn Gentle Border Lite 3" X 3" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223047551</ndc>
    <ndc_label_name>Allevyn Gentle Border Lite 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223047554</ndc>
    <ndc_label_name>Allevyn Gentle Border Lite 2 1/8" X 4 3/4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223047560</ndc>
    <ndc_label_name>Allevyn Gentle Border Lite 6" X 6" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223047614</ndc>
    <ndc_label_name>Allevyn Gentle Border Sacrum 6 5/8" X 6 3/4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223047652</ndc>
    <ndc_label_name>Allevyn Gentle Border Multisite 6 3/4" X 7 1/16" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223047782</ndc>
    <ndc_label_name>Allevyn Gentle Border Sacrum 8 1/2" X 9" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223047799</ndc>
    <ndc_label_name>Allevyn Life Dressing 4" X 4"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223047803</ndc>
    <ndc_label_name>Allevyn Life Dressing 5 1/16" X 5 1/16"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223047806</ndc>
    <ndc_label_name>Allevyn Life Dressing 6 1/16" X 6 1/16"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223047809</ndc>
    <ndc_label_name>Allevyn Life Dressing 8 1/4" X 8 1/4"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00223172001</ndc>
    <ndc_label_name>SODIUM BICARB 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00223172101</ndc>
    <ndc_label_name>SODIUM BICARB 650 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223176001</ndc>
    <ndc_label_name>SODIUM CHLORIDE 1 GM TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00223176002</ndc>
    <ndc_label_name>SODIUM CHLORIDE 1 GM TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225029515</ndc>
    <ndc_label_name>Anaspaz 0.125 mg disintegrating tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225029520</ndc>
    <ndc_label_name>Anaspaz 0.125 mg disintegrating tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225036011</ndc>
    <ndc_label_name>Mobisyl 10 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225036035</ndc>
    <ndc_label_name>Mobisyl 10 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225038080</ndc>
    <ndc_label_name>Ayr Saline 0.65 % nasal spray aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225038180</ndc>
    <ndc_label_name>Ayr Allergy and Sinus 2.65 % nasal spray aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225038280</ndc>
    <ndc_label_name>Ayr Saline 0.65 % nasal drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225049533</ndc>
    <ndc_label_name>ITCH-X 1 %-10 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225052053</ndc>
    <ndc_label_name>Pretty Feet Hands topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225052547</ndc>
    <ndc_label_name>Ayr Saline nasal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225052848</ndc>
    <ndc_label_name>Ayr Saline Gel nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225055050</ndc>
    <ndc_label_name>Baby Ayr Saline 0.65 % nasal drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225061023</ndc>
    <ndc_label_name>Benzedrex nasal inhaler</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225070010</ndc>
    <ndc_label_name>Ayr Sinus Rinse with packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225070015</ndc>
    <ndc_label_name>Ayr Sinus Rinse with packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225070515</ndc>
    <ndc_label_name>Ayr Sinus Rinse Refill packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225070591</ndc>
    <ndc_label_name>Ayr Sinus Rinse Refill packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225071019</ndc>
    <ndc_label_name>Ayr Saline Nasal Neti Rinse with packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225080047</ndc>
    <ndc_label_name>Neo-Synephrine (phenylephrine) 0.25 % nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225080547</ndc>
    <ndc_label_name>Neo-Synephrine (phenylephrine) 0.5 % nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00225081047</ndc>
    <ndc_label_name>Neo-Synephrine (phenylephrine) 1 % nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228141003</ndc>
    <ndc_label_name>LAMOTRIGINE ER 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228142203</ndc>
    <ndc_label_name>LAMOTRIGINE ER 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228143503</ndc>
    <ndc_label_name>LAMOTRIGINE ER 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228145303</ndc>
    <ndc_label_name>LAMOTRIGINE ER 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228158003</ndc>
    <ndc_label_name>LAMOTRIGINE ER 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228163803</ndc>
    <ndc_label_name>LAMOTRIGINE ER 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228202710</ndc>
    <ndc_label_name>ALPRAZOLAM 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228202750</ndc>
    <ndc_label_name>ALPRAZOLAM 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228202796</ndc>
    <ndc_label_name>ALPRAZOLAM 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228202910</ndc>
    <ndc_label_name>ALPRAZOLAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228202950</ndc>
    <ndc_label_name>ALPRAZOLAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228202996</ndc>
    <ndc_label_name>ALPRAZOLAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228203110</ndc>
    <ndc_label_name>ALPRAZOLAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228203150</ndc>
    <ndc_label_name>ALPRAZOLAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228203196</ndc>
    <ndc_label_name>ALPRAZOLAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228203910</ndc>
    <ndc_label_name>ALPRAZOLAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228206710</ndc>
    <ndc_label_name>OXAZEPAM 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228206910</ndc>
    <ndc_label_name>OXAZEPAM 15 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228207310</ndc>
    <ndc_label_name>OXAZEPAM 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228207610</ndc>
    <ndc_label_name>TEMAZEPAM 15 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228207650</ndc>
    <ndc_label_name>TEMAZEPAM 15 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228207710</ndc>
    <ndc_label_name>TEMAZEPAM 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228207750</ndc>
    <ndc_label_name>TEMAZEPAM 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228212710</ndc>
    <ndc_label_name>CLONIDINE HCL 0.1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228212750</ndc>
    <ndc_label_name>CLONIDINE HCL 0.1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228212810</ndc>
    <ndc_label_name>CLONIDINE HCL 0.2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228212850</ndc>
    <ndc_label_name>CLONIDINE HCL 0.2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228212910</ndc>
    <ndc_label_name>CLONIDINE HCL 0.3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228234810</ndc>
    <ndc_label_name>PROPYLTHIOURACIL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228249710</ndc>
    <ndc_label_name>NIFEDIPINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228253010</ndc>
    <ndc_label_name>NIFEDIPINE 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228255006</ndc>
    <ndc_label_name>DICLOFENAC SOD EC 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228255011</ndc>
    <ndc_label_name>DICLOFENAC SOD EC 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228255096</ndc>
    <ndc_label_name>DICLOFENAC SOD EC 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228255106</ndc>
    <ndc_label_name>DICLOFENAC SOD EC 75 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228255111</ndc>
    <ndc_label_name>DICLOFENAC SOD EC 75 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228255196</ndc>
    <ndc_label_name>DICLOFENAC SOD EC 75 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228257111</ndc>
    <ndc_label_name>INDAPAMIDE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228257196</ndc>
    <ndc_label_name>INDAPAMIDE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228259711</ndc>
    <ndc_label_name>INDAPAMIDE 1.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228259796</ndc>
    <ndc_label_name>INDAPAMIDE 1.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228262011</ndc>
    <ndc_label_name>ISOSORBIDE MONONIT 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228263111</ndc>
    <ndc_label_name>ISOSORBIDE MONONIT 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228263611</ndc>
    <ndc_label_name>GABAPENTIN 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228263650</ndc>
    <ndc_label_name>GABAPENTIN 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228263711</ndc>
    <ndc_label_name>GABAPENTIN 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228263750</ndc>
    <ndc_label_name>GABAPENTIN 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228277811</ndc>
    <ndc_label_name>PROPRANOLOL ER 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228277911</ndc>
    <ndc_label_name>PROPRANOLOL ER 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228278011</ndc>
    <ndc_label_name>PROPRANOLOL ER 120 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228278111</ndc>
    <ndc_label_name>PROPRANOLOL ER 160 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228280111</ndc>
    <ndc_label_name>PILOCARPINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228282011</ndc>
    <ndc_label_name>HYDROCHLOROTHIAZIDE 12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228282096</ndc>
    <ndc_label_name>HYDROCHLOROTHIAZIDE 12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228283711</ndc>
    <ndc_label_name>PILOCARPINE HCL 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228284803</ndc>
    <ndc_label_name>FLUVOXAMINE ER 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228284903</ndc>
    <ndc_label_name>FLUVOXAMINE ER 150 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228285011</ndc>
    <ndc_label_name>GUANFACINE HCL ER 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228285111</ndc>
    <ndc_label_name>GUANFACINE HCL ER 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228285311</ndc>
    <ndc_label_name>GUANFACINE HCL ER 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228285511</ndc>
    <ndc_label_name>GUANFACINE HCL ER 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228289006</ndc>
    <ndc_label_name>DULOXETINE HCL DR 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228289103</ndc>
    <ndc_label_name>DULOXETINE HCL DR 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228289150</ndc>
    <ndc_label_name>DULOXETINE HCL DR 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228289203</ndc>
    <ndc_label_name>DULOXETINE HCL DR 60 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228289296</ndc>
    <ndc_label_name>DULOXETINE HCL DR 60 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228289506</ndc>
    <ndc_label_name>DOXYCYCLINE HYC DR 75 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228289611</ndc>
    <ndc_label_name>DOXYCYCLINE HYC DR 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228305911</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228306011</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228306111</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228306211</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228306311</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 15 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228306411</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228308306</ndc>
    <ndc_label_name>ALPRAZOLAM ER 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228308406</ndc>
    <ndc_label_name>ALPRAZOLAM ER 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228308606</ndc>
    <ndc_label_name>ALPRAZOLAM ER 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228308706</ndc>
    <ndc_label_name>ALPRAZOLAM ER 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228309011</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228309111</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 60 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228309211</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 90 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228309311</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 120 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228311611</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 45 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228311711</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228315303</ndc>
    <ndc_label_name>BUPRENORPHINE 8 MG TABLET SL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228315403</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 2-0.5MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228315503</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 8-2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228315603</ndc>
    <ndc_label_name>BUPRENORPHINE 2 MG TABLET SL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228331503</ndc>
    <ndc_label_name>DOXEPIN HCL 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228331603</ndc>
    <ndc_label_name>DOXEPIN HCL 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228364003</ndc>
    <ndc_label_name>ROPINIROLE HCL ER 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228365803</ndc>
    <ndc_label_name>ROPINIROLE HCL ER 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228365809</ndc>
    <ndc_label_name>ROPINIROLE HCL ER 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228365903</ndc>
    <ndc_label_name>ROPINIROLE HCL ER 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228365909</ndc>
    <ndc_label_name>ROPINIROLE HCL ER 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228366003</ndc>
    <ndc_label_name>ROPINIROLE HCL ER 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228366009</ndc>
    <ndc_label_name>ROPINIROLE HCL ER 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00228366103</ndc>
    <ndc_label_name>ROPINIROLE HCL ER 12 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228401911</ndc>
    <ndc_label_name>ALPRAZOLAM ODT 0.25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228402211</ndc>
    <ndc_label_name>ALPRAZOLAM ODT 0.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228402411</ndc>
    <ndc_label_name>ALPRAZOLAM ODT 1 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228402511</ndc>
    <ndc_label_name>ALPRAZOLAM ODT 2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228424106</ndc>
    <ndc_label_name>CLONIDINE HCL ER 0.1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228427011</ndc>
    <ndc_label_name>MORPHINE SULF ER 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228427111</ndc>
    <ndc_label_name>MORPHINE SULF ER 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228431111</ndc>
    <ndc_label_name>MORPHINE SULF ER 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228432311</ndc>
    <ndc_label_name>MORPHINE SULF ER 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00228434711</ndc>
    <ndc_label_name>MORPHINE SULF ER 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00234057504</ndc>
    <ndc_label_name>Hibiclens 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00234057508</ndc>
    <ndc_label_name>Hibiclens 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00234057516</ndc>
    <ndc_label_name>Hibiclens 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00234057517</ndc>
    <ndc_label_name>Hibiclens 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00234057532</ndc>
    <ndc_label_name>Hibiclens 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00234057541</ndc>
    <ndc_label_name>Hibiclens 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00234057580</ndc>
    <ndc_label_name>Hibiclens 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00234057591</ndc>
    <ndc_label_name>Hibiclens 4 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00240021201</ndc>
    <ndc_label_name>Campho-Phenique 10.8 %-4.7 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00240021202</ndc>
    <ndc_label_name>Campho-Phenique 10.8 %-4.7 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00240053785</ndc>
    <ndc_label_name>Bronkaid Dual Action 25 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00240053787</ndc>
    <ndc_label_name>Bronkaid Dual Action 25 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245003623</ndc>
    <ndc_label_name>Prevalite 4 gram oral powder</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245003642</ndc>
    <ndc_label_name>Prevalite 4 gram powder for suspension in a packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245003660</ndc>
    <ndc_label_name>Prevalite 4 gram powder for suspension in a packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245003689</ndc>
    <ndc_label_name>Prevalite 4 gram powder for suspension in a packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245007011</ndc>
    <ndc_label_name>POTASSIUM CITRATE ER 5 MEQ TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245007111</ndc>
    <ndc_label_name>POTASSIUM CITRATE ER 10 MEQ TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245010801</ndc>
    <ndc_label_name>FERROUS SULF EC 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245010810</ndc>
    <ndc_label_name>FERROUS SULF EC 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245010811</ndc>
    <ndc_label_name>FERROUS SULF EC 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245010889</ndc>
    <ndc_label_name>FERROUS SULF EC 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245014401</ndc>
    <ndc_label_name>Pacerone 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245014430</ndc>
    <ndc_label_name>Pacerone 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245014489</ndc>
    <ndc_label_name>Pacerone 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245014701</ndc>
    <ndc_label_name>Pacerone 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245014715</ndc>
    <ndc_label_name>Pacerone 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245014760</ndc>
    <ndc_label_name>Pacerone 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245014789</ndc>
    <ndc_label_name>Pacerone 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245014790</ndc>
    <ndc_label_name>Pacerone 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245021111</ndc>
    <ndc_label_name>MIDODRINE HCL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245021201</ndc>
    <ndc_label_name>MIDODRINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245021211</ndc>
    <ndc_label_name>MIDODRINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245021289</ndc>
    <ndc_label_name>MIDODRINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245021311</ndc>
    <ndc_label_name>MIDODRINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245036001</ndc>
    <ndc_label_name>Klor-Con 20 mEq oral packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245036030</ndc>
    <ndc_label_name>Klor-Con 20 mEq oral packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245036089</ndc>
    <ndc_label_name>Klor-Con 20 mEq oral packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245055650</ndc>
    <ndc_label_name>Vigadrone 500 mg oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245055689</ndc>
    <ndc_label_name>Vigadrone 500 mg oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245057001</ndc>
    <ndc_label_name>ISOTRETINOIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245057089</ndc>
    <ndc_label_name>ISOTRETINOIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245057101</ndc>
    <ndc_label_name>ISOTRETINOIN 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245057189</ndc>
    <ndc_label_name>ISOTRETINOIN 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245057301</ndc>
    <ndc_label_name>ISOTRETINOIN 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245057389</ndc>
    <ndc_label_name>ISOTRETINOIN 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245057501</ndc>
    <ndc_label_name>ISOTRETINOIN 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245057589</ndc>
    <ndc_label_name>ISOTRETINOIN 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245080938</ndc>
    <ndc_label_name>Zembrace Symtouch 3 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245080989</ndc>
    <ndc_label_name>Zembrace Symtouch 3 mg/0.5 mL subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245081261</ndc>
    <ndc_label_name>Tosymra 10 mg/actuation nasal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245081289</ndc>
    <ndc_label_name>Tosymra 10 mg/actuation nasal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245081411</ndc>
    <ndc_label_name>Kymbee 6 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245081530</ndc>
    <ndc_label_name>Kymbee 18 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245081630</ndc>
    <ndc_label_name>Kymbee 30 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245081730</ndc>
    <ndc_label_name>Kymbee 36 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245082204</ndc>
    <ndc_label_name>Torpenz 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245082230</ndc>
    <ndc_label_name>Torpenz 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245082289</ndc>
    <ndc_label_name>Torpenz 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245082304</ndc>
    <ndc_label_name>Torpenz 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245082330</ndc>
    <ndc_label_name>Torpenz 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245082389</ndc>
    <ndc_label_name>Torpenz 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245082404</ndc>
    <ndc_label_name>Torpenz 7.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245082430</ndc>
    <ndc_label_name>Torpenz 7.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245082489</ndc>
    <ndc_label_name>Torpenz 7.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245082504</ndc>
    <ndc_label_name>Torpenz 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245082530</ndc>
    <ndc_label_name>Torpenz 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245082589</ndc>
    <ndc_label_name>Torpenz 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245083515</ndc>
    <ndc_label_name>Klor-Con 8 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245083601</ndc>
    <ndc_label_name>Klor-Con 10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245083611</ndc>
    <ndc_label_name>Klor-Con 10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245083615</ndc>
    <ndc_label_name>Klor-Con 10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245083689</ndc>
    <ndc_label_name>Klor-Con 10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245086070</ndc>
    <ndc_label_name>Vandazole 0.75 % (37.5 mg/5 gram) vaginal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245087105</ndc>
    <ndc_label_name>Vogelxo 50 mg/5 gram (1 %) transdermal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245087135</ndc>
    <ndc_label_name>Vogelxo 1 % (50 mg/5 gram) transdermal gel packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245087165</ndc>
    <ndc_label_name>Vogelxo 50 mg/5 gram (1 %) transdermal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245087189</ndc>
    <ndc_label_name>Vogelxo 1 % (50 mg/5 gram) transdermal gel packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245087240</ndc>
    <ndc_label_name>Vogelxo 12.5 mg/1.25 gram per pump actuation (1 %) transdermal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245087242</ndc>
    <ndc_label_name>Vogelxo 12.5 mg/1.25 gram per pump actuation (1 %) transdermal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245088030</ndc>
    <ndc_label_name>Divigel 0.25 mg/0.25 gram (0.1 %) transdermal gel packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245088230</ndc>
    <ndc_label_name>Divigel 1 mg/gram (0.1 %) transdermal gel packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245107130</ndc>
    <ndc_label_name>QUDEXY XR 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245107230</ndc>
    <ndc_label_name>QUDEXY XR 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245107330</ndc>
    <ndc_label_name>QUDEXY XR 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245107430</ndc>
    <ndc_label_name>QUDEXY XR 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245107530</ndc>
    <ndc_label_name>QUDEXY XR 150 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245164501</ndc>
    <ndc_label_name>PACERONE 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245164530</ndc>
    <ndc_label_name>PACERONE 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245164589</ndc>
    <ndc_label_name>PACERONE 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245531501</ndc>
    <ndc_label_name>Klor-Con 8 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245531511</ndc>
    <ndc_label_name>Klor-Con 8 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245531515</ndc>
    <ndc_label_name>Klor-Con 8 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245531589</ndc>
    <ndc_label_name>Klor-Con 8 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531601</ndc>
    <ndc_label_name>Klor-Con 10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531611</ndc>
    <ndc_label_name>Klor-Con 10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531615</ndc>
    <ndc_label_name>Klor-Con 10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531689</ndc>
    <ndc_label_name>Klor-Con 10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531701</ndc>
    <ndc_label_name>Klor-Con M10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531710</ndc>
    <ndc_label_name>Klor-Con M10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531711</ndc>
    <ndc_label_name>Klor-Con M10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531789</ndc>
    <ndc_label_name>Klor-Con M10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531790</ndc>
    <ndc_label_name>Klor-Con M10 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531801</ndc>
    <ndc_label_name>Klor-Con M15 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531811</ndc>
    <ndc_label_name>Klor-Con M15 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531889</ndc>
    <ndc_label_name>Klor-Con M15 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531901</ndc>
    <ndc_label_name>Klor-Con M20 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531910</ndc>
    <ndc_label_name>Klor-Con M20 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531911</ndc>
    <ndc_label_name>Klor-Con M20 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531915</ndc>
    <ndc_label_name>Klor-Con M20 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531989</ndc>
    <ndc_label_name>Klor-Con M20 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245531990</ndc>
    <ndc_label_name>Klor-Con M20 mEq tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245532601</ndc>
    <ndc_label_name>KLOR-CON-EF 25 MEQ TAB EFF</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245532630</ndc>
    <ndc_label_name>KLOR-CON-EF 25 MEQ TAB EFF</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00245532689</ndc>
    <ndc_label_name>KLOR-CON-EF 25 MEQ TAB EFF</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00245600111</ndc>
    <ndc_label_name>Vigadrone 500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00254046001</ndc>
    <ndc_label_name>COLCHICINE 0.6 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00254101019</ndc>
    <ndc_label_name>DIAZOXIDE 50 MG/ML ORAL SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00254101196</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00254101636</ndc>
    <ndc_label_name>POSACONAZOLE 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00254200001</ndc>
    <ndc_label_name>PENICILLAMINE 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00254200501</ndc>
    <ndc_label_name>CHLORZOXAZONE 750 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00254204502</ndc>
    <ndc_label_name>POSACONAZOLE DR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00254205301</ndc>
    <ndc_label_name>CHLORZOXAZONE 375 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00254301255</ndc>
    <ndc_label_name>ALVIMOPAN 12 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00254301278</ndc>
    <ndc_label_name>ALVIMOPAN 12 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00254302002</ndc>
    <ndc_label_name>NITISINONE 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00254302102</ndc>
    <ndc_label_name>NITISINONE 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00254302202</ndc>
    <ndc_label_name>NITISINONE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00254302802</ndc>
    <ndc_label_name>LUBIPROSTONE 8 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00254302902</ndc>
    <ndc_label_name>LUBIPROSTONE 24 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00254303430</ndc>
    <ndc_label_name>TIOPRONIN DR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00254303509</ndc>
    <ndc_label_name>TIOPRONIN DR 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00259050116</ndc>
    <ndc_label_name>Cuvposa 1 mg/5 mL (0.2 mg/mL) oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00259160501</ndc>
    <ndc_label_name>Xeomin 50 unit intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00259161001</ndc>
    <ndc_label_name>Xeomin 100 unit intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00259162001</ndc>
    <ndc_label_name>Xeomin 200 unit intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00259162010</ndc>
    <ndc_label_name>Xeomin 200 unit intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00259411001</ndc>
    <ndc_label_name>Xeomin 100 unit intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00259415001</ndc>
    <ndc_label_name>Xeomin 50 unit intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00259501060</ndc>
    <ndc_label_name>Ampyra 10 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264100990</ndc>
    <ndc_label_name>LEVETIRACETAM-NACL 1,000MG/100</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264150990</ndc>
    <ndc_label_name>LEVETIRACETAM-NACL 1,500MG/100</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264151031</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264151032</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264180031</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264180032</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264180036</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264193310</ndc>
    <ndc_label_name>TrophAmine 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264194420</ndc>
    <ndc_label_name>POTASSIUM CL 2 MEQ/ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264196510</ndc>
    <ndc_label_name>HESPAN 6%-NS INFUSION BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264210100</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264210110</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264220100</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264220110</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264220200</ndc>
    <ndc_label_name>RINGERS IRRIGATION SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264220300</ndc>
    <ndc_label_name>LACTATED RINGERS IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264220500</ndc>
    <ndc_label_name>Physiolyte 140 mEq-5 mEq-3 mEq-98 mEq/L irrigation solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264230400</ndc>
    <ndc_label_name>ACETIC ACID 0.25% IRRIG SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264230410</ndc>
    <ndc_label_name>ACETIC ACID 0.25% IRRIG SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264251410</ndc>
    <ndc_label_name>BALANCED SALT SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264310311</ndc>
    <ndc_label_name>CEFAZOLIN 1 G/50 ML-DEXTROSE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264310511</ndc>
    <ndc_label_name>CEFAZOLIN 2 G/50 ML-DEXTROSE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264310711</ndc>
    <ndc_label_name>CEFAZOLIN 3 G/50 ML-DEXTROSE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264312311</ndc>
    <ndc_label_name>CEFOXITIN 1 GM PIGGYBACK BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264312511</ndc>
    <ndc_label_name>CEFOXITIN 2 GM PIGGYBACK BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264315311</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264315511</ndc>
    <ndc_label_name>CEFTRIAXONE 2 GM-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264318311</ndc>
    <ndc_label_name>MEROPENEM-0.9% NACL 500 MG/50</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264318511</ndc>
    <ndc_label_name>MEROPENEM-0.9% NACL 1 GRAM/50</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264319311</ndc>
    <ndc_label_name>CEFEPIME-DEXTROSE 1 GM/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264319511</ndc>
    <ndc_label_name>CEFEPIME-DEXTROSE 2 GM/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264330110</ndc>
    <ndc_label_name>HEPARIN 25,000 UNIT/500-1/2 NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264344611</ndc>
    <ndc_label_name>PIPERACILLIN-TAZO 2.25 G DPLX</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264344811</ndc>
    <ndc_label_name>PIPERACILLIN-TAZO 3.375 G DPLX</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264345022</ndc>
    <ndc_label_name>PIPERACILLIN-TAZO 4.5 G DUPLEX</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264346220</ndc>
    <ndc_label_name>HEPARIN 25,000 UNIT/250-1/2 NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264405080</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG/50 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264410090</ndc>
    <ndc_label_name>ACETAMINOPHEN 1000MG/100ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264420452</ndc>
    <ndc_label_name>MAGNESIUM SULF 2 G/50 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264420552</ndc>
    <ndc_label_name>MAGNESIUM SULF 4 G/50 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264420654</ndc>
    <ndc_label_name>MAGNESIUM SULF 4 G/100 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264440054</ndc>
    <ndc_label_name>MAGNESIUM SULF 1 G/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264446000</ndc>
    <ndc_label_name>Nutrilipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264446010</ndc>
    <ndc_label_name>Nutrilipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264446030</ndc>
    <ndc_label_name>Nutrilipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264450000</ndc>
    <ndc_label_name>Plenamine 15 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264450005</ndc>
    <ndc_label_name>Plenamine 15 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264500990</ndc>
    <ndc_label_name>LEVETIRACETAM-NACL 500 MG/100</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264553532</ndc>
    <ndc_label_name>Metro I.V. 500 mg/100 mL intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264560052</ndc>
    <ndc_label_name>CALCIUM GLUC 10,000 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264570505</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/0.5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264570510</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/0.5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264580200</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264580210</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264580400</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.45% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264705505</ndc>
    <ndc_label_name>CLOROTEKAL 50 MG/5 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264705510</ndc>
    <ndc_label_name>CLOROTEKAL 50 MG/5 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264738550</ndc>
    <ndc_label_name>STERILE WATER FOR INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264738560</ndc>
    <ndc_label_name>STERILE WATER FOR INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264738650</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264738660</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264738750</ndc>
    <ndc_label_name>DEXTROSE 70%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264738850</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264738860</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264738960</ndc>
    <ndc_label_name>LACTATED RINGERS IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264739060</ndc>
    <ndc_label_name>GLYCINE 1.5% IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264751000</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264751010</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264751020</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264752000</ndc>
    <ndc_label_name>DEXTROSE 10%-WATER IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264752010</ndc>
    <ndc_label_name>DEXTROSE 10%-WATER IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264752020</ndc>
    <ndc_label_name>DEXTROSE 10%-WATER IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264757810</ndc>
    <ndc_label_name>MANNITOL 20% (100 GM/500 ML)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264761000</ndc>
    <ndc_label_name>DEXTROSE 5%-0.9% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264761010</ndc>
    <ndc_label_name>DEXTROSE 5%-0.9% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264761200</ndc>
    <ndc_label_name>DEXTROSE 5%-0.45% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264761210</ndc>
    <ndc_label_name>DEXTROSE 5%-0.45% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264761410</ndc>
    <ndc_label_name>DEXTROSE 5%-0.33% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264761600</ndc>
    <ndc_label_name>DEXTROSE 5%-0.2% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264761610</ndc>
    <ndc_label_name>DEXTROSE 5%-0.2% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264761620</ndc>
    <ndc_label_name>DEXTROSE 5%-0.2% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264762200</ndc>
    <ndc_label_name>DEXTROSE 10%-0.45% NACL IV SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264762320</ndc>
    <ndc_label_name>DEXTROSE 10%-0.2% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264762500</ndc>
    <ndc_label_name>KCL 20 MEQ/L IN D5W SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264763400</ndc>
    <ndc_label_name>KCL 10 MEQ/L-D5W-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264763500</ndc>
    <ndc_label_name>KCL 20 MEQ/L-D5W-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264763600</ndc>
    <ndc_label_name>KCL 30 MEQ/L-D5W-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264763800</ndc>
    <ndc_label_name>KCL 40 MEQ/L-D5W-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264764500</ndc>
    <ndc_label_name>KCL 20 MEQ/L-D5W-0.2% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264765200</ndc>
    <ndc_label_name>KCL 20 MEQ/L-D5W-0.9% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264770300</ndc>
    <ndc_label_name>Isolyte-S intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264770700</ndc>
    <ndc_label_name>Isolyte S pH 7.4 intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264770710</ndc>
    <ndc_label_name>Isolyte S pH 7.4 intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264773010</ndc>
    <ndc_label_name>Isolyte-P in 5 % dextrose intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264775000</ndc>
    <ndc_label_name>LACTATED RINGERS INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264775007</ndc>
    <ndc_label_name>LACTATED RINGERS INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264775010</ndc>
    <ndc_label_name>LACTATED RINGERS INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264775020</ndc>
    <ndc_label_name>LACTATED RINGERS INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264775100</ndc>
    <ndc_label_name>DEXTROSE 5%-LR IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264775110</ndc>
    <ndc_label_name>DEXTROSE 5%-LR IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00264778000</ndc>
    <ndc_label_name>RINGER'S IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264780000</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOL-EXCEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264780001</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264780009</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264780010</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOL-EXCEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264780020</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOL-EXCEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264780200</ndc>
    <ndc_label_name>SALINE 0.45% SOLN-EXCEL CON</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264780210</ndc>
    <ndc_label_name>SALINE 0.45% SOLN-EXCEL CON</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264780510</ndc>
    <ndc_label_name>SODIUM CHLORIDE 3% IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264780610</ndc>
    <ndc_label_name>SODIUM CHLORIDE 5% IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264785000</ndc>
    <ndc_label_name>STERILE WATER FOR INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264785010</ndc>
    <ndc_label_name>STERILE WATER FOR INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264785020</ndc>
    <ndc_label_name>STERILE WATER FOR INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264786500</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ/1,000ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264800232</ndc>
    <ndc_label_name>MIDAZOLAM 100MG/100ML-0.8%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264800531</ndc>
    <ndc_label_name>MIDAZOLAM 50 MG/50 ML-0.8%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264803110</ndc>
    <ndc_label_name>TROMETHAMINE 18 GRAM/500 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264937588</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264937688</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264937988</ndc>
    <ndc_label_name>BUPIVACAIN 0.75%-DEXTROS 8.25%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264955550</ndc>
    <ndc_label_name>Microbore Extension Set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264956710</ndc>
    <ndc_label_name>HEPARIN 20,000 UNIT/500 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264957710</ndc>
    <ndc_label_name>HEPARIN 25,000 UNIT/500 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264958720</ndc>
    <ndc_label_name>HEPARIN 25,000 UNIT/250 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264959410</ndc>
    <ndc_label_name>LIDOCAINE 0.4% IN D5W SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264959420</ndc>
    <ndc_label_name>LIDOCAINE 0.4% IN D5W SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264959820</ndc>
    <ndc_label_name>LIDOCAINE 0.8% IN D5W SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264987200</ndc>
    <ndc_label_name>HEPARIN 2,000 UNIT/1,000 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00264987210</ndc>
    <ndc_label_name>HEPARIN 1,000 UNIT/500 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268024705</ndc>
    <ndc_label_name>Histatrol 1 mg/mL (2.75 mg/mL) percutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268024805</ndc>
    <ndc_label_name>Histatrol 0.1 mg/mL (0.275 mg/mL) intradermal injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268027510</ndc>
    <ndc_label_name>STD D.FARINAE 10,000 AU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268027550</ndc>
    <ndc_label_name>STD D.FARINAE 10,000 AU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268027710</ndc>
    <ndc_label_name>STD MITE D.PTERONYS 10,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268027750</ndc>
    <ndc_label_name>STD MITE D.PTERONYS 10,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268027910</ndc>
    <ndc_label_name>STD TIMOTHY GRASS 100,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268027950</ndc>
    <ndc_label_name>STD TIMOTHY GRASS 100,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268028110</ndc>
    <ndc_label_name>STD ORCHARD GRASS 100,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268028310</ndc>
    <ndc_label_name>STD JUNE GRASS 100,000 BAU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268028510</ndc>
    <ndc_label_name>STD RED TOP GRASS 100,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268028710</ndc>
    <ndc_label_name>STD SWEET VERNAL 100,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268028910</ndc>
    <ndc_label_name>STD RYE GRASS 100,000 BAU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268029110</ndc>
    <ndc_label_name>STD MEADOW FESCUE 100,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268029310</ndc>
    <ndc_label_name>STD BERMUDA GRASS 10,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268029350</ndc>
    <ndc_label_name>STD BERMUDA GRASS 10,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268060310</ndc>
    <ndc_label_name>CATTLE EPITHELIUM 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268062110</ndc>
    <ndc_label_name>DOG EPITHELIUM 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268062150</ndc>
    <ndc_label_name>DOG EPITHELIUM 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268062610</ndc>
    <ndc_label_name>DOG EPITHELIUM 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268062650</ndc>
    <ndc_label_name>DOG EPITHELIUM 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268062810</ndc>
    <ndc_label_name>HORSE EPITHELIUM 1:10 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268063110</ndc>
    <ndc_label_name>HORSE EPITHELIUM 1:20 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268063810</ndc>
    <ndc_label_name>MOUSE EPITHELIUM 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268065010</ndc>
    <ndc_label_name>RABBIT EPITHELIUM 1:10 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268065110</ndc>
    <ndc_label_name>RABBIT EPITHELIUM 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268065310</ndc>
    <ndc_label_name>GUINEA PIG EPITHELIUM 1:20 W/V</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268070710</ndc>
    <ndc_label_name>AMERICAN COCKROACH 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268070750</ndc>
    <ndc_label_name>AMERICAN COCKROACH 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268071410</ndc>
    <ndc_label_name>GERMAN COCKROACH 1:20 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268072210</ndc>
    <ndc_label_name>FIRE ANT 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268072310</ndc>
    <ndc_label_name>MIXED FEATHERS 1:20 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268072410</ndc>
    <ndc_label_name>FIRE ANT 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268072510</ndc>
    <ndc_label_name>MOSQUITO 1:100 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268094510</ndc>
    <ndc_label_name>CORN SMUT 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268100110</ndc>
    <ndc_label_name>ACACIA 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268100810</ndc>
    <ndc_label_name>ALDER 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268102310</ndc>
    <ndc_label_name>WHITE ASH 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268103510</ndc>
    <ndc_label_name>BAHIA 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268104210</ndc>
    <ndc_label_name>BAYBERRY 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268104710</ndc>
    <ndc_label_name>AMERICAN BEECH 1:20 W/V VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268106310</ndc>
    <ndc_label_name>RED BIRCH 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268107010</ndc>
    <ndc_label_name>WHITE BIRCH 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268108110</ndc>
    <ndc_label_name>BOX ELDER 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268108710</ndc>
    <ndc_label_name>BROME 1:20 W/V VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268109310</ndc>
    <ndc_label_name>CARELESSWEED 1:40 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268109810</ndc>
    <ndc_label_name>MOUNTAIN CEDAR 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268109850</ndc>
    <ndc_label_name>MOUNTAIN CEDAR 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268111110</ndc>
    <ndc_label_name>COCKLEBUR 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268112110</ndc>
    <ndc_label_name>CORN POLLEN 1:20 W/V VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268112710</ndc>
    <ndc_label_name>EASTERN COTTONWOOD 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268112750</ndc>
    <ndc_label_name>EASTERN COTTONWOOD 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268114310</ndc>
    <ndc_label_name>ARIZONA CYPRESS 1:20 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268114710</ndc>
    <ndc_label_name>BALD CYPRESS 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268115010</ndc>
    <ndc_label_name>MIXED COCKROACH 1:20 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268115210</ndc>
    <ndc_label_name>SHEEP SORREL 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268116010</ndc>
    <ndc_label_name>YELLOW DOCK 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268116510</ndc>
    <ndc_label_name>DOG FENNEL 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268116910</ndc>
    <ndc_label_name>AMERICAN ELM 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268116950</ndc>
    <ndc_label_name>AMERICAN ELM 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268117850</ndc>
    <ndc_label_name>CEDAR ELM 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268119210</ndc>
    <ndc_label_name>GOLDENROD 1:20 W/V VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268119910</ndc>
    <ndc_label_name>HACKBERRY 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268121510</ndc>
    <ndc_label_name>JOHNSON GRASS 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268121550</ndc>
    <ndc_label_name>JOHNSON GRASS 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268122410</ndc>
    <ndc_label_name>WESTERN JUNIPER 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268123310</ndc>
    <ndc_label_name>KOCHIA 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268123910</ndc>
    <ndc_label_name>LAMB'S QUARTERS 1:20 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268124910</ndc>
    <ndc_label_name>RED MAPLE 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268126410</ndc>
    <ndc_label_name>ROUGH MARSH ELDER 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268127710</ndc>
    <ndc_label_name>MELALEUCA 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268128010</ndc>
    <ndc_label_name>MESQUITE 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268129810</ndc>
    <ndc_label_name>MUGWORT 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268130210</ndc>
    <ndc_label_name>SORREL-DOCK MIX 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268130510</ndc>
    <ndc_label_name>RED MULBERRY 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268131110</ndc>
    <ndc_label_name>WHITE MULBERRY 1:20 W/V VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268131910</ndc>
    <ndc_label_name>RED OAK 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268132310</ndc>
    <ndc_label_name>VIRGINIA LIVE OAK 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268132810</ndc>
    <ndc_label_name>WHITE OAK 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268132850</ndc>
    <ndc_label_name>WHITE OAK 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268134010</ndc>
    <ndc_label_name>OLIVE TREE 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268134810</ndc>
    <ndc_label_name>QUEEN PALM 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268135510</ndc>
    <ndc_label_name>PECAN POLLEN 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268136110</ndc>
    <ndc_label_name>CAL PEPPER TREE 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268136510</ndc>
    <ndc_label_name>ROUGH PIGWEED 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268137210</ndc>
    <ndc_label_name>SPINY PIGWEED 1:20 W/V VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268137710</ndc>
    <ndc_label_name>AUSTRALIAN PINE 1:20 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268138310</ndc>
    <ndc_label_name>WHITE PINE 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268139510</ndc>
    <ndc_label_name>ENGLISH PLANTAIN 1:20 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268141310</ndc>
    <ndc_label_name>PRIVET 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268141510</ndc>
    <ndc_label_name>SHAGBARK HICKORY 1:20 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268141710</ndc>
    <ndc_label_name>MIXED RAGWEED 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268141750</ndc>
    <ndc_label_name>MIXED RAGWEED 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268141850</ndc>
    <ndc_label_name>QUACK GRASS 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268144010</ndc>
    <ndc_label_name>TALL RAGWEED 1:20 W/V VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268144610</ndc>
    <ndc_label_name>WESTERN RAGWEED 1:20 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268145410</ndc>
    <ndc_label_name>RUSSIAN THISTLE 1:20 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268147210</ndc>
    <ndc_label_name>SAGEBRUSH 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268149410</ndc>
    <ndc_label_name>SWEETGUM 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268150210</ndc>
    <ndc_label_name>AMERICAN SYCAMORE 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268151310</ndc>
    <ndc_label_name>BLACK WALNUT POLLEN 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268153210</ndc>
    <ndc_label_name>SHORT RAGWEED 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268160310</ndc>
    <ndc_label_name>RED CEDAR 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268200010</ndc>
    <ndc_label_name>STD CAT HAIR 10,000 BAU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268200050</ndc>
    <ndc_label_name>STD CAT HAIR 10,000 BAU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268610010</ndc>
    <ndc_label_name>ALMOND 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268610110</ndc>
    <ndc_label_name>APPLE 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268610410</ndc>
    <ndc_label_name>AVOCADO 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268610510</ndc>
    <ndc_label_name>BANANA 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268610910</ndc>
    <ndc_label_name>BEEF 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268611510</ndc>
    <ndc_label_name>CANTALOUPE 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268611810</ndc>
    <ndc_label_name>CASEIN 1:100 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268612210</ndc>
    <ndc_label_name>CHICKEN MEAT 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268612510</ndc>
    <ndc_label_name>COCOA BEAN 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268613010</ndc>
    <ndc_label_name>CRAB 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268613510</ndc>
    <ndc_label_name>WHOLE EGG 1:100 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268613610</ndc>
    <ndc_label_name>EGG YOLK 1:100 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268618310</ndc>
    <ndc_label_name>OAT GRAIN 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268618710</ndc>
    <ndc_label_name>ORANGE 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268619310</ndc>
    <ndc_label_name>PEANUT 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268619610</ndc>
    <ndc_label_name>PECAN NUT (FOOD) 1:10 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268620210</ndc>
    <ndc_label_name>PISTACHIO NUT 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268620410</ndc>
    <ndc_label_name>PORK 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268620810</ndc>
    <ndc_label_name>RICE 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268621310</ndc>
    <ndc_label_name>SESAME SEED 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268621410</ndc>
    <ndc_label_name>SHRIMP 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268621610</ndc>
    <ndc_label_name>SOYBEAN 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268622010</ndc>
    <ndc_label_name>STRAWBERRY 1:10 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268622110</ndc>
    <ndc_label_name>SWEET CORN (FOOD) 1:10 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268660206</ndc>
    <ndc_label_name>ALFALFA 1:20 (W/V) VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268700210</ndc>
    <ndc_label_name>STD MIX MITE 5,000-5,000 UNIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268700250</ndc>
    <ndc_label_name>STD MIX MITE 5,000-5,000 UNIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268802250</ndc>
    <ndc_label_name>9 TREE MIX EXTRACT 1:20 (W/V)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268807450</ndc>
    <ndc_label_name>STD MIX 6 GRASS 100,000 BAU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268807850</ndc>
    <ndc_label_name>WEED MIX NO. 7B 1:20 (W/V) VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808010</ndc>
    <ndc_label_name>SAROCLADIUM STRICTUM 53,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808050</ndc>
    <ndc_label_name>SAROCLADIUM STRICTUM 94,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808210</ndc>
    <ndc_label_name>ALTERNARIA ALTERNATA 36,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808350</ndc>
    <ndc_label_name>ALTERNARIA ALTERNATA 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808410</ndc>
    <ndc_label_name>ASPERGILLUS FUMIGATUS 8,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808450</ndc>
    <ndc_label_name>ASPERGILLUS FUMIGATUS 8,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808505</ndc>
    <ndc_label_name>ASPERGILLUS FUMIGATUS 1:20 VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808510</ndc>
    <ndc_label_name>ASPERGILLUS FUMIGATUS 1:20 VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808550</ndc>
    <ndc_label_name>ASPERGILLUS FUMIGATUS 1:20 VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808610</ndc>
    <ndc_label_name>AUREOBASIDIUM 51,000 PNU/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808650</ndc>
    <ndc_label_name>AUREOBASIDIUM 36,000 PNU/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808705</ndc>
    <ndc_label_name>AUREOBASIDIUM PULLULANS 1:20</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808710</ndc>
    <ndc_label_name>AUREOBASIDIUM PULLULANS 1:20</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268808750</ndc>
    <ndc_label_name>AUREOBASIDIUM PULLULANS 1:20</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809010</ndc>
    <ndc_label_name>BOTRYTIS CINEREA 43,000 PNU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809050</ndc>
    <ndc_label_name>BOTRYTIS CINEREA 43,000 PNU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809105</ndc>
    <ndc_label_name>BOTRYTIS CINEREA 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809110</ndc>
    <ndc_label_name>BOTRYTIS CINEREA 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809150</ndc>
    <ndc_label_name>BOTRYTIS CINEREA 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809410</ndc>
    <ndc_label_name>C. CLADOSPORIOIDES 64,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809450</ndc>
    <ndc_label_name>C. CLADOSPORIOIDES 64,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809505</ndc>
    <ndc_label_name>C. CLADOSPORIOIDES 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809510</ndc>
    <ndc_label_name>C. CLADOSPORIOIDES 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809550</ndc>
    <ndc_label_name>C. CLADOSPORIOIDES 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809610</ndc>
    <ndc_label_name>EPICOCCUM NIGRUM 27,000 PNU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809650</ndc>
    <ndc_label_name>EPICOCCUM NIGRUM 27,000 PNU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268809750</ndc>
    <ndc_label_name>EPICOCCUM NIGRUM 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810010</ndc>
    <ndc_label_name>MUCOR PLUMBEUS 30,000 PNU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810050</ndc>
    <ndc_label_name>MUCOR PLUMBEUS 57,000 PNU/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810105</ndc>
    <ndc_label_name>MUCOR PLUMBEUS 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810110</ndc>
    <ndc_label_name>MUCOR PLUMBEUS 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810150</ndc>
    <ndc_label_name>MUCOR PLUMBEUS 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810210</ndc>
    <ndc_label_name>PENICILLIUM NOTATUM 31,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810250</ndc>
    <ndc_label_name>PENICILLIUM NOTATUM 31,000/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810305</ndc>
    <ndc_label_name>PENICILLIUM NOTATUM 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810310</ndc>
    <ndc_label_name>PENICILLIUM NOTATUM 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810350</ndc>
    <ndc_label_name>PENICILLIUM NOTATUM 1:20 VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810605</ndc>
    <ndc_label_name>SACCHAROMYCES CEREVISIAE 1:20</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810610</ndc>
    <ndc_label_name>SACCHAROMYCES CEREVISIAE 1:20</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810650</ndc>
    <ndc_label_name>SACCHAROMYCES CEREVISIAE 1:20</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810805</ndc>
    <ndc_label_name>TRICHOPHYTON MENTAGROPHYT 1:20</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810810</ndc>
    <ndc_label_name>TRICHOPHYTON MENTAGROPHYT 1:20</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00268810850</ndc>
    <ndc_label_name>TRICHOPHYTON MENTAGROPHYT 1:20</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270000431</ndc>
    <ndc_label_name>SOLUTION ADMINISTRATION SET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270000475</ndc>
    <ndc_label_name>FLUID ADMINISTRATION SET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270005110</ndc>
    <ndc_label_name>Solution Transfer Device</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270008320</ndc>
    <ndc_label_name>Choletec 45 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270009101</ndc>
    <ndc_label_name>CardioGen-82 intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270014957</ndc>
    <ndc_label_name>Cystografin 30 % urethral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270014960</ndc>
    <ndc_label_name>Cystografin 30 % urethral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270044535</ndc>
    <ndc_label_name>Gastrografin 66 %-10 % oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270044540</ndc>
    <ndc_label_name>Gastrografin 66 %-10 % oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270052330</ndc>
    <ndc_label_name>Sinografin 52.7 %-26.8 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270055615</ndc>
    <ndc_label_name>Kinevac 5 mcg solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270111101</ndc>
    <ndc_label_name>Prohance 279.3 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270111102</ndc>
    <ndc_label_name>Prohance 279.3 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270111103</ndc>
    <ndc_label_name>Prohance 279.3 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270111104</ndc>
    <ndc_label_name>Prohance 279.3 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270111116</ndc>
    <ndc_label_name>Prohance 279.3 mg/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270111145</ndc>
    <ndc_label_name>Prohance 279.3 mg/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270111170</ndc>
    <ndc_label_name>ProHance Multipack 279.3 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270111185</ndc>
    <ndc_label_name>ProHance Multipack 279.3 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131415</ndc>
    <ndc_label_name>Isovue-200  41 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131525</ndc>
    <ndc_label_name>Isovue-300  61 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131530</ndc>
    <ndc_label_name>Isovue-300  61 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131535</ndc>
    <ndc_label_name>Isovue-300  61 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131541</ndc>
    <ndc_label_name>Isovue-300  61 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131545</ndc>
    <ndc_label_name>Isovue-300  61 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131595</ndc>
    <ndc_label_name>Isovue-300  61 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131598</ndc>
    <ndc_label_name>Isovue-300  61 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131604</ndc>
    <ndc_label_name>Isovue-370  76 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131630</ndc>
    <ndc_label_name>Isovue-370  76 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131635</ndc>
    <ndc_label_name>Isovue-370  76 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131637</ndc>
    <ndc_label_name>Isovue-370  76 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131645</ndc>
    <ndc_label_name>Isovue-370  76 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131652</ndc>
    <ndc_label_name>Isovue-370  76 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131695</ndc>
    <ndc_label_name>Isovue-370  76 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131702</ndc>
    <ndc_label_name>Isovue-250  51 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131705</ndc>
    <ndc_label_name>Isovue-250  51 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270131741</ndc>
    <ndc_label_name>Isovue-250  51 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270141030</ndc>
    <ndc_label_name>Cystografin-Dilute 18 % urethral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270141111</ndc>
    <ndc_label_name>Isovue-M 200  41 % intrathecal solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270141125</ndc>
    <ndc_label_name>Isovue-M 200  41 % intrathecal solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270141215</ndc>
    <ndc_label_name>Isovue-M 300  61 % intrathecal solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270516412</ndc>
    <ndc_label_name>Multihance 529 mg/mL (0.1 mmol/0.2 mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270516413</ndc>
    <ndc_label_name>Multihance 529 mg/mL (0.1 mmol/0.2 mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270516414</ndc>
    <ndc_label_name>Multihance 529 mg/mL (0.1 mmol/0.2 mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270516415</ndc>
    <ndc_label_name>Multihance 529 mg/mL (0.1 mmol/0.2 mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270526416</ndc>
    <ndc_label_name>Multihance Multipack 529 mg/mL (0.1 mmol/0.2 mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270526417</ndc>
    <ndc_label_name>Multihance Multipack 529 mg/mL (0.1 mmol/0.2 mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270701546</ndc>
    <ndc_label_name>Vueway 0.5 mmol/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270701548</ndc>
    <ndc_label_name>Vueway 0.5 mmol/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270702038</ndc>
    <ndc_label_name>Vueway 0.5 mmol/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270702540</ndc>
    <ndc_label_name>Vueway 0.5 mmol/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270703042</ndc>
    <ndc_label_name>Vueway 0.5 mmol/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270709707</ndc>
    <ndc_label_name>Lumason 25 mg intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270709708</ndc>
    <ndc_label_name>Lumason 25 mg intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270709916</ndc>
    <ndc_label_name>Lumason 25 mg intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270709973</ndc>
    <ndc_label_name>Lumason 25 mg intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00270735020</ndc>
    <ndc_label_name>Iomeron 350 mg iodine/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00273010410</ndc>
    <ndc_label_name>AMMONIA AROMATIC AMPUL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00276050110</ndc>
    <ndc_label_name>FENOPROFEN 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00276050410</ndc>
    <ndc_label_name>KETOPROFEN 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00276050610</ndc>
    <ndc_label_name>KETOPROFEN 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00276050810</ndc>
    <ndc_label_name>METAXALONE 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00276050930</ndc>
    <ndc_label_name>MEFENAMIC ACID 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00276051010</ndc>
    <ndc_label_name>METHOCARBAMOL 1,000 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00276060030</ndc>
    <ndc_label_name>Juvazin topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00276060328</ndc>
    <ndc_label_name>Proxivol 2 % topical gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00276070030</ndc>
    <ndc_label_name>Primidar 31 billion cell capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00276070830</ndc>
    <ndc_label_name>Zeldana 5 mg-5 mg-37.5 mg-25 mg-1 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00276070930</ndc>
    <ndc_label_name>Amladex 1 mg-5 mg-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00276071030</ndc>
    <ndc_label_name>Bevitrol 9,000-112,500-112,500 unit capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280003012</ndc>
    <ndc_label_name>Phillips Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280006501</ndc>
    <ndc_label_name>Astepro Allergy 205.5 mcg (0.15 %) nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280006502</ndc>
    <ndc_label_name>Astepro Allergy 205.5 mcg (0.15 %) nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280006504</ndc>
    <ndc_label_name>Astepro Allergy 205.5 mcg (0.15 %) nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280006510</ndc>
    <ndc_label_name>Astepro Allergy 205.5 mcg (0.15 %) nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280006601</ndc>
    <ndc_label_name>Children's Astepro Allergy 205.5 mcg (0.15 %) nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280006602</ndc>
    <ndc_label_name>Children's Astepro Allergy 205.5 mcg (0.15 %) nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280006603</ndc>
    <ndc_label_name>Children's Astepro Allergy 205.5 mcg (0.15 %) nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280007210</ndc>
    <ndc_label_name>ClariSpray 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280007215</ndc>
    <ndc_label_name>ClariSpray 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280021001</ndc>
    <ndc_label_name>Campho-Phenique 10.8 %-4.7 % topical solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280119540</ndc>
    <ndc_label_name>Alka-Seltzer Plus Sinus-Allergy-Cgh 6.25 mg-5 mg-10 mg-325 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280119720</ndc>
    <ndc_label_name>Alka-Seltzer Plus-D Sinus-Cold 2 mg-30 mg-10 mg-325 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280200010</ndc>
    <ndc_label_name>Bayer Aspirin 325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280200020</ndc>
    <ndc_label_name>Bayer Aspirin 325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280200051</ndc>
    <ndc_label_name>Bayer Aspirin 325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280208036</ndc>
    <ndc_label_name>Bayer Chewable Low Dose Aspirin 81 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280210012</ndc>
    <ndc_label_name>Bayer Low Dose Aspirin 81 mg tablet,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280210020</ndc>
    <ndc_label_name>Bayer Low Dose Aspirin 81 mg tablet,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280210032</ndc>
    <ndc_label_name>Bayer Low Dose Aspirin 81 mg tablet,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280210040</ndc>
    <ndc_label_name>Bayer Low Dose Aspirin 81 mg tablet,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280211010</ndc>
    <ndc_label_name>Bayer Aspirin 325 mg tablet,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280220060</ndc>
    <ndc_label_name>Women's Aspirin with Calcium 81 mg-300 mg calcium (777 mg) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280400004</ndc>
    <ndc_label_name>Alka-Seltzer Original 325 mg-1,916 mg-1,000 mg effervescent tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280603002</ndc>
    <ndc_label_name>Aleve Cold and Sinus 220 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280604010</ndc>
    <ndc_label_name>Aleve Sinus and Headache 220 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280800540</ndc>
    <ndc_label_name>Midol Complete 500 mg-60 mg-15 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00280803024</ndc>
    <ndc_label_name>Midol 500 mg-25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280900002</ndc>
    <ndc_label_name>RID Lice Killing 0.33 %-4 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280900008</ndc>
    <ndc_label_name>RID Lice Killing 0.33 %-4 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280902509</ndc>
    <ndc_label_name>RID Complete Lice Elimination Kit 4 %-0.33 %-0.5 % Topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00280903006</ndc>
    <ndc_label_name>RID Lice Killing 0.33 %-4 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00281020502</ndc>
    <ndc_label_name>Surgilube topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00281020512</ndc>
    <ndc_label_name>Surgilube topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00281020536</ndc>
    <ndc_label_name>Surgilube topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00281020537</ndc>
    <ndc_label_name>Surgilube topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00281020543</ndc>
    <ndc_label_name>Surgilube topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00281020545</ndc>
    <ndc_label_name>Surgilube topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00281020555</ndc>
    <ndc_label_name>Surgilube topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00281032608</ndc>
    <ndc_label_name>Nitro-Bid 2 % transdermal ointment</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00281032630</ndc>
    <ndc_label_name>Nitro-Bid 2 % transdermal ointment</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00281032660</ndc>
    <ndc_label_name>Nitro-Bid 2 % transdermal ointment</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283007497</ndc>
    <ndc_label_name>Beutlich pH Test Roll misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283007599</ndc>
    <ndc_label_name>Hurricaine Liquid Dispenser misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283022027</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283029331</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283029359</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283052027</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283052029</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283052034</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283052043</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283052044</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283052227</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283056931</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283056972</ndc>
    <ndc_label_name>HURRICAINE 20% LIQUID SWAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283059701</ndc>
    <ndc_label_name>Peridin-C 200 mg-150 mg-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283060943</ndc>
    <ndc_label_name>Hurricaine Luer-Lock Dispensing Cap</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283061011</ndc>
    <ndc_label_name>Hurricaine One 20 % mucosal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283061026</ndc>
    <ndc_label_name>Hurricaine One 20 % mucosal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283061043</ndc>
    <ndc_label_name>Hurricaine One 20 % mucosal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283062234</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283062243</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283067902</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283067960</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283080811</ndc>
    <ndc_label_name>Ceo-Two 0.9 gram-0.6 gram rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283080836</ndc>
    <ndc_label_name>Ceo-Two 0.9 gram-0.6 gram rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283087112</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283087131</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283087159</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283088631</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283088659</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283091401</ndc>
    <ndc_label_name>Hurricaine Spray Extension Tube</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283091402</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283091460</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283092027</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283092034</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283099831</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283099859</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283101631</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283101659</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283102302</ndc>
    <ndc_label_name>Ceo-Two 0.9 gram-0.6 gram rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283102336</ndc>
    <ndc_label_name>Ceo-Two 0.9 gram-0.6 gram rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283118520</ndc>
    <ndc_label_name>Hurricaine Spray Extension Tube</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283182027</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283182029</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283182034</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283182043</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283182044</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00283188631</ndc>
    <ndc_label_name>HurriCaine 20 % mucosal solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00295134796</ndc>
    <ndc_label_name>Hydrolatum topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00295134797</ndc>
    <ndc_label_name>Hydrolatum topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299011022</ndc>
    <ndc_label_name>Cetaphil Gentle Skin Cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299011024</ndc>
    <ndc_label_name>Cetaphil Gentle Skin Cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299011026</ndc>
    <ndc_label_name>Cetaphil Gentle Skin Cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299011504</ndc>
    <ndc_label_name>Cetaphil Eczema Restoraderm 1 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299024132</ndc>
    <ndc_label_name>Cetaphil Moisturizing lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299024133</ndc>
    <ndc_label_name>Cetaphil Moisturizing lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299145002</ndc>
    <ndc_label_name>DY-O-DERM LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299201210</ndc>
    <ndc_label_name>Vectical 3 mcg/gram topical ointment</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299382060</ndc>
    <ndc_label_name>Metrogel 1 % topical</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299382230</ndc>
    <ndc_label_name>Oracea 40 mg capsule,immediate - delay release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299382345</ndc>
    <ndc_label_name>Soolantra 1 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299383645</ndc>
    <ndc_label_name>MetroCream 0.75 % topical</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299383802</ndc>
    <ndc_label_name>MetroLotion 0.75 % topical</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299384704</ndc>
    <ndc_label_name>Clobex 0.05 % shampoo</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299384802</ndc>
    <ndc_label_name>Clobex 0.05 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299384804</ndc>
    <ndc_label_name>Clobex 0.05 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299384902</ndc>
    <ndc_label_name>Clobex 0.05 % topical spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299384904</ndc>
    <ndc_label_name>Clobex 0.05 % topical spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299391408</ndc>
    <ndc_label_name>Cetaphil DailyAdvance lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299391416</ndc>
    <ndc_label_name>Cetaphil DailyAdvance lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299391702</ndc>
    <ndc_label_name>Cetaphil Moisturizing topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299391742</ndc>
    <ndc_label_name>Cetaphil Moisturizing topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299391756</ndc>
    <ndc_label_name>Cetaphil Moisturizing topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299391808</ndc>
    <ndc_label_name>Cetaphil Moisturizing lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299391816</ndc>
    <ndc_label_name>Cetaphil Moisturizing lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299392001</ndc>
    <ndc_label_name>Cetaphil topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299392304</ndc>
    <ndc_label_name>Cetaphil Bar</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299392708</ndc>
    <ndc_label_name>Cetaphil topical cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299392734</ndc>
    <ndc_label_name>Cetaphil Daily Facial Cleanser topical cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299392804</ndc>
    <ndc_label_name>Cetaphil Daily Facial SPF 15 lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299412800</ndc>
    <ndc_label_name>Cetaphil Eczema Restoraderm 1 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299412810</ndc>
    <ndc_label_name>Cetaphil Eczema Restoraderm 1 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299492030</ndc>
    <ndc_label_name>Differin 0.1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299492045</ndc>
    <ndc_label_name>Differin 0.1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299550004</ndc>
    <ndc_label_name>Capex 0.01 % shampoo</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299589000</ndc>
    <ndc_label_name>Epsolay 5 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299589030</ndc>
    <ndc_label_name>Epsolay 5 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299590645</ndc>
    <ndc_label_name>Epiduo Forte 0.3 %-2.5 % topical gel with pump</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299590660</ndc>
    <ndc_label_name>Epiduo Forte 0.3 %-2.5 % topical gel with pump</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299590825</ndc>
    <ndc_label_name>Epiduo 0.1 %-2.5 % topical gel with pump</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299591202</ndc>
    <ndc_label_name>Differin 0.1 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299591545</ndc>
    <ndc_label_name>Differin 0.1 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299591825</ndc>
    <ndc_label_name>Differin 0.3 % topical gel with pump</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299593545</ndc>
    <ndc_label_name>Aklief 0.005 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299594530</ndc>
    <ndc_label_name>Twyneo 0.1 %-3 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299595030</ndc>
    <ndc_label_name>Tri-Luma 0.01 %-4 %-0.05 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299596230</ndc>
    <ndc_label_name>Dysport 300 unit intramuscular solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299598035</ndc>
    <ndc_label_name>Mirvaso 0.33 % topical gel with pump</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299622010</ndc>
    <ndc_label_name>Nemluvio 30 mg subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00299622015</ndc>
    <ndc_label_name>Nemluvio 30 mg subcutaneous pen injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310008828</ndc>
    <ndc_label_name>Daliresp 250 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310008839</ndc>
    <ndc_label_name>Daliresp 250 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310009530</ndc>
    <ndc_label_name>Daliresp 500 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310009590</ndc>
    <ndc_label_name>Daliresp 500 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310027110</ndc>
    <ndc_label_name>Seroquel 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310027210</ndc>
    <ndc_label_name>Seroquel 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310027460</ndc>
    <ndc_label_name>Seroquel 300 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310027510</ndc>
    <ndc_label_name>Seroquel 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310027810</ndc>
    <ndc_label_name>Seroquel 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310027910</ndc>
    <ndc_label_name>Seroquel 400 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310028060</ndc>
    <ndc_label_name>Seroquel XR 50 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310028160</ndc>
    <ndc_label_name>Seroquel XR 150 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310028260</ndc>
    <ndc_label_name>Seroquel XR 200 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310028360</ndc>
    <ndc_label_name>Seroquel XR 300 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310028460</ndc>
    <ndc_label_name>Seroquel XR 400 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310029792</ndc>
    <ndc_label_name>Seroquel XR 50 mg(3)-200 mg(1)-300 mg(11) tablet, ER 24 hr dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310048230</ndc>
    <ndc_label_name>Iressa 250 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310056912</ndc>
    <ndc_label_name>Lynparza 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310056960</ndc>
    <ndc_label_name>Lynparza 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310057812</ndc>
    <ndc_label_name>Lynparza 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310057860</ndc>
    <ndc_label_name>Lynparza 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310061028</ndc>
    <ndc_label_name>Koselugo 10 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310061060</ndc>
    <ndc_label_name>Koselugo 10 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310062528</ndc>
    <ndc_label_name>Koselugo 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310062560</ndc>
    <ndc_label_name>Koselugo 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310063560</ndc>
    <ndc_label_name>Koselugo 5 mg sprinkle capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310064060</ndc>
    <ndc_label_name>Koselugo 7.5 mg sprinkle capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310066812</ndc>
    <ndc_label_name>Lynparza 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310066860</ndc>
    <ndc_label_name>Lynparza 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310067912</ndc>
    <ndc_label_name>Lynparza 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310067960</ndc>
    <ndc_label_name>Lynparza 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310072010</ndc>
    <ndc_label_name>Faslodex 250 mg/5 mL intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310090060</ndc>
    <ndc_label_name>Duaklir Pressair 400 mcg-12 mcg/actuation breath activated</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310110501</ndc>
    <ndc_label_name>Lokelma 5 gram oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310110530</ndc>
    <ndc_label_name>Lokelma 5 gram oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310110539</ndc>
    <ndc_label_name>Lokelma 5 gram oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310111001</ndc>
    <ndc_label_name>Lokelma 10 gram oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310111030</ndc>
    <ndc_label_name>Lokelma 10 gram oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310111039</ndc>
    <ndc_label_name>Lokelma 10 gram oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310124830</ndc>
    <ndc_label_name>Tagrisso 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310125130</ndc>
    <ndc_label_name>Tagrisso 80 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310134930</ndc>
    <ndc_label_name>Tagrisso 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310135030</ndc>
    <ndc_label_name>Tagrisso 80 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310173030</ndc>
    <ndc_label_name>Fasenra 30 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310173085</ndc>
    <ndc_label_name>Fasenra 30 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310174501</ndc>
    <ndc_label_name>Fasenra 10 mg/0.5 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310183030</ndc>
    <ndc_label_name>Fasenra Pen 30 mg/mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310183085</ndc>
    <ndc_label_name>Fasenra Pen 30 mg/mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310304000</ndc>
    <ndc_label_name>Saphnelo 300 mg/2 mL (150 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier/>
    <ndc>00310308001</ndc>
    <ndc_label_name>Saphnelo Pen 120 mg/0.8 mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>True</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier/>
    <ndc>00310308025</ndc>
    <ndc_label_name>Saphnelo Pen 120 mg/0.8 mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>True</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310320001</ndc>
    <ndc_label_name>ANDEXXA 200 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310320004</ndc>
    <ndc_label_name>ANDEXXA 200 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310320005</ndc>
    <ndc_label_name>ANDEXXA 200 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310351260</ndc>
    <ndc_label_name>Calquence (acalabrutinib maleate) 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310450012</ndc>
    <ndc_label_name>Imfinzi 50 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310450525</ndc>
    <ndc_label_name>Imjudo 20 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310451360</ndc>
    <ndc_label_name>Calquence (acalabrutinib maleate) 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310453530</ndc>
    <ndc_label_name>Imjudo 20 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310460012</ndc>
    <ndc_label_name>Bevespi Aerosphere 9 mcg-4.8 mcg HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310461150</ndc>
    <ndc_label_name>Imfinzi 50 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310461612</ndc>
    <ndc_label_name>Breztri Aerosphere 160 mcg-9mcg-4.8mcg/actuation HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310461628</ndc>
    <ndc_label_name>Breztri Aerosphere 160 mcg-9mcg-4.8mcg/actuation HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310461639</ndc>
    <ndc_label_name>Breztri Aerosphere 160 mcg-9mcg-4.8mcg/actuation HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310620530</ndc>
    <ndc_label_name>Farxiga 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310620590</ndc>
    <ndc_label_name>Farxiga 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310620595</ndc>
    <ndc_label_name>Farxiga 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310621030</ndc>
    <ndc_label_name>Farxiga 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310621039</ndc>
    <ndc_label_name>Farxiga 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310621090</ndc>
    <ndc_label_name>Farxiga 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310621095</ndc>
    <ndc_label_name>Farxiga 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310622560</ndc>
    <ndc_label_name>Xigduo XR 2.5 mg-1,000 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310625030</ndc>
    <ndc_label_name>Xigduo XR 5 mg-500 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310626060</ndc>
    <ndc_label_name>Xigduo XR 5 mg-1,000 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310627030</ndc>
    <ndc_label_name>Xigduo XR 10 mg-500 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310628030</ndc>
    <ndc_label_name>Xigduo XR 10 mg-1,000 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310651201</ndc>
    <ndc_label_name>BYETTA 5 MCG DOSE PEN INJ</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310652401</ndc>
    <ndc_label_name>BYETTA 10 MCG DOSE PEN INJ</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310654001</ndc>
    <ndc_label_name>Bydureon BCise 2 mg/0.85 mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310654004</ndc>
    <ndc_label_name>Bydureon BCise 2 mg/0.85 mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310654085</ndc>
    <ndc_label_name>Bydureon BCise 2 mg/0.85 mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310661502</ndc>
    <ndc_label_name>SYMLINPEN 60 PEN INJECTOR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00310662702</ndc>
    <ndc_label_name>SYMLINPEN 120 PEN INJECTOR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310677030</ndc>
    <ndc_label_name>QTERN 5 MG-5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310678030</ndc>
    <ndc_label_name>QTERN 10 MG-5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310737020</ndc>
    <ndc_label_name>BUDESONIDE-FORMOTEROL 160-4.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310737220</ndc>
    <ndc_label_name>BUDESONIDE-FORMOTEROL 80-4.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310756090</ndc>
    <ndc_label_name>Crestor 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310757090</ndc>
    <ndc_label_name>Crestor 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310758090</ndc>
    <ndc_label_name>Crestor 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310759030</ndc>
    <ndc_label_name>Crestor 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310908012</ndc>
    <ndc_label_name>Airsupra 90 mcg-80 mcg/actuation HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310908028</ndc>
    <ndc_label_name>Airsupra 90 mcg-80 mcg/actuation HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310940001</ndc>
    <ndc_label_name>Wainua 45 mg/0.8 mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier/>
    <ndc>00310942001</ndc>
    <ndc_label_name>Wainua 45 mg/0.8 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>True</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310950001</ndc>
    <ndc_label_name>Truqap 160 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310950002</ndc>
    <ndc_label_name>Truqap 160 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310950101</ndc>
    <ndc_label_name>Truqap 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00310950102</ndc>
    <ndc_label_name>Truqap 200 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316012601</ndc>
    <ndc_label_name>Ala-Cort 1 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316017001</ndc>
    <ndc_label_name>TRIDERM 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316017516</ndc>
    <ndc_label_name>Triderm 0.5 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00316018601</ndc>
    <ndc_label_name>HYDROCORTISONE 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00316018616</ndc>
    <ndc_label_name>HYDROCORTISONE 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00316019316</ndc>
    <ndc_label_name>HYDROCORTISONE 2.5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00316019320</ndc>
    <ndc_label_name>HYDROCORTISONE 2.5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00316019330</ndc>
    <ndc_label_name>HYDROCORTISONE 2.5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316022515</ndc>
    <ndc_label_name>Desenex 2 % topical powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316022530</ndc>
    <ndc_label_name>Desenex 2 % topical powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316022608</ndc>
    <ndc_label_name>THERAPEUTIC MINERAL ICE 2% GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316022616</ndc>
    <ndc_label_name>THERAPEUTIC MINERAL ICE 2% GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316022706</ndc>
    <ndc_label_name>Panoxyl 4 % topical cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316022803</ndc>
    <ndc_label_name>Panoxyl 10 % topical cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316022855</ndc>
    <ndc_label_name>Panoxyl 10 % topical cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316023075</ndc>
    <ndc_label_name>Sarna Sensitive 1 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316023125</ndc>
    <ndc_label_name>Zeasorb AF 2 % topical powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316023225</ndc>
    <ndc_label_name>Zeasorb AF 2 % topical powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316023475</ndc>
    <ndc_label_name>Sarna Calm-Cool 1 %-0.5 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316025501</ndc>
    <ndc_label_name>Desenex 2 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316025675</ndc>
    <ndc_label_name>Sarna Eczema Relief 2 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316026404</ndc>
    <ndc_label_name>Panoxyl 10 % Bar</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316028415</ndc>
    <ndc_label_name>PanOxyl (adapalene) 0.1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316029604</ndc>
    <ndc_label_name>PanOxyl (salicylic acid) 2 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316029701</ndc>
    <ndc_label_name>PanOxyl (salicylic acid) 2 % topical spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316029901</ndc>
    <ndc_label_name>PanOxyl (salicylic acid) 2 % topical cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00316029903</ndc>
    <ndc_label_name>PanOxyl (salicylic acid) 2 % topical cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00318069213</ndc>
    <ndc_label_name>Child Robitussin Night Cough DM 1 mg-7.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00327000110</ndc>
    <ndc_label_name>Clorpactin WCS-90 topical powder for solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00327001230</ndc>
    <ndc_label_name>Renacidin 1980.6 mg-59.4mg-980.4mg/30mL irrigation solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338000344</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338000346</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338000347</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338000402</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338000403</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338000404</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338000801</ndc>
    <ndc_label_name>FOSAPREPITANT 150 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001304</ndc>
    <ndc_label_name>STERILE WATER FOR INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001306</ndc>
    <ndc_label_name>STERILE WATER FOR INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001308</ndc>
    <ndc_label_name>STERILE WATER FOR INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001329</ndc>
    <ndc_label_name>STERILE WATER FOR INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001702</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001703</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001704</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001710</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001711</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001718</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001731</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001738</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001741</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338001748</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338002302</ndc>
    <ndc_label_name>DEXTROSE 10%-WATER IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338002303</ndc>
    <ndc_label_name>DEXTROSE 10%-WATER IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338002304</ndc>
    <ndc_label_name>DEXTROSE 10%-WATER IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338002420</ndc>
    <ndc_label_name>EPINEPH 16 MG/250 ML-0.9% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338004303</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.45% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338004304</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.45% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338004727</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338004729</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338004744</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338004746</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338004747</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338004802</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338004803</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338004804</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338004902</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338004903</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338004904</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338004910</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338004911</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338004918</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338004931</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338004938</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338004941</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338004948</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338005047</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% PRCSS SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338005144</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338005403</ndc>
    <ndc_label_name>SODIUM CHLORIDE 3% IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338005603</ndc>
    <ndc_label_name>SODIUM CHLORIDE 5% IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338006230</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338006301</ndc>
    <ndc_label_name>Doxil 2 mg/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338006620</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338006701</ndc>
    <ndc_label_name>Doxil 2 mg/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338006910</ndc>
    <ndc_label_name>KETOROLAC 15 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338007010</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338007225</ndc>
    <ndc_label_name>KETOROLAC 30 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338007304</ndc>
    <ndc_label_name>DEXTROSE 2.5%-0.45% NACL IV</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338007430</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338007704</ndc>
    <ndc_label_name>DEXTROSE 5%-0.2% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338007820</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338008212</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338008503</ndc>
    <ndc_label_name>DEXTROSE 5%-0.45% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338008504</ndc>
    <ndc_label_name>DEXTROSE 5%-0.45% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338008903</ndc>
    <ndc_label_name>DEXTROSE 5%-0.9% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338008904</ndc>
    <ndc_label_name>DEXTROSE 5%-0.9% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338009606</ndc>
    <ndc_label_name>CEFAZOLIN 3 G/150 ML-DEXTROSE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338010820</ndc>
    <ndc_label_name>NOREPINEPHRINE 8 MG/250 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338011001</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338011004</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338011220</ndc>
    <ndc_label_name>NOREPINEPHRINE 4 MG/250 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338011404</ndc>
    <ndc_label_name>LACTATED RINGERS IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338011620</ndc>
    <ndc_label_name>NOREPINEPHRINE 16 MG/250ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338011702</ndc>
    <ndc_label_name>LACTATED RINGERS INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338011703</ndc>
    <ndc_label_name>LACTATED RINGERS INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338011704</ndc>
    <ndc_label_name>LACTATED RINGERS INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338012204</ndc>
    <ndc_label_name>VANCOMYCIN 1.25 GRAM/250ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338012404</ndc>
    <ndc_label_name>VANCOMYCIN 1.5 GRAM/300 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338012503</ndc>
    <ndc_label_name>DEXTROSE 5%-LR IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338012504</ndc>
    <ndc_label_name>DEXTROSE 5%-LR IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338012612</ndc>
    <ndc_label_name>Myxredlin (regular insulin) 100 unit/100 mL (1 unit/mL) IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338013727</ndc>
    <ndc_label_name>LACTATED RINGERS IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338013729</ndc>
    <ndc_label_name>LACTATED RINGERS IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338014303</ndc>
    <ndc_label_name>DEXTROSE 5%-ELECTROLYTE 48</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338018001</ndc>
    <ndc_label_name>Clinimix 8 % in 14 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338018006</ndc>
    <ndc_label_name>Clinimix 8 % in 14 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338018401</ndc>
    <ndc_label_name>Clinimix 8 % in 14 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338018404</ndc>
    <ndc_label_name>Clinimix 8 % in 14 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338018801</ndc>
    <ndc_label_name>Clinimix 8 % in 10 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338018806</ndc>
    <ndc_label_name>Clinimix 8 % in 10 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338019004</ndc>
    <ndc_label_name>TIS-U-SOL PENTALYTE IRRIG SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338019401</ndc>
    <ndc_label_name>Clinimix 8 % in 10 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338019404</ndc>
    <ndc_label_name>Clinimix 8 % in 10 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338019801</ndc>
    <ndc_label_name>Clinimix 6 % in 5 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338019806</ndc>
    <ndc_label_name>Clinimix 6 % in 5 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338020201</ndc>
    <ndc_label_name>Clinimix E 8 % in 14 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338020206</ndc>
    <ndc_label_name>Clinimix E 8 % in 14 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338020601</ndc>
    <ndc_label_name>Clinimix E 8 % in 14 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338020604</ndc>
    <ndc_label_name>Clinimix E 8 % in 14 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338021001</ndc>
    <ndc_label_name>Clinimix E 8 % in 10 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338021006</ndc>
    <ndc_label_name>Clinimix E 8 % in 10 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338021401</ndc>
    <ndc_label_name>Clinimix E 8 % in 10 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338021404</ndc>
    <ndc_label_name>Clinimix E 8 % in 10 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338022103</ndc>
    <ndc_label_name>Plasma-Lyte A intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338022104</ndc>
    <ndc_label_name>Plasma-Lyte A intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338028947</ndc>
    <ndc_label_name>GLYCINE 1.5% IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338029547</ndc>
    <ndc_label_name>SORBITOL 3% UROLOGIC IRRIG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338032201</ndc>
    <ndc_label_name>Recothrom 5,000 unit topical solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338032401</ndc>
    <ndc_label_name>Recothrom 5,000 unit topical solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338032601</ndc>
    <ndc_label_name>Recothrom 20,000 unit topical solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338032801</ndc>
    <ndc_label_name>Recothrom 20,000 unit topical solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338033001</ndc>
    <ndc_label_name>Recothrom Spray Kit 20,000 unit topical solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338034104</ndc>
    <ndc_label_name>CARDIOPLEGIC 16 MEQ K/1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338035104</ndc>
    <ndc_label_name>OSMITROL 5% (50 GM/1,000 ML)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338035303</ndc>
    <ndc_label_name>Osmitrol 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338035702</ndc>
    <ndc_label_name>Osmitrol 20 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338035703</ndc>
    <ndc_label_name>Osmitrol 20 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338040903</ndc>
    <ndc_label_name>LIDOCAINE 0.4% IN D5W SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338041102</ndc>
    <ndc_label_name>LIDOCAINE 0.8% IN D5W SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338042418</ndc>
    <ndc_label_name>HEPARIN 1,000 UNIT/500 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338043103</ndc>
    <ndc_label_name>HEPARIN 1,000 UNIT/500 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338043304</ndc>
    <ndc_label_name>HEPARIN 2,000 UNIT/1,000 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338049906</ndc>
    <ndc_label_name>Prosol 20 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338050203</ndc>
    <ndc_label_name>Clinisol SF 15 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338050206</ndc>
    <ndc_label_name>Clinisol SF 15 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338050348</ndc>
    <ndc_label_name>ISOTON GENTAMICIN 80 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338050548</ndc>
    <ndc_label_name>ISO GENTAMICIN 100 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338050741</ndc>
    <ndc_label_name>ISOTON GENTAMICIN 60 MG/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338050748</ndc>
    <ndc_label_name>ISO GENTAMICIN 120 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338050941</ndc>
    <ndc_label_name>ISOTON GENTAMICIN 80 MG/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338051141</ndc>
    <ndc_label_name>ISOTON GENTAMICIN 100 MG/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338051909</ndc>
    <ndc_label_name>Intralipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338051913</ndc>
    <ndc_label_name>Intralipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338051914</ndc>
    <ndc_label_name>Intralipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338051958</ndc>
    <ndc_label_name>Intralipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338052013</ndc>
    <ndc_label_name>Intralipid 30 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338055111</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338055118</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338055311</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338055318</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338064403</ndc>
    <ndc_label_name>Travasol 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338064404</ndc>
    <ndc_label_name>Travasol 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338064406</ndc>
    <ndc_label_name>Travasol 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338065604</ndc>
    <ndc_label_name>ACETIC ACID 0.25% IRRIG SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338066304</ndc>
    <ndc_label_name>KCL 20 MEQ/L-D5W-0.2% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338066904</ndc>
    <ndc_label_name>KCL 10 MEQ/L-D5W-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338067104</ndc>
    <ndc_label_name>KCL 20 MEQ/L-D5W-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338067304</ndc>
    <ndc_label_name>KCL 30 MEQ/L-D5W-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338067504</ndc>
    <ndc_label_name>KCL 40 MEQ/L-D5W-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338068304</ndc>
    <ndc_label_name>KCL 20 MEQ/L IN D5W SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338069104</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ/1,000ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338069504</ndc>
    <ndc_label_name>POTASSIUM CL 40 MEQ/1,000ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338070341</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ/50 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338070348</ndc>
    <ndc_label_name>POTASSIUM CL 40 MEQ/100 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338070434</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338070541</ndc>
    <ndc_label_name>POTASSIUM CL 10 MEQ/50 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338070548</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ/100 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338070948</ndc>
    <ndc_label_name>POTASSIUM CL 10 MEQ/100 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338071224</ndc>
    <ndc_label_name>DAPTOMYCIN 350 MG/50 ML-NS BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338071424</ndc>
    <ndc_label_name>DAPTOMYCIN 500 MG/50 ML-NS BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338071612</ndc>
    <ndc_label_name>DAPTOMYCIN 700 MG/100ML-NS BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338071812</ndc>
    <ndc_label_name>DAPTOMYCIN 1,000 MG/100 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338071906</ndc>
    <ndc_label_name>DEXTROSE 70%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338080304</ndc>
    <ndc_label_name>KCL 20 MEQ/L-D5W-0.9% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338080704</ndc>
    <ndc_label_name>KCL 40 MEQ/L-D5W-0.9% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338081104</ndc>
    <ndc_label_name>KCL 20 MEQ IN D5W-LACT RINGER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338100502</ndc>
    <ndc_label_name>DOPAMINE 200 MG-D5W 250 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338100503</ndc>
    <ndc_label_name>DOPAMINE 400 MG-D5W 500 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338100702</ndc>
    <ndc_label_name>DOPAMINE 400 MG/250 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338100703</ndc>
    <ndc_label_name>DOPAMINE 800 MG/500 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338100902</ndc>
    <ndc_label_name>DOPAMINE 800 MG/250 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338101541</ndc>
    <ndc_label_name>OXACILLIN 2 GM/ 50 ML INJ</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338101741</ndc>
    <ndc_label_name>NAFCILLIN 1 GM/ 50 ML INJ</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338101948</ndc>
    <ndc_label_name>NAFCILLIN 2 GM/ 100 ML INJ</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338102341</ndc>
    <ndc_label_name>PEN G K 2 MILLION UNIT/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338102541</ndc>
    <ndc_label_name>PEN G K 3 MILLION UNIT/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338104702</ndc>
    <ndc_label_name>NTG 25 MG/250 ML IN D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338104902</ndc>
    <ndc_label_name>NTG 0.2 MG/ML IN D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338105102</ndc>
    <ndc_label_name>NTG 100 MG/250 ML IN D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338105548</ndc>
    <ndc_label_name>METRONIDAZOLE 500 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338107302</ndc>
    <ndc_label_name>DOBUTAMINE 250 MG/250 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338107502</ndc>
    <ndc_label_name>DOBUTAMINE 500 MG/250 ML D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338107702</ndc>
    <ndc_label_name>DOBUTAMINE 1,000 MG/250 ML D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338108904</ndc>
    <ndc_label_name>Clinimix 4.25 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338109104</ndc>
    <ndc_label_name>Clinimix 4.25 % in 10 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338109904</ndc>
    <ndc_label_name>Clinimix 5 % in 15 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338110104</ndc>
    <ndc_label_name>Clinimix 5 % in 20 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338111304</ndc>
    <ndc_label_name>Clinimix E 4.25 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338111504</ndc>
    <ndc_label_name>Clinimix E 4.25 % in 10 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338112304</ndc>
    <ndc_label_name>Clinimix E 5 % in 15 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338112504</ndc>
    <ndc_label_name>Clinimix E 5 % in 20 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338113003</ndc>
    <ndc_label_name>Premasol 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338113004</ndc>
    <ndc_label_name>Premasol 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338113006</ndc>
    <ndc_label_name>Premasol 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338113303</ndc>
    <ndc_label_name>Clinimix 4.25 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338113403</ndc>
    <ndc_label_name>Clinimix 4.25 % in 10 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338113703</ndc>
    <ndc_label_name>Clinimix 5 % in 15 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338113803</ndc>
    <ndc_label_name>Clinimix 5 % in 20 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338114203</ndc>
    <ndc_label_name>Clinimix E 2.75 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338114403</ndc>
    <ndc_label_name>Clinimix E 4.25 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338114503</ndc>
    <ndc_label_name>Clinimix E 4.25 % in 10 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338114703</ndc>
    <ndc_label_name>Clinimix E 5 % in 15 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338114803</ndc>
    <ndc_label_name>Clinimix E 5 % in 20 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338130141</ndc>
    <ndc_label_name>CEFEPIME 1 GM INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338130148</ndc>
    <ndc_label_name>CEFEPIME 2 GM INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338130501</ndc>
    <ndc_label_name>Mesnex 100 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338170840</ndc>
    <ndc_label_name>MAGNESIUM SULF 2 G/50 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338170940</ndc>
    <ndc_label_name>MAGNESIUM SULF 1 G/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338171540</ndc>
    <ndc_label_name>MAGNESIUM SULF 4 G/100 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338171940</ndc>
    <ndc_label_name>MAGNESIUM SULF 4 G/50 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338341024</ndc>
    <ndc_label_name>CLINDAMYCIN 300 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338341050</ndc>
    <ndc_label_name>CLINDAMYCIN 300 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338350341</ndc>
    <ndc_label_name>CEFAZOLIN 1 G/50 ML-DEXTROSE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338350841</ndc>
    <ndc_label_name>CEFAZOLIN 2 G/100 ML-DEXTROSE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338355148</ndc>
    <ndc_label_name>VANCOMYCIN-D5W 500 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338355248</ndc>
    <ndc_label_name>VANCOMYCIN HCL 1G/200 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338358048</ndc>
    <ndc_label_name>VANCOMYCIN 750 MG/150 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338358101</ndc>
    <ndc_label_name>VANCO 500 MG/100 ML-0.9% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338358201</ndc>
    <ndc_label_name>VANCO 750 MG/150 ML-0.9% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338358301</ndc>
    <ndc_label_name>VANCOMYCIN 1 G/200ML-0.9% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338361224</ndc>
    <ndc_label_name>CLINDAMYCIN 600 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338361250</ndc>
    <ndc_label_name>CLINDAMYCIN 600 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338361624</ndc>
    <ndc_label_name>CLINDAMYCIN 600 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338361650</ndc>
    <ndc_label_name>CLINDAMYCIN 600 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338381424</ndc>
    <ndc_label_name>CLINDAMYCIN 900 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338381450</ndc>
    <ndc_label_name>CLINDAMYCIN 900 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338399101</ndc>
    <ndc_label_name>Ifex 1 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338399301</ndc>
    <ndc_label_name>Ifex 3 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338411424</ndc>
    <ndc_label_name>CLINDAMYCIN 900 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338411450</ndc>
    <ndc_label_name>CLINDAMYCIN 900 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338421002</ndc>
    <ndc_label_name>Tisseel VHSD (with aprotinin, synthetic) 2 mL topical kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338421104</ndc>
    <ndc_label_name>Tisseel VHSD (with aprotinin, synthetic) 4 mL topical kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338421210</ndc>
    <ndc_label_name>Tisseel VHSD (with aprotinin, synthetic) 10 mL topical kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338430102</ndc>
    <ndc_label_name>Tisseel VHSD (with aprotinin, synthetic) 2 mL topical kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338430204</ndc>
    <ndc_label_name>Tisseel VHSD (with aprotinin, synthetic) 4 mL topical kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338430310</ndc>
    <ndc_label_name>Tisseel VHSD (with aprotinin, synthetic) 10 mL topical kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338500241</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM PIGGYBACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338500341</ndc>
    <ndc_label_name>CEFTRIAXONE 2 GM PIGGYBACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338519741</ndc>
    <ndc_label_name>FAMOTIDINE 20 MG PIGGYBACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338601048</ndc>
    <ndc_label_name>MILRINONE-D5W 20 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338601137</ndc>
    <ndc_label_name>MILRINONE-D5W 40 MG/200 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338604537</ndc>
    <ndc_label_name>FLUCONAZOLE-NACL 400 MG/200 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338604648</ndc>
    <ndc_label_name>FLUCONAZOLE-NACL 200 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338635301</ndc>
    <ndc_label_name>MAGNESIUM SULF 3 G/100 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338635340</ndc>
    <ndc_label_name>MAGNESIUM SULF 3 G/100 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338700101</ndc>
    <ndc_label_name>Clinimix 4.25 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338700106</ndc>
    <ndc_label_name>Clinimix 4.25 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338700301</ndc>
    <ndc_label_name>Clinimix 4.25 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338700304</ndc>
    <ndc_label_name>Clinimix 4.25 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338701101</ndc>
    <ndc_label_name>Clinimix 5 % in 15 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338701104</ndc>
    <ndc_label_name>Clinimix 5 % in 15 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338701501</ndc>
    <ndc_label_name>Clinimix 5 % in 20 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338701504</ndc>
    <ndc_label_name>Clinimix 5 % in 20 % dextrose (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338702001</ndc>
    <ndc_label_name>Clinimix E 2.75 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338702006</ndc>
    <ndc_label_name>Clinimix E 2.75 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338702201</ndc>
    <ndc_label_name>Clinimix E 4.25 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338702206</ndc>
    <ndc_label_name>Clinimix E 4.25 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338702401</ndc>
    <ndc_label_name>Clinimix E 4.25 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338702404</ndc>
    <ndc_label_name>Clinimix E 4.25 % in 5 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338702601</ndc>
    <ndc_label_name>Clinimix E 4.25 % in 10 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338702606</ndc>
    <ndc_label_name>Clinimix E 4.25 % in 10 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338702801</ndc>
    <ndc_label_name>Clinimix E 4.25 % in 10 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338702804</ndc>
    <ndc_label_name>Clinimix E 4.25 % in 10 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338703001</ndc>
    <ndc_label_name>Clinimix E 5 % in 15 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338703006</ndc>
    <ndc_label_name>Clinimix E 5 % in 15 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338703201</ndc>
    <ndc_label_name>Clinimix E 5 % in 15 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338703204</ndc>
    <ndc_label_name>Clinimix E 5 % in 15 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338703401</ndc>
    <ndc_label_name>Clinimix E 5 % in 20 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338703406</ndc>
    <ndc_label_name>Clinimix E 5 % in 20 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338703601</ndc>
    <ndc_label_name>Clinimix E 5 % in 20 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338703604</ndc>
    <ndc_label_name>Clinimix E 5 % in 20 % dextrose Sulfite Free intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338850301</ndc>
    <ndc_label_name>Artiss 2.5 unit to 6.5 unit/mL (2mL) topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338850302</ndc>
    <ndc_label_name>Artiss 2.5 unit to 6.5 unit/mL (2mL) topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338850303</ndc>
    <ndc_label_name>Artiss 2.5 unit to 6.5 unit/mL (4mL) topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338850304</ndc>
    <ndc_label_name>Artiss 2.5 unit to 6.5 unit/mL (4mL) topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338850309</ndc>
    <ndc_label_name>Artiss 2.5 unit to 6.5 unit/mL(10mL) topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338850310</ndc>
    <ndc_label_name>Artiss 2.5 unit to 6.5 unit/mL(10mL) topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338870101</ndc>
    <ndc_label_name>TachoSil 9.5 cm X 4.8 cm topical patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338870202</ndc>
    <ndc_label_name>TachoSil 4.8 cm X 4.8 cm topical patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338905101</ndc>
    <ndc_label_name>MICAFUNGIN 50 MG/50ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338905112</ndc>
    <ndc_label_name>MICAFUNGIN 50 MG/50ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338905301</ndc>
    <ndc_label_name>MICAFUNGIN 100 MG/100-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338905312</ndc>
    <ndc_label_name>MICAFUNGIN 100 MG/100-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338905501</ndc>
    <ndc_label_name>MICAFUNGIN 150 MG/150-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338905510</ndc>
    <ndc_label_name>MICAFUNGIN 150 MG/150-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338914330</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338914730</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338915130</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338915930</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338953096</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER 100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338953196</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338953396</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER 50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338953572</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338953972</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER 100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954001</ndc>
    <ndc_label_name>Clinolipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954002</ndc>
    <ndc_label_name>Clinolipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954003</ndc>
    <ndc_label_name>Clinolipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954004</ndc>
    <ndc_label_name>Clinolipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954005</ndc>
    <ndc_label_name>Clinolipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954006</ndc>
    <ndc_label_name>Clinolipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954007</ndc>
    <ndc_label_name>Clinolipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954008</ndc>
    <ndc_label_name>Clinolipid 20 % intravenous emulsion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954124</ndc>
    <ndc_label_name>METRONIDAZOLE 500 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954301</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 250 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954302</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954303</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 500 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954304</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954305</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954306</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338954307</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338954524</ndc>
    <ndc_label_name>CLINDAMYCIN 300 MG/50 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338954550</ndc>
    <ndc_label_name>CLINDAMYCIN 300 MG/50 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338954924</ndc>
    <ndc_label_name>CLINDAMYCIN 600 MG/50 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338954950</ndc>
    <ndc_label_name>CLINDAMYCIN 600 MG/50 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338955324</ndc>
    <ndc_label_name>CLINDAMYCIN 900 MG/50 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338955350</ndc>
    <ndc_label_name>CLINDAMYCIN 900 MG/50 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338955524</ndc>
    <ndc_label_name>DEXMEDETOMIDINE 200MCG/50ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338955712</ndc>
    <ndc_label_name>DEXMEDETOMIDIN 400MCG/100ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338955810</ndc>
    <ndc_label_name>EPTIFIBATIDE 75 MG/100 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338956001</ndc>
    <ndc_label_name>Tisseel VHSD (with aprotinin, synthetic) 2 mL topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338956401</ndc>
    <ndc_label_name>Tisseel VHSD (with aprotinin, synthetic) 4 mL topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338956760</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338956801</ndc>
    <ndc_label_name>Tisseel VHSD (with aprotinin, synthetic) 10 mL topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338956948</ndc>
    <ndc_label_name>GLUCOSE 5%-WATER 100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338957360</ndc>
    <ndc_label_name>GLUCOSE 5%-WATER 50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338957996</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338958101</ndc>
    <ndc_label_name>Caelyx 2 mg/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338958102</ndc>
    <ndc_label_name>Caelyx 2 mg/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338958801</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338958812</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338959101</ndc>
    <ndc_label_name>Plasma-Lyte A intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338959112</ndc>
    <ndc_label_name>Plasma-Lyte A intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338959301</ndc>
    <ndc_label_name>Plasma-Lyte 148 pH 7.4 intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338959310</ndc>
    <ndc_label_name>Plasma-Lyte 148 pH 7.4 intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338960001</ndc>
    <ndc_label_name>LACTATED RINGERS 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00338960012</ndc>
    <ndc_label_name>LACTATED RINGERS 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338960401</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 250 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338960430</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 250 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338960801</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 500 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338960824</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 500 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338961201</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338961212</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338963201</ndc>
    <ndc_label_name>Zosyn 2.25 gram/50 mL in dextrose (iso-osmotic) intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338963224</ndc>
    <ndc_label_name>Zosyn 2.25 gram/50 mL in dextrose (iso-osmotic) intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338963601</ndc>
    <ndc_label_name>Zosyn 3.375 gram/50 mL in dextrose (iso-osmotic) intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338963624</ndc>
    <ndc_label_name>Zosyn 3.375 gram/50 mL in dextrose (iso-osmotic) intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338963701</ndc>
    <ndc_label_name>Artiss 2.5 unit to 6.5 unit/mL (2mL) topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338963801</ndc>
    <ndc_label_name>Zosyn 4.5 gram/100 mL in dextrose (iso-osmotic) intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338963812</ndc>
    <ndc_label_name>Zosyn 4.5 gram/100 mL in dextrose (iso-osmotic) intravenous piggyback</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338963901</ndc>
    <ndc_label_name>Artiss 2.5 unit to 6.5 unit/mL (4mL) topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338964012</ndc>
    <ndc_label_name>VASOPRESSIN 20 UNIT/100 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338964101</ndc>
    <ndc_label_name>Artiss 2.5 unit to 6.5 unit/mL(10mL) topical syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338964401</ndc>
    <ndc_label_name>PANTOPRAZOLE SOD 40MG/100ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338964412</ndc>
    <ndc_label_name>PANTOPRAZOLE SOD 40MG/100ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338964601</ndc>
    <ndc_label_name>PANTOPRAZOLE SOD 40 MG/50ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338964624</ndc>
    <ndc_label_name>PANTOPRAZOLE SOD 40 MG/50ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338964712</ndc>
    <ndc_label_name>VASOPRESSIN 40 UNIT/100 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338964801</ndc>
    <ndc_label_name>PANTOPRAZOLE SOD 80MG/100ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338964812</ndc>
    <ndc_label_name>PANTOPRAZOLE SOD 80MG/100ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338964975</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338965360</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338965775</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338966040</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338966160</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338966235</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338966440</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338966501</ndc>
    <ndc_label_name>Doxil 2 mg/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338966635</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338966701</ndc>
    <ndc_label_name>Doxil 2 mg/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338977701</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 500 MG/2.5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338977901</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 1 GM/5 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338978201</ndc>
    <ndc_label_name>STERILE WATER INJECT 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338978212</ndc>
    <ndc_label_name>STERILE WATER INJECT 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338978501</ndc>
    <ndc_label_name>GLUCOSE 70%-WATER 500 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338978520</ndc>
    <ndc_label_name>GLUCOSE 70%-WATER 500 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338978701</ndc>
    <ndc_label_name>GLUCOSE 50%-WATER 3,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338978704</ndc>
    <ndc_label_name>GLUCOSE 50%-WATER 3,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338978901</ndc>
    <ndc_label_name>DEXTROSE 70%-WATER 3,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338978904</ndc>
    <ndc_label_name>DEXTROSE 70%-WATER 3,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338979101</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 250 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338979140</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 250 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338979301</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338979312</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338979901</ndc>
    <ndc_label_name>dextrose (d-glucose) 5 % and 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338979912</ndc>
    <ndc_label_name>dextrose (d-glucose) 5 % and 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338980401</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 250 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338980440</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 250 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338980601</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338980612</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338980801</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 500 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338980824</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 500 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338981001</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 500 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338981024</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% 500 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338983001</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER 250 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00338983003</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER 250 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00362022110</ndc>
    <ndc_label_name>LIDOCAINE 5% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00362026205</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:50,000 CART</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00362055705</ndc>
    <ndc_label_name>Marcaine-Epinephrine 0.5 %-1:200,000 injection cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00362075305</ndc>
    <ndc_label_name>Carbocaine 30 mg/mL (3 %) injection dental cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00362089805</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00362093105</ndc>
    <ndc_label_name>Carbocaine with Neo-Cobefrin 2 %-1:20,000 injection cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00362109560</ndc>
    <ndc_label_name>Lignospan Standard 2 %-1:100,000 injection cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00362109890</ndc>
    <ndc_label_name>Scandonest Plain 30 mg/mL (3 %) injection dental cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00362397105</ndc>
    <ndc_label_name>DycloPro 0.5 % topical solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00362901150</ndc>
    <ndc_label_name>Vivacaine 0.5 %-1:200,000 injection cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00362904802</ndc>
    <ndc_label_name>Septocaine 4 %-1:200,000 injection cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00362904902</ndc>
    <ndc_label_name>Septocaine 4 %-1:100,000 injection cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363000220</ndc>
    <ndc_label_name>Stool Softener-Laxative 8.6 mg-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363000501</ndc>
    <ndc_label_name>Chocolate Laxative 15 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363000511</ndc>
    <ndc_label_name>Enema 19 gram-7 gram/118 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363000520</ndc>
    <ndc_label_name>Enema 19 gram-7 gram/118 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363000536</ndc>
    <ndc_label_name>Enema 19 gram-7 gram/118 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363000540</ndc>
    <ndc_label_name>Pediatric Enema 9.5 gram-3.5 gram/59 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363000611</ndc>
    <ndc_label_name>MINERAL OIL ENEMA</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363000703</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363000905</ndc>
    <ndc_label_name>Stool Softener 100 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363000920</ndc>
    <ndc_label_name>Stool Softener 100 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363001339</ndc>
    <ndc_label_name>Wal-Itin D 12 Hour 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363001607</ndc>
    <ndc_label_name>Soothe Regular Strength 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363001608</ndc>
    <ndc_label_name>Soothe Regular Strength 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363002271</ndc>
    <ndc_label_name>CIMETIDINE 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363002272</ndc>
    <ndc_label_name>CIMETIDINE 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363002401</ndc>
    <ndc_label_name>24 Hour Allergy Relief 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363002402</ndc>
    <ndc_label_name>24 Hour Allergy Relief 50 mcg/actuation nasal spray,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363002405</ndc>
    <ndc_label_name>Wal-Som (diphenhydramine) 50 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363002508</ndc>
    <ndc_label_name>Soothe Regular Strength 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363003102</ndc>
    <ndc_label_name>Daytime-Nighttime Cough 15mg/15 mL(d)/12.5-30mg(nt)/30 mL oral liquids</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363003216</ndc>
    <ndc_label_name>Hair Regrowth Treatment 5 % topical solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363003626</ndc>
    <ndc_label_name>Acid Controller 20 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363003650</ndc>
    <ndc_label_name>Acid Controller 20 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363003683</ndc>
    <ndc_label_name>Acid Controller 20 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363004138</ndc>
    <ndc_label_name>Cold-Flu Relief 12.5 mg-30 mg-1,000 mg/30 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363004143</ndc>
    <ndc_label_name>Cold-Flu Relief 12.5 mg-30 mg-1,000 mg/30 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363004227</ndc>
    <ndc_label_name>OMEPRAZOLE MAG DR 20 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363004915</ndc>
    <ndc_label_name>Allergy Relief-D (fexofenadine) 180 mg-240 mg tablet,ext.release 24 hr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363005002</ndc>
    <ndc_label_name>Comfort Gel Extra Strength 400 mg-400 mg-40 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363005294</ndc>
    <ndc_label_name>Children's Wal-Fex 30 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363005460</ndc>
    <ndc_label_name>Wal-phed 12 hour 120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363005705</ndc>
    <ndc_label_name>Infant's Ibuprofen 50 mg/1.25 mL oral drops,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363005710</ndc>
    <ndc_label_name>Infant's Ibuprofen 50 mg/1.25 mL oral drops,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363006048</ndc>
    <ndc_label_name>Wal-Sleep Z 25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363006160</ndc>
    <ndc_label_name>Wal-Phed D 120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363006330</ndc>
    <ndc_label_name>CALAMINE LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363006510</ndc>
    <ndc_label_name>Anefrin 0.05 % nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363006907</ndc>
    <ndc_label_name>Lip Treatment topical jelly</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363007120</ndc>
    <ndc_label_name>Mucus Relief ER 600 mg tablet, extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363007302</ndc>
    <ndc_label_name>Antacid Regular Strength 200 mg-200 mg-20 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363007318</ndc>
    <ndc_label_name>Antacid Ultra Strength 470 mg (calcium carb 1,177 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363007326</ndc>
    <ndc_label_name>Antacid Regular Strength 200 mg-200 mg-20 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363007336</ndc>
    <ndc_label_name>Antacid Ultra Strength 470 mg (calcium carb 1,177 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363007428</ndc>
    <ndc_label_name>Mucus Relief ER 1,200 mg tablet, extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363007564</ndc>
    <ndc_label_name>BACITRACIN 500 UNIT/GM OINTMNT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363007826</ndc>
    <ndc_label_name>CASTOR OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363008100</ndc>
    <ndc_label_name>Miconazole-3  200 mg-2 % (9 gram) vaginal kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363008360</ndc>
    <ndc_label_name>Wal-Profen Cold-Sinus 30 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363008501</ndc>
    <ndc_label_name>Wal-itin 5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363008808</ndc>
    <ndc_label_name>Children's Wal-Zyr 1 mg/mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363008816</ndc>
    <ndc_label_name>Wal-itin 5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363009208</ndc>
    <ndc_label_name>Children's Wal-Dryl Allergy 12.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363009827</ndc>
    <ndc_label_name>NAPROXEN SODIUM 220 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363010104</ndc>
    <ndc_label_name>Children's Wal-Dryl Allergy 12.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363010162</ndc>
    <ndc_label_name>Complete Lice Treatment 4 %-0.33 %-0.5 % topical kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363010301</ndc>
    <ndc_label_name>Infants' Pain and Fever 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363010302</ndc>
    <ndc_label_name>Infants' Pain and Fever 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363010412</ndc>
    <ndc_label_name>Pain Reliever (acetaminophen) 325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363010526</ndc>
    <ndc_label_name>Children's Non-Aspirin 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363010540</ndc>
    <ndc_label_name>Children's Pain Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363010612</ndc>
    <ndc_label_name>Wal-Dryl Allergy 12.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363010706</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363010708</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363010714</ndc>
    <ndc_label_name>Antacid Extra Strength (calcium-mag hyd) 675 mg-135 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363010722</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363010908</ndc>
    <ndc_label_name>Gentle Laxative (bisacodyl) 10 mg rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363011018</ndc>
    <ndc_label_name>Gas Relief Extra Strength 125 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363011122</ndc>
    <ndc_label_name>Wal-phed 4 mg-60 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363011208</ndc>
    <ndc_label_name>Wal-phed 30 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363011222</ndc>
    <ndc_label_name>Wal-phed 30 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363011246</ndc>
    <ndc_label_name>Wal-phed 30 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363011312</ndc>
    <ndc_label_name>Urinary Pain Relief 97.5 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363011701</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363011702</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363011703</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363011916</ndc>
    <ndc_label_name>Wal-Mucil Fiber 0.52 gram capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363011932</ndc>
    <ndc_label_name>Wal-Mucil Fiber 0.52 gram capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363012010</ndc>
    <ndc_label_name>Fiber Therapy (methylcellulose) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363012014</ndc>
    <ndc_label_name>Fiber Laxative (calcium polycarbophil) 625 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363012020</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363012140</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363012201</ndc>
    <ndc_label_name>Wal-Dryl (diphenhydramine-Zn acetate) 2 %-0.1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363012280</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363012318</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363012405</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363012406</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363012410</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363012460</ndc>
    <ndc_label_name>Lactase Fast Acting 9,000 unit chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363012550</ndc>
    <ndc_label_name>Gas Relief (simethicone) 180 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363012612</ndc>
    <ndc_label_name>Oral Saline Laxative 7.2 gram-2.7 gram/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363012824</ndc>
    <ndc_label_name>Wal-Mucil with Calcium 1 gram-60 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363013026</ndc>
    <ndc_label_name>Children's Non-Aspirin 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363013318</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363013326</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363013338</ndc>
    <ndc_label_name>MAGNESIUM CITRATE SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363013607</ndc>
    <ndc_label_name>Soothe Regular Strength 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363013608</ndc>
    <ndc_label_name>Soothe Regular Strength 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363013810</ndc>
    <ndc_label_name>senna 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363013830</ndc>
    <ndc_label_name>senna 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363013850</ndc>
    <ndc_label_name>senna 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363014082</ndc>
    <ndc_label_name>All Day Pain Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363014101</ndc>
    <ndc_label_name>Infants' Pain Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363014175</ndc>
    <ndc_label_name>Acid Controller 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363014178</ndc>
    <ndc_label_name>Children's Wal-Dryl Allergy 12.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363014460</ndc>
    <ndc_label_name>Lactase Fast Acting 9,000 unit tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363014468</ndc>
    <ndc_label_name>Mucus Relief D (pseudoephed) 60 mg-600 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363014489</ndc>
    <ndc_label_name>Mucus Relief D (pseudoephed) 60 mg-600 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363014730</ndc>
    <ndc_label_name>Cool Heat (methyl salicylate-menthol) 30 %-10 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363014940</ndc>
    <ndc_label_name>Pain Relieving (camphor-m.salicyl-menth) topical patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363015601</ndc>
    <ndc_label_name>Mucus Relief Severe Sinus Congestion 5 mg-325 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363015712</ndc>
    <ndc_label_name>ASPIRIN 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363015714</ndc>
    <ndc_label_name>ASPIRIN 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363015717</ndc>
    <ndc_label_name>ASPIRIN 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363015798</ndc>
    <ndc_label_name>ASPIRIN 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363015904</ndc>
    <ndc_label_name>Wal-Tussin Cough 15 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363015912</ndc>
    <ndc_label_name>Headache Relief (ASA-acetaminophn-caffeine) 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363015915</ndc>
    <ndc_label_name>Headache Relief (ASA-acetaminophn-caffeine) 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363016004</ndc>
    <ndc_label_name>Children's Pain Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363016012</ndc>
    <ndc_label_name>Senna-S 8.6 mg-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363016060</ndc>
    <ndc_label_name>Senna-S 8.6 mg-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363016110</ndc>
    <ndc_label_name>Infants' Pain and Fever 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363016115</ndc>
    <ndc_label_name>Pain Reliever PM Ex-Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363016116</ndc>
    <ndc_label_name>Infants' Pain and Fever 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363016150</ndc>
    <ndc_label_name>Pain Reliever PM Ex-Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363016204</ndc>
    <ndc_label_name>Children's Pain Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363016406</ndc>
    <ndc_label_name>Oral Relief Sore Throat Spray 1.4 % aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363016513</ndc>
    <ndc_label_name>Wal-itin D 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363016522</ndc>
    <ndc_label_name>Wal-itin D 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363016532</ndc>
    <ndc_label_name>Wal-itin D 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363016552</ndc>
    <ndc_label_name>Wal-itin D 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363016626</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363016634</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363016640</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363016704</ndc>
    <ndc_label_name>Children's Pain Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363017001</ndc>
    <ndc_label_name>Stool Softener (docusate calcium) 240 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363017508</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363017512</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363017514</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363017515</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363017520</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363017526</ndc>
    <ndc_label_name>Children's Non-Aspirin 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363017529</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363017534</ndc>
    <ndc_label_name>Children's Pain Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363017537</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363017653</ndc>
    <ndc_label_name>Wal-Zyr D 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363017804</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363017822</ndc>
    <ndc_label_name>Wal-Act D Cold and Allergy 2.5 mg-60 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363018001</ndc>
    <ndc_label_name>senna 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363018005</ndc>
    <ndc_label_name>senna 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363018330</ndc>
    <ndc_label_name>Tri-Buffered Aspirin 325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363018422</ndc>
    <ndc_label_name>Antacid Extra Strength 300 mg (as calcium carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363018601</ndc>
    <ndc_label_name>Non-Aspirin 80 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363018762</ndc>
    <ndc_label_name>Wal-Flu Night Time 20 mg-10 mg-650 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363018908</ndc>
    <ndc_label_name>Sleep II 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363018921</ndc>
    <ndc_label_name>Sleep II 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363019005</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019007</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019008</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363019010</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019012</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019051</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019326</ndc>
    <ndc_label_name>Cough-Sore Throat Night 12.5 mg-30 mg-1,000 mg/30 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019401</ndc>
    <ndc_label_name>Acid Controller 20 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363019404</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019415</ndc>
    <ndc_label_name>Wal-Finate 4 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019471</ndc>
    <ndc_label_name>Acid Controller 20 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363019502</ndc>
    <ndc_label_name>NICOTINE 14 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363019602</ndc>
    <ndc_label_name>NICOTINE 7 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019716</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019720</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019730</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019740</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019780</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363019808</ndc>
    <ndc_label_name>Wal-Dram 50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363019816</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363019900</ndc>
    <ndc_label_name>MICONAZOLE 1 COMBINATION PACK</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363020105</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363020176</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363020401</ndc>
    <ndc_label_name>Epsom Salt 100 % crystals</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363020403</ndc>
    <ndc_label_name>Epsom Salt 100 % crystals</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363020421</ndc>
    <ndc_label_name>Wal-phed 12 hour 120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363020469</ndc>
    <ndc_label_name>Wal-Phed D 120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363020765</ndc>
    <ndc_label_name>Acid Controller 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363020775</ndc>
    <ndc_label_name>Acid Controller 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363020801</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363020807</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363020901</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363020907</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363021108</ndc>
    <ndc_label_name>Soothe Regular Strength 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363021116</ndc>
    <ndc_label_name>Soothe Regular Strength 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363021125</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363021234</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363021324</ndc>
    <ndc_label_name>Pain Reliever PM Ex-Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363021807</ndc>
    <ndc_label_name>ASPIRIN 81 MG CHEWABLE TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363021830</ndc>
    <ndc_label_name>Calahist 1 %-0.1 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363021874</ndc>
    <ndc_label_name>ASPIRIN 81 MG CHEWABLE TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363021879</ndc>
    <ndc_label_name>ASPIRIN 81 MG CHEWABLE TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363021899</ndc>
    <ndc_label_name>ASPIRIN 81 MG CHEWABLE TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363022430</ndc>
    <ndc_label_name>CALAMINE LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363022434</ndc>
    <ndc_label_name>Antacid 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363022608</ndc>
    <ndc_label_name>Stay Awake Maximum Strength 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363022612</ndc>
    <ndc_label_name>Stay Awake Maximum Strength 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363022714</ndc>
    <ndc_label_name>ASPIRIN EC 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363022757</ndc>
    <ndc_label_name>ASPIRIN EC 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363023064</ndc>
    <ndc_label_name>Wal-Som (diphenhydramine) 50 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363023108</ndc>
    <ndc_label_name>Soothe Regular Strength 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363023116</ndc>
    <ndc_label_name>Soothe Regular Strength 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363023206</ndc>
    <ndc_label_name>Mucus Relief DM Max 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363023208</ndc>
    <ndc_label_name>Mucus Relief DM Max 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363023408</ndc>
    <ndc_label_name>Mucus Relief Congestion-Cough 2.5 mg-5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363023508</ndc>
    <ndc_label_name>Wal-Nadol PM 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363023512</ndc>
    <ndc_label_name>Acetaminophen PM Extra Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363023515</ndc>
    <ndc_label_name>Acetaminophen PM 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363023632</ndc>
    <ndc_label_name>Wal-Som (diphenhydramine) 50 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363023660</ndc>
    <ndc_label_name>Wal-Som (diphenhydramine) 50 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363023664</ndc>
    <ndc_label_name>Wal-Som (diphenhydramine) 50 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363023806</ndc>
    <ndc_label_name>Stool Softener 100 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363023820</ndc>
    <ndc_label_name>Stool Softener 100 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363023840</ndc>
    <ndc_label_name>Stool Softener 100 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363024108</ndc>
    <ndc_label_name>Cold MultiSymptom NighTime 6.25 mg-5 mg-10 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363024610</ndc>
    <ndc_label_name>Pain Reliever PM Ex-Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363024615</ndc>
    <ndc_label_name>Pain Reliever PM Ex-Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363024625</ndc>
    <ndc_label_name>Pain Reliever PM Ex-Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363024650</ndc>
    <ndc_label_name>Pain Reliever PM Ex-Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363025402</ndc>
    <ndc_label_name>Child Wal-Tussin Cough Relief 7.5 mg disintegrating tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363025510</ndc>
    <ndc_label_name>INFANT IBUPROFEN 50 MG/1.25 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363025514</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363025517</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363025527</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363025532</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363025602</ndc>
    <ndc_label_name>Wal-Sleep Z 25 mg disintegrating tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363027808</ndc>
    <ndc_label_name>Pain Relief Adult 500 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363027962</ndc>
    <ndc_label_name>Hemorrhoidal (phenyleph-cocoa) 0.25 %-88.44 % rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363028404</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363028826</ndc>
    <ndc_label_name>Children's Chest Congestion 100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363029108</ndc>
    <ndc_label_name>Wal-Profen 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363029112</ndc>
    <ndc_label_name>Wal-Profen 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363029115</ndc>
    <ndc_label_name>Wal-Profen 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363029116</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363029137</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363029214</ndc>
    <ndc_label_name>IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363029215</ndc>
    <ndc_label_name>Wal-Profen 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363029237</ndc>
    <ndc_label_name>IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363029908</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363030026</ndc>
    <ndc_label_name>Wal-Tussin Max Strength Cough 15 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363030410</ndc>
    <ndc_label_name>Anefrin 0.05 % nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363030602</ndc>
    <ndc_label_name>SmoothLax 17 gram/dose oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363030603</ndc>
    <ndc_label_name>SmoothLax 17 gram/dose oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363030604</ndc>
    <ndc_label_name>SmoothLax 17 gram/dose oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363030652</ndc>
    <ndc_label_name>SmoothLax 17 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363030702</ndc>
    <ndc_label_name>Lubricant Eye (PG-PEG 400) 0.4 %-0.3 % drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363030801</ndc>
    <ndc_label_name>Anefrin 0.05 % nasal mist</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363030901</ndc>
    <ndc_label_name>Anefrin 0.05 % nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363031026</ndc>
    <ndc_label_name>Adult Wal-Tussin 100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363031034</ndc>
    <ndc_label_name>Adult Wal-Tussin 100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363031301</ndc>
    <ndc_label_name>Anefrin 0.05 % nasal mist</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363031603</ndc>
    <ndc_label_name>Anefrin 0.05 % nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363031734</ndc>
    <ndc_label_name>Antacid 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363031801</ndc>
    <ndc_label_name>Non-Aspirin 80 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363031901</ndc>
    <ndc_label_name>Soothe (bismuth subsalicylate) 262 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363032003</ndc>
    <ndc_label_name>Saline Nasal 0.65 % spray aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363032163</ndc>
    <ndc_label_name>Acid Controller Complete 10 mg-800 mg-165 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363032171</ndc>
    <ndc_label_name>Acid Controller Complete 10 mg-800 mg-165 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363032601</ndc>
    <ndc_label_name>Woman's Laxative (bisacodyl) 5 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363032652</ndc>
    <ndc_label_name>Woman's Laxative (bisacodyl) 5 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363032706</ndc>
    <ndc_label_name>Laxative (bisacodyl) 5 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363032712</ndc>
    <ndc_label_name>Gentle Laxative (bisacodyl) 5 mg tablet,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363032756</ndc>
    <ndc_label_name>Gentle Laxative (bisacodyl) 5 mg tablet,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363032830</ndc>
    <ndc_label_name>Ora Relief 1.4 % mucosal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363032907</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363032908</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363032912</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363032922</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363032978</ndc>
    <ndc_label_name>Wal-Dryl Allergy 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033016</ndc>
    <ndc_label_name>Infants' Pain and Fever 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033082</ndc>
    <ndc_label_name>Tioconazole-1 6.5 % vaginal ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033144</ndc>
    <ndc_label_name>Children's Pain Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033235</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033240</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033304</ndc>
    <ndc_label_name>Arthritis Pain Relief (acetaminophen) ER 650 mg tablet,extend release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033350</ndc>
    <ndc_label_name>Arthritis Pain Relief (acetaminophen) ER 650 mg tablet,extend release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033355</ndc>
    <ndc_label_name>Arthritis Pain Reliever 650 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033412</ndc>
    <ndc_label_name>Headache Relief (ASA-acetaminophn-caffeine) 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033422</ndc>
    <ndc_label_name>Arthritis Pain Relief (acetaminophen) ER 650 mg tablet,extend release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033444</ndc>
    <ndc_label_name>Children's Pain Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363033534</ndc>
    <ndc_label_name>Nighttime Cold-Flu Relief 6.25 mg-15 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033550</ndc>
    <ndc_label_name>Antacid Extra Strength 300 mg (as calcium carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033601</ndc>
    <ndc_label_name>Pain Relief (acetaminophen) 650 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363033630</ndc>
    <ndc_label_name>Calahist with Pramoxine 1 %-8 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363033706</ndc>
    <ndc_label_name>Mucus Relief Congestion-Cough 2.5 mg-5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363033808</ndc>
    <ndc_label_name>Backache Relief Extra Strength 580 mg (467 mg) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363033950</ndc>
    <ndc_label_name>Antacid Extra Strength 300 mg (as calcium carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363034040</ndc>
    <ndc_label_name>Comfort Gel Extra Strength 400 mg-400 mg-40 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363034044</ndc>
    <ndc_label_name>Children's Pain Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363034050</ndc>
    <ndc_label_name>Antacid Extra Strength 300 mg (as calcium carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363034080</ndc>
    <ndc_label_name>Arthritis Pain Reliever 650 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363034190</ndc>
    <ndc_label_name>Athlete's Foot 2 % topical spray powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363034208</ndc>
    <ndc_label_name>Allergy Sinus-D 2 mg-30 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363034330</ndc>
    <ndc_label_name>Ora Relief 1.4 % mucosal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363034356</ndc>
    <ndc_label_name>HYDROCORTISONE 1% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363034411</ndc>
    <ndc_label_name>Awake 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363034423</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363034544</ndc>
    <ndc_label_name>Children's Pain Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363034610</ndc>
    <ndc_label_name>Soothe (bismuth subsalicylate) 262 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363034701</ndc>
    <ndc_label_name>Laxative Pills Regular 15 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363034808</ndc>
    <ndc_label_name>Laxative Pills 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363034822</ndc>
    <ndc_label_name>Laxative Pills 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363035278</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363035926</ndc>
    <ndc_label_name>Wal-Tussin DM 10 mg-100 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363035934</ndc>
    <ndc_label_name>Wal-Tussin DM 10 mg-100 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363035940</ndc>
    <ndc_label_name>Wal-Tussin DM 10 mg-100 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363036010</ndc>
    <ndc_label_name>Acetaminophen PM 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363036050</ndc>
    <ndc_label_name>Acetaminophen PM Extra Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363036506</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363036578</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363036707</ndc>
    <ndc_label_name>NightTime Sleep Aid (diphenhydramine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363036708</ndc>
    <ndc_label_name>NightTime Sleep Aid (diphenhydramine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363036712</ndc>
    <ndc_label_name>NightTime Sleep Aid (diphenhydramine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363036852</ndc>
    <ndc_label_name>All Day Pain Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363036861</ndc>
    <ndc_label_name>All Day Pain Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363036862</ndc>
    <ndc_label_name>All Day Pain Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363036871</ndc>
    <ndc_label_name>All Day Pain Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363036878</ndc>
    <ndc_label_name>All Day Pain Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363036879</ndc>
    <ndc_label_name>All Day Pain Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363036882</ndc>
    <ndc_label_name>Wal-Proxen 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363036964</ndc>
    <ndc_label_name>HYDROCORTISONE 1% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363037312</ndc>
    <ndc_label_name>Headache Relief PM 38 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363037478</ndc>
    <ndc_label_name>Migraine Relief 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363037502</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363037506</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363037507</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363037508</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363037522</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363037545</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363037546</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363037606</ndc>
    <ndc_label_name>Oral Relief Sore Throat Spray 1.4 % aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363037926</ndc>
    <ndc_label_name>Children's Wal-Dryl Allergy 12.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363037934</ndc>
    <ndc_label_name>Wal-Dryl Allergy 12.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363038016</ndc>
    <ndc_label_name>ISOPROPYL ALCOHOL 70%</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363038030</ndc>
    <ndc_label_name>MINOXIDIL 5% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363038222</ndc>
    <ndc_label_name>Wal-Finate-D 4 mg-60 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363038421</ndc>
    <ndc_label_name>Cough DM ER 30 mg/5 mL oral suspension,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363038428</ndc>
    <ndc_label_name>Cough DM ER 30 mg/5 mL oral suspension,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363039010</ndc>
    <ndc_label_name>Ephrine 1 % nasal drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363039208</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363039212</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363039214</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363039215</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363039216</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363039237</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363039308</ndc>
    <ndc_label_name>IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363039312</ndc>
    <ndc_label_name>IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363039314</ndc>
    <ndc_label_name>IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363039315</ndc>
    <ndc_label_name>IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363039337</ndc>
    <ndc_label_name>IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363039504</ndc>
    <ndc_label_name>Epsom Salt 100 % crystals</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363039707</ndc>
    <ndc_label_name>ASPIRIN 81 MG CHEWABLE TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363039733</ndc>
    <ndc_label_name>OMEPRAZOLE MAG DR 20.6 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363039752</ndc>
    <ndc_label_name>OMEPRAZOLE MAG DR 20.6 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363040321</ndc>
    <ndc_label_name>Wal-Dram 2 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363040421</ndc>
    <ndc_label_name>Motion Sickness Relief (meclizine) 25 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363040702</ndc>
    <ndc_label_name>Cold Sore Treatment (benzalkonium-camphor) 0.13 %-3 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363041006</ndc>
    <ndc_label_name>Mucus Relief Severe Cold 10 mg-20 mg-650 mg/20 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363041105</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363041106</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363041110</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363041112</ndc>
    <ndc_label_name>Diarrhea Relief (bismuth subsalicylate) 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363041208</ndc>
    <ndc_label_name>Wal-Phed PE Triple Relief 5 mg-325 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363041315</ndc>
    <ndc_label_name>Back and Body Pain Reliever 500 mg-32.5 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363041327</ndc>
    <ndc_label_name>Ibuprofen PM 200 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363041407</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363041412</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363041414</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363041460</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363041474</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363041701</ndc>
    <ndc_label_name>All Day Pain Relief Sinus and Cold 220 mg-120 mg tablet,extend release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363041706</ndc>
    <ndc_label_name>Cough-Chest Congestion DM 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363041804</ndc>
    <ndc_label_name>Wal-Dryl Allergy 12.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363041926</ndc>
    <ndc_label_name>Children's Cough 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042013</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042020</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042062</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042098</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042113</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042162</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042198</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363042208</ndc>
    <ndc_label_name>Child Cold-Cough Day-Night 6.25 mg-2.5 mg-5 mg/5 mL oral solutions</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363042321</ndc>
    <ndc_label_name>Wal-Profen D Cold and Sinus 30 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363042341</ndc>
    <ndc_label_name>Wal-Profen Cold-Sinus 30 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042405</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042476</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363042553</ndc>
    <ndc_label_name>Wal-Fex Allergy 60 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042654</ndc>
    <ndc_label_name>TIOCONAZOLE-1 6.5% OINTMENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042816</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042844</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042849</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042944</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363042949</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363043212</ndc>
    <ndc_label_name>Antacid-Antigas 200 mg-200 mg-20 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363043226</ndc>
    <ndc_label_name>Antacid-Antigas 200 mg-200 mg-20 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363043812</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363043815</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363043837</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363043925</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363043929</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363043982</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363044101</ndc>
    <ndc_label_name>Wal-Som (doxylamine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363044167</ndc>
    <ndc_label_name>Wal-Som (doxylamine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363044209</ndc>
    <ndc_label_name>Wal-Tussin Cough 15 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363044308</ndc>
    <ndc_label_name>Headache Relief (ASA-acetaminophn-caffeine) 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363044602</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363044603</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363044701</ndc>
    <ndc_label_name>ACETAMINOPHEN 80 MG RAPID TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363044814</ndc>
    <ndc_label_name>Wal-Fex D 12 Hour 60 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363044908</ndc>
    <ndc_label_name>Jr. Strength Pain Reliever 160 mg disintegrating tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045008</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg disintegrating tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045201</ndc>
    <ndc_label_name>ACETAMINOPHEN 80 MG RAPID TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045307</ndc>
    <ndc_label_name>Wal-phed PE 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045312</ndc>
    <ndc_label_name>Wal-phed PE 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045344</ndc>
    <ndc_label_name>Wal-phed PE 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363045658</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363045660</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363045678</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363045774</ndc>
    <ndc_label_name>NICOTINE 14 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045802</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045813</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045839</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045847</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045865</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045866</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045872</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045875</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045887</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045895</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045934</ndc>
    <ndc_label_name>Nighttime Cold-Flu Relief 6.25 mg-15 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045940</ndc>
    <ndc_label_name>Nighttime Cold-Flu Relief 6.25 mg-15 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045943</ndc>
    <ndc_label_name>Nighttime Cold-Flu Relief 6.25 mg-15 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363045950</ndc>
    <ndc_label_name>Nighttime Cold-Flu Relief 6.25 mg-15 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363046109</ndc>
    <ndc_label_name>Flu HBP 2 mg-15 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363046207</ndc>
    <ndc_label_name>Wal-Phed PE Sinus and Allergy 4 mg-10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363046208</ndc>
    <ndc_label_name>Wal-Phed PE Sinus and Allergy 4 mg-10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363046510</ndc>
    <ndc_label_name>SmoothLax 17 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363047008</ndc>
    <ndc_label_name>Cold Multi-Symptom 5 mg-10 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363047340</ndc>
    <ndc_label_name>Day-Time Cough 5 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363047526</ndc>
    <ndc_label_name>Children's Wal-Zyr 1 mg/mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363048044</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363048144</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363048316</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363048344</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363048349</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363048452</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363048508</ndc>
    <ndc_label_name>Wal-Dryl-D Allergy and Sinus 25 mg-10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363048630</ndc>
    <ndc_label_name>senna 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363049062</ndc>
    <ndc_label_name>Wal-Proxen 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363049071</ndc>
    <ndc_label_name>All Day Pain Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363049078</ndc>
    <ndc_label_name>All Day Pain Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363049082</ndc>
    <ndc_label_name>All Day Pain Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363049115</ndc>
    <ndc_label_name>Wal-Finate 4 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363049421</ndc>
    <ndc_label_name>Cough DM ER 30 mg/5 mL oral suspension,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363049539</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363049547</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363049575</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363049587</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363049595</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363049860</ndc>
    <ndc_label_name>Mucus Relief ER 600 mg tablet, extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363049878</ndc>
    <ndc_label_name>Mucus Relief ER 600 mg tablet, extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363050208</ndc>
    <ndc_label_name>Wal-Phed PE Sinus Headache 5 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363050304</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363050307</ndc>
    <ndc_label_name>Severe Cold Multi-Symptom 5 mg-10 mg-325 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363050308</ndc>
    <ndc_label_name>Severe Cold Multi-Symptom 5 mg-10 mg-325 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363050322</ndc>
    <ndc_label_name>Severe Cold Multi-Symptom 5 mg-10 mg-325 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363051111</ndc>
    <ndc_label_name>Wal-Mucil Fiber (sugar) 3.4 gram/7 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363051311</ndc>
    <ndc_label_name>Wal-Mucil Natural Fiber Laxative 3.4 gram/12 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363051511</ndc>
    <ndc_label_name>Wal-Mucil Fiber (aspartame) 3.4 gram/5.8 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363051518</ndc>
    <ndc_label_name>Wal-Mucil Fiber (aspartame) 3.4 gram/5.8 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363051626</ndc>
    <ndc_label_name>Wal-Tussin Cough and Cold CF 5 mg-10 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363051634</ndc>
    <ndc_label_name>Wal-Tussin Cough and Cold CF 5 mg-10 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363051808</ndc>
    <ndc_label_name>Severe Allergy 12.5 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363051908</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363051912</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363051915</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363051919</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363051920</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363051929</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363051937</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363051954</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363052024</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363052048</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052162</ndc>
    <ndc_label_name>Ibuprofen Jr Strength 100 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052243</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052278</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363052556</ndc>
    <ndc_label_name>Wal-Dryl (diphenhydramine-Zn acetate) 2 %-0.1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052608</ndc>
    <ndc_label_name>Wal-phed PE Severe Cold 12.5 mg-5 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052611</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052613</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052621</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052631</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052660</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052690</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052708</ndc>
    <ndc_label_name>Sinus Congestion and Pain (guaifenesin) 5 mg-325 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052808</ndc>
    <ndc_label_name>Head Congestion Day-Night 2 mg-5 mg-10 mg-325 mg tablets</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363052812</ndc>
    <ndc_label_name>Antacid Plus Anti-Gas 400 mg-400 mg-40 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052907</ndc>
    <ndc_label_name>Cold Multi-Symptom Day/Night 2 mg-5 mg-10 mg-325 mg tablets</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363052908</ndc>
    <ndc_label_name>Cold Multi-Symptom Day/Night 2 mg-5 mg-10 mg-325 mg tablets</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363053060</ndc>
    <ndc_label_name>Gas Relief (simethicone) 180 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363053112</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363053115</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363053129</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363053137</ndc>
    <ndc_label_name>Pain Reliever Extra Strength (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363053201</ndc>
    <ndc_label_name>Mucus Relief 400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363053211</ndc>
    <ndc_label_name>Mucus Relief 400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363053225</ndc>
    <ndc_label_name>Mucus Relief 400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363053232</ndc>
    <ndc_label_name>Mucus Relief 400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363053260</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363053278</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363053301</ndc>
    <ndc_label_name>Mucus Relief DM 20 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363053311</ndc>
    <ndc_label_name>Mucus Relief DM 20 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363053325</ndc>
    <ndc_label_name>Mucus Relief DM 20 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363053332</ndc>
    <ndc_label_name>Mucus Relief DM 20 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363054201</ndc>
    <ndc_label_name>Mucus Relief PE 10 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363054211</ndc>
    <ndc_label_name>Mucus Relief PE 10 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363054225</ndc>
    <ndc_label_name>Mucus Relief PE 10 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363054309</ndc>
    <ndc_label_name>Wal-Dryl Severe Allergy-Sinus 25 mg-5 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363054409</ndc>
    <ndc_label_name>Wal-Phed PE Nighttime Cold 25 mg-5 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363054447</ndc>
    <ndc_label_name>Arthritis Pain Reliever 650 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363054462</ndc>
    <ndc_label_name>Arthritis Pain Relief (acetaminophen) ER 650 mg tablet,extend release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363054471</ndc>
    <ndc_label_name>Arthritis Pain Reliever 650 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363054478</ndc>
    <ndc_label_name>Arthritis Pain Relief (acetaminophen) ER 650 mg tablet,extend release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363054485</ndc>
    <ndc_label_name>Arthritis Pain Reliever 650 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363054609</ndc>
    <ndc_label_name>Wal-Phed PE Cold-Cough 5 mg-10 mg-325 mg-100 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363054663</ndc>
    <ndc_label_name>Acid Controller Complete 10 mg-800 mg-165 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363054671</ndc>
    <ndc_label_name>Acid Controller Complete 10 mg-800 mg-165 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363054772</ndc>
    <ndc_label_name>Mucus Relief D (pseudoephed) 40 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363055020</ndc>
    <ndc_label_name>Gas Relief Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363055050</ndc>
    <ndc_label_name>Gas Relief Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363055072</ndc>
    <ndc_label_name>Gas Relief Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363055522</ndc>
    <ndc_label_name>Sinus Daytime-Nightime 5-325 mg(dy)/6.25-5-325mg(nt) capsules</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363055601</ndc>
    <ndc_label_name>Pain Reliever PM Ex-Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363055609</ndc>
    <ndc_label_name>Pain Reliever PM Ex-Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363055654</ndc>
    <ndc_label_name>Pain Reliever PM Ex-Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363055657</ndc>
    <ndc_label_name>Pain Reliever PM Ex-Strength 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363055707</ndc>
    <ndc_label_name>Wal-Fex D 24 Hour 180 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363055729</ndc>
    <ndc_label_name>Wal-Fex D 24 Hour 180 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363055735</ndc>
    <ndc_label_name>Wal-Fex D 24 Hour 180 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363055807</ndc>
    <ndc_label_name>Sinus Congestion and Pain 5 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363055808</ndc>
    <ndc_label_name>Sinus Congestion and Pain 5 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363056007</ndc>
    <ndc_label_name>Cold Multi-Symptom 5 mg-10 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363056314</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363056317</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363056322</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363056329</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363056332</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363056450</ndc>
    <ndc_label_name>Vapor Inhaler 50 mg nasal</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363056702</ndc>
    <ndc_label_name>Daytime-Nighttime Cold-Flu 6.25-5-10-325 mg/15 mL oral liquids</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363057113</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363057122</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363057133</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363057139</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363057175</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363057195</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363057501</ndc>
    <ndc_label_name>senna 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363057708</ndc>
    <ndc_label_name>Wal-Zyr D 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363057826</ndc>
    <ndc_label_name>Wal-Tussin DM 10 mg-100 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363057834</ndc>
    <ndc_label_name>Wal-Tussin DM 10 mg-100 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363057953</ndc>
    <ndc_label_name>Children's Pain Reliever and Fever Reducer 120 mg rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363058572</ndc>
    <ndc_label_name>Children's Wal-Dryl Allergy 12.5 mg disintegrating tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363058714</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363058732</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363059016</ndc>
    <ndc_label_name>Infants' Pain and Fever 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363059108</ndc>
    <ndc_label_name>Cold Multi-Symptom (chlorpheniramine) 2 mg-5 mg-10 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363059608</ndc>
    <ndc_label_name>Children's Soothe 160 mg (as calcium carbonate 400 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363059944</ndc>
    <ndc_label_name>Children's Wal-Dryl Allergy 12.5 mg disintegrating tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363059972</ndc>
    <ndc_label_name>Children's Wal-Dryl Allergy 12.5 mg disintegrating tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363060022</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363060075</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363060099</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363060106</ndc>
    <ndc_label_name>Wal-Flu Cold and Sore Throat 20 mg-10 mg-325 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363060206</ndc>
    <ndc_label_name>Wal-Flu Severe Cold and Cough 25 mg-10 mg-650 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363060340</ndc>
    <ndc_label_name>Severe Cold-Flu (phenylephrine) 5 mg-10 mg-325 mg-200 mg/15 mL liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363060452</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363060822</ndc>
    <ndc_label_name>Gas Relief Extra Strength 125 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363060839</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363060862</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363060962</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363060998</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061121</ndc>
    <ndc_label_name>Ibuprofen PM 200 mg-25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363061212</ndc>
    <ndc_label_name>Comfort Gel Extra Strength 400 mg-400 mg-40 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061239</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061246</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061247</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061260</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061265</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061272</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061275</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061287</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061501</ndc>
    <ndc_label_name>Wal-Zyr (ketotifen) 0.025 % (0.035 %) eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061739</ndc>
    <ndc_label_name>Wal-Itin D 12 Hour 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061752</ndc>
    <ndc_label_name>Wal-Itin D 12 Hour 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363061760</ndc>
    <ndc_label_name>Wal-Itin D 12 Hour 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363061801</ndc>
    <ndc_label_name>Pinworm Treatment 50 mg/mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363062712</ndc>
    <ndc_label_name>Sleep Aid (diphenhydramine) 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363062809</ndc>
    <ndc_label_name>Mucus Relief Sinus Pressure and Pain 5 mg-325 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363064008</ndc>
    <ndc_label_name>Cold and Flu Severe 5 mg-10 mg-325 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363064526</ndc>
    <ndc_label_name>LOPERAMIDE 1 MG/7.5 ML SUSP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363064534</ndc>
    <ndc_label_name>LOPERAMIDE 1 MG/7.5 ML SOLN</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363064810</ndc>
    <ndc_label_name>Wal-Four 1 % nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363065301</ndc>
    <ndc_label_name>AZELASTINE 0.15% NASAL SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363065302</ndc>
    <ndc_label_name>AZELASTINE 0.15% NASAL SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363065303</ndc>
    <ndc_label_name>AZELASTINE 0.15% NASAL SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363065304</ndc>
    <ndc_label_name>AZELASTINE 0.15% NASAL SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363065634</ndc>
    <ndc_label_name>Daytime Cold-Flu 5 mg-10 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363065638</ndc>
    <ndc_label_name>Daytime Cold and Flu Relief (PE) 5 mg-10 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363065640</ndc>
    <ndc_label_name>Daytime Cold-Flu 5 mg-10 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363065772</ndc>
    <ndc_label_name>Gas Relief (simethicone) 180 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363066026</ndc>
    <ndc_label_name>IBUPROFEN 100 MG/5 ML SUSP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363066703</ndc>
    <ndc_label_name>Chest Rub 4.8 %-1.2 %-2.6 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363066738</ndc>
    <ndc_label_name>MAGNESIUM CITRATE SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363066834</ndc>
    <ndc_label_name>NightTime Cough 6.25 mg-15 mg/15 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363066838</ndc>
    <ndc_label_name>NightTime Cough 6.25 mg-15 mg/15 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363066840</ndc>
    <ndc_label_name>NightTime Cough 6.25 mg-15 mg/15 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363067364</ndc>
    <ndc_label_name>Anti-Itch Vaginal (benzocaine-resorcinol) 5 %-2 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363067560</ndc>
    <ndc_label_name>Lactase Fast Acting 9,000 unit tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363067660</ndc>
    <ndc_label_name>Lactase Fast Acting 9,000 unit chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363068526</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363069031</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363069112</ndc>
    <ndc_label_name>ASPIRIN EC 325 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363069338</ndc>
    <ndc_label_name>MAGNESIUM CITRATE SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363069590</ndc>
    <ndc_label_name>Jock Itch 1 % topical spray powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363069834</ndc>
    <ndc_label_name>Daytime Cold and Cough 1,000 mg-30 mg/30 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363069904</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363069960</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363069965</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363069987</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363069995</ndc>
    <ndc_label_name>Wal-itin 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363070008</ndc>
    <ndc_label_name>Sore Throat (benzocaine with menthol) 6 mg-10 mg lozenges</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363070102</ndc>
    <ndc_label_name>Acid Controller 20 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363070530</ndc>
    <ndc_label_name>Children's Saline Nasal Spray 0.65 % aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363070578</ndc>
    <ndc_label_name>IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363070653</ndc>
    <ndc_label_name>Children's Pain Reliever and Fever Reducer 120 mg rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363070804</ndc>
    <ndc_label_name>Nausea Control oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363070906</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363071008</ndc>
    <ndc_label_name>Children's Wal-Dryl Allergy 12.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363071010</ndc>
    <ndc_label_name>Children's Wal-Dryl Allergy 12.5 mg/5 mL prefilled spoon</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363071312</ndc>
    <ndc_label_name>Diarrhea Relief (bismuth subsalicylate) 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363072415</ndc>
    <ndc_label_name>Wal-itin D 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363072456</ndc>
    <ndc_label_name>Wal-itin D 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363072469</ndc>
    <ndc_label_name>Wal-itin D 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363072515</ndc>
    <ndc_label_name>Wal-itin D 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363072556</ndc>
    <ndc_label_name>Wal-itin D 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363072569</ndc>
    <ndc_label_name>Wal-itin D 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363073203</ndc>
    <ndc_label_name>OMEPRAZOLE-BICARB 20-1,100 CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363073306</ndc>
    <ndc_label_name>Cold and Flu Relief (diphen-pe) 12.5 mg-5 mg-325 mg/10 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363073402</ndc>
    <ndc_label_name>NICOTINE 2 MG MINI LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363073530</ndc>
    <ndc_label_name>Mucus DM Max ER 60 mg-1,200 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363073745</ndc>
    <ndc_label_name>MICONAZOLE 1 COMBINATION PACK</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363073927</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363073933</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363074227</ndc>
    <ndc_label_name>NAPROXEN SODIUM 220 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363074258</ndc>
    <ndc_label_name>NAPROXEN SODIUM 220 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363074260</ndc>
    <ndc_label_name>NAPROXEN SODIUM 220 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363075208</ndc>
    <ndc_label_name>Children's Cough and Cold Relief 2 mg-15 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363075312</ndc>
    <ndc_label_name>Wal-Sleep Z 50 mg/30 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363075926</ndc>
    <ndc_label_name>Children's Pain Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363075934</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363076340</ndc>
    <ndc_label_name>Severe Cold-Flu Nighttime 6.25 mg-5 mg-10 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363076616</ndc>
    <ndc_label_name>Infants' Pain and Fever 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363077332</ndc>
    <ndc_label_name>Urinary Pain Relief 95 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363078407</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363078415</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363078429</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363078430</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363078443</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363078445</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363078475</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363078490</ndc>
    <ndc_label_name>Wal-Fex Allergy 180 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363079926</ndc>
    <ndc_label_name>Adult Wal-Tussin DM Max 10 mg-200 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363079934</ndc>
    <ndc_label_name>Adult Wal-Tussin DM Max 10 mg-200 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363080026</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363080443</ndc>
    <ndc_label_name>ISOPROPYL ALCOHOL 91%</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363080626</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363080930</ndc>
    <ndc_label_name>ALCOHOL 70% SWABS</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363081043</ndc>
    <ndc_label_name>ISOPROPYL ALCOHOL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363081045</ndc>
    <ndc_label_name>ISOPROPYL ALCOHOL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363081101</ndc>
    <ndc_label_name>24 Hour Nasal Allergy 55 mcg spray aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363081930</ndc>
    <ndc_label_name>MINOXIDIL 2% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363083143</ndc>
    <ndc_label_name>MINERAL OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363083962</ndc>
    <ndc_label_name>Severe Cold and Flu (phenylephrine) 5 mg-10 mg-325 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363084301</ndc>
    <ndc_label_name>Hemorrhoidal Cooling 0.25 %-50 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363085140</ndc>
    <ndc_label_name>Antacid Regular Strength 200 mg-200 mg-20 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363085406</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363085460</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363086626</ndc>
    <ndc_label_name>Lice Killing 0.33 %-4 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363086634</ndc>
    <ndc_label_name>Lice Killing 0.33 %-4 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363087143</ndc>
    <ndc_label_name>HYDROGEN PEROXIDE 3% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363087145</ndc>
    <ndc_label_name>HYDROGEN PEROXIDE 3% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363087240</ndc>
    <ndc_label_name>Nighttime Cold-Flu Relief 6.25 mg-15 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363087250</ndc>
    <ndc_label_name>Nighttime Cold-Flu Relief 6.25 mg-15 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363087305</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363087306</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363087308</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363087310</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363087323</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363087520</ndc>
    <ndc_label_name>Cold Relief Plus 2 mg-7.8 mg-325 mg effervescent tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363087643</ndc>
    <ndc_label_name>ETHYL RUBBING ALCOHOL 70% LIQ</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363087825</ndc>
    <ndc_label_name>Anti-Itch (hydrocortisone) 1 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363088078</ndc>
    <ndc_label_name>Heartburn Antacid 160 mg-105 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363088210</ndc>
    <ndc_label_name>Infants Gas Relief 40 mg/0.6 mL oral drops,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363088426</ndc>
    <ndc_label_name>Children's Wal-Zyr 1 mg/mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363089488</ndc>
    <ndc_label_name>NICOTINE 7 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363089588</ndc>
    <ndc_label_name>NICOTINE 14 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363089653</ndc>
    <ndc_label_name>NICOTINE 21 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363089688</ndc>
    <ndc_label_name>NICOTINE 21 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363089726</ndc>
    <ndc_label_name>IBUPROFEN 100 MG/5 ML SUSP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363089921</ndc>
    <ndc_label_name>Cough DM ER 30 mg/5 mL oral suspension,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363090362</ndc>
    <ndc_label_name>Wal-Fex Allergy 60 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363090626</ndc>
    <ndc_label_name>Children's Wal-Tap Cold-Allergy 1 mg-2.5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363090838</ndc>
    <ndc_label_name>Cold-Flu Relief 12.5 mg-30 mg-1,000 mg/30 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363091208</ndc>
    <ndc_label_name>Wal-Phed PE Day-Night 5 mg-10 mg-325 mg tablets</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363091209</ndc>
    <ndc_label_name>Wal-Phed PE Day-Night 5 mg-10 mg-325 mg tablets</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363091501</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363091503</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363091530</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363091555</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363091574</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363091600</ndc>
    <ndc_label_name>MICONAZOLE 1 COMBINATION PACK</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363091906</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363092301</ndc>
    <ndc_label_name>Eye Itch Relief 0.025 % (0.035 %) drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363092311</ndc>
    <ndc_label_name>Eye Itch Relief 0.025 % (0.035 %) drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363092962</ndc>
    <ndc_label_name>Wal-Zyr D 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363093426</ndc>
    <ndc_label_name>Adult Wal-Tussin DM Max 10 mg-200 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363093604</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 1 mg/mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363094424</ndc>
    <ndc_label_name>Hemorrhoidal Cream 0.25 %-1 % rectal</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363094610</ndc>
    <ndc_label_name>Infants' Pain and Fever 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363094616</ndc>
    <ndc_label_name>Infants' Pain and Fever 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363094935</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363094940</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363095235</ndc>
    <ndc_label_name>Lubricant Eye 57.3 %-42.5 % ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363095526</ndc>
    <ndc_label_name>Lice Treatment 1 % topical liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363095702</ndc>
    <ndc_label_name>NICOTINE 4 MG MINI LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363095704</ndc>
    <ndc_label_name>NICOTINE 4 MG MINI LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363095828</ndc>
    <ndc_label_name>Cough DM ER 30 mg/5 mL oral suspension,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363095926</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363097426</ndc>
    <ndc_label_name>Wal-Zyr (cetirizine) 1 mg/mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363098200</ndc>
    <ndc_label_name>MICONAZOLE 3 COMBO PACK</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363098726</ndc>
    <ndc_label_name>Wal-tap DM 1 mg-2.5 mg-5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363099526</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363100101</ndc>
    <ndc_label_name>Chest Rub 4.8 %-1.2 %-2.6 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363100504</ndc>
    <ndc_label_name>Nighttime Cold-Flu 6.25 mg-15 mg-325 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363103102</ndc>
    <ndc_label_name>Cold and Flu Relief Plus(Day/Night) 6.25 mg-5 mg-10 mg-325 mg capsules</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363106108</ndc>
    <ndc_label_name>Antiseptic Skin Cleanser (chlorhexidine) 4 % liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363110006</ndc>
    <ndc_label_name>Wal-Flu Severe Cold-Cough 10 mg-20 mg-650 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363110106</ndc>
    <ndc_label_name>Wal-Flu Severe Cold and Cough 25 mg-10 mg-650 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363110212</ndc>
    <ndc_label_name>Wal-Flu Day-Night Sev. Cold-Cough 25 mg-10 mg-20 mg-650mg powder packs</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363110316</ndc>
    <ndc_label_name>Antacid Ultra Strength 400 mg (calcium carb 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363110510</ndc>
    <ndc_label_name>Heartburn Antacid 160 mg-105 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363112112</ndc>
    <ndc_label_name>Antacid Liquid 200 mg-200 mg-20 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363113256</ndc>
    <ndc_label_name>COD LIVER OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363124001</ndc>
    <ndc_label_name>NICOTINE 7 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363124101</ndc>
    <ndc_label_name>NICOTINE 14 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363124201</ndc>
    <ndc_label_name>NICOTINE 21 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363124502</ndc>
    <ndc_label_name>NICOTINE 21 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363125223</ndc>
    <ndc_label_name>Infant's Ibuprofen 50 mg/1.25 mL oral drops,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363125224</ndc>
    <ndc_label_name>Infant's Ibuprofen 50 mg/1.25 mL oral drops,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363125594</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363126294</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363126394</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363135206</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363135260</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363141955</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG ODT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363159702</ndc>
    <ndc_label_name>Severe Cold and Flu (Day/Night) 6.25 mg-5 mg-325 mg/15 mL oral liquids</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363165006</ndc>
    <ndc_label_name>Oral Relief Sore Throat Spray 1.4 % aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363173012</ndc>
    <ndc_label_name>Wal-Sleep Z 50 mg/30 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363189802</ndc>
    <ndc_label_name>ESOMEPRAZOLE MAG DR 20 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363192112</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363193112</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363201022</ndc>
    <ndc_label_name>Allergy Relief D-24hr 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363206002</ndc>
    <ndc_label_name>Allergy Nasal (mometasone) 50 mcg/actuation spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363206302</ndc>
    <ndc_label_name>Hydrocortisone Plus 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363208001</ndc>
    <ndc_label_name>Athlete's Foot (terbinafine) 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363208002</ndc>
    <ndc_label_name>Athlete's Foot (terbinafine) 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363209208</ndc>
    <ndc_label_name>Wal-itin 5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363210017</ndc>
    <ndc_label_name>SmoothLax 17 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363210204</ndc>
    <ndc_label_name>Children's Wal-Zyr 1 mg/mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363210316</ndc>
    <ndc_label_name>Antacid Ultra Strength 400 mg (calcium carb 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363210372</ndc>
    <ndc_label_name>Antacid Ultra Strength 400 mg (calcium carb 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363210808</ndc>
    <ndc_label_name>Children's Allergy Relief (loratadine) 5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363214002</ndc>
    <ndc_label_name>NALOXONE HCL 4 MG NASAL SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363217107</ndc>
    <ndc_label_name>Cool and Heat 5 % topical patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363217108</ndc>
    <ndc_label_name>Cool and Heat 5 % topical patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363217109</ndc>
    <ndc_label_name>Cool and Heat 5 % topical patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363217207</ndc>
    <ndc_label_name>Pain Relieving (menthol) 5 % topical patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363224220</ndc>
    <ndc_label_name>Gas Relief Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363224272</ndc>
    <ndc_label_name>Gas Relief Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363233630</ndc>
    <ndc_label_name>LANCING DEVICE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363237001</ndc>
    <ndc_label_name>Ultra Thin Lancets 30 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363237102</ndc>
    <ndc_label_name>Micro Thin Lancets 33 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363237203</ndc>
    <ndc_label_name>Super Thin Lancets 28 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363239012</ndc>
    <ndc_label_name>Wal-itin D 10 mg-240 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363307312</ndc>
    <ndc_label_name>Antacid M 200 mg-200 mg-20 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363326702</ndc>
    <ndc_label_name>Chest Rub 4.8 %-1.2 %-2.6 % topical stick</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363335006</ndc>
    <ndc_label_name>Mucus Relief Cold and Sinus 10 mg-650 mg-400 mg/20 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363336006</ndc>
    <ndc_label_name>Mucus Relief Cold-Flu-Sore Throat 10 mg-20 mg-650 mg/20 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363338006</ndc>
    <ndc_label_name>Mucus Relief DM Max 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363345056</ndc>
    <ndc_label_name>HYDROCORTISONE 1% OINTMENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363368004</ndc>
    <ndc_label_name>Moisture Barrier Ointment 0.44 %-20.6 %</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363402576</ndc>
    <ndc_label_name>Children's Wal-Zyr 10 mg disintegrating tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363405004</ndc>
    <ndc_label_name>Children's Cold-Cough-Sore Throat 5 mg-10 mg-325 mg/10 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363410040</ndc>
    <ndc_label_name>Stool Softener 100 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363412213</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363412262</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363412298</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363414913</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363414962</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363414998</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363419005</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363419010</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363419340</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363420008</ndc>
    <ndc_label_name>Children Mult-Sympt Cold Day-Nite 325 mg-12.5 mg-5 mg/10 mL(nt) liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363436010</ndc>
    <ndc_label_name>CALAMINE LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363450108</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363492353</ndc>
    <ndc_label_name>Allergy Relief-D (cetirizine) 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363500024</ndc>
    <ndc_label_name>Chocolate Laxative 15 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363510118</ndc>
    <ndc_label_name>Children's Pain and Fever Relief 160 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363527007</ndc>
    <ndc_label_name>Severe Sinus 5 mg-325 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363546001</ndc>
    <ndc_label_name>Wal-Phed PE Cold-Cough 5 mg-10 mg-325 mg-100 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363546008</ndc>
    <ndc_label_name>Wal-Phed PE Pressure+Pain+Cold 5 mg-10 mg-325 mg-100 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363552980</ndc>
    <ndc_label_name>LEVOCETIRIZINE 5 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363578022</ndc>
    <ndc_label_name>Children's Wal-Zyr 10 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363645007</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363645012</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363645014</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363645060</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363668008</ndc>
    <ndc_label_name>Nighttime Allergy Relief 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363677157</ndc>
    <ndc_label_name>ZINC OXIDE 40% OINTMENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363689825</ndc>
    <ndc_label_name>Pain Reliever (acetaminophen) 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363702056</ndc>
    <ndc_label_name>Alcohol, Rubbing 70 % solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363710004</ndc>
    <ndc_label_name>Allergy Relief (diphenhydramine) 12.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363713005</ndc>
    <ndc_label_name>Eye Allergy Itch-Redness Relief 0.1 % drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363713125</ndc>
    <ndc_label_name>Eye Allergy Itch Relief 0.2 % drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363714201</ndc>
    <ndc_label_name>ZINC OXIDE 40% OINTMENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363721601</ndc>
    <ndc_label_name>Chest Rub 4.8 %-1.2 %-2.6 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363722025</ndc>
    <ndc_label_name>Lubricant Eye (PG-PEG 400) (PF) 0.4 %-0.3 % drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363726978</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363727412</ndc>
    <ndc_label_name>Lubricant Eye 57.3 %-42.5 % ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363816638</ndc>
    <ndc_label_name>MAGNESIUM CITRATE SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363822034</ndc>
    <ndc_label_name>Double Antibiotic-Pain Relief 3.5 mg-10,000 unit-10 mg/gram top cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363848001</ndc>
    <ndc_label_name>Chest Rub 4.8 %-1.2 %-2.6 % topical stick</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363853020</ndc>
    <ndc_label_name>Stool Softener 100 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363876020</ndc>
    <ndc_label_name>Senna-S 8.6 mg-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363899310</ndc>
    <ndc_label_name>Pain Reliever (acetaminophen) 325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363904000</ndc>
    <ndc_label_name>SODIUM CHLORIDE 5% EYE DROP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363905000</ndc>
    <ndc_label_name>SODIUM CHLORIDE 5% EYE OINT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363906000</ndc>
    <ndc_label_name>Eye Itch Relief 0.025 % (0.035 %) drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363911005</ndc>
    <ndc_label_name>LIDOCAINE PAIN RELIEF 4% PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363917002</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363917102</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363918001</ndc>
    <ndc_label_name>NICOTINE 21 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363918002</ndc>
    <ndc_label_name>NICOTINE 21 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363920003</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363933010</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363951161</ndc>
    <ndc_label_name>TOLNAFTATE 1% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363965002</ndc>
    <ndc_label_name>Allergy Eye (naphazoline-pheniramine) 0.025 %-0.3 % drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00363965101</ndc>
    <ndc_label_name>Moisturizing Lubricant 0.25 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00363983926</ndc>
    <ndc_label_name>Children's Multi-Symptom Cold 2.5 mg-5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00372000604</ndc>
    <ndc_label_name>Scot-Tussin Expectorant 100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00372003604</ndc>
    <ndc_label_name>Scot-Tussin DM 2 mg-15 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00372004304</ndc>
    <ndc_label_name>Scot-Tussin Diabetes CF 10 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00372004416</ndc>
    <ndc_label_name>Scot-Tussin DM Cough Chasers 2.5 mg lozenges</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00372005004</ndc>
    <ndc_label_name>Scot-Tussin Senior 15 mg-200 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00374508001</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12%  15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378000532</ndc>
    <ndc_label_name>EVEROLIMUS 2 MG TAB FOR SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378000585</ndc>
    <ndc_label_name>EVEROLIMUS 2 MG TAB FOR SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378000632</ndc>
    <ndc_label_name>EVEROLIMUS 3 MG TAB FOR SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378000685</ndc>
    <ndc_label_name>EVEROLIMUS 3 MG TAB FOR SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378000732</ndc>
    <ndc_label_name>EVEROLIMUS 5 MG TAB FOR SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378000785</ndc>
    <ndc_label_name>EVEROLIMUS 5 MG TAB FOR SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378001401</ndc>
    <ndc_label_name>METHOTREXATE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378001801</ndc>
    <ndc_label_name>METOPROLOL TARTRATE 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378001805</ndc>
    <ndc_label_name>METOPROLOL TARTRATE 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378002801</ndc>
    <ndc_label_name>NADOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378003201</ndc>
    <ndc_label_name>METOPROLOL TARTRATE 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378003210</ndc>
    <ndc_label_name>METOPROLOL TARTRATE 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378004201</ndc>
    <ndc_label_name>PERPHEN-AMITRIP 4 MG-10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378004701</ndc>
    <ndc_label_name>METOPROLOL TARTRATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378004710</ndc>
    <ndc_label_name>METOPROLOL TARTRATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378005201</ndc>
    <ndc_label_name>PINDOLOL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378005301</ndc>
    <ndc_label_name>CIMETIDINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378005501</ndc>
    <ndc_label_name>TIMOLOL MALEATE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378007301</ndc>
    <ndc_label_name>PERPHEN-AMITRIP 4 MG-50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378007801</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 10-100 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378008501</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 25-100 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378008801</ndc>
    <ndc_label_name>CARBIDOPA-LEVO ER 25-100 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378009401</ndc>
    <ndc_label_name>CARBIDOPA-LEVO ER 50-200 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378012701</ndc>
    <ndc_label_name>PINDOLOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378013701</ndc>
    <ndc_label_name>ALLOPURINOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378013710</ndc>
    <ndc_label_name>ALLOPURINOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378014491</ndc>
    <ndc_label_name>TAMOXIFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378016702</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378016713</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378018101</ndc>
    <ndc_label_name>ALLOPURINOL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378018105</ndc>
    <ndc_label_name>ALLOPURINOL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378018201</ndc>
    <ndc_label_name>PROPRANOLOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378018210</ndc>
    <ndc_label_name>PROPRANOLOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378018301</ndc>
    <ndc_label_name>PROPRANOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378018310</ndc>
    <ndc_label_name>PROPRANOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378018401</ndc>
    <ndc_label_name>PROPRANOLOL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378018410</ndc>
    <ndc_label_name>PROPRANOLOL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378018501</ndc>
    <ndc_label_name>PROPRANOLOL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378018505</ndc>
    <ndc_label_name>PROPRANOLOL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378018701</ndc>
    <ndc_label_name>PROPRANOLOL 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378020810</ndc>
    <ndc_label_name>FUROSEMIDE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378021101</ndc>
    <ndc_label_name>CHLORDIAZEPO-AMITRIPTYL 5-12.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378021105</ndc>
    <ndc_label_name>CHLORDIAZEPO-AMITRIPTYL 5-12.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378021301</ndc>
    <ndc_label_name>CHLORTHALIDONE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378021310</ndc>
    <ndc_label_name>CHLORTHALIDONE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378021401</ndc>
    <ndc_label_name>HALOPERIDOL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378021410</ndc>
    <ndc_label_name>HALOPERIDOL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378021610</ndc>
    <ndc_label_name>FUROSEMIDE 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378021801</ndc>
    <ndc_label_name>ATENOLOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378021810</ndc>
    <ndc_label_name>ATENOLOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378022101</ndc>
    <ndc_label_name>TIMOLOL MALEATE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378022201</ndc>
    <ndc_label_name>CHLORTHALIDONE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378022210</ndc>
    <ndc_label_name>CHLORTHALIDONE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378023101</ndc>
    <ndc_label_name>ATENOLOL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378023110</ndc>
    <ndc_label_name>ATENOLOL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378023201</ndc>
    <ndc_label_name>FUROSEMIDE 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378024301</ndc>
    <ndc_label_name>SPIRONOLACTONE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378024305</ndc>
    <ndc_label_name>SPIRONOLACTONE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378025701</ndc>
    <ndc_label_name>HALOPERIDOL 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378025710</ndc>
    <ndc_label_name>HALOPERIDOL 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378026591</ndc>
    <ndc_label_name>DABIGATRAN ETEXILATE 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378026691</ndc>
    <ndc_label_name>DABIGATRAN ETEXILATE 150 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378027101</ndc>
    <ndc_label_name>DIAZEPAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378027105</ndc>
    <ndc_label_name>DIAZEPAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378027493</ndc>
    <ndc_label_name>TAMOXIFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378027701</ndc>
    <ndc_label_name>CHLORDIAZEPOX-AMITRIPTYL 10-25</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378027705</ndc>
    <ndc_label_name>CHLORDIAZEPOX-AMITRIPTYL 10-25</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378031701</ndc>
    <ndc_label_name>CIMETIDINE 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378032701</ndc>
    <ndc_label_name>HALOPERIDOL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378032710</ndc>
    <ndc_label_name>HALOPERIDOL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378033001</ndc>
    <ndc_label_name>PERPHEN-AMITRIP 2 MG-10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378033401</ndc>
    <ndc_label_name>HALOPERIDOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378033501</ndc>
    <ndc_label_name>HALOPERIDOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378034501</ndc>
    <ndc_label_name>DIAZEPAM 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378034505</ndc>
    <ndc_label_name>DIAZEPAM 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378035101</ndc>
    <ndc_label_name>HALOPERIDOL 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378035110</ndc>
    <ndc_label_name>HALOPERIDOL 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378037201</ndc>
    <ndc_label_name>CIMETIDINE 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378039614</ndc>
    <ndc_label_name>DIMETHYL FUMARATE DR 120 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378039991</ndc>
    <ndc_label_name>DIMETHYL FUMARATE DR 240 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378040301</ndc>
    <ndc_label_name>SPIRONOLACTONE-HCTZ 25-25 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378040305</ndc>
    <ndc_label_name>SPIRONOLACTONE-HCTZ 25-25 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378042401</ndc>
    <ndc_label_name>METOPROLOL-HCTZ 50-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378043401</ndc>
    <ndc_label_name>METOPROLOL-HCTZ 100-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378043701</ndc>
    <ndc_label_name>SPIRONOLACTONE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378044201</ndc>
    <ndc_label_name>PERPHEN-AMITRIP 2 MG-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378044501</ndc>
    <ndc_label_name>METOPROLOL-HCTZ 100-50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378047201</ndc>
    <ndc_label_name>DIVALPROEX SOD ER 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378047205</ndc>
    <ndc_label_name>DIVALPROEX SOD ER 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378047301</ndc>
    <ndc_label_name>DIVALPROEX SOD ER 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378047305</ndc>
    <ndc_label_name>DIVALPROEX SOD ER 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378047701</ndc>
    <ndc_label_name>DIAZEPAM 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378047705</ndc>
    <ndc_label_name>DIAZEPAM 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378050101</ndc>
    <ndc_label_name>BISOPROLOL-HCTZ 2.5-6.25 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378050301</ndc>
    <ndc_label_name>BISOPROLOL-HCTZ 5-6.25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378050501</ndc>
    <ndc_label_name>BISOPROLOL-HCTZ 10-6.25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378054101</ndc>
    <ndc_label_name>CIMETIDINE 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378057401</ndc>
    <ndc_label_name>PERPHEN-AMITRIP 4 MG-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378061201</ndc>
    <ndc_label_name>THIORIDAZINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378061401</ndc>
    <ndc_label_name>THIORIDAZINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378061601</ndc>
    <ndc_label_name>THIORIDAZINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378061801</ndc>
    <ndc_label_name>THIORIDAZINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378064001</ndc>
    <ndc_label_name>PREDNISONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378064010</ndc>
    <ndc_label_name>PREDNISONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378064101</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378064110</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378064201</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378064205</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378064210</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378071501</ndc>
    <ndc_label_name>TIMOLOL MALEATE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378075701</ndc>
    <ndc_label_name>ATENOLOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378075710</ndc>
    <ndc_label_name>ATENOLOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378082501</ndc>
    <ndc_label_name>CLOZAPINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378086001</ndc>
    <ndc_label_name>CLOZAPINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378086005</ndc>
    <ndc_label_name>CLOZAPINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378087116</ndc>
    <ndc_label_name>CLONIDINE 0.1 MG/DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378087199</ndc>
    <ndc_label_name>CLONIDINE 0.1 MG/DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378087216</ndc>
    <ndc_label_name>CLONIDINE 0.2 MG/DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378087299</ndc>
    <ndc_label_name>CLONIDINE 0.2 MG/DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378087316</ndc>
    <ndc_label_name>CLONIDINE 0.3 MG/DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378087399</ndc>
    <ndc_label_name>CLONIDINE 0.3 MG/DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378089655</ndc>
    <ndc_label_name>PENCICLOVIR 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378097201</ndc>
    <ndc_label_name>CLOZAPINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378097301</ndc>
    <ndc_label_name>CLOZAPINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378104901</ndc>
    <ndc_label_name>DOXEPIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378104910</ndc>
    <ndc_label_name>DOXEPIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378107593</ndc>
    <ndc_label_name>TELMISARTAN-AMLODIPINE 40-5 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378107693</ndc>
    <ndc_label_name>TELMISARTAN-AMLODIPINE 40-10</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378107793</ndc>
    <ndc_label_name>TELMISARTAN-AMLODIPINE 80-5 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378107893</ndc>
    <ndc_label_name>TELMISARTAN-AMLODIPINE 80-10</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378108601</ndc>
    <ndc_label_name>COLCHICINE 0.6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378110101</ndc>
    <ndc_label_name>PRAZOSIN 1 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378110110</ndc>
    <ndc_label_name>PRAZOSIN 1 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378111001</ndc>
    <ndc_label_name>GLIPIZIDE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378111005</ndc>
    <ndc_label_name>GLIPIZIDE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378113201</ndc>
    <ndc_label_name>NADOLOL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378113210</ndc>
    <ndc_label_name>NADOLOL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378113301</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 25-250 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378113401</ndc>
    <ndc_label_name>KETOROLAC 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378114001</ndc>
    <ndc_label_name>BUSPIRONE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378114005</ndc>
    <ndc_label_name>BUSPIRONE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378114501</ndc>
    <ndc_label_name>BUSPIRONE HCL 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378115001</ndc>
    <ndc_label_name>BUSPIRONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378115005</ndc>
    <ndc_label_name>BUSPIRONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378116505</ndc>
    <ndc_label_name>BUSPIRONE HCL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378116580</ndc>
    <ndc_label_name>BUSPIRONE HCL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378116591</ndc>
    <ndc_label_name>BUSPIRONE HCL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378117101</ndc>
    <ndc_label_name>NADOLOL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378117110</ndc>
    <ndc_label_name>NADOLOL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378117591</ndc>
    <ndc_label_name>BUSPIRONE HCL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378120178</ndc>
    <ndc_label_name>SORAFENIB 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378127193</ndc>
    <ndc_label_name>RASAGILINE MESYLATE 1 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378130001</ndc>
    <ndc_label_name>LITHIUM CARBONATE ER 300 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378130005</ndc>
    <ndc_label_name>LITHIUM CARBONATE ER 300 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378135201</ndc>
    <ndc_label_name>TRIAMTERENE-HCTZ 37.5-25 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378137578</ndc>
    <ndc_label_name>MESALAMINE ER 0.375 GRAM CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378140396</ndc>
    <ndc_label_name>RIZATRIPTAN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378140496</ndc>
    <ndc_label_name>RIZATRIPTAN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378141877</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 50-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378141893</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 50-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378141977</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 100-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378141993</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 100-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378142077</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 100-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378142093</ndc>
    <ndc_label_name>LOSARTAN-HCTZ 100-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378145001</ndc>
    <ndc_label_name>LITHIUM CARBONATE ER 450 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378162693</ndc>
    <ndc_label_name>VORICONAZOLE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378163132</ndc>
    <ndc_label_name>FORMOTEROL 20 MCG/2 ML NEB VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378163191</ndc>
    <ndc_label_name>FORMOTEROL 20 MCG/2 ML NEB VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378163193</ndc>
    <ndc_label_name>FORMOTEROL 20 MCG/2 ML NEB VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378164093</ndc>
    <ndc_label_name>VORICONAZOLE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378165893</ndc>
    <ndc_label_name>SILDENAFIL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378165993</ndc>
    <ndc_label_name>SILDENAFIL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378166093</ndc>
    <ndc_label_name>SILDENAFIL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378166519</ndc>
    <ndc_label_name>TIZANIDINE HCL 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378166619</ndc>
    <ndc_label_name>TIZANIDINE HCL 4 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378166719</ndc>
    <ndc_label_name>TIZANIDINE HCL 6 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378170405</ndc>
    <ndc_label_name>PRAMIPEXOLE 0.125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378170477</ndc>
    <ndc_label_name>PRAMIPEXOLE 0.125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378170505</ndc>
    <ndc_label_name>PRAMIPEXOLE 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378170577</ndc>
    <ndc_label_name>PRAMIPEXOLE 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378170705</ndc>
    <ndc_label_name>PRAMIPEXOLE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378170777</ndc>
    <ndc_label_name>PRAMIPEXOLE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378171105</ndc>
    <ndc_label_name>PRAMIPEXOLE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378171177</ndc>
    <ndc_label_name>PRAMIPEXOLE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378171205</ndc>
    <ndc_label_name>PRAMIPEXOLE 1.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378171277</ndc>
    <ndc_label_name>PRAMIPEXOLE 1.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378171377</ndc>
    <ndc_label_name>PRAMIPEXOLE 0.75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378172193</ndc>
    <ndc_label_name>AMLODIPINE-VALSARTAN 5-160 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378172293</ndc>
    <ndc_label_name>AMLODIPINE-VALSARTAN 10-160 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378172393</ndc>
    <ndc_label_name>AMLODIPINE-VALSARTAN 5-320 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378172493</ndc>
    <ndc_label_name>AMLODIPINE-VALSARTAN 10-320 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378180010</ndc>
    <ndc_label_name>LEVOTHYROXINE 25 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378180077</ndc>
    <ndc_label_name>LEVOTHYROXINE 25 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378180310</ndc>
    <ndc_label_name>LEVOTHYROXINE 50 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378180377</ndc>
    <ndc_label_name>LEVOTHYROXINE 50 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378180510</ndc>
    <ndc_label_name>LEVOTHYROXINE 75 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378180577</ndc>
    <ndc_label_name>LEVOTHYROXINE 75 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378180710</ndc>
    <ndc_label_name>LEVOTHYROXINE 88 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378180777</ndc>
    <ndc_label_name>LEVOTHYROXINE 88 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378180910</ndc>
    <ndc_label_name>LEVOTHYROXINE 100 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378180977</ndc>
    <ndc_label_name>LEVOTHYROXINE 100 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378181110</ndc>
    <ndc_label_name>LEVOTHYROXINE 112 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378181177</ndc>
    <ndc_label_name>LEVOTHYROXINE 112 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378181310</ndc>
    <ndc_label_name>LEVOTHYROXINE 125 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378181377</ndc>
    <ndc_label_name>LEVOTHYROXINE 125 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378181510</ndc>
    <ndc_label_name>LEVOTHYROXINE 150 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378181577</ndc>
    <ndc_label_name>LEVOTHYROXINE 150 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378181710</ndc>
    <ndc_label_name>LEVOTHYROXINE 175 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378181777</ndc>
    <ndc_label_name>LEVOTHYROXINE 175 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378181910</ndc>
    <ndc_label_name>LEVOTHYROXINE 200 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378181977</ndc>
    <ndc_label_name>LEVOTHYROXINE 200 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378182177</ndc>
    <ndc_label_name>LEVOTHYROXINE 300 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378182310</ndc>
    <ndc_label_name>LEVOTHYROXINE 137 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378182377</ndc>
    <ndc_label_name>LEVOTHYROXINE 137 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378190101</ndc>
    <ndc_label_name>MIDODRINE HCL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378190201</ndc>
    <ndc_label_name>MIDODRINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378190301</ndc>
    <ndc_label_name>MIDODRINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378190577</ndc>
    <ndc_label_name>ROFLUMILAST 500 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378190593</ndc>
    <ndc_label_name>ROFLUMILAST 500 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378193093</ndc>
    <ndc_label_name>EMTRICITABINE-TENOFV 200-300MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378193501</ndc>
    <ndc_label_name>LENALIDOMIDE 2.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378193528</ndc>
    <ndc_label_name>LENALIDOMIDE 2.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378193601</ndc>
    <ndc_label_name>LENALIDOMIDE 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378193628</ndc>
    <ndc_label_name>LENALIDOMIDE 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378193701</ndc>
    <ndc_label_name>LENALIDOMIDE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378193728</ndc>
    <ndc_label_name>LENALIDOMIDE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378194001</ndc>
    <ndc_label_name>LENALIDOMIDE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378194021</ndc>
    <ndc_label_name>LENALIDOMIDE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378194101</ndc>
    <ndc_label_name>LENALIDOMIDE 15 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378194121</ndc>
    <ndc_label_name>LENALIDOMIDE 15 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378194201</ndc>
    <ndc_label_name>LENALIDOMIDE 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378194221</ndc>
    <ndc_label_name>LENALIDOMIDE 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378200201</ndc>
    <ndc_label_name>THIOTHIXENE 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378204501</ndc>
    <ndc_label_name>TACROLIMUS 0.5 MG CAPSULE (IR)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378204601</ndc>
    <ndc_label_name>TACROLIMUS 1 MG CAPSULE (IR)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378204605</ndc>
    <ndc_label_name>TACROLIMUS 1 MG CAPSULE (IR)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378204701</ndc>
    <ndc_label_name>TACROLIMUS 5 MG CAPSULE (IR)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378206301</ndc>
    <ndc_label_name>ATENOLOL-CHLORTHALIDONE 50-25</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378206401</ndc>
    <ndc_label_name>ATENOLOL-CHLORTHALIDONE 100-25</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378208593</ndc>
    <ndc_label_name>DEXLANSOPRAZOLE DR 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378208677</ndc>
    <ndc_label_name>DEXLANSOPRAZOLE DR 60 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378208693</ndc>
    <ndc_label_name>DEXLANSOPRAZOLE DR 60 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378209601</ndc>
    <ndc_label_name>NISOLDIPINE ER 8.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378209701</ndc>
    <ndc_label_name>NISOLDIPINE ER 17 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378209801</ndc>
    <ndc_label_name>NISOLDIPINE ER 25.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378209901</ndc>
    <ndc_label_name>NISOLDIPINE ER 34 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378210001</ndc>
    <ndc_label_name>LOPERAMIDE 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378210005</ndc>
    <ndc_label_name>LOPERAMIDE 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378214601</ndc>
    <ndc_label_name>SPIRONOLACTONE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378214605</ndc>
    <ndc_label_name>SPIRONOLACTONE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378215001</ndc>
    <ndc_label_name>MECLOFENAMATE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378221491</ndc>
    <ndc_label_name>TICAGRELOR 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378221591</ndc>
    <ndc_label_name>TICAGRELOR 90 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378222201</ndc>
    <ndc_label_name>NISOLDIPINE ER 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378222301</ndc>
    <ndc_label_name>NISOLDIPINE ER 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378222401</ndc>
    <ndc_label_name>NISOLDIPINE ER 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378224577</ndc>
    <ndc_label_name>IMATINIB MESYLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378224693</ndc>
    <ndc_label_name>IMATINIB MESYLATE 400 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378225001</ndc>
    <ndc_label_name>MYCOPHENOLATE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378225005</ndc>
    <ndc_label_name>MYCOPHENOLATE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378230201</ndc>
    <ndc_label_name>PRAZOSIN 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378230210</ndc>
    <ndc_label_name>PRAZOSIN 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378233078</ndc>
    <ndc_label_name>RUFINAMIDE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378233178</ndc>
    <ndc_label_name>RUFINAMIDE 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378235077</ndc>
    <ndc_label_name>ESOMEPRAZOLE MAG DR 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378235093</ndc>
    <ndc_label_name>ESOMEPRAZOLE MAG DR 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378235177</ndc>
    <ndc_label_name>ESOMEPRAZOLE MAG DR 40 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378235193</ndc>
    <ndc_label_name>ESOMEPRAZOLE MAG DR 40 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378240101</ndc>
    <ndc_label_name>TRIFLUOPERAZINE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378240201</ndc>
    <ndc_label_name>TRIFLUOPERAZINE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378240501</ndc>
    <ndc_label_name>TRIFLUOPERAZINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378241001</ndc>
    <ndc_label_name>TRIFLUOPERAZINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378251693</ndc>
    <ndc_label_name>FLUCONAZOLE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378267001</ndc>
    <ndc_label_name>Phenytek 200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378267093</ndc>
    <ndc_label_name>Phenytek 200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378280026</ndc>
    <ndc_label_name>CABERGOLINE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378289520</ndc>
    <ndc_label_name>FERRIC CITRATE 210 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378292077</ndc>
    <ndc_label_name>TELMISARTAN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378292093</ndc>
    <ndc_label_name>TELMISARTAN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378292177</ndc>
    <ndc_label_name>TELMISARTAN 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378292193</ndc>
    <ndc_label_name>TELMISARTAN 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378292277</ndc>
    <ndc_label_name>TELMISARTAN 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378292293</ndc>
    <ndc_label_name>TELMISARTAN 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378300001</ndc>
    <ndc_label_name>MECLOFENAMATE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378300177</ndc>
    <ndc_label_name>CANDESARTAN-HCTZ 16-12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378300277</ndc>
    <ndc_label_name>CANDESARTAN-HCTZ 32-12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378300377</ndc>
    <ndc_label_name>CANDESARTAN-HCTZ 32-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378300501</ndc>
    <ndc_label_name>THIOTHIXENE 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378302301</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378302401</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378302405</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378303001</ndc>
    <ndc_label_name>DOXYCYCLINE HYC DR 150 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378303377</ndc>
    <ndc_label_name>IRBESARTAN-HCTZ 150-12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378303477</ndc>
    <ndc_label_name>IRBESARTAN-HCTZ 300-12.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378306577</ndc>
    <ndc_label_name>FENOFIBRATE 48 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378306605</ndc>
    <ndc_label_name>FENOFIBRATE 145 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378306677</ndc>
    <ndc_label_name>FENOFIBRATE 145 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378309632</ndc>
    <ndc_label_name>EVEROLIMUS 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378309685</ndc>
    <ndc_label_name>EVEROLIMUS 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378309732</ndc>
    <ndc_label_name>EVEROLIMUS 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378309785</ndc>
    <ndc_label_name>EVEROLIMUS 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378309832</ndc>
    <ndc_label_name>EVEROLIMUS 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378309885</ndc>
    <ndc_label_name>EVEROLIMUS 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378309932</ndc>
    <ndc_label_name>EVEROLIMUS 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378309985</ndc>
    <ndc_label_name>EVEROLIMUS 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378312501</ndc>
    <ndc_label_name>DOXEPIN 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378312510</ndc>
    <ndc_label_name>DOXEPIN 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378320501</ndc>
    <ndc_label_name>PRAZOSIN 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378320525</ndc>
    <ndc_label_name>PRAZOSIN 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378322477</ndc>
    <ndc_label_name>CANDESARTAN CILEXETIL 4 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378322493</ndc>
    <ndc_label_name>CANDESARTAN CILEXETIL 4 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378322577</ndc>
    <ndc_label_name>CANDESARTAN CILEXETIL 8 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378322593</ndc>
    <ndc_label_name>CANDESARTAN CILEXETIL 8 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378323177</ndc>
    <ndc_label_name>CANDESARTAN CILEXETIL 16 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378323193</ndc>
    <ndc_label_name>CANDESARTAN CILEXETIL 16 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378323277</ndc>
    <ndc_label_name>CANDESARTAN CILEXETIL 32 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378323293</ndc>
    <ndc_label_name>CANDESARTAN CILEXETIL 32 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378326632</ndc>
    <ndc_label_name>ETOPOSIDE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378326694</ndc>
    <ndc_label_name>ETOPOSIDE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378334016</ndc>
    <ndc_label_name>Xulane 150 mcg-35 mcg/24 hr transdermal patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378334032</ndc>
    <ndc_label_name>Xulane 150 mcg-35 mcg/24 hr transdermal patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378334053</ndc>
    <ndc_label_name>Xulane 150 mcg-35 mcg/24 hr transdermal patch</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378334916</ndc>
    <ndc_label_name>ESTRADIOL 0.025 MG PATCH(1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378334999</ndc>
    <ndc_label_name>ESTRADIOL 0.025 MG PATCH(1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378335016</ndc>
    <ndc_label_name>ESTRADIOL 0.05 MG PATCH (1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378335099</ndc>
    <ndc_label_name>ESTRADIOL 0.05 MG PATCH (1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378335116</ndc>
    <ndc_label_name>ESTRADIOL 0.075 MG PATCH(1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378335199</ndc>
    <ndc_label_name>ESTRADIOL 0.075 MG PATCH(1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378335216</ndc>
    <ndc_label_name>ESTRADIOL 0.1 MG PATCH (1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378335299</ndc>
    <ndc_label_name>ESTRADIOL 0.1 MG PATCH (1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378336016</ndc>
    <ndc_label_name>ESTRADIOL 0.0375MG PATCH(1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378336099</ndc>
    <ndc_label_name>ESTRADIOL 0.0375MG PATCH(1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378336116</ndc>
    <ndc_label_name>ESTRADIOL 0.06 MG PATCH (1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378336199</ndc>
    <ndc_label_name>ESTRADIOL 0.06 MG PATCH (1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378343193</ndc>
    <ndc_label_name>ARMODAFINIL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378343293</ndc>
    <ndc_label_name>ARMODAFINIL 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378343393</ndc>
    <ndc_label_name>ARMODAFINIL 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378345823</ndc>
    <ndc_label_name>AZELASTIN-FLUTIC 137-50MCG SPR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378351501</ndc>
    <ndc_label_name>MIRTAZAPINE 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378351510</ndc>
    <ndc_label_name>MIRTAZAPINE 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378351593</ndc>
    <ndc_label_name>MIRTAZAPINE 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378352091</ndc>
    <ndc_label_name>FOSAMPRENAVIR 700 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378353001</ndc>
    <ndc_label_name>MIRTAZAPINE 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378353005</ndc>
    <ndc_label_name>MIRTAZAPINE 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378353093</ndc>
    <ndc_label_name>MIRTAZAPINE 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378354501</ndc>
    <ndc_label_name>MIRTAZAPINE 45 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378354505</ndc>
    <ndc_label_name>MIRTAZAPINE 45 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378354593</ndc>
    <ndc_label_name>MIRTAZAPINE 45 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378354725</ndc>
    <ndc_label_name>MERCAPTOPURINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378354752</ndc>
    <ndc_label_name>MERCAPTOPURINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378362793</ndc>
    <ndc_label_name>CLOPIDOGREL 75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378363201</ndc>
    <ndc_label_name>CARVEDILOL 6.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378363205</ndc>
    <ndc_label_name>CARVEDILOL 6.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378363305</ndc>
    <ndc_label_name>CARVEDILOL 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378363401</ndc>
    <ndc_label_name>CARVEDILOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378363405</ndc>
    <ndc_label_name>CARVEDILOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378363501</ndc>
    <ndc_label_name>CETIRIZINE HCL 5 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378363701</ndc>
    <ndc_label_name>CETIRIZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378363705</ndc>
    <ndc_label_name>CETIRIZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378375001</ndc>
    <ndc_label_name>Phenytek 300 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378375093</ndc>
    <ndc_label_name>Phenytek 300 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378381301</ndc>
    <ndc_label_name>CLOZAPINE ODT 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378381501</ndc>
    <ndc_label_name>CLOZAPINE ODT 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378381601</ndc>
    <ndc_label_name>CLOZAPINE ODT 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378381701</ndc>
    <ndc_label_name>CLOZAPINE ODT 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378385777</ndc>
    <ndc_label_name>ESCITALOPRAM 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378395005</ndc>
    <ndc_label_name>ATORVASTATIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378395077</ndc>
    <ndc_label_name>ATORVASTATIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378395105</ndc>
    <ndc_label_name>ATORVASTATIN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378395177</ndc>
    <ndc_label_name>ATORVASTATIN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378395205</ndc>
    <ndc_label_name>ATORVASTATIN 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378395277</ndc>
    <ndc_label_name>ATORVASTATIN 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378395305</ndc>
    <ndc_label_name>ATORVASTATIN 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378395377</ndc>
    <ndc_label_name>ATORVASTATIN 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378404293</ndc>
    <ndc_label_name>LOSARTAN POTASSIUM 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378405091</ndc>
    <ndc_label_name>NEVIRAPINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378407001</ndc>
    <ndc_label_name>KETOPROFEN 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378410591</ndc>
    <ndc_label_name>ABACAVIR 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378414591</ndc>
    <ndc_label_name>RILUZOLE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378416001</ndc>
    <ndc_label_name>ATOVAQUONE-PROGUANIL 62.5-25</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378416201</ndc>
    <ndc_label_name>ATOVAQUONE-PROGUANIL 250-100</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378425001</ndc>
    <ndc_label_name>DOXEPIN 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378425010</ndc>
    <ndc_label_name>DOXEPIN 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378425201</ndc>
    <ndc_label_name>LAMOTRIGINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378425205</ndc>
    <ndc_label_name>LAMOTRIGINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378425305</ndc>
    <ndc_label_name>LAMOTRIGINE 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378425391</ndc>
    <ndc_label_name>LAMOTRIGINE 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378425405</ndc>
    <ndc_label_name>LAMOTRIGINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378425491</ndc>
    <ndc_label_name>LAMOTRIGINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378427093</ndc>
    <ndc_label_name>AMBRISENTAN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378427193</ndc>
    <ndc_label_name>AMBRISENTAN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378427577</ndc>
    <ndc_label_name>VALACYCLOVIR HCL 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378427593</ndc>
    <ndc_label_name>VALACYCLOVIR HCL 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378427677</ndc>
    <ndc_label_name>VALACYCLOVIR HCL 1 GRAM TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378427693</ndc>
    <ndc_label_name>VALACYCLOVIR HCL 1 GRAM TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378428732</ndc>
    <ndc_label_name>ELETRIPTAN HBR 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378428785</ndc>
    <ndc_label_name>ELETRIPTAN HBR 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378428808</ndc>
    <ndc_label_name>ELETRIPTAN HBR 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378428832</ndc>
    <ndc_label_name>ELETRIPTAN HBR 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378428885</ndc>
    <ndc_label_name>ELETRIPTAN HBR 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378439077</ndc>
    <ndc_label_name>FENOFIBRATE 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378439177</ndc>
    <ndc_label_name>FENOFIBRATE 120 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378447201</ndc>
    <ndc_label_name>MYCOPHENOLATE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378447205</ndc>
    <ndc_label_name>MYCOPHENOLATE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378449093</ndc>
    <ndc_label_name>FAMCICLOVIR 125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378449193</ndc>
    <ndc_label_name>FAMCICLOVIR 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378449293</ndc>
    <ndc_label_name>FAMCICLOVIR 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378450093</ndc>
    <ndc_label_name>BUDESONIDE ER 9 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378451393</ndc>
    <ndc_label_name>AMLODIPINE-ATORVAST 5-10 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378451493</ndc>
    <ndc_label_name>AMLODIPINE-ATORVAST 5-20 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378451593</ndc>
    <ndc_label_name>AMLODIPINE-ATORVAST 5-40 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378451693</ndc>
    <ndc_label_name>AMLODIPINE-ATORVAST 5-80 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378451793</ndc>
    <ndc_label_name>AMLODIPINE-ATORVAST 10-10 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378451893</ndc>
    <ndc_label_name>AMLODIPINE-ATORVAST 10-20 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378451993</ndc>
    <ndc_label_name>AMLODIPINE-ATORVAST 10-40 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378452093</ndc>
    <ndc_label_name>AMLODIPINE-ATORVAST 10-80 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378452593</ndc>
    <ndc_label_name>FINGOLIMOD 0.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378456005</ndc>
    <ndc_label_name>POTASSIUM CL ER 8 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378456077</ndc>
    <ndc_label_name>POTASSIUM CL ER 8 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378456105</ndc>
    <ndc_label_name>POTASSIUM CL ER 10 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378456177</ndc>
    <ndc_label_name>POTASSIUM CL ER 10 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378459301</ndc>
    <ndc_label_name>METOPROLOL TARTRATE 37.5 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378459401</ndc>
    <ndc_label_name>METOPROLOL TARTRATE 75 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378459510</ndc>
    <ndc_label_name>METOPROLOL SUCC ER 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378459577</ndc>
    <ndc_label_name>METOPROLOL SUCC ER 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378459610</ndc>
    <ndc_label_name>METOPROLOL SUCC ER 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378459677</ndc>
    <ndc_label_name>METOPROLOL SUCC ER 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378459710</ndc>
    <ndc_label_name>METOPROLOL SUCC ER 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378459777</ndc>
    <ndc_label_name>METOPROLOL SUCC ER 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378459805</ndc>
    <ndc_label_name>METOPROLOL SUCC ER 200 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378459877</ndc>
    <ndc_label_name>METOPROLOL SUCC ER 200 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378461501</ndc>
    <ndc_label_name>DOXYLAMINE-PYRIDOXINE 10-10 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378461916</ndc>
    <ndc_label_name>ESTRADIOL 0.025 MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378461926</ndc>
    <ndc_label_name>ESTRADIOL 0.025 MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378462016</ndc>
    <ndc_label_name>ESTRADIOL 0.0375MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378462026</ndc>
    <ndc_label_name>ESTRADIOL 0.0375MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378462116</ndc>
    <ndc_label_name>ESTRADIOL 0.05 MG PATCH (2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378462126</ndc>
    <ndc_label_name>ESTRADIOL 0.05 MG PATCH (2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378462216</ndc>
    <ndc_label_name>ESTRADIOL 0.075 MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378462226</ndc>
    <ndc_label_name>ESTRADIOL 0.075 MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378462316</ndc>
    <ndc_label_name>ESTRADIOL 0.1 MG PATCH (2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378462326</ndc>
    <ndc_label_name>ESTRADIOL 0.1 MG PATCH (2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378464016</ndc>
    <ndc_label_name>ESTRADIOL 0.1 MG PATCH (2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378464026</ndc>
    <ndc_label_name>ESTRADIOL 0.1 MG PATCH (2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378464116</ndc>
    <ndc_label_name>ESTRADIOL 0.075 MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378464126</ndc>
    <ndc_label_name>ESTRADIOL 0.075 MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378464216</ndc>
    <ndc_label_name>ESTRADIOL 0.05 MG PATCH (2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378464226</ndc>
    <ndc_label_name>ESTRADIOL 0.05 MG PATCH (2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378464316</ndc>
    <ndc_label_name>ESTRADIOL 0.0375MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378464326</ndc>
    <ndc_label_name>ESTRADIOL 0.0375MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378464416</ndc>
    <ndc_label_name>ESTRADIOL 0.025 MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378464426</ndc>
    <ndc_label_name>ESTRADIOL 0.025 MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378470577</ndc>
    <ndc_label_name>SAXAGLIPTIN HCL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378470593</ndc>
    <ndc_label_name>SAXAGLIPTIN HCL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378470677</ndc>
    <ndc_label_name>SAXAGLIPTIN HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378470693</ndc>
    <ndc_label_name>SAXAGLIPTIN HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378479106</ndc>
    <ndc_label_name>FLUOROURACIL 5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378483060</ndc>
    <ndc_label_name>DAPSONE 7.5% GEL PUMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378483090</ndc>
    <ndc_label_name>DAPSONE 7.5% GEL PUMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378489093</ndc>
    <ndc_label_name>NEVIRAPINE ER 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378501001</ndc>
    <ndc_label_name>THIOTHIXENE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378505577</ndc>
    <ndc_label_name>PITAVASTATIN 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378505677</ndc>
    <ndc_label_name>PITAVASTATIN 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378505777</ndc>
    <ndc_label_name>PITAVASTATIN 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378508973</ndc>
    <ndc_label_name>VARENICLINE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378509073</ndc>
    <ndc_label_name>VARENICLINE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378509185</ndc>
    <ndc_label_name>VARENICLINE STARTING MONTH BOX</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378514405</ndc>
    <ndc_label_name>DONEPEZIL HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378514477</ndc>
    <ndc_label_name>DONEPEZIL HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378514493</ndc>
    <ndc_label_name>DONEPEZIL HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378514505</ndc>
    <ndc_label_name>DONEPEZIL HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378514577</ndc>
    <ndc_label_name>DONEPEZIL HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378514593</ndc>
    <ndc_label_name>DONEPEZIL HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378518593</ndc>
    <ndc_label_name>PRASUGREL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378518693</ndc>
    <ndc_label_name>PRASUGREL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378524532</ndc>
    <ndc_label_name>ALMOTRIPTAN MALATE 6.25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378524585</ndc>
    <ndc_label_name>ALMOTRIPTAN MALATE 6.25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378524632</ndc>
    <ndc_label_name>ALMOTRIPTAN MALATE 12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378524685</ndc>
    <ndc_label_name>ALMOTRIPTAN MALATE 12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378527001</ndc>
    <ndc_label_name>ESZOPICLONE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378527101</ndc>
    <ndc_label_name>ESZOPICLONE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378527201</ndc>
    <ndc_label_name>ESZOPICLONE 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378537501</ndc>
    <ndc_label_name>DOXEPIN 75 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378537510</ndc>
    <ndc_label_name>DOXEPIN 75 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378542601</ndc>
    <ndc_label_name>GABAPENTIN 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378542605</ndc>
    <ndc_label_name>GABAPENTIN 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378542805</ndc>
    <ndc_label_name>GABAPENTIN 400 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378543035</ndc>
    <ndc_label_name>MOXIFLOXACIN 0.5% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378544093</ndc>
    <ndc_label_name>EMTRICIT-RILP-TENOF 200-25-300</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378544591</ndc>
    <ndc_label_name>TOLTERODINE TARTRATE 1 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378544605</ndc>
    <ndc_label_name>TOLTERODINE TARTRATE 2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378544691</ndc>
    <ndc_label_name>TOLTERODINE TARTRATE 2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378551093</ndc>
    <ndc_label_name>OLANZAPINE ODT 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378551193</ndc>
    <ndc_label_name>OLANZAPINE ODT 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378551293</ndc>
    <ndc_label_name>OLANZAPINE ODT 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378551393</ndc>
    <ndc_label_name>OLANZAPINE ODT 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378561505</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378561578</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378561705</ndc>
    <ndc_label_name>LEVETIRACETAM 750 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378561778</ndc>
    <ndc_label_name>LEVETIRACETAM 750 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378561991</ndc>
    <ndc_label_name>LEVETIRACETAM 1,000 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378563059</ndc>
    <ndc_label_name>SUMATRIPTAN SUCC 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378563159</ndc>
    <ndc_label_name>SUMATRIPTAN SUCC 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378563259</ndc>
    <ndc_label_name>SUMATRIPTAN SUCC 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378580793</ndc>
    <ndc_label_name>VALSARTAN 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378581377</ndc>
    <ndc_label_name>VALSARTAN 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378581477</ndc>
    <ndc_label_name>VALSARTAN 160 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378581577</ndc>
    <ndc_label_name>VALSARTAN 320 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378600191</ndc>
    <ndc_label_name>METFORMIN ER 1,000 MG OSM-TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378600291</ndc>
    <ndc_label_name>METFORMIN ER 500 MG OSMOTIC TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378603405</ndc>
    <ndc_label_name>ANASTROZOLE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378603477</ndc>
    <ndc_label_name>ANASTROZOLE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378606001</ndc>
    <ndc_label_name>DILTIAZEM 12HR ER 60 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378609001</ndc>
    <ndc_label_name>DILTIAZEM 12HR ER 90 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378612001</ndc>
    <ndc_label_name>DILTIAZEM 12HR ER 120 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378617201</ndc>
    <ndc_label_name>METOLAZONE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378617301</ndc>
    <ndc_label_name>METOLAZONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378617401</ndc>
    <ndc_label_name>METOLAZONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378623101</ndc>
    <ndc_label_name>CITALOPRAM HBR 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378623105</ndc>
    <ndc_label_name>CITALOPRAM HBR 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378623201</ndc>
    <ndc_label_name>CITALOPRAM HBR 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378623205</ndc>
    <ndc_label_name>CITALOPRAM HBR 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378623301</ndc>
    <ndc_label_name>CITALOPRAM HBR 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378623305</ndc>
    <ndc_label_name>CITALOPRAM HBR 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378632001</ndc>
    <ndc_label_name>VERAPAMIL ER 120 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378632177</ndc>
    <ndc_label_name>VALSARTAN-HCTZ 80-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378632277</ndc>
    <ndc_label_name>VALSARTAN-HCTZ 160-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378632377</ndc>
    <ndc_label_name>VALSARTAN-HCTZ 160-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378632477</ndc>
    <ndc_label_name>VALSARTAN-HCTZ 320-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378632577</ndc>
    <ndc_label_name>VALSARTAN-HCTZ 320-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378633380</ndc>
    <ndc_label_name>ACAMPROSATE CALC DR 333 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378638001</ndc>
    <ndc_label_name>VERAPAMIL ER 180 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378641001</ndc>
    <ndc_label_name>DOXEPIN 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378641010</ndc>
    <ndc_label_name>DOXEPIN 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378644001</ndc>
    <ndc_label_name>VERAPAMIL ER 240 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378647016</ndc>
    <ndc_label_name>SCOPOLAMINE 1 MG/3 DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378647044</ndc>
    <ndc_label_name>SCOPOLAMINE 1 MG/3 DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378647097</ndc>
    <ndc_label_name>SCOPOLAMINE 1 MG/3 DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378647099</ndc>
    <ndc_label_name>SCOPOLAMINE 1 MG/3 DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378655053</ndc>
    <ndc_label_name>LEVONOR-ETH ESTRAD 0.15-0.03</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378655085</ndc>
    <ndc_label_name>LEVONOR-ETH ESTRAD 0.15-0.03</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378661185</ndc>
    <ndc_label_name>Amnesteem 10 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378661193</ndc>
    <ndc_label_name>Amnesteem 10 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378661285</ndc>
    <ndc_label_name>Amnesteem 20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378661293</ndc>
    <ndc_label_name>Amnesteem 20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378661385</ndc>
    <ndc_label_name>Amnesteem 30 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378661393</ndc>
    <ndc_label_name>Amnesteem 30 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378661485</ndc>
    <ndc_label_name>Amnesteem 40 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378661493</ndc>
    <ndc_label_name>Amnesteem 40 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378667828</ndc>
    <ndc_label_name>SUNITINIB MALATE 12.5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378667928</ndc>
    <ndc_label_name>SUNITINIB MALATE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378668028</ndc>
    <ndc_label_name>SUNITINIB MALATE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378668128</ndc>
    <ndc_label_name>SUNITINIB MALATE 37.5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378668877</ndc>
    <ndc_label_name>PANTOPRAZOLE SOD DR 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378668910</ndc>
    <ndc_label_name>PANTOPRAZOLE SOD DR 40 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378668977</ndc>
    <ndc_label_name>PANTOPRAZOLE SOD DR 40 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378675082</ndc>
    <ndc_label_name>BALSALAZIDE DISODIUM 750 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378685477</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378685577</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378685677</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378685777</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378685877</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378685977</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378686077</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 70 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378692078</ndc>
    <ndc_label_name>ABIRATERONE ACETATE 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378692191</ndc>
    <ndc_label_name>ABIRATERONE ACETATE 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378695501</ndc>
    <ndc_label_name>BEXAROTENE 75 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378696032</ndc>
    <ndc_label_name>GLATIRAMER 20 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378696093</ndc>
    <ndc_label_name>GLATIRAMER 20 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378696112</ndc>
    <ndc_label_name>GLATIRAMER 40 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378696132</ndc>
    <ndc_label_name>GLATIRAMER 40 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378698132</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378698185</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378698188</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378698232</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 30 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378698285</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 30 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378698288</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 30 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378698501</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% INHAL VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378698601</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% INHAL VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378698789</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% INHAL VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378699331</ndc>
    <ndc_label_name>LEVALBUTEROL CONC 1.25 MG/0.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378699393</ndc>
    <ndc_label_name>LEVALBUTEROL CONC 1.25 MG/0.5</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378699789</ndc>
    <ndc_label_name>SODIUM CHLORIDE 3% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378699889</ndc>
    <ndc_label_name>SODIUM CHLORIDE 10% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378700110</ndc>
    <ndc_label_name>PAROXETINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378700193</ndc>
    <ndc_label_name>PAROXETINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378700210</ndc>
    <ndc_label_name>PAROXETINE HCL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378700293</ndc>
    <ndc_label_name>PAROXETINE HCL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378700310</ndc>
    <ndc_label_name>PAROXETINE HCL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378700393</ndc>
    <ndc_label_name>PAROXETINE HCL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378700410</ndc>
    <ndc_label_name>PAROXETINE HCL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378700493</ndc>
    <ndc_label_name>PAROXETINE HCL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378701705</ndc>
    <ndc_label_name>BICALUTAMIDE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378701793</ndc>
    <ndc_label_name>BICALUTAMIDE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378702093</ndc>
    <ndc_label_name>ACITRETIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378702393</ndc>
    <ndc_label_name>ACITRETIN 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378705535</ndc>
    <ndc_label_name>BEPOTASTINE 1.5% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378705567</ndc>
    <ndc_label_name>BEPOTASTINE 1.5% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378705752</ndc>
    <ndc_label_name>ALBUTEROL SUL 0.63 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378705798</ndc>
    <ndc_label_name>ALBUTEROL SUL 0.63 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378705852</ndc>
    <ndc_label_name>ALBUTEROL SUL 1.25 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378705898</ndc>
    <ndc_label_name>ALBUTEROL SUL 1.25 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378709601</ndc>
    <ndc_label_name>BROMOCRIPTINE 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378709693</ndc>
    <ndc_label_name>BROMOCRIPTINE 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378710077</ndc>
    <ndc_label_name>FENOFIBRATE 54 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378710177</ndc>
    <ndc_label_name>FENOFIBRATE 160 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378715505</ndc>
    <ndc_label_name>BUDESONIDE DR 3 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378718505</ndc>
    <ndc_label_name>METFORMIN HCL 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378718605</ndc>
    <ndc_label_name>METFORMIN HCL 850 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378718705</ndc>
    <ndc_label_name>METFORMIN HCL 1,000 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378727253</ndc>
    <ndc_label_name>NORETHINDRONE 0.35 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378727285</ndc>
    <ndc_label_name>NORETHINDRONE 0.35 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378727453</ndc>
    <ndc_label_name>NORETHIN-EE 1.5-0.03 MG(21) TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378727485</ndc>
    <ndc_label_name>NORETHIN-EE 1.5-0.03 MG(21) TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378728053</ndc>
    <ndc_label_name>NORETHIND-ETH ESTRAD 1-0.02 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378728085</ndc>
    <ndc_label_name>NORETHIND-ETH ESTRAD 1-0.02 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378728153</ndc>
    <ndc_label_name>LEVONOR-ETH ESTRAD 0.15-0.03</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378728353</ndc>
    <ndc_label_name>NORETH-EE-FE 1-0.02(21)-75 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378728385</ndc>
    <ndc_label_name>NORETH-EE-FE 1-0.02(21)-75 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378728485</ndc>
    <ndc_label_name>LEVONOR-E ESTRAD 0.1-0.02-0.01</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378728490</ndc>
    <ndc_label_name>LEVONOR-E ESTRAD 0.1-0.02-0.01</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378728590</ndc>
    <ndc_label_name>LEVONO-E ESTRAD 0.15-0.03-0.01</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378728753</ndc>
    <ndc_label_name>LEVONOR-ETH ESTRAD 0.1-0.02 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378728785</ndc>
    <ndc_label_name>LEVONOR-ETH ESTRAD 0.1-0.02 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378728853</ndc>
    <ndc_label_name>NORETH-EE-FE 1.5-0.03MG(21)-75</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378728885</ndc>
    <ndc_label_name>NORETH-EE-FE 1.5-0.03MG(21)-75</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378729189</ndc>
    <ndc_label_name>NORETHINDRONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378729253</ndc>
    <ndc_label_name>NORETHINDRONE 0.35 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378729285</ndc>
    <ndc_label_name>NORETHINDRONE 0.35 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378729453</ndc>
    <ndc_label_name>ESTRADIOL-NORETH 0.5-0.1 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378729485</ndc>
    <ndc_label_name>ESTRADIOL-NORETH 0.5-0.1 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378729553</ndc>
    <ndc_label_name>ESTRADIOL-NORETH 1-0.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378729585</ndc>
    <ndc_label_name>ESTRADIOL-NORETH 1-0.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378729653</ndc>
    <ndc_label_name>DESOGESTR-ETH ESTRAD ETH ESTRA</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378729753</ndc>
    <ndc_label_name>NORET-ESTR-FE 0.4-0.035(21)-75</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378729785</ndc>
    <ndc_label_name>NORET-ESTR-FE 0.4-0.035(21)-75</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378729953</ndc>
    <ndc_label_name>DROSPIRENONE-EE 3-0.02 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378729985</ndc>
    <ndc_label_name>DROSPIRENONE-EE 3-0.02 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378730053</ndc>
    <ndc_label_name>DROSPIRENONE-EE 3-0.03 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378730353</ndc>
    <ndc_label_name>NORETH-EE-FE 1 MG/20-30-35 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378730385</ndc>
    <ndc_label_name>NORETH-EE-FE 1 MG/20-30-35 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378730653</ndc>
    <ndc_label_name>ETHYNODIOL-ETH ESTRA 1MG-50MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378730685</ndc>
    <ndc_label_name>ETHYNODIOL-ETH ESTRA 1MG-50MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378730753</ndc>
    <ndc_label_name>ETHYNODIOL-ETH ESTRA 1MG-35MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378730785</ndc>
    <ndc_label_name>ETHYNODIOL-ETH ESTRA 1MG-35MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378730853</ndc>
    <ndc_label_name>NORETHIN-ESTRA-FE 0.8-0.025 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378730885</ndc>
    <ndc_label_name>NORETHIN-ESTRA-FE 0.8-0.025 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378731685</ndc>
    <ndc_label_name>LEVONORG 0.15MG-EE 20-25-30MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378750232</ndc>
    <ndc_label_name>Breyna 80 mcg-4.5 mcg/actuation HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378750332</ndc>
    <ndc_label_name>Breyna 160 mcg-4.5 mcg/actuation HFA aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378751835</ndc>
    <ndc_label_name>DIFLUPREDNATE 0.05% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378773293</ndc>
    <ndc_label_name>ONDANSETRON ODT 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378773493</ndc>
    <ndc_label_name>ONDANSETRON ODT 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378773497</ndc>
    <ndc_label_name>ONDANSETRON ODT 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378797031</ndc>
    <ndc_label_name>IPRATROPIUM BR 0.02% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378797052</ndc>
    <ndc_label_name>IPRATROPIUM BR 0.02% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378797055</ndc>
    <ndc_label_name>IPRATROPIUM BR 0.02% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378797062</ndc>
    <ndc_label_name>IPRATROPIUM BR 0.02% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378797064</ndc>
    <ndc_label_name>IPRATROPIUM BR 0.02% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378797091</ndc>
    <ndc_label_name>IPRATROPIUM BR 0.02% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378797093</ndc>
    <ndc_label_name>IPRATROPIUM BR 0.02% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378800801</ndc>
    <ndc_label_name>DIVALPROEX DR 125 MG CAP SPRNK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378800805</ndc>
    <ndc_label_name>DIVALPROEX DR 125 MG CAP SPRNK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378801593</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378802077</ndc>
    <ndc_label_name>FLUVASTATIN SODIUM 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378802093</ndc>
    <ndc_label_name>FLUVASTATIN SODIUM 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378802177</ndc>
    <ndc_label_name>FLUVASTATIN SODIUM 40 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378802193</ndc>
    <ndc_label_name>FLUVASTATIN SODIUM 40 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378803005</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378803077</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378803093</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378805649</ndc>
    <ndc_label_name>HALCINONIDE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378805660</ndc>
    <ndc_label_name>HALCINONIDE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378806532</ndc>
    <ndc_label_name>Glucagon Emergency Kit 1 mg solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378806790</ndc>
    <ndc_label_name>Glucagon Emergency Kit 1 mg solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378807560</ndc>
    <ndc_label_name>ERYGEL 2% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378807593</ndc>
    <ndc_label_name>ERYGEL 2% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378807849</ndc>
    <ndc_label_name>FLUOROURACIL 0.5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378808220</ndc>
    <ndc_label_name>TRETINOIN 0.025% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378808245</ndc>
    <ndc_label_name>TRETINOIN 0.025% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378808320</ndc>
    <ndc_label_name>TRETINOIN 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378808345</ndc>
    <ndc_label_name>TRETINOIN 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378808420</ndc>
    <ndc_label_name>TRETINOIN 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378808445</ndc>
    <ndc_label_name>TRETINOIN 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378808515</ndc>
    <ndc_label_name>TRETINOIN 0.01% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378808545</ndc>
    <ndc_label_name>TRETINOIN 0.01% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378808615</ndc>
    <ndc_label_name>TRETINOIN 0.025% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378808645</ndc>
    <ndc_label_name>TRETINOIN 0.025% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378809045</ndc>
    <ndc_label_name>TRETINOIN 0.05% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378809220</ndc>
    <ndc_label_name>TRETINOIN GEL MICRO 0.04% TUBE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378809245</ndc>
    <ndc_label_name>TRETINOIN GEL MICRO 0.04% TUBE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378809250</ndc>
    <ndc_label_name>TRETINOIN GEL MICRO 0.04% PUMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378809320</ndc>
    <ndc_label_name>TRETINOIN GEL MICRO 0.1% TUBE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378809345</ndc>
    <ndc_label_name>TRETINOIN GEL MICRO 0.1% TUBE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378809350</ndc>
    <ndc_label_name>TRETINOIN GEL MICRO 0.1% PUMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378810593</ndc>
    <ndc_label_name>GALANTAMINE ER 8 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378810693</ndc>
    <ndc_label_name>GALANTAMINE ER 16 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378810793</ndc>
    <ndc_label_name>GALANTAMINE ER 24 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378811745</ndc>
    <ndc_label_name>DOXEPIN 5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378812330</ndc>
    <ndc_label_name>Zonalon 5 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378812345</ndc>
    <ndc_label_name>Zonalon 5 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378813045</ndc>
    <ndc_label_name>Prudoxin 5 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378817593</ndc>
    <ndc_label_name>SAXAGLIPTIN-METFORMIN ER 5-500</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378817691</ndc>
    <ndc_label_name>SAXAGLIPTN-METFORM ER 2.5-1000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378817793</ndc>
    <ndc_label_name>SAXAGLIPTIN-METFORMN ER 5-1000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378820001</ndc>
    <ndc_label_name>KETOPROFEN ER 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378821260</ndc>
    <ndc_label_name>ERYTHROMYCIN 2% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378821293</ndc>
    <ndc_label_name>ERYTHROMYCIN 2% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378822250</ndc>
    <ndc_label_name>MICONAZOLE-ZINC-PETRO 0.25-15%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378826016</ndc>
    <ndc_label_name>METHYLPHENIDATE 10 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378826093</ndc>
    <ndc_label_name>METHYLPHENIDATE 10 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378826116</ndc>
    <ndc_label_name>METHYLPHENIDATE 15 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378826193</ndc>
    <ndc_label_name>METHYLPHENIDATE 15 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378826216</ndc>
    <ndc_label_name>METHYLPHENIDATE 20 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378826293</ndc>
    <ndc_label_name>METHYLPHENIDATE 20 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378826316</ndc>
    <ndc_label_name>METHYLPHENIDATE 30 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378826393</ndc>
    <ndc_label_name>METHYLPHENIDATE 30 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378827031</ndc>
    <ndc_label_name>ALBUTEROL SUL 2.5 MG/3 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378827052</ndc>
    <ndc_label_name>ALBUTEROL SUL 2.5 MG/3 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378827055</ndc>
    <ndc_label_name>ALBUTEROL SUL 2.5 MG/3 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378827062</ndc>
    <ndc_label_name>ALBUTEROL SUL 2.5 MG/3 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378827064</ndc>
    <ndc_label_name>ALBUTEROL SUL 2.5 MG/3 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378827091</ndc>
    <ndc_label_name>ALBUTEROL SUL 2.5 MG/3 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378827093</ndc>
    <ndc_label_name>ALBUTEROL SUL 2.5 MG/3 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378868835</ndc>
    <ndc_label_name>CLINDAMYCIN-BENZOYL PEROX 1-5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378868854</ndc>
    <ndc_label_name>CLINDAMYCIN-BENZOYL PEROX 1-5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378870006</ndc>
    <ndc_label_name>ACYCLOVIR 5% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378870049</ndc>
    <ndc_label_name>ACYCLOVIR 5% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378876058</ndc>
    <ndc_label_name>CYCLOSPORINE 0.05% EYE EMULS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378876091</ndc>
    <ndc_label_name>CYCLOSPORINE 0.05% EYE EMULS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378876098</ndc>
    <ndc_label_name>CYCLOSPORINE 0.05% EYE EMULS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378876516</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 2-0.5MG FM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378876593</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 2-0.5MG FM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378876616</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 4-1MG FILM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378876693</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 4-1MG FILM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378876716</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 8-2MG FILM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378876793</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 8-2MG FILM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378876816</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 12-3MG FLM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378876893</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 12-3MG FLM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378877035</ndc>
    <ndc_label_name>ESTRADIOL 0.01% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378904001</ndc>
    <ndc_label_name>Cystagon 50 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378904005</ndc>
    <ndc_label_name>Cystagon 50 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378904501</ndc>
    <ndc_label_name>Cystagon 150 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378904505</ndc>
    <ndc_label_name>Cystagon 150 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378905516</ndc>
    <ndc_label_name>LIDOCAINE 5% PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378905593</ndc>
    <ndc_label_name>LIDOCAINE 5% PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378907016</ndc>
    <ndc_label_name>RIVASTIGMINE 4.6 MG/24HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378907093</ndc>
    <ndc_label_name>RIVASTIGMINE 4.6 MG/24HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378907116</ndc>
    <ndc_label_name>RIVASTIGMINE 9.5 MG/24HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378907193</ndc>
    <ndc_label_name>RIVASTIGMINE 9.5 MG/24HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378907216</ndc>
    <ndc_label_name>RIVASTIGMINE 13.3 MG/24HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378907293</ndc>
    <ndc_label_name>RIVASTIGMINE 13.3 MG/24HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378910216</ndc>
    <ndc_label_name>NITROGLYCERIN 0.1 MG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378910293</ndc>
    <ndc_label_name>NITROGLYCERIN 0.1 MG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378910416</ndc>
    <ndc_label_name>NITROGLYCERIN 0.2 MG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378910493</ndc>
    <ndc_label_name>NITROGLYCERIN 0.2 MG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378911216</ndc>
    <ndc_label_name>NITROGLYCERIN 0.4 MG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378911293</ndc>
    <ndc_label_name>NITROGLYCERIN 0.4 MG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378911616</ndc>
    <ndc_label_name>NITROGLYCERIN 0.6 MG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378911693</ndc>
    <ndc_label_name>NITROGLYCERIN 0.6 MG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378911916</ndc>
    <ndc_label_name>FENTANYL 12 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378911998</ndc>
    <ndc_label_name>FENTANYL 12 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378912116</ndc>
    <ndc_label_name>FENTANYL 25 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378912198</ndc>
    <ndc_label_name>FENTANYL 25 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378912216</ndc>
    <ndc_label_name>FENTANYL 50 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378912298</ndc>
    <ndc_label_name>FENTANYL 50 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378912316</ndc>
    <ndc_label_name>FENTANYL 75 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378912398</ndc>
    <ndc_label_name>FENTANYL 75 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378912416</ndc>
    <ndc_label_name>FENTANYL 100 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378912498</ndc>
    <ndc_label_name>FENTANYL 100 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378912516</ndc>
    <ndc_label_name>FENTANYL 37.5 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378912598</ndc>
    <ndc_label_name>FENTANYL 37.5 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378912616</ndc>
    <ndc_label_name>FENTANYL 62.5 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378912698</ndc>
    <ndc_label_name>FENTANYL 62.5 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378912716</ndc>
    <ndc_label_name>FENTANYL 87.5 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378912798</ndc>
    <ndc_label_name>FENTANYL 87.5 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378920535</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378932032</ndc>
    <ndc_label_name>Wixela Inhub 100 mcg-50 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378932132</ndc>
    <ndc_label_name>Wixela Inhub 250 mcg-50 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378932232</ndc>
    <ndc_label_name>Wixela Inhub 500 mcg-50 mcg/dose powder for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378965132</ndc>
    <ndc_label_name>TRAVOPROST 0.004% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378965150</ndc>
    <ndc_label_name>TRAVOPROST 0.004% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378967130</ndc>
    <ndc_label_name>IPRAT-ALBUT 0.5-3(2.5) MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378967131</ndc>
    <ndc_label_name>IPRAT-ALBUT 0.5-3(2.5) MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378967160</ndc>
    <ndc_label_name>IPRAT-ALBUT 0.5-3(2.5) MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378967164</ndc>
    <ndc_label_name>IPRAT-ALBUT 0.5-3(2.5) MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00378967193</ndc>
    <ndc_label_name>IPRAT-ALBUT 0.5-3(2.5) MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378969052</ndc>
    <ndc_label_name>LEVALBUTEROL 0.31 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378969062</ndc>
    <ndc_label_name>LEVALBUTEROL 0.31 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378969152</ndc>
    <ndc_label_name>LEVALBUTEROL 0.63 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378969162</ndc>
    <ndc_label_name>LEVALBUTEROL 0.63 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378969252</ndc>
    <ndc_label_name>LEVALBUTEROL 1.25 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378969262</ndc>
    <ndc_label_name>LEVALBUTEROL 1.25 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378972055</ndc>
    <ndc_label_name>Denavir 1 % topical cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00378973050</ndc>
    <ndc_label_name>Vusion 0.25 %-15 %-81.35 % topical ointment</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00386000102</ndc>
    <ndc_label_name>ETHYL CHLORIDE SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00386000103</ndc>
    <ndc_label_name>ETHYL CHLORIDE SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00386000104</ndc>
    <ndc_label_name>ETHYL CHLORIDE SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00386000111</ndc>
    <ndc_label_name>ETHYL CHLORIDE SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00386000113</ndc>
    <ndc_label_name>ETHYL CHLORIDE SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00386000404</ndc>
    <ndc_label_name>Spray And Stretch topical</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00386000801</ndc>
    <ndc_label_name>Pain Ease Mist Spray topical</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00386000802</ndc>
    <ndc_label_name>Pain Ease Mist Spray topical</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00386000803</ndc>
    <ndc_label_name>Pain Ease Medium Stream Spray topical</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00386000804</ndc>
    <ndc_label_name>Pain Ease Medium Stream Spray topical</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394002553</ndc>
    <ndc_label_name>Nomlands lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394010002</ndc>
    <ndc_label_name>Florical 3.75 mg (8.25)-145 mg (364) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394010005</ndc>
    <ndc_label_name>Florical 3.75 mg (8.25)-145 mg (364) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394010202</ndc>
    <ndc_label_name>Florical 3.75 mg (8.25)-145 mg (364) capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394010205</ndc>
    <ndc_label_name>Florical 3.75 mg (8.25)-145 mg (364) capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394010502</ndc>
    <ndc_label_name>Monocal 22.75 mg-625 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394012202</ndc>
    <ndc_label_name>Zinc-15 66 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394012402</ndc>
    <ndc_label_name>Orazinc 25 mg zinc (110 mg) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394013012</ndc>
    <ndc_label_name>Meribin 5 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394013142</ndc>
    <ndc_label_name>Hard Nails 2,500 mcg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394021760</ndc>
    <ndc_label_name>GINKGO 60 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394025009</ndc>
    <ndc_label_name>GLUCOSAMINE 500 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00394049902</ndc>
    <ndc_label_name>Orazinc 50 mg zinc (220 mg) capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00394085932</ndc>
    <ndc_label_name>HYDROCORTISONE 1% LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395001916</ndc>
    <ndc_label_name>ACETONE CP LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395001928</ndc>
    <ndc_label_name>ACETONE CP LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395001994</ndc>
    <ndc_label_name>ACETONE CP LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395003594</ndc>
    <ndc_label_name>COLA SYRUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395003716</ndc>
    <ndc_label_name>Alcohol, Denatured 95 % liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395003728</ndc>
    <ndc_label_name>Alcohol, Denatured 95 % liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395004016</ndc>
    <ndc_label_name>RUBBING ALCOHOL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395004912</ndc>
    <ndc_label_name>ALUM AMMONIUM POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395004996</ndc>
    <ndc_label_name>AMMONIUM ALUM POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395008916</ndc>
    <ndc_label_name>Flavor Blend 2 in 1 oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395008928</ndc>
    <ndc_label_name>Flavor Blend 2 in 1 oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395008985</ndc>
    <ndc_label_name>Flavor Blend 2 in 1 oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395009016</ndc>
    <ndc_label_name>Flavor Sweet oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395009028</ndc>
    <ndc_label_name>Flavor Sweet oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395009085</ndc>
    <ndc_label_name>Flavor Sweet oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395009116</ndc>
    <ndc_label_name>Flavor Plus oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395009128</ndc>
    <ndc_label_name>Flavor Plus oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395009185</ndc>
    <ndc_label_name>Flavor Plus oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395009416</ndc>
    <ndc_label_name>Flavor Sweet-SF oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395009428</ndc>
    <ndc_label_name>Flavor Sweet-SF oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395009485</ndc>
    <ndc_label_name>Flavor Sweet-SF oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395009891</ndc>
    <ndc_label_name>Ear Drops For Swimmers 95 %-5 %</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395011231</ndc>
    <ndc_label_name>SANARE ADV SCAR THERAPY BASE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395011256</ndc>
    <ndc_label_name>SANARE ADV SCAR THERAPY BASE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395011259</ndc>
    <ndc_label_name>SANARE ADV SCAR THERAPY BASE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395011594</ndc>
    <ndc_label_name>ARNICA TINCTURE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395012394</ndc>
    <ndc_label_name>ASCORBIC ACID GRANULES</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395012516</ndc>
    <ndc_label_name>Versa Free oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395012528</ndc>
    <ndc_label_name>Versa Free oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395012585</ndc>
    <ndc_label_name>Versa Free oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395012616</ndc>
    <ndc_label_name>Versa Plus oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395012628</ndc>
    <ndc_label_name>Versa Plus oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395012685</ndc>
    <ndc_label_name>Versa Plus oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395012791</ndc>
    <ndc_label_name>ASAFETIDA TINCTURE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395012994</ndc>
    <ndc_label_name>CASTIVA COOLING LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395013094</ndc>
    <ndc_label_name>CASTIVA WARMING 0.035% LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395013501</ndc>
    <ndc_label_name>PLO20 FLOWABLE BASE GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395013554</ndc>
    <ndc_label_name>PLO20 FLOWABLE BASE GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395020001</ndc>
    <ndc_label_name>BARIUM SULFATE POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395020116</ndc>
    <ndc_label_name>BAY RUM ELIXIR</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395024316</ndc>
    <ndc_label_name>benzoin compound 10 %-2 %-8 %-4 % topical tincture</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395024392</ndc>
    <ndc_label_name>benzoin compound 10 %-2 %-8 %-4 % topical tincture</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395024792</ndc>
    <ndc_label_name>BENZOIN TINCTURE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395030001</ndc>
    <ndc_label_name>BORIC ACID GRANULES</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395030094</ndc>
    <ndc_label_name>BORIC ACID GRANULES</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395030312</ndc>
    <ndc_label_name>BORIC ACID POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395030396</ndc>
    <ndc_label_name>BORIC ACID POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395040096</ndc>
    <ndc_label_name>Calaclear lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395040796</ndc>
    <ndc_label_name>CALAMINE PHENOLATED LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395041396</ndc>
    <ndc_label_name>CALAMINE LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395042096</ndc>
    <ndc_label_name>Calagesic 1 %-8 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395043101</ndc>
    <ndc_label_name>CALCIUM CARBONATE POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395045591</ndc>
    <ndc_label_name>CAMPHOR GUM BLOCKS</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395046716</ndc>
    <ndc_label_name>CAMPHOR SPIRIT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395046792</ndc>
    <ndc_label_name>CAMPHOR SPIRIT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395051394</ndc>
    <ndc_label_name>CASTOR OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395051516</ndc>
    <ndc_label_name>CASTOR OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395051592</ndc>
    <ndc_label_name>CASTOR OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395051596</ndc>
    <ndc_label_name>CASTOR OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395052791</ndc>
    <ndc_label_name>ACTIVATED CHARCOAL POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395052798</ndc>
    <ndc_label_name>ACTIVATED CHARCOAL POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395060501</ndc>
    <ndc_label_name>CITRIC ACID GRANULES</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395060594</ndc>
    <ndc_label_name>CITRIC ACID GRANULES</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395061716</ndc>
    <ndc_label_name>COAL TAR SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395063516</ndc>
    <ndc_label_name>COD LIVER OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395063594</ndc>
    <ndc_label_name>COD LIVER OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395067716</ndc>
    <ndc_label_name>COTTONSEED OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395071392</ndc>
    <ndc_label_name>DEWEE'S CARMINATIVE LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395080716</ndc>
    <ndc_label_name>Epsom Salt 100 % crystals</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395096712</ndc>
    <ndc_label_name>FULLER'S EARTH POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395100392</ndc>
    <ndc_label_name>GENTIAN VIOLET 1% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395100592</ndc>
    <ndc_label_name>GENTIAN VIOLET 2% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395103116</ndc>
    <ndc_label_name>GLYCERIN SKIN PROTECTANT LIQ</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395103128</ndc>
    <ndc_label_name>GLYCERIN 99.5% LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395103175</ndc>
    <ndc_label_name>GLYCERIN 99.5% SKIN PROTECT LQ</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395103185</ndc>
    <ndc_label_name>GLYCERIN 99.5% SKIN PROTECT LQ</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395103196</ndc>
    <ndc_label_name>GLYCERIN 99.5% LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395103796</ndc>
    <ndc_label_name>GLYCERIN AND ROSE WATER LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395104916</ndc>
    <ndc_label_name>GREEN SOAP TINCTURE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395104928</ndc>
    <ndc_label_name>GREEN SOAP TINCTURE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395104994</ndc>
    <ndc_label_name>GREEN SOAP TINCTURE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395111328</ndc>
    <ndc_label_name>HYDROGEN PEROXIDE 3% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395120716</ndc>
    <ndc_label_name>IODINE MILD TINCTURE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395120792</ndc>
    <ndc_label_name>Iodides Tincture topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395121116</ndc>
    <ndc_label_name>Iodine Tincture 1 %-70 % topical solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395121316</ndc>
    <ndc_label_name>IODINE 2% MILD TINCTURE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395121391</ndc>
    <ndc_label_name>IODINE 2% MILD TINCTURE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395121916</ndc>
    <ndc_label_name>IODINE STRONG TINCTURE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395124316</ndc>
    <ndc_label_name>ISOPROPYL ALCOHOL 99%</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395124328</ndc>
    <ndc_label_name>ISOPROPYL ALCOHOL 99%</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395124904</ndc>
    <ndc_label_name>ISOPROPYL RUBBING ALCOHOL 70%</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395124928</ndc>
    <ndc_label_name>ISOPROPYL ALCOHOL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395125928</ndc>
    <ndc_label_name>ISOPROPYL ALCOHOL 70%</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395140194</ndc>
    <ndc_label_name>KARAYA GUM POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395150101</ndc>
    <ndc_label_name>LACTOSE MONOHYDRATE POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395161994</ndc>
    <ndc_label_name>MENTHOL CRYSTALS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395166716</ndc>
    <ndc_label_name>METHYL SALICYLATE LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395166792</ndc>
    <ndc_label_name>METHYL SALICYLATE LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395167016</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395167328</ndc>
    <ndc_label_name>MINERAL OIL LIGHT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395168528</ndc>
    <ndc_label_name>Mineral Oil Heavy oral</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395191391</ndc>
    <ndc_label_name>ANISE OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395193116</ndc>
    <ndc_label_name>Cinnamon Oil</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395193191</ndc>
    <ndc_label_name>Cinnamon Oil</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395193791</ndc>
    <ndc_label_name>Cinnamon Oil</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395194391</ndc>
    <ndc_label_name>CITRONELLA OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395194988</ndc>
    <ndc_label_name>CLOVE OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395194991</ndc>
    <ndc_label_name>CLOVE OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395196194</ndc>
    <ndc_label_name>COCONUT OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395197316</ndc>
    <ndc_label_name>EUCALYPTUS OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395197394</ndc>
    <ndc_label_name>EUCALYPTUS OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395197991</ndc>
    <ndc_label_name>LAVENDER OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395199728</ndc>
    <ndc_label_name>OLIVE OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395199794</ndc>
    <ndc_label_name>OLIVE OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395200391</ndc>
    <ndc_label_name>ORANGE OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395201591</ndc>
    <ndc_label_name>PEPPERMINT OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395206311</ndc>
    <ndc_label_name>Sweet Oil</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395206394</ndc>
    <ndc_label_name>Sweet Oil</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395207592</ndc>
    <ndc_label_name>TURPENTINE OIL, RECTIFIED</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395211794</ndc>
    <ndc_label_name>OXALIC ACID CRYSTALS</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395224391</ndc>
    <ndc_label_name>PEPPERMINT SPIRIT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395225594</ndc>
    <ndc_label_name>PERUVIAN BALSAM LIQUID</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395232516</ndc>
    <ndc_label_name>POVIDONE-IODINE 10% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395232598</ndc>
    <ndc_label_name>POVIDONE-IODINE 10% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395232728</ndc>
    <ndc_label_name>PROPYLENE GLYCOL LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395233575</ndc>
    <ndc_label_name>POLYETHYLENE GLYCOL 300 LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395251394</ndc>
    <ndc_label_name>ROSE WATER LIQ ARTIFICIAL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395253198</ndc>
    <ndc_label_name>ROSIN POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395262501</ndc>
    <ndc_label_name>SALICYLIC ACID POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395262594</ndc>
    <ndc_label_name>SALICYLIC ACID POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395263701</ndc>
    <ndc_label_name>POTASSIUM NITRATE GRANULES</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395263794</ndc>
    <ndc_label_name>POTASSIUM NITRATE GRANULES</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395266116</ndc>
    <ndc_label_name>SIMPLE SYRUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395266128</ndc>
    <ndc_label_name>SIMPLE SYRUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395266175</ndc>
    <ndc_label_name>SIMPLE SYRUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395266185</ndc>
    <ndc_label_name>SIMPLE SYRUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395266216</ndc>
    <ndc_label_name>CHERRY SYRUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395266228</ndc>
    <ndc_label_name>CHERRY SYRUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395266285</ndc>
    <ndc_label_name>CHERRY SYRUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395266416</ndc>
    <ndc_label_name>RASPBERRY SYRUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395268501</ndc>
    <ndc_label_name>SODIUM BICARBONATE POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395268594</ndc>
    <ndc_label_name>SODIUM BICARBONATE POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395270901</ndc>
    <ndc_label_name>SODIUM PERBORATE CRYSTALS</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395272730</ndc>
    <ndc_label_name>SODIUM SILICATE SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395277516</ndc>
    <ndc_label_name>Strong Iodine 5 % oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395279912</ndc>
    <ndc_label_name>SULFUR SUBLIMED POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395279994</ndc>
    <ndc_label_name>SULFUR SUBLIMED POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395294316</ndc>
    <ndc_label_name>TURPENTINE LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395294394</ndc>
    <ndc_label_name>TURPENTINE LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395350101</ndc>
    <ndc_label_name>ZINC OXIDE POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395391385</ndc>
    <ndc_label_name>SORBITOL 70% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395392016</ndc>
    <ndc_label_name>SyrPalta Vehicle oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395392085</ndc>
    <ndc_label_name>SyrPalta Vehicle oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395420228</ndc>
    <ndc_label_name>ISOPROPYL RUBBING ALCOHOL 70%</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395481791</ndc>
    <ndc_label_name>AUSTRALIAN TEA TREE 100% OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395571694</ndc>
    <ndc_label_name>SODIUM BICARBONATE POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600154</ndc>
    <ndc_label_name>HRT BASE BOTANICAL CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600156</ndc>
    <ndc_label_name>HRT BASE BOTANICAL CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600254</ndc>
    <ndc_label_name>HRT BASE HEAVY OINTMENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600256</ndc>
    <ndc_label_name>HRT Heavy Cream Base transdermal</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600257</ndc>
    <ndc_label_name>BHRT BASE CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600258</ndc>
    <ndc_label_name>BHRT BASE CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600354</ndc>
    <ndc_label_name>LIPOBASE REGULAR CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600457</ndc>
    <ndc_label_name>LIPOSOMAL HEAVY CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600458</ndc>
    <ndc_label_name>LIPOSOMAL HEAVY CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600801</ndc>
    <ndc_label_name>PLO20 BASE GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600854</ndc>
    <ndc_label_name>PLO20 BASE GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600879</ndc>
    <ndc_label_name>PLO20 BASE GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600954</ndc>
    <ndc_label_name>SaltStable LO cream base</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600956</ndc>
    <ndc_label_name>SaltStable LO cream base</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600957</ndc>
    <ndc_label_name>SaltStable LO cream base</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395600958</ndc>
    <ndc_label_name>SaltStable LO cream base</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601054</ndc>
    <ndc_label_name>PENCREAM COMPOUNDING AGENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601056</ndc>
    <ndc_label_name>PENCREAM COMPOUNDING AGENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601057</ndc>
    <ndc_label_name>PENCREAM COMPOUNDING AGENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601058</ndc>
    <ndc_label_name>PENCREAM COMPOUNDING AGENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601354</ndc>
    <ndc_label_name>Anhydrous Base topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601356</ndc>
    <ndc_label_name>Anhydrous Base topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601554</ndc>
    <ndc_label_name>MULTIBASE CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601557</ndc>
    <ndc_label_name>MULTIUSE BASE CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601754</ndc>
    <ndc_label_name>UNIVERSAL WATER GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601954</ndc>
    <ndc_label_name>WILEY BASIC ELEMENTS BHRT BASE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601970</ndc>
    <ndc_label_name>WILEY BASIC ELEMENTS BHRT BASE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601973</ndc>
    <ndc_label_name>WILEY BASIC ELEMENTS BHRT BASE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395601977</ndc>
    <ndc_label_name>WILEY BASIC ELEMENTS BHRT BASE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395602056</ndc>
    <ndc_label_name>RECURA CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395602059</ndc>
    <ndc_label_name>RECURA CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395602156</ndc>
    <ndc_label_name>SaltStable LS cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395602157</ndc>
    <ndc_label_name>SaltStable LS cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395602158</ndc>
    <ndc_label_name>SaltStable LS cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395602257</ndc>
    <ndc_label_name>BHRT BASE CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395602258</ndc>
    <ndc_label_name>BHRT BASE CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395801092</ndc>
    <ndc_label_name>Merthiolate (benzalkonium) 0.13 % topical solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395916702</ndc>
    <ndc_label_name>CHERRY SYRUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395916801</ndc>
    <ndc_label_name>Flavor Sweet-SF oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00395916802</ndc>
    <ndc_label_name>Flavor Sweet-SF oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395916901</ndc>
    <ndc_label_name>Flavor Sweet oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00395916902</ndc>
    <ndc_label_name>Flavor Sweet oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00396391000</ndc>
    <ndc_label_name>Pro-Ception vaginal</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00396401060</ndc>
    <ndc_label_name>WIDE SEAL DIAPHRAGM 60MM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00396401065</ndc>
    <ndc_label_name>WIDE SEAL DIAPHRAGM 65MM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00396401070</ndc>
    <ndc_label_name>WIDE SEAL DIAPHRAGM 70MM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00396401075</ndc>
    <ndc_label_name>WIDE SEAL DIAPHRAGM 75MM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00396401080</ndc>
    <ndc_label_name>WIDE SEAL DIAPHRAGM 80MM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00396401085</ndc>
    <ndc_label_name>WIDE SEAL DIAPHRAGM 85MM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00396401090</ndc>
    <ndc_label_name>WIDE SEAL DIAPHRAGM 90MM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00396401095</ndc>
    <ndc_label_name>WIDE SEAL DIAPHRAGM 95MM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00404001713</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00404071413</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00404071499</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00404071613</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00404071699</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00404100003</ndc>
    <ndc_label_name>SILVER NITRATE APPLICATOR 6"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00404407501</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12% RINSE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00404650015</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:50,000 CART</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00404651205</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00404662505</ndc>
    <ndc_label_name>ARTICAINE 4%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00404673005</ndc>
    <ndc_label_name>MEPIVACAINE 3% CARTRIDGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00404719901</ndc>
    <ndc_label_name>PROPARACAINE 0.5% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012301</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 5-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012305</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 5-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012310</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 5-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012312</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 5-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012323</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 5-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012362</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 5-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012401</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 7.5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012405</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 7.5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012410</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 7.5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012412</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 7.5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012423</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 7.5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012462</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 7.5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012501</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 10-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012505</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 10-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012510</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 10-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012512</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 10-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012523</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 10-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012560</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 10-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012562</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 10-325 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406012701</ndc>
    <ndc_label_name>METHYLPHENIDATE ER 27 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406013601</ndc>
    <ndc_label_name>METHYLPHENIDATE ER 36 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406015401</ndc>
    <ndc_label_name>METHYLPHENIDATE ER 54 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406037601</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 5-300 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406037605</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 5-300 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406037701</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 7.5-300</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406037705</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 7.5-300</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406037801</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 10-300 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406037805</ndc>
    <ndc_label_name>HYDROCODONE-ACETAMIN 10-300 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406048301</ndc>
    <ndc_label_name>ACETAMINOPHEN-COD #2 TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406048401</ndc>
    <ndc_label_name>ACETAMINOPHEN-COD #3 TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406048403</ndc>
    <ndc_label_name>ACETAMINOPHEN-COD #3 TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406048410</ndc>
    <ndc_label_name>ACETAMINOPHEN-COD #3 TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406048423</ndc>
    <ndc_label_name>ACETAMINOPHEN-COD #3 TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406048462</ndc>
    <ndc_label_name>ACETAMINOPHEN-COD #3 TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406048501</ndc>
    <ndc_label_name>ACETAMINOPHEN-COD #4 TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406048505</ndc>
    <ndc_label_name>ACETAMINOPHEN-COD #4 TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406051201</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHEN 5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406051205</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHEN 5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406051223</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHEN 5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406051262</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHEN 5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406052201</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHN 7.5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406052205</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHN 7.5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406052223</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHN 7.5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406052262</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHN 7.5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406052301</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHEN 10-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406052305</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHEN 10-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406052323</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHEN 10-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406052362</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHEN 10-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406052710</ndc>
    <ndc_label_name>Methadose 10 mg/mL oral concentrate</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406054034</ndc>
    <ndc_label_name>Methadose 40 mg soluble tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406055201</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406055223</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406055262</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406067252</ndc>
    <ndc_label_name>SUFENTANIL CITRATE POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406080301</ndc>
    <ndc_label_name>DEXTROAMPH-AMPHET ER 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406080401</ndc>
    <ndc_label_name>DEXTROAMPH-AMPHET ER 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406080701</ndc>
    <ndc_label_name>DEXTROAMPH-AMPHET ER 37.5MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406113052</ndc>
    <ndc_label_name>FENTANYL CITRATE POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406114201</ndc>
    <ndc_label_name>METHYLPHENIDATE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406114401</ndc>
    <ndc_label_name>METHYLPHENIDATE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406114601</ndc>
    <ndc_label_name>METHYLPHENIDATE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406117001</ndc>
    <ndc_label_name>NALTREXONE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406117003</ndc>
    <ndc_label_name>NALTREXONE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406121901</ndc>
    <ndc_label_name>AMPHETAMINE SULFATE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406122001</ndc>
    <ndc_label_name>AMPHETAMINE SULFATE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406123601</ndc>
    <ndc_label_name>DIPHENOXYLATE-ATROP 2.5-0.025</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406123610</ndc>
    <ndc_label_name>DIPHENOXYLATE-ATROP 2.5-0.025</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406144501</ndc>
    <ndc_label_name>METHYLPHENIDATE ER 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406147301</ndc>
    <ndc_label_name>METHYLPHENIDATE ER 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406149252</ndc>
    <ndc_label_name>NALOXONE HCL POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406151056</ndc>
    <ndc_label_name>METHADONE HCL POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406151057</ndc>
    <ndc_label_name>METHADONE HCL POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406152053</ndc>
    <ndc_label_name>COCAINE HYDROCHLORIDE PWD</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406152055</ndc>
    <ndc_label_name>COCAINE HYDROCHLORIDE PWD</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406152153</ndc>
    <ndc_label_name>MORPHINE SULFATE POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406152155</ndc>
    <ndc_label_name>MORPHINE SULFATE POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406152156</ndc>
    <ndc_label_name>MORPHINE SULFATE POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406152157</ndc>
    <ndc_label_name>MORPHINE SULFATE POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406154832</ndc>
    <ndc_label_name>CODEINE PHOSPHATE POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406154835</ndc>
    <ndc_label_name>CODEINE PHOSPHATE POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406155953</ndc>
    <ndc_label_name>HYDROCODONE BITARTRATE CRYSTAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406157155</ndc>
    <ndc_label_name>METHYLPHENIDATE HCL POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406158253</ndc>
    <ndc_label_name>HYDROCODONE BITARTRATE CRYSTAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406181001</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(CD) 10MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406182001</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(CD) 20MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406183001</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(CD) 30MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406184001</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(CD) 40MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406185001</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(CD) 50MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406186001</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(CD) 60MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406192303</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 2-0.5MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406222401</ndc>
    <ndc_label_name>LEVORPHANOL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406254001</ndc>
    <ndc_label_name>METHADONE 40 MG TABLET DISPR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406322257</ndc>
    <ndc_label_name>HYDROMORPHONE HCL POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406324301</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406324401</ndc>
    <ndc_label_name>HYDROMORPHONE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406324901</ndc>
    <ndc_label_name>HYDROMORPHONE 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406412303</ndc>
    <ndc_label_name>METHADONE 10 MG/ML ORAL CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406412310</ndc>
    <ndc_label_name>METHADONE 10 MG/ML ORAL CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406511101</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406511201</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406511301</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406511401</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406511501</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406511601</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406511701</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 70 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406511801</ndc>
    <ndc_label_name>MORPHINE SULFATE IR 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406511823</ndc>
    <ndc_label_name>MORPHINE SULFATE IR 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406511862</ndc>
    <ndc_label_name>MORPHINE SULFATE IR 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406511901</ndc>
    <ndc_label_name>MORPHINE SULFATE IR 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406511923</ndc>
    <ndc_label_name>MORPHINE SULFATE IR 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406511962</ndc>
    <ndc_label_name>MORPHINE SULFATE IR 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406512401</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 10 MG TB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406512501</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 20 MG TB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406512601</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 30 MG TB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406512701</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 40 MG TB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406512801</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 50 MG TB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406512901</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 60 MG TB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406575501</ndc>
    <ndc_label_name>METHADONE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406575523</ndc>
    <ndc_label_name>METHADONE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406575562</ndc>
    <ndc_label_name>METHADONE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406577101</ndc>
    <ndc_label_name>METHADONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406577123</ndc>
    <ndc_label_name>METHADONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406577162</ndc>
    <ndc_label_name>METHADONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406622105</ndc>
    <ndc_label_name>METHADONE 10 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406622505</ndc>
    <ndc_label_name>METHADONE 5 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406630103</ndc>
    <ndc_label_name>PRUCALOPRIDE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406630203</ndc>
    <ndc_label_name>PRUCALOPRIDE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406701203</ndc>
    <ndc_label_name>BUPRENORPHINE 2 MG TABLET SL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406701803</ndc>
    <ndc_label_name>BUPRENORPHINE 8 MG TABLET SL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406771160</ndc>
    <ndc_label_name>POSACONAZOLE DR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406800312</ndc>
    <ndc_label_name>MORPHINE SULF 100 MG/5 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406800315</ndc>
    <ndc_label_name>MORPHINE SULF 100 MG/5 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406800324</ndc>
    <ndc_label_name>MORPHINE SULF 100 MG/5 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406800330</ndc>
    <ndc_label_name>MORPHINE SULF 100 MG/5 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406800503</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 2-0.5MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406802003</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 8-2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406831501</ndc>
    <ndc_label_name>MORPHINE SULF ER 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406831523</ndc>
    <ndc_label_name>MORPHINE SULF ER 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406831562</ndc>
    <ndc_label_name>MORPHINE SULF ER 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406832001</ndc>
    <ndc_label_name>MORPHINE SULF ER 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406833001</ndc>
    <ndc_label_name>MORPHINE SULF ER 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406833023</ndc>
    <ndc_label_name>MORPHINE SULF ER 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406833062</ndc>
    <ndc_label_name>MORPHINE SULF ER 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406838001</ndc>
    <ndc_label_name>MORPHINE SULF ER 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406838023</ndc>
    <ndc_label_name>MORPHINE SULF ER 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406838062</ndc>
    <ndc_label_name>MORPHINE SULF ER 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406839001</ndc>
    <ndc_label_name>MORPHINE SULF ER 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406839023</ndc>
    <ndc_label_name>MORPHINE SULF ER 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406839062</ndc>
    <ndc_label_name>MORPHINE SULF ER 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406851001</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406851023</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406851062</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406851501</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406851523</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406851562</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406852001</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406853001</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406853023</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406853062</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406855605</ndc>
    <ndc_label_name>OXYCODONE HCL 5 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406855730</ndc>
    <ndc_label_name>OXYCODONE HCL 100 MG/5 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406872510</ndc>
    <ndc_label_name>Methadose 10 mg/mL oral concentrate</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406880601</ndc>
    <ndc_label_name>CLOMIPRAMINE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406880701</ndc>
    <ndc_label_name>CLOMIPRAMINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406880801</ndc>
    <ndc_label_name>CLOMIPRAMINE 75 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406887353</ndc>
    <ndc_label_name>OXYCODONE HCL POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406887357</ndc>
    <ndc_label_name>OXYCODONE HCL POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406888401</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAM 7.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406888501</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406889101</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMINE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406889201</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406889301</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406889401</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406895101</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406895201</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406895301</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 15 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406895401</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406895501</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406895601</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406895801</ndc>
    <ndc_label_name>DEXTROAMPHETAMINE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406895901</ndc>
    <ndc_label_name>DEXTROAMPHETAMINE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406896001</ndc>
    <ndc_label_name>DEXTROAMPHETAMINE ER 5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406896101</ndc>
    <ndc_label_name>DEXTROAMPHETAMINE ER 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406896201</ndc>
    <ndc_label_name>DEXTROAMPHETAMINE ER 15 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406900076</ndc>
    <ndc_label_name>FENTANYL 100 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406901276</ndc>
    <ndc_label_name>FENTANYL 12 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406902576</ndc>
    <ndc_label_name>FENTANYL 25 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406903776</ndc>
    <ndc_label_name>FENTANYL 37.5 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406905076</ndc>
    <ndc_label_name>FENTANYL 50 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406906276</ndc>
    <ndc_label_name>FENTANYL 62.5 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406907576</ndc>
    <ndc_label_name>FENTANYL 75 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406910076</ndc>
    <ndc_label_name>FENTANYL 100 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406911276</ndc>
    <ndc_label_name>FENTANYL 12 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406912576</ndc>
    <ndc_label_name>FENTANYL 25 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406915076</ndc>
    <ndc_label_name>FENTANYL 50 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406917576</ndc>
    <ndc_label_name>FENTANYL 75 MCG/HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406920230</ndc>
    <ndc_label_name>FENTANYL CITRATE OTFC 200 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406920430</ndc>
    <ndc_label_name>FENTANYL CITRATE OTFC 400 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406920830</ndc>
    <ndc_label_name>FENTANYL CITRATE OTFC 800 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406921230</ndc>
    <ndc_label_name>FENTANYL CIT OTFC 1,200 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406921630</ndc>
    <ndc_label_name>FENTANYL CIT OTFC 1,600 MCG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406990603</ndc>
    <ndc_label_name>Anafranil 25 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406990703</ndc>
    <ndc_label_name>Anafranil 50 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406990803</ndc>
    <ndc_label_name>Anafranil 75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406991003</ndc>
    <ndc_label_name>PAMELOR 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406991103</ndc>
    <ndc_label_name>PAMELOR 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406991203</ndc>
    <ndc_label_name>PAMELOR 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406991303</ndc>
    <ndc_label_name>PAMELOR 75 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406991403</ndc>
    <ndc_label_name>Restoril 22.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406991501</ndc>
    <ndc_label_name>Restoril 7.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406991503</ndc>
    <ndc_label_name>Restoril 7.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406991601</ndc>
    <ndc_label_name>Restoril 15 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00406991701</ndc>
    <ndc_label_name>Restoril 30 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406995903</ndc>
    <ndc_label_name>TEMAZEPAM 22.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406996001</ndc>
    <ndc_label_name>TEMAZEPAM 7.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406996101</ndc>
    <ndc_label_name>TEMAZEPAM 15 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00406996201</ndc>
    <ndc_label_name>TEMAZEPAM 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407069010</ndc>
    <ndc_label_name>Omniscan 5 mmol/10 mL (287 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407069015</ndc>
    <ndc_label_name>Omniscan 7.5 mmol/15 mL (287 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407069020</ndc>
    <ndc_label_name>Omniscan 10 mmol/20 mL (287 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407140152</ndc>
    <ndc_label_name>Omnipaque 140 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141110</ndc>
    <ndc_label_name>Omnipaque 180 mg iodine/mL intrathecal solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141208</ndc>
    <ndc_label_name>Omnipaque 240 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141210</ndc>
    <ndc_label_name>Omnipaque 240 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141220</ndc>
    <ndc_label_name>Omnipaque 240 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141230</ndc>
    <ndc_label_name>Omnipaque 240 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141233</ndc>
    <ndc_label_name>Omnipaque 240 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141308</ndc>
    <ndc_label_name>Omnipaque 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141310</ndc>
    <ndc_label_name>Omnipaque 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141358</ndc>
    <ndc_label_name>Omnipaque 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141359</ndc>
    <ndc_label_name>Omnipaque 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141361</ndc>
    <ndc_label_name>Omnipaque 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141363</ndc>
    <ndc_label_name>Omnipaque 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141365</ndc>
    <ndc_label_name>Omnipaque 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141372</ndc>
    <ndc_label_name>Omnipaque 300 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141408</ndc>
    <ndc_label_name>Omnipaque 350 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141472</ndc>
    <ndc_label_name>Omnipaque 350 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141489</ndc>
    <ndc_label_name>Omnipaque 350 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141490</ndc>
    <ndc_label_name>Omnipaque 350 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141491</ndc>
    <ndc_label_name>Omnipaque 350 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141493</ndc>
    <ndc_label_name>Omnipaque 350 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141494</ndc>
    <ndc_label_name>Omnipaque 350 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141509</ndc>
    <ndc_label_name>Omnipaque 9 mg iodine/mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407141612</ndc>
    <ndc_label_name>Omnipaque 12  mg iodine/mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407222216</ndc>
    <ndc_label_name>Visipaque 270 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407222217</ndc>
    <ndc_label_name>Visipaque 270 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407222219</ndc>
    <ndc_label_name>Visipaque 270 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407222221</ndc>
    <ndc_label_name>Visipaque 270 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407222316</ndc>
    <ndc_label_name>Visipaque 320 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407222317</ndc>
    <ndc_label_name>Visipaque 320 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407222319</ndc>
    <ndc_label_name>Visipaque 320 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407222321</ndc>
    <ndc_label_name>Visipaque 320 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407222323</ndc>
    <ndc_label_name>Visipaque 320 mg iodine/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407270703</ndc>
    <ndc_label_name>Optison 0.22 mg/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407270718</ndc>
    <ndc_label_name>Optison 0.22 mg/mL intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407294301</ndc>
    <ndc_label_name>Clariscan 0.5 mmol/mL (376.9 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407294302</ndc>
    <ndc_label_name>Clariscan 0.5 mmol/mL (376.9 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407294305</ndc>
    <ndc_label_name>Clariscan 0.5 mmol/mL (376.9 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407294306</ndc>
    <ndc_label_name>Clariscan 0.5 mmol/mL (376.9 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407294312</ndc>
    <ndc_label_name>Clariscan 0.5 mmol/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407294317</ndc>
    <ndc_label_name>Clariscan 0.5 mmol/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407294322</ndc>
    <ndc_label_name>Clariscan 0.5 mmol/mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407294370</ndc>
    <ndc_label_name>Clariscan 0.5 mmol/mL (376.9 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00407878701</ndc>
    <ndc_label_name>Flyrcado 190 MBq/mL to 2,050 MBq/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409000101</ndc>
    <ndc_label_name>MIDAZOLAM HCL 2 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409000125</ndc>
    <ndc_label_name>MIDAZOLAM HCL 2 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409000404</ndc>
    <ndc_label_name>PEMETREXED DISODIUM 1 GM/40 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409000701</ndc>
    <ndc_label_name>LIDOCAINE 1%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409000710</ndc>
    <ndc_label_name>LIDOCAINE 1%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409000902</ndc>
    <ndc_label_name>ONDANSETRON HCL 4 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409000925</ndc>
    <ndc_label_name>ONDANSETRON HCL 4 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409001202</ndc>
    <ndc_label_name>HEPARIN 12,500 UNIT/250-1/2 NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409001230</ndc>
    <ndc_label_name>HEPARIN 12,500 UNIT/250-1/2 NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409001601</ndc>
    <ndc_label_name>DOCETAXEL 160 MG/16 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409002002</ndc>
    <ndc_label_name>PEMETREXED DISODIUM 100 MG/4ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409002103</ndc>
    <ndc_label_name>PEMETREXED DISODIUM 500MG/20ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409002401</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409002410</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409002501</ndc>
    <ndc_label_name>DOBUTAMINE 250 MG/250 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409002510</ndc>
    <ndc_label_name>DOBUTAMINE 250 MG/250 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409003201</ndc>
    <ndc_label_name>POTASSIUM PHOSP 45 MMOL/15 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409003210</ndc>
    <ndc_label_name>POTASSIUM PHOSP 45 MMOL/15 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409004005</ndc>
    <ndc_label_name>KETAMINE 500 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409004010</ndc>
    <ndc_label_name>KETAMINE 500 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409004201</ndc>
    <ndc_label_name>DOPAMINE 400 MG/250 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409004212</ndc>
    <ndc_label_name>DOPAMINE 400 MG/250 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409005101</ndc>
    <ndc_label_name>ADD-Vantage ADDaptor</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409006401</ndc>
    <ndc_label_name>CARBOPROST 250 MCG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409006410</ndc>
    <ndc_label_name>CARBOPROST 250 MCG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409012001</ndc>
    <ndc_label_name>DAPTOMYCIN 350 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409012201</ndc>
    <ndc_label_name>DAPTOMYCIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409012501</ndc>
    <ndc_label_name>LABETALOL HCL 100 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409012525</ndc>
    <ndc_label_name>LABETALOL HCL 100 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409014411</ndc>
    <ndc_label_name>AZITHROMYCIN 500 MG ADD-VAN VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409014421</ndc>
    <ndc_label_name>AZITHROMYCIN 500 MG ADD-VAN VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409014701</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409014710</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409015101</ndc>
    <ndc_label_name>DOBUTAMINE 500 MG/250 ML D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409015110</ndc>
    <ndc_label_name>DOBUTAMINE 500 MG/250 ML D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409015201</ndc>
    <ndc_label_name>METRONIDAZOLE 500 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409015224</ndc>
    <ndc_label_name>METRONIDAZOLE 500 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409015501</ndc>
    <ndc_label_name>Precedex 400 mcg/100 mL (4 mcg/mL) in 0.9% sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409015502</ndc>
    <ndc_label_name>Precedex 400 mcg/100 mL (4 mcg/mL) in 0.9% sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409016101</ndc>
    <ndc_label_name>Levophed 1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409016110</ndc>
    <ndc_label_name>Levophed 1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409018101</ndc>
    <ndc_label_name>GEMCITABINE 1 GRAM/26.3 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409018125</ndc>
    <ndc_label_name>GEMCITABINE 1 GRAM/26.3 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409018201</ndc>
    <ndc_label_name>GEMCITABINE 2 GRAM/52.6 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409018225</ndc>
    <ndc_label_name>GEMCITABINE 2 GRAM/52.6 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409018301</ndc>
    <ndc_label_name>GEMCITABINE 200 MG/5.26 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409018325</ndc>
    <ndc_label_name>GEMCITABINE 200 MG/5.26 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409018501</ndc>
    <ndc_label_name>GEMCITABINE HCL 200 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409018601</ndc>
    <ndc_label_name>GEMCITABINE HCL 1 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409018701</ndc>
    <ndc_label_name>GEMCITABINE HCL 2 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409020102</ndc>
    <ndc_label_name>DOCETAXEL 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409020110</ndc>
    <ndc_label_name>DOCETAXEL 80 MG/8 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409020120</ndc>
    <ndc_label_name>DOCETAXEL 160 MG/16 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409021201</ndc>
    <ndc_label_name>MILRINONE LACT 10 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409021202</ndc>
    <ndc_label_name>MILRINONE LACT 20 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409021203</ndc>
    <ndc_label_name>MILRINONE LACT 50 MG/50 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409021210</ndc>
    <ndc_label_name>MILRINONE LACT 10 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409021211</ndc>
    <ndc_label_name>MILRINONE LACT 20 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409022201</ndc>
    <ndc_label_name>MEROPENEM IV 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409022210</ndc>
    <ndc_label_name>MEROPENEM IV 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409030201</ndc>
    <ndc_label_name>TOPOTECAN HCL 4 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409032320</ndc>
    <ndc_label_name>BLEOMYCIN SULFATE 30 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409033220</ndc>
    <ndc_label_name>BLEOMYCIN SULFATE 15 UNIT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409036501</ndc>
    <ndc_label_name>DOCETAXEL 160 MG/8 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409036601</ndc>
    <ndc_label_name>DOCETAXEL 20 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409036701</ndc>
    <ndc_label_name>DOCETAXEL 80 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409036801</ndc>
    <ndc_label_name>DOCETAXEL 160 MG/8 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409052501</ndc>
    <ndc_label_name>Marcaine 0.5 % (5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409052525</ndc>
    <ndc_label_name>Marcaine 0.5 % (5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409052813</ndc>
    <ndc_label_name>LEVOFLOXACIN 250 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409052815</ndc>
    <ndc_label_name>LEVOFLOXACIN 250 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409052823</ndc>
    <ndc_label_name>LEVOFLOXACIN 500 MG/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409052825</ndc>
    <ndc_label_name>LEVOFLOXACIN 500 MG/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409052831</ndc>
    <ndc_label_name>LEVOFLOXACIN 750 MG/150 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409052835</ndc>
    <ndc_label_name>LEVOFLOXACIN 750 MG/150 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409080101</ndc>
    <ndc_label_name>Nipent 10 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409082901</ndc>
    <ndc_label_name>AZTREONAM 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409082911</ndc>
    <ndc_label_name>AZTREONAM 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409083001</ndc>
    <ndc_label_name>AZTREONAM 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409083011</ndc>
    <ndc_label_name>AZTREONAM 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409100501</ndc>
    <ndc_label_name>HEPARIN 1,000 UNIT/500 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409100520</ndc>
    <ndc_label_name>HEPARIN 1,000 UNIT/500 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409104501</ndc>
    <ndc_label_name>PEMETREXED DISODIUM 100 MG/4ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409106001</ndc>
    <ndc_label_name>PEMETREXED 100 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409106101</ndc>
    <ndc_label_name>PEMETREXED 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409109802</ndc>
    <ndc_label_name>CISATRACURIUM 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409109812</ndc>
    <ndc_label_name>CISATRACURIUM 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409110001</ndc>
    <ndc_label_name>DOBUTAMINE 1,000 MG/250 ML D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409110010</ndc>
    <ndc_label_name>DOBUTAMINE 1,000 MG/250 ML D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409110301</ndc>
    <ndc_label_name>CISATRACURIUM 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409110311</ndc>
    <ndc_label_name>CISATRACURIUM 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409110502</ndc>
    <ndc_label_name>ATRACURIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409110522</ndc>
    <ndc_label_name>ATRACURIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409110901</ndc>
    <ndc_label_name>ATRACURIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409110911</ndc>
    <ndc_label_name>ATRACURIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409111201</ndc>
    <ndc_label_name>BUSULFAN 60 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409111210</ndc>
    <ndc_label_name>BUSULFAN 60 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409113405</ndc>
    <ndc_label_name>MORPHINE SULFATE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409114001</ndc>
    <ndc_label_name>ARGATROBAN 250 MG/2.5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409114102</ndc>
    <ndc_label_name>SODIUM CHLORIDE 400 MEQ/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409114112</ndc>
    <ndc_label_name>SODIUM CHLORIDE 400 MEQ/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409114402</ndc>
    <ndc_label_name>VERAPAMIL 10 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409114405</ndc>
    <ndc_label_name>VERAPAMIL 5 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409114410</ndc>
    <ndc_label_name>VERAPAMIL 5 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409114411</ndc>
    <ndc_label_name>VERAPAMIL 5 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409114462</ndc>
    <ndc_label_name>VERAPAMIL 10 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409114465</ndc>
    <ndc_label_name>VERAPAMIL 5 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409115901</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409115902</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409115909</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409115910</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409115918</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409115919</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116001</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116018</ndc>
    <ndc_label_name>BUPIVACAINE 0.25% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116201</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116202</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116209</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116210</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116218</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116219</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116301</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116318</ndc>
    <ndc_label_name>BUPIVACAINE 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116501</ndc>
    <ndc_label_name>BUPIVACAINE 0.75% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116502</ndc>
    <ndc_label_name>BUPIVACAINE 0.75% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116518</ndc>
    <ndc_label_name>BUPIVACAINE 0.75% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409116519</ndc>
    <ndc_label_name>BUPIVACAINE 0.75% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409117401</ndc>
    <ndc_label_name>Precedex 400 mcg/100 mL (4 mcg/mL) in 0.9% sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409117410</ndc>
    <ndc_label_name>Precedex 400 mcg/100 mL (4 mcg/mL) in 0.9% sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409117603</ndc>
    <ndc_label_name>Demerol (PF) 25 mg/mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409117630</ndc>
    <ndc_label_name>Demerol (PF) 25 mg/mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409117803</ndc>
    <ndc_label_name>Demerol (PF) 50 mg/mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409117830</ndc>
    <ndc_label_name>Demerol (PF) 50 mg/mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409117903</ndc>
    <ndc_label_name>Demerol (PF) 75 mg/mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409117930</ndc>
    <ndc_label_name>Demerol (PF) 75 mg/mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409118059</ndc>
    <ndc_label_name>DEMEROL 100 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409118069</ndc>
    <ndc_label_name>DEMEROL 100 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409118130</ndc>
    <ndc_label_name>Demerol 50 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409120703</ndc>
    <ndc_label_name>GENTAMICIN 80 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409120713</ndc>
    <ndc_label_name>GENTAMICIN 80 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409120801</ndc>
    <ndc_label_name>CISATRACURIUM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409120811</ndc>
    <ndc_label_name>CISATRACURIUM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409120901</ndc>
    <ndc_label_name>LIDOCAINE 1.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409120910</ndc>
    <ndc_label_name>LIDOCAINE 1.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409120965</ndc>
    <ndc_label_name>LIDOCAINE 1.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409120970</ndc>
    <ndc_label_name>LIDOCAINE 1.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409121501</ndc>
    <ndc_label_name>NALOXONE 0.4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409121521</ndc>
    <ndc_label_name>NALOXONE 0.4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409121901</ndc>
    <ndc_label_name>NALOXONE 4 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409121941</ndc>
    <ndc_label_name>NALOXONE 4 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409127303</ndc>
    <ndc_label_name>DIAZEPAM 10 MG/2 ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409127332</ndc>
    <ndc_label_name>DIAZEPAM 10 MG/2 ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409128303</ndc>
    <ndc_label_name>HYDROMORPHONE 1 MG/ML CARPUJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409128317</ndc>
    <ndc_label_name>HYDROMORPHONE 1 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409128331</ndc>
    <ndc_label_name>HYDROMORPHONE 1 MG/ML CARPUJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409128337</ndc>
    <ndc_label_name>HYDROMORPHONE 1 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409130403</ndc>
    <ndc_label_name>HYDROMORPHONE 4 MG/ML CARPUJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409130431</ndc>
    <ndc_label_name>HYDROMORPHONE 4 MG/ML CARPUJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409131203</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG/ML CARPUJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409131216</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409131230</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG/ML CARPUJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409131236</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409131611</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/0.5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409131632</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/0.5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409131901</ndc>
    <ndc_label_name>VANCOMYCIN HCL 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409132305</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409132315</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409136201</ndc>
    <ndc_label_name>Demerol (PF) 25 mg/mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409136211</ndc>
    <ndc_label_name>Demerol (PF) 25 mg/mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409139021</ndc>
    <ndc_label_name>MEROPENEM IV 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409139051</ndc>
    <ndc_label_name>MEROPENEM IV 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409139121</ndc>
    <ndc_label_name>MEROPENEM IV 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409139122</ndc>
    <ndc_label_name>MEROPENEM IV 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409140101</ndc>
    <ndc_label_name>REGADENOSON 0.4 MG/5 ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409140105</ndc>
    <ndc_label_name>REGADENOSON 0.4 MG/5 ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409140212</ndc>
    <ndc_label_name>HEPARIN 5,000 UNIT/ML CARPUJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409140227</ndc>
    <ndc_label_name>HEPARIN 5,000 UNIT/ML CARPUJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409140305</ndc>
    <ndc_label_name>ROCURONIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409140310</ndc>
    <ndc_label_name>ROCURONIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409141001</ndc>
    <ndc_label_name>ISUPREL 0.2 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409141801</ndc>
    <ndc_label_name>Demerol (PF) 50 mg/mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409141811</ndc>
    <ndc_label_name>Demerol (PF) 50 mg/mL injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409143401</ndc>
    <ndc_label_name>Precedex 1,000 mcg/250 mL (4 mcg/mL) in 0.9% sodium chloride IV soln</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409145401</ndc>
    <ndc_label_name>Precedex 200 mcg/50 mL (4 mcg/mL) in 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409145420</ndc>
    <ndc_label_name>Precedex 200 mcg/50 mL (4 mcg/mL) in 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409146301</ndc>
    <ndc_label_name>NALBUPHINE 10 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409146349</ndc>
    <ndc_label_name>NALBUPHINE 10 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409146369</ndc>
    <ndc_label_name>NALBUPHINE 10 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409146371</ndc>
    <ndc_label_name>NALBUPHINE 10 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409146401</ndc>
    <ndc_label_name>NALBUPHINE 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409146461</ndc>
    <ndc_label_name>NALBUPHINE 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409146501</ndc>
    <ndc_label_name>NALBUPHINE 20 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409146571</ndc>
    <ndc_label_name>NALBUPHINE 20 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409146701</ndc>
    <ndc_label_name>NALBUPHINE 200 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409146761</ndc>
    <ndc_label_name>NALBUPHINE 200 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409153001</ndc>
    <ndc_label_name>Marcaine (PF) 0.5 % (5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409153025</ndc>
    <ndc_label_name>Marcaine (PF) 0.5 % (5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409154101</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.25 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409154110</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.25 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409155554</ndc>
    <ndc_label_name>Hextend 6 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409155564</ndc>
    <ndc_label_name>Hextend 6 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409155910</ndc>
    <ndc_label_name>Marcaine (PF) 0.25 % (2.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409155918</ndc>
    <ndc_label_name>Marcaine (PF) 0.25 % (2.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409155919</ndc>
    <ndc_label_name>Marcaine (PF) 0.25 % (2.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409155930</ndc>
    <ndc_label_name>Marcaine (PF) 0.25 % (2.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409156010</ndc>
    <ndc_label_name>Marcaine (PF) 0.5 % (5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409156018</ndc>
    <ndc_label_name>Marcaine (PF) 0.5 % (5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409156019</ndc>
    <ndc_label_name>Marcaine (PF) 0.5 % (5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409156029</ndc>
    <ndc_label_name>Marcaine (PF) 0.5 % (5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409158210</ndc>
    <ndc_label_name>Marcaine (PF) 0.75 % (7.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409158218</ndc>
    <ndc_label_name>Marcaine (PF) 0.75 % (7.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409158219</ndc>
    <ndc_label_name>Marcaine (PF) 0.75 % (7.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409158229</ndc>
    <ndc_label_name>Marcaine (PF) 0.75 % (7.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409158750</ndc>
    <ndc_label_name>Marcaine 0.25 % (2.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409159304</ndc>
    <ndc_label_name>Tham 36 mg/mL (0.3 M) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409159314</ndc>
    <ndc_label_name>Tham 36 mg/mL (0.3 M) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409159601</ndc>
    <ndc_label_name>Precedex 400 mcg/100 mL (4 mcg/mL) in 0.9% sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409159610</ndc>
    <ndc_label_name>Precedex 400 mcg/100 mL (4 mcg/mL) in 0.9% sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409161050</ndc>
    <ndc_label_name>Marcaine 0.5 % (5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409162301</ndc>
    <ndc_label_name>BUTORPHANOL 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409162321</ndc>
    <ndc_label_name>BUTORPHANOL 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409162601</ndc>
    <ndc_label_name>BUTORPHANOL 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409162602</ndc>
    <ndc_label_name>BUTORPHANOL 4 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409162621</ndc>
    <ndc_label_name>BUTORPHANOL 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409162642</ndc>
    <ndc_label_name>BUTORPHANOL 4 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409163010</ndc>
    <ndc_label_name>ATROPINE 1 MG/10 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409163015</ndc>
    <ndc_label_name>ATROPINE 1 MG/10 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409163110</ndc>
    <ndc_label_name>CALCIUM CHLORIDE 1 GM/10ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409163140</ndc>
    <ndc_label_name>CALCIUM CHLORIDE 1 GM/10ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409163201</ndc>
    <ndc_label_name>VECURONIUM 10 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409163221</ndc>
    <ndc_label_name>VECURONIUM 10 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409163802</ndc>
    <ndc_label_name>Precedex 100 mcg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409163832</ndc>
    <ndc_label_name>Precedex 100 mcg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409166020</ndc>
    <ndc_label_name>Precedex 80 mcg/20 mL (4 mcg/mL) in 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409166022</ndc>
    <ndc_label_name>Precedex 80 mcg/20 mL (4 mcg/mL) in 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409166050</ndc>
    <ndc_label_name>Precedex 200 mcg/50 mL (4 mcg/mL) in 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409166055</ndc>
    <ndc_label_name>Precedex 200 mcg/50 mL (4 mcg/mL) in 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409170001</ndc>
    <ndc_label_name>BORTEZOMIB 3.5 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409170301</ndc>
    <ndc_label_name>BORTEZOMIB 2.5 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409170401</ndc>
    <ndc_label_name>BORTEZOMIB 1 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409173201</ndc>
    <ndc_label_name>DOCETAXEL 160 MG/16 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409174610</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.25 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409174630</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.25 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409174670</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.25 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409174671</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.25 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409174910</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.5 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409174929</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.5 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409174970</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.5 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409174971</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.5 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409175250</ndc>
    <ndc_label_name>Marcaine-Epinephrine 0.25 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409175410</ndc>
    <ndc_label_name>MAGNESIUM SULFATE 50% SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409175415</ndc>
    <ndc_label_name>MAGNESIUM SULFATE 50% SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409175550</ndc>
    <ndc_label_name>Marcaine-Epinephrine 0.5 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409176105</ndc>
    <ndc_label_name>Marcaine Spinal (PF) 0.75 % (7.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409176110</ndc>
    <ndc_label_name>Marcaine Spinal (PF) 0.75 % (7.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409176118</ndc>
    <ndc_label_name>Marcaine Spinal (PF) 0.75 % (7.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409176162</ndc>
    <ndc_label_name>Marcaine Spinal (PF) 0.75 % (7.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409177510</ndc>
    <ndc_label_name>DEXTROSE 25%-WATER SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409177540</ndc>
    <ndc_label_name>DEXTROSE 25%-WATER SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409177805</ndc>
    <ndc_label_name>METOPROLOL TART 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409177815</ndc>
    <ndc_label_name>METOPROLOL TART 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409178203</ndc>
    <ndc_label_name>NALOXONE 0.4 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409178269</ndc>
    <ndc_label_name>NALOXONE 0.4 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409180501</ndc>
    <ndc_label_name>HYDROMORPHONE 0.25 MG/0.5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409180510</ndc>
    <ndc_label_name>HYDROMORPHONE 0.25 MG/0.5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409184432</ndc>
    <ndc_label_name>PHENYTOIN 50 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409185801</ndc>
    <ndc_label_name>DOPAMINE 800 MG/250 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409185812</ndc>
    <ndc_label_name>DOPAMINE 800 MG/250 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409188602</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409188622</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189001</ndc>
    <ndc_label_name>MORPHINE 2 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189003</ndc>
    <ndc_label_name>MORPHINE 2 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189013</ndc>
    <ndc_label_name>MORPHINE 2 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189023</ndc>
    <ndc_label_name>MORPHINE 2 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189101</ndc>
    <ndc_label_name>MORPHINE 4 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189103</ndc>
    <ndc_label_name>MORPHINE 4 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189113</ndc>
    <ndc_label_name>MORPHINE 4 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189123</ndc>
    <ndc_label_name>MORPHINE 4 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189201</ndc>
    <ndc_label_name>MORPHINE 8 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189203</ndc>
    <ndc_label_name>MORPHINE 8 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189301</ndc>
    <ndc_label_name>MORPHINE 10 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189303</ndc>
    <ndc_label_name>MORPHINE 10 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189313</ndc>
    <ndc_label_name>MORPHINE 10 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189323</ndc>
    <ndc_label_name>MORPHINE 10 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409189620</ndc>
    <ndc_label_name>MORPHINE SULF 1,000 MG/20 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409190201</ndc>
    <ndc_label_name>PROCAINAMIDE 1 GRAM/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409190211</ndc>
    <ndc_label_name>PROCAINAMIDE 1 GRAM/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409196601</ndc>
    <ndc_label_name>BACTERIOSTATIC SALINE VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409196602</ndc>
    <ndc_label_name>BACTERIOSTATIC SALINE VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409196605</ndc>
    <ndc_label_name>BACTERIOSTATIC SALINE VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409196606</ndc>
    <ndc_label_name>BACTERIOSTATIC SALINE VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409196607</ndc>
    <ndc_label_name>BACTERIOSTATIC SALINE VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409196612</ndc>
    <ndc_label_name>BACTERIOSTATIC SALINE VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409196703</ndc>
    <ndc_label_name>CITRATE PHOS DEXTROSE SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409198301</ndc>
    <ndc_label_name>MILRINONE-D5W 40 MG/200 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409198310</ndc>
    <ndc_label_name>MILRINONE-D5W 40 MG/200 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409198503</ndc>
    <ndc_label_name>LORAZEPAM 2 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409198530</ndc>
    <ndc_label_name>LORAZEPAM 2 MG/ML CARPUJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409201105</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409201125</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409201203</ndc>
    <ndc_label_name>BUPRENORPHINE 0.3 MG/ML CRPJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409201232</ndc>
    <ndc_label_name>BUPRENORPHINE 0.3 MG/ML CRPJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409201605</ndc>
    <ndc_label_name>METOPROLOL TART 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409201610</ndc>
    <ndc_label_name>METOPROLOL TART 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409202201</ndc>
    <ndc_label_name>MORPHINE SULF 2,500 MG/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409202601</ndc>
    <ndc_label_name>DOCETAXEL 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409204501</ndc>
    <ndc_label_name>MILRINONE-D5W 20 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409204510</ndc>
    <ndc_label_name>MILRINONE-D5W 20 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409205001</ndc>
    <ndc_label_name>MAGNESIUM SULF 20 G/500 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409205020</ndc>
    <ndc_label_name>MAGNESIUM SULF 20 G/500 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409205105</ndc>
    <ndc_label_name>KETAMINE 500 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409205115</ndc>
    <ndc_label_name>KETAMINE 500 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409205310</ndc>
    <ndc_label_name>KETAMINE 500 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409205320</ndc>
    <ndc_label_name>KETAMINE 500 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409206605</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% 100 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409206610</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% 100 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409216817</ndc>
    <ndc_label_name>MAGNESIUM SULFATE 50% 10G/20ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409216877</ndc>
    <ndc_label_name>MAGNESIUM SULFATE 50% 10G/20ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409218801</ndc>
    <ndc_label_name>PEMETREXED DISODIUM 500MG/20ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409222001</ndc>
    <ndc_label_name>LEVOFLOXACIN 250 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409222024</ndc>
    <ndc_label_name>LEVOFLOXACIN 250 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409222201</ndc>
    <ndc_label_name>HEPARIN 2,000 UNIT/1,000 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409222212</ndc>
    <ndc_label_name>HEPARIN 2,000 UNIT/1,000 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409225301</ndc>
    <ndc_label_name>Marcaine (PF) 0.75 % (7.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409225325</ndc>
    <ndc_label_name>Marcaine (PF) 0.75 % (7.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409226720</ndc>
    <ndc_label_name>LABETALOL HCL 100 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409226754</ndc>
    <ndc_label_name>LABETALOL HCL 200 MG/40 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409227102</ndc>
    <ndc_label_name>ONDANSETRON HCL 4 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409227125</ndc>
    <ndc_label_name>ONDANSETRON HCL 4 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409230001</ndc>
    <ndc_label_name>CIPROFLOXACIN 200 MG/100ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409230024</ndc>
    <ndc_label_name>CIPROFLOXACIN 200 MG/100ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230504</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230505</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230516</ndc>
    <ndc_label_name>MIDAZOLAM HCL 2 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230517</ndc>
    <ndc_label_name>MIDAZOLAM HCL 2 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230550</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230555</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230801</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230802</ndc>
    <ndc_label_name>MIDAZOLAM HCL 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230821</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230822</ndc>
    <ndc_label_name>MIDAZOLAM HCL 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230849</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230850</ndc>
    <ndc_label_name>MIDAZOLAM HCL 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230869</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409230870</ndc>
    <ndc_label_name>MIDAZOLAM HCL 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409233715</ndc>
    <ndc_label_name>DEFEROXAMINE 2 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409233725</ndc>
    <ndc_label_name>DEFEROXAMINE 2 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409233924</ndc>
    <ndc_label_name>LABETALOL HCL 20 MG/4 ML CRPJT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409233934</ndc>
    <ndc_label_name>LABETALOL HCL 20 MG/4 ML CRPJT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409234401</ndc>
    <ndc_label_name>DOBUTAMINE 250 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409234402</ndc>
    <ndc_label_name>DOBUTAMINE 250 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409234462</ndc>
    <ndc_label_name>DOBUTAMINE 250 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409234468</ndc>
    <ndc_label_name>DOBUTAMINE 250 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409234488</ndc>
    <ndc_label_name>DOBUTAMINE 250 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409234631</ndc>
    <ndc_label_name>DOBUTAMINE 250 MG/250 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409234632</ndc>
    <ndc_label_name>DOBUTAMINE 250 MG/250 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409234731</ndc>
    <ndc_label_name>DOBUTAMINE 500 MG/250 ML D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409234732</ndc>
    <ndc_label_name>DOBUTAMINE 500 MG/250 ML D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409251001</ndc>
    <ndc_label_name>Marcaine (PF) 0.25 % (2.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409251025</ndc>
    <ndc_label_name>Marcaine (PF) 0.25 % (2.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409255201</ndc>
    <ndc_label_name>HYDROMORPHONE HCL 1 MG/ML AMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409255211</ndc>
    <ndc_label_name>HYDROMORPHONE HCL 1 MG/ML AMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409258501</ndc>
    <ndc_label_name>CEFAZOLIN 1 GM ADD-VAN VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409258511</ndc>
    <ndc_label_name>CEFAZOLIN 1 GM ADD-VAN VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409258704</ndc>
    <ndc_label_name>MIDAZOLAM HCL 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409258705</ndc>
    <ndc_label_name>MIDAZOLAM HCL 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409259603</ndc>
    <ndc_label_name>MIDAZOLAM HCL 25 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409259605</ndc>
    <ndc_label_name>MIDAZOLAM HCL 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409259613</ndc>
    <ndc_label_name>MIDAZOLAM HCL 25 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409259615</ndc>
    <ndc_label_name>MIDAZOLAM HCL 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409263401</ndc>
    <ndc_label_name>HYDROMORPHONE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409263405</ndc>
    <ndc_label_name>HYDROMORPHONE 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409263410</ndc>
    <ndc_label_name>HYDROMORPHONE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409263425</ndc>
    <ndc_label_name>HYDROMORPHONE 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409263450</ndc>
    <ndc_label_name>HYDROMORPHONE 500 MG/50 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409268901</ndc>
    <ndc_label_name>AMPICILLIN-SULB 1.5 G ADD VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409268921</ndc>
    <ndc_label_name>AMPICILLIN-SULB 1.5 G ADD VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409272001</ndc>
    <ndc_label_name>HEPARIN SOD 1,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409272002</ndc>
    <ndc_label_name>HEPARIN 10,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409272003</ndc>
    <ndc_label_name>HEPARIN 30,000 UNIT/30 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409272030</ndc>
    <ndc_label_name>HEPARIN SOD 1,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409272031</ndc>
    <ndc_label_name>HEPARIN 10,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409272032</ndc>
    <ndc_label_name>HEPARIN 30,000 UNIT/30 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409272101</ndc>
    <ndc_label_name>HEPARIN SOD 10,000 UNIT/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409272130</ndc>
    <ndc_label_name>HEPARIN SOD 10,000 UNIT/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409272301</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409272302</ndc>
    <ndc_label_name>HEPARIN 50,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409272330</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409272331</ndc>
    <ndc_label_name>HEPARIN 50,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409281501</ndc>
    <ndc_label_name>Precedex 1,000 mcg/250 mL (4 mcg/mL) in 0.9% sodium chloride IV soln</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409298703</ndc>
    <ndc_label_name>AMPICILLIN-SULB 3 GM ADD VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409298723</ndc>
    <ndc_label_name>AMPICILLIN-SULB 3 GM ADD VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409299914</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 13.5 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409315005</ndc>
    <ndc_label_name>HEPARIN 25,000 UNIT/500-1/2 NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409315020</ndc>
    <ndc_label_name>HEPARIN 25,000 UNIT/500-1/2 NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409316401</ndc>
    <ndc_label_name>MAGNESIUM SULF 40 G/1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409316412</ndc>
    <ndc_label_name>MAGNESIUM SULF 40 G/1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409317701</ndc>
    <ndc_label_name>LIDOCAINE 0.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409317716</ndc>
    <ndc_label_name>LIDOCAINE 0.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409317801</ndc>
    <ndc_label_name>LIDOCAINE 1%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409317802</ndc>
    <ndc_label_name>LIDOCAINE 1%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409317803</ndc>
    <ndc_label_name>LIDOCAINE 1%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409317816</ndc>
    <ndc_label_name>LIDOCAINE 1%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409317817</ndc>
    <ndc_label_name>LIDOCAINE 1%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409317818</ndc>
    <ndc_label_name>LIDOCAINE 1%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409318101</ndc>
    <ndc_label_name>LIDOCAINE 1.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409318111</ndc>
    <ndc_label_name>LIDOCAINE 1.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409318201</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409318202</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409318203</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409318211</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409318221</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409318231</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:100,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409318301</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409318311</ndc>
    <ndc_label_name>LIDOCAINE 2%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409318905</ndc>
    <ndc_label_name>ROCURONIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409318910</ndc>
    <ndc_label_name>ROCURONIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409321311</ndc>
    <ndc_label_name>DIAZEPAM 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409321312</ndc>
    <ndc_label_name>DIAZEPAM 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409329415</ndc>
    <ndc_label_name>POTASSIUM ACET 100 MEQ/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409329425</ndc>
    <ndc_label_name>POTASSIUM ACET 100 MEQ/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409329451</ndc>
    <ndc_label_name>POTASSIUM ACET 100 MEQ/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409329461</ndc>
    <ndc_label_name>POTASSIUM ACET 100 MEQ/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409329905</ndc>
    <ndc_label_name>SODIUM ACETATE 100 MEQ/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409329906</ndc>
    <ndc_label_name>SODIUM ACETATE 200 MEQ/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409329915</ndc>
    <ndc_label_name>SODIUM ACETATE 100 MEQ/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409329916</ndc>
    <ndc_label_name>SODIUM ACETATE 200 MEQ/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409329925</ndc>
    <ndc_label_name>SODIUM ACETATE 200 MEQ/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409329926</ndc>
    <ndc_label_name>SODIUM ACETATE 100 MEQ/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409329945</ndc>
    <ndc_label_name>SODIUM ACETATE 200 MEQ/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409329946</ndc>
    <ndc_label_name>SODIUM ACETATE 100 MEQ/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409330001</ndc>
    <ndc_label_name>CIPROFLOXACIN 400 MG/200ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409330024</ndc>
    <ndc_label_name>CIPROFLOXACIN 400 MG/200ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409330101</ndc>
    <ndc_label_name>Precedex 80 mcg/20 mL (4 mcg/mL) in 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409330110</ndc>
    <ndc_label_name>Precedex 80 mcg/20 mL (4 mcg/mL) in 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409330703</ndc>
    <ndc_label_name>ACETYLCYSTEINE 10% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409330711</ndc>
    <ndc_label_name>ACETYLCYSTEINE 10% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409330803</ndc>
    <ndc_label_name>ACETYLCYSTEINE 20% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409330811</ndc>
    <ndc_label_name>ACETYLCYSTEINE 20% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409333001</ndc>
    <ndc_label_name>LEVOFLOXACIN 500 MG/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409333024</ndc>
    <ndc_label_name>LEVOFLOXACIN 500 MG/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409336510</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409336511</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409337402</ndc>
    <ndc_label_name>PIPERACIL-TAZO 2.25 GM ADD VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409337411</ndc>
    <ndc_label_name>PIPERACIL-TAZO 2.25 GM ADD VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409337504</ndc>
    <ndc_label_name>Levophed 1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409337514</ndc>
    <ndc_label_name>Levophed 1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409337811</ndc>
    <ndc_label_name>PIPERACIL-TAZO 3.375 GM ADD VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409337813</ndc>
    <ndc_label_name>PIPERACIL-TAZO 3.375 GM ADD VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409337904</ndc>
    <ndc_label_name>PIPERACIL-TAZO 4.5 GM ADD VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409337911</ndc>
    <ndc_label_name>PIPERACIL-TAZO 4.5 GM ADD VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409338211</ndc>
    <ndc_label_name>SUFENTANIL 50 MCG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409338221</ndc>
    <ndc_label_name>SUFENTANIL 50 MCG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409338302</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 2.25 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409338310</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 2.25 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409338311</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 2.25 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409338511</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 3.375 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409338513</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 3.375 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409338515</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 3.375 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409339004</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 4.5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409339010</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 4.5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409339011</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 4.5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409341201</ndc>
    <ndc_label_name>MEROPENEM IV 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409341210</ndc>
    <ndc_label_name>MEROPENEM IV 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409341401</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409341411</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409341418</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409341421</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409343501</ndc>
    <ndc_label_name>FLUCONAZOLE-NACL 200 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409343524</ndc>
    <ndc_label_name>FLUCONAZOLE-NACL 200 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409351021</ndc>
    <ndc_label_name>ERTAPENEM 1 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409351022</ndc>
    <ndc_label_name>ERTAPENEM 1 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409351501</ndc>
    <ndc_label_name>VANCOMYCIN HCL 1.5 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409351511</ndc>
    <ndc_label_name>VANCOMYCIN HCL 1.5 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409353201</ndc>
    <ndc_label_name>PEMETREXED DISODIUM 1 GM/40 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409357801</ndc>
    <ndc_label_name>TOBRAMYCIN 80 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409357811</ndc>
    <ndc_label_name>TOBRAMYCIN 80 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409359501</ndc>
    <ndc_label_name>CEFOTAXIME SODIUM 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409359511</ndc>
    <ndc_label_name>CEFOTAXIME SODIUM 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409361301</ndc>
    <ndc_label_name>BUPIVACAIN 0.75%-DEXTROS 8.25%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409361311</ndc>
    <ndc_label_name>BUPIVACAIN 0.75%-DEXTROS 8.25%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409367001</ndc>
    <ndc_label_name>CISATRACURIUM 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409367010</ndc>
    <ndc_label_name>CISATRACURIUM 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409372411</ndc>
    <ndc_label_name>DOBUTAMINE 1,000 MG/250 ML D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409372432</ndc>
    <ndc_label_name>DOBUTAMINE 1,000 MG/250 ML D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409379301</ndc>
    <ndc_label_name>KETOROLAC 15 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409379319</ndc>
    <ndc_label_name>KETOROLAC 15 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409379325</ndc>
    <ndc_label_name>KETOROLAC 15 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409379501</ndc>
    <ndc_label_name>KETOROLAC 30 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409379519</ndc>
    <ndc_label_name>KETOROLAC 30 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409379525</ndc>
    <ndc_label_name>KETOROLAC 30 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409379601</ndc>
    <ndc_label_name>KETOROLAC 60 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409379619</ndc>
    <ndc_label_name>KETOROLAC 60 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409379625</ndc>
    <ndc_label_name>KETOROLAC 60 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409381201</ndc>
    <ndc_label_name>Marcaine-Epinephrine 0.25 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409381411</ndc>
    <ndc_label_name>MORPHINE 5 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409381412</ndc>
    <ndc_label_name>MORPHINE 5 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409381511</ndc>
    <ndc_label_name>MORPHINE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409381512</ndc>
    <ndc_label_name>MORPHINE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409397701</ndc>
    <ndc_label_name>BACTERIOSTATIC WATER VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409397703</ndc>
    <ndc_label_name>BACTERIOSTATIC WATER VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409401101</ndc>
    <ndc_label_name>VERAPAMIL 5 MG/2 ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409401161</ndc>
    <ndc_label_name>VERAPAMIL 5 MG/2 ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409403101</ndc>
    <ndc_label_name>MANNITOL 25% (12.5 GM/50 ML)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409403116</ndc>
    <ndc_label_name>MANNITOL 25% (12.5 GM/50 ML)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409409001</ndc>
    <ndc_label_name>ZINC CHLORIDE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409409011</ndc>
    <ndc_label_name>ZINC CHLORIDE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409409101</ndc>
    <ndc_label_name>MANGANESE 1 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409409111</ndc>
    <ndc_label_name>MANGANESE 1 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409409201</ndc>
    <ndc_label_name>Copper Chloride 0.4 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409409211</ndc>
    <ndc_label_name>Copper Chloride 0.4 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409409301</ndc>
    <ndc_label_name>CHROMIUM CL 40 MCG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409409309</ndc>
    <ndc_label_name>CHROMIUM CL 40 MCG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409409310</ndc>
    <ndc_label_name>CHROMIUM CL 40 MCG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409409311</ndc>
    <ndc_label_name>CHROMIUM CL 40 MCG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409412101</ndc>
    <ndc_label_name>MAGNESIUM SULF 4 G/100 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409412150</ndc>
    <ndc_label_name>MAGNESIUM SULF 4 G/100 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409420801</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.5 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409420810</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.5 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409423501</ndc>
    <ndc_label_name>DOCETAXEL 20 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409426401</ndc>
    <ndc_label_name>HYDROMORPHONE 0.5 MG/0.5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409426411</ndc>
    <ndc_label_name>HYDROMORPHONE 0.5 MG/0.5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427501</ndc>
    <ndc_label_name>LIDOCAINE HCL 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427516</ndc>
    <ndc_label_name>LIDOCAINE HCL 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427601</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427602</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427616</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427617</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427701</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427702</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427716</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427717</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427801</ndc>
    <ndc_label_name>LIDOCAINE HCL 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427816</ndc>
    <ndc_label_name>LIDOCAINE HCL 0.5% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427902</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 300 MG/30 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409427916</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 300 MG/30 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409428201</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% 40 MG/2 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409428202</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% 200 MG/10 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409428211</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% 40 MG/2 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409428212</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% 200 MG/10 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409428301</ndc>
    <ndc_label_name>LIDOCAINE HCL 4% AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409428311</ndc>
    <ndc_label_name>LIDOCAINE HCL 4% AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409428325</ndc>
    <ndc_label_name>LIDOCAINE HCL 4% AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409432101</ndc>
    <ndc_label_name>FLUCONAZOLE-NACL 400 MG/200 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409432124</ndc>
    <ndc_label_name>FLUCONAZOLE-NACL 400 MG/200 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409433201</ndc>
    <ndc_label_name>VANCOMYCIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409433211</ndc>
    <ndc_label_name>VANCOMYCIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409434616</ndc>
    <ndc_label_name>AMINOCAPROIC ACID 5 G/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409434673</ndc>
    <ndc_label_name>AMINOCAPROIC ACID 5 G/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409435003</ndc>
    <ndc_label_name>DILTIAZEM 100 MG ADD-VAN VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409435013</ndc>
    <ndc_label_name>DILTIAZEM 100 MG ADD-VAN VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409444401</ndc>
    <ndc_label_name>LEVOFLOXACIN 750 MG/150 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409444424</ndc>
    <ndc_label_name>LEVOFLOXACIN 750 MG/150 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409452002</ndc>
    <ndc_label_name>HEPARIN 25,000 UNIT/250 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409452030</ndc>
    <ndc_label_name>HEPARIN 25,000 UNIT/250 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409459601</ndc>
    <ndc_label_name>Precedex 200 mcg/50 mL (4 mcg/mL) in 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409459620</ndc>
    <ndc_label_name>Precedex 200 mcg/50 mL (4 mcg/mL) in 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409468812</ndc>
    <ndc_label_name>FLUCONAZOLE-NACL 400 MG/200 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409468816</ndc>
    <ndc_label_name>FLUCONAZOLE-NACL 400 MG/200 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409468818</ndc>
    <ndc_label_name>FLUCONAZOLE-NACL 200 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409468822</ndc>
    <ndc_label_name>FLUCONAZOLE-NACL 200 MG/100 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409469924</ndc>
    <ndc_label_name>PROPOFOL 1,000 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409469933</ndc>
    <ndc_label_name>PROPOFOL 500 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409469953</ndc>
    <ndc_label_name>PROPOFOL 500 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409469954</ndc>
    <ndc_label_name>PROPOFOL 1,000 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409471302</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 50 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409471312</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 50 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409471325</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 20 MG/2 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409471332</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 20 MG/2 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409471342</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 20 MG/2 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409471362</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 20 MG/2 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409471372</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% 20 MG/2 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409475503</ndc>
    <ndc_label_name>ONDANSETRON HCL 4 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409475518</ndc>
    <ndc_label_name>ONDANSETRON HCL 4 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409475901</ndc>
    <ndc_label_name>ONDANSETRON 40 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409477601</ndc>
    <ndc_label_name>LIDOCAINE HCL 1.5% AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409477610</ndc>
    <ndc_label_name>LIDOCAINE HCL 1.5% AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409485749</ndc>
    <ndc_label_name>FOSPHENYTOIN 100 MG PE/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409485750</ndc>
    <ndc_label_name>FOSPHENYTOIN 500 MG PE/10 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488301</ndc>
    <ndc_label_name>LINEZOLID 600MG/300ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488303</ndc>
    <ndc_label_name>LINEZOLID 600MG/300ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488310</ndc>
    <ndc_label_name>LINEZOLID 600MG/300ML-0.9%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488710</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488717</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488720</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488723</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488724</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488725</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488750</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488799</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488801</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488802</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488803</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488806</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488810</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488812</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488820</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409488850</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409490014</ndc>
    <ndc_label_name>SODIUM BICARB 8.4% ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409490024</ndc>
    <ndc_label_name>SODIUM BICARB 8.4% ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409490234</ndc>
    <ndc_label_name>DEXTROSE 50%-WATER ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409490264</ndc>
    <ndc_label_name>DEXTROSE 50%-WATER ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409490311</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409490334</ndc>
    <ndc_label_name>LIDOCAINE HCL 2% ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409490411</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409490434</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409491011</ndc>
    <ndc_label_name>ATROPINE 0.5 MG/5 ML ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409491034</ndc>
    <ndc_label_name>ATROPINE 0.5 MG/5 ML ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409491111</ndc>
    <ndc_label_name>ATROPINE 1 MG/10 ML ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409491134</ndc>
    <ndc_label_name>ATROPINE 1 MG/10 ML ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409491614</ndc>
    <ndc_label_name>SODIUM BICARB 7.5% ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409491624</ndc>
    <ndc_label_name>SODIUM BICARB 7.5% ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409492811</ndc>
    <ndc_label_name>CALCIUM CHLORIDE 1 GM/10ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409492834</ndc>
    <ndc_label_name>CALCIUM CHLORIDE 1 GM/10ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409493301</ndc>
    <ndc_label_name>EPINEPHRINE 1 MG/10 ML ABBOJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409493305</ndc>
    <ndc_label_name>EPINEPHRINE 1 MG/10 ML ABBOJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409493310</ndc>
    <ndc_label_name>EPINEPHRINE 1 MG/10 ML ABBOJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409493311</ndc>
    <ndc_label_name>EPINEPHRINE 1 MG/10 ML ABBOJCT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409501001</ndc>
    <ndc_label_name>Marcaine (PF) 0.5 % (5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409501025</ndc>
    <ndc_label_name>Marcaine (PF) 0.5 % (5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409501701</ndc>
    <ndc_label_name>VANCOMYCIN HCL 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409506801</ndc>
    <ndc_label_name>DOCETAXEL 80 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409508211</ndc>
    <ndc_label_name>Tazicef 1 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409508216</ndc>
    <ndc_label_name>Tazicef 1 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409508411</ndc>
    <ndc_label_name>Tazicef 2 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409508413</ndc>
    <ndc_label_name>Tazicef 2 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409508611</ndc>
    <ndc_label_name>Tazicef 6 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409508613</ndc>
    <ndc_label_name>Tazicef 6 gram solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409509211</ndc>
    <ndc_label_name>Tazicef 1 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409509216</ndc>
    <ndc_label_name>Tazicef 1 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409509311</ndc>
    <ndc_label_name>Tazicef 2 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409509314</ndc>
    <ndc_label_name>Tazicef 2 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409516001</ndc>
    <ndc_label_name>ROCURONIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409516010</ndc>
    <ndc_label_name>ROCURONIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409523901</ndc>
    <ndc_label_name>MAGNESIUM SULF 2 G/50 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409523960</ndc>
    <ndc_label_name>MAGNESIUM SULF 2 G/50 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409525502</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409525510</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409525515</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409525525</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409553414</ndc>
    <ndc_label_name>SODIUM BICARB 4.2% ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409553424</ndc>
    <ndc_label_name>SODIUM BICARB 4.2% ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409554701</ndc>
    <ndc_label_name>CISATRACURIUM 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409554710</ndc>
    <ndc_label_name>CISATRACURIUM 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409555501</ndc>
    <ndc_label_name>SODIUM BICARBONATE 4.2% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409555502</ndc>
    <ndc_label_name>SODIUM BICARBONATE 4.2% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409555511</ndc>
    <ndc_label_name>SODIUM BICARBONATE 4.2% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409555512</ndc>
    <ndc_label_name>SODIUM BICARBONATE 4.2% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409573801</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.25 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409573810</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.25 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409577901</ndc>
    <ndc_label_name>TPN Electrolytes 35 mEq-20 mEq-5 mEq/20 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409577911</ndc>
    <ndc_label_name>TPN Electrolytes 35 mEq-20 mEq-5 mEq/20 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409581610</ndc>
    <ndc_label_name>Sterile Empty 10ml Vial</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409581611</ndc>
    <ndc_label_name>Sterile Empty 10ml Vial</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409581631</ndc>
    <ndc_label_name>Sterile Empty 30 mL Vial</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409582001</ndc>
    <ndc_label_name>DOPAMINE 200 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409582011</ndc>
    <ndc_label_name>DOPAMINE 200 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409592101</ndc>
    <ndc_label_name>AMINOPHYLLINE 250 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409592116</ndc>
    <ndc_label_name>AMINOPHYLLINE 250 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409592201</ndc>
    <ndc_label_name>AMINOPHYLLINE 500 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409592216</ndc>
    <ndc_label_name>AMINOPHYLLINE 500 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409601002</ndc>
    <ndc_label_name>PROPOFOL 200 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409601025</ndc>
    <ndc_label_name>PROPOFOL 200 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409610202</ndc>
    <ndc_label_name>FUROSEMIDE 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409610204</ndc>
    <ndc_label_name>FUROSEMIDE 40 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409610210</ndc>
    <ndc_label_name>FUROSEMIDE 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409610218</ndc>
    <ndc_label_name>FUROSEMIDE 40 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409610219</ndc>
    <ndc_label_name>FUROSEMIDE 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409610220</ndc>
    <ndc_label_name>FUROSEMIDE 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409610225</ndc>
    <ndc_label_name>FUROSEMIDE 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409610226</ndc>
    <ndc_label_name>FUROSEMIDE 40 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409610227</ndc>
    <ndc_label_name>FUROSEMIDE 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409610235</ndc>
    <ndc_label_name>FUROSEMIDE 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409610236</ndc>
    <ndc_label_name>FUROSEMIDE 40 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409610237</ndc>
    <ndc_label_name>FUROSEMIDE 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409647644</ndc>
    <ndc_label_name>Erythrocin 500 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409647654</ndc>
    <ndc_label_name>Erythrocin 500 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409648201</ndc>
    <ndc_label_name>Erythrocin 500 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409648211</ndc>
    <ndc_label_name>Erythrocin 500 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409650901</ndc>
    <ndc_label_name>VANCOMYCIN HCL 5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409650949</ndc>
    <ndc_label_name>VANCOMYCIN HCL 5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409653101</ndc>
    <ndc_label_name>VANCOMYCIN 750 MG ADD-VAN VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409653102</ndc>
    <ndc_label_name>VANCOMYCIN HCL 750 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409653111</ndc>
    <ndc_label_name>VANCOMYCIN 750 MG ADD-VAN VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409653112</ndc>
    <ndc_label_name>VANCOMYCIN HCL 750 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409653311</ndc>
    <ndc_label_name>VANCOMYCIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409653321</ndc>
    <ndc_label_name>VANCOMYCIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409653331</ndc>
    <ndc_label_name>VANCOMYCIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409653359</ndc>
    <ndc_label_name>VANCOMYCIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409653401</ndc>
    <ndc_label_name>VANCOMYCIN 500 MG ADD-VAN VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409653411</ndc>
    <ndc_label_name>VANCOMYCIN 500 MG ADD-VAN VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409653501</ndc>
    <ndc_label_name>VANCOMYCIN 1 GM ADD-VAN VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409653511</ndc>
    <ndc_label_name>VANCOMYCIN 1 GM ADD-VAN VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409655701</ndc>
    <ndc_label_name>TESTOSTERONE CYP 1,000 MG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409656201</ndc>
    <ndc_label_name>TESTOSTERONE CYP 200 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409656202</ndc>
    <ndc_label_name>TESTOSTERONE CYP 200 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409656220</ndc>
    <ndc_label_name>TESTOSTERONE CYP 2,000 MG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409656222</ndc>
    <ndc_label_name>TESTOSTERONE CYP 2,000 MG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409658101</ndc>
    <ndc_label_name>Marcaine-Epinephrine 0.5 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409662514</ndc>
    <ndc_label_name>SODIUM BICARBONATE 8.4% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409662522</ndc>
    <ndc_label_name>SODIUM BICARBONATE 8.4% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409662530</ndc>
    <ndc_label_name>SODIUM BICARBONATE 8.4% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409662535</ndc>
    <ndc_label_name>SODIUM BICARBONATE 8.4% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409662902</ndc>
    <ndc_label_name>Quelicin 20 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409662912</ndc>
    <ndc_label_name>Quelicin 20 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409663501</ndc>
    <ndc_label_name>POTASSIUM CL 10 MEQ/5 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409663518</ndc>
    <ndc_label_name>POTASSIUM CL 10 MEQ/5 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409663714</ndc>
    <ndc_label_name>SODIUM BICARB 8.4% ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409663724</ndc>
    <ndc_label_name>SODIUM BICARB 8.4% ABBOJECT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409664802</ndc>
    <ndc_label_name>DEXTROSE 50%-WATER VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409664816</ndc>
    <ndc_label_name>DEXTROSE 50%-WATER VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409665106</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ/10 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409665119</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ/10 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409665305</ndc>
    <ndc_label_name>POTASSIUM CL 40 MEQ/20 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409665318</ndc>
    <ndc_label_name>POTASSIUM CL 40 MEQ/20 ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409666001</ndc>
    <ndc_label_name>SODIUM CHLORIDE 100 MEQ/40 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409666075</ndc>
    <ndc_label_name>SODIUM CHLORIDE 100 MEQ/40 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409669501</ndc>
    <ndc_label_name>Amidate 2 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409669502</ndc>
    <ndc_label_name>Amidate 2 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409669511</ndc>
    <ndc_label_name>Amidate 2 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409669512</ndc>
    <ndc_label_name>Amidate 2 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409672711</ndc>
    <ndc_label_name>MAGNESIUM SULF 1 G/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409672723</ndc>
    <ndc_label_name>MAGNESIUM SULF 1 G/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409672750</ndc>
    <ndc_label_name>MAGNESIUM SULF 1 G/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409672755</ndc>
    <ndc_label_name>MAGNESIUM SULF 1 G/100 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409672909</ndc>
    <ndc_label_name>MAGNESIUM SULF 40 G/1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409672911</ndc>
    <ndc_label_name>MAGNESIUM SULF 2 G/50 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409672923</ndc>
    <ndc_label_name>MAGNESIUM SULF 4 G/100 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409672924</ndc>
    <ndc_label_name>MAGNESIUM SULF 2 G/50 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409672931</ndc>
    <ndc_label_name>MAGNESIUM SULF 40 G/1,000 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409672941</ndc>
    <ndc_label_name>MAGNESIUM SULF 4 G/100 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409673050</ndc>
    <ndc_label_name>MAGNESIUM SULF 4 G/50 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409673060</ndc>
    <ndc_label_name>MAGNESIUM SULF 4 G/50 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409701205</ndc>
    <ndc_label_name>Physiosol Irrigation 140 mEq-5 mEq-3 mEq-98 mEq/L solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409703701</ndc>
    <ndc_label_name>ROCURONIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409703710</ndc>
    <ndc_label_name>ROCURONIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409708301</ndc>
    <ndc_label_name>CISATRACURIUM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409708310</ndc>
    <ndc_label_name>CISATRACURIUM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409710002</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409710004</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409710066</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409710067</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409710068</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409710069</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409710102</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409710104</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409710166</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409710167</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409710168</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409710169</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409724803</ndc>
    <ndc_label_name>HETASTARCH 6%-0.9% NACL BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409724813</ndc>
    <ndc_label_name>HETASTARCH 6%-0.9% NACL BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409729501</ndc>
    <ndc_label_name>POTASSIUM PHOSP 45 MMOL/15 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409729511</ndc>
    <ndc_label_name>POTASSIUM PHOSP 45 MMOL/15 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409729925</ndc>
    <ndc_label_name>SODIUM ACETATE 40 MEQ/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409729945</ndc>
    <ndc_label_name>SODIUM ACETATE 40 MEQ/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409729973</ndc>
    <ndc_label_name>SODIUM ACETATE 40 MEQ/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409729983</ndc>
    <ndc_label_name>SODIUM ACETATE 40 MEQ/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733201</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733211</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733220</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733221</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733304</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM ADD-VANT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733311</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM ADD-VANT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733331</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM ADD-VANT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733349</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM ADD-VANT VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733410</ndc>
    <ndc_label_name>CEFTRIAXONE 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733420</ndc>
    <ndc_label_name>CEFTRIAXONE 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733503</ndc>
    <ndc_label_name>CEFTRIAXONE 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733513</ndc>
    <ndc_label_name>CEFTRIAXONE 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733520</ndc>
    <ndc_label_name>CEFTRIAXONE 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733521</ndc>
    <ndc_label_name>CEFTRIAXONE 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733604</ndc>
    <ndc_label_name>CEFTRIAXONE 2 GM ADD VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733611</ndc>
    <ndc_label_name>CEFTRIAXONE 2 GM ADD VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733701</ndc>
    <ndc_label_name>CEFTRIAXONE 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733711</ndc>
    <ndc_label_name>CEFTRIAXONE 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733720</ndc>
    <ndc_label_name>CEFTRIAXONE 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733721</ndc>
    <ndc_label_name>CEFTRIAXONE 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733801</ndc>
    <ndc_label_name>CEFTRIAXONE 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733811</ndc>
    <ndc_label_name>CEFTRIAXONE 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733820</ndc>
    <ndc_label_name>CEFTRIAXONE 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409733821</ndc>
    <ndc_label_name>CEFTRIAXONE 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409739172</ndc>
    <ndc_label_name>SODIUM PHOSPHATE 45 MMOL/15 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409739182</ndc>
    <ndc_label_name>SODIUM PHOSPHATE 45 MMOL/15 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409741803</ndc>
    <ndc_label_name>LMD (dextran 40) 10 % in 5 % dextrose intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409741813</ndc>
    <ndc_label_name>LMD (dextran 40) 10 % in 5 % dextrose intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409741903</ndc>
    <ndc_label_name>LMD (dextran 40) 10 % in 0.9 % sodium chloride intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409741914</ndc>
    <ndc_label_name>LMD (dextran 40) 10 % in 0.9 % sodium chloride intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409751716</ndc>
    <ndc_label_name>DEXTROSE 50%-WATER SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409751766</ndc>
    <ndc_label_name>DEXTROSE 50%-WATER SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409753501</ndc>
    <ndc_label_name>Marcaine (PF) 0.25 % (2.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409753525</ndc>
    <ndc_label_name>Marcaine (PF) 0.25 % (2.5 mg/mL) injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409762003</ndc>
    <ndc_label_name>HEPARIN 1,000 UNIT/500 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409762013</ndc>
    <ndc_label_name>HEPARIN 1,000 UNIT/500 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409762049</ndc>
    <ndc_label_name>HEPARIN 2,000 UNIT/1,000 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409762059</ndc>
    <ndc_label_name>HEPARIN 2,000 UNIT/1,000 ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409765005</ndc>
    <ndc_label_name>HEPARIN 25,000 UNIT/250-1/2 NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409765030</ndc>
    <ndc_label_name>HEPARIN 25,000 UNIT/250-1/2 NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409780911</ndc>
    <ndc_label_name>DOPAMINE 400 MG/250 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409780922</ndc>
    <ndc_label_name>DOPAMINE 400 MG/250 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409780924</ndc>
    <ndc_label_name>DOPAMINE 800 MG/500 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409780931</ndc>
    <ndc_label_name>DOPAMINE 800 MG/500 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409781011</ndc>
    <ndc_label_name>DOPAMINE 800 MG/250 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409781022</ndc>
    <ndc_label_name>DOPAMINE 800 MG/250 ML-D5W BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409783801</ndc>
    <ndc_label_name>Precedex 200 mcg/50 mL (4 mcg/mL) in 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409783824</ndc>
    <ndc_label_name>Precedex 200 mcg/50 mL (4 mcg/mL) in 0.9 % sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409785301</ndc>
    <ndc_label_name>Precedex 400 mcg/100 mL (4 mcg/mL) in 0.9% sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409785324</ndc>
    <ndc_label_name>Precedex 400 mcg/100 mL (4 mcg/mL) in 0.9% sodium chloride IV solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409787001</ndc>
    <ndc_label_name>DOCETAXEL 80 MG/8 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409787501</ndc>
    <ndc_label_name>Precedex 1,000 mcg/250 mL (4 mcg/mL) in 0.9% sodium chloride IV soln</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409787512</ndc>
    <ndc_label_name>Precedex 1,000 mcg/250 mL (4 mcg/mL) in 0.9% sodium chloride IV soln</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409796905</ndc>
    <ndc_label_name>Plegisol 16 mEq/L (potassium) perfusion solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409796911</ndc>
    <ndc_label_name>Plegisol 16 mEq/L (potassium) perfusion solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409798353</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409812601</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.5 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409812610</ndc>
    <ndc_label_name>Marcaine-Epinephrine (PF) 0.5 %-1:200,000 injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409818301</ndc>
    <ndc_label_name>POTASSIUM ACET 40 MEQ/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409818311</ndc>
    <ndc_label_name>POTASSIUM ACET 40 MEQ/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409818315</ndc>
    <ndc_label_name>POTASSIUM ACET 40 MEQ/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409818325</ndc>
    <ndc_label_name>POTASSIUM ACET 40 MEQ/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409904201</ndc>
    <ndc_label_name>BUPIVACAINE 0.25%-EPI 1:200000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409904211</ndc>
    <ndc_label_name>BUPIVACAINE 0.25%-EPI 1:200000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409904216</ndc>
    <ndc_label_name>BUPIVACAINE 0.25%-EPI 1:200000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409904217</ndc>
    <ndc_label_name>BUPIVACAINE 0.25%-EPI 1:200000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409904301</ndc>
    <ndc_label_name>BUPIVACAINE 0.25%-EPI 1:200000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409904311</ndc>
    <ndc_label_name>BUPIVACAINE 0.25%-EPI 1:200000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409904501</ndc>
    <ndc_label_name>BUPIVACAINE 0.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409904511</ndc>
    <ndc_label_name>BUPIVACAINE 0.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409904516</ndc>
    <ndc_label_name>BUPIVACAINE 0.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409904517</ndc>
    <ndc_label_name>BUPIVACAINE 0.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409904601</ndc>
    <ndc_label_name>BUPIVACAINE 0.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409904611</ndc>
    <ndc_label_name>BUPIVACAINE 0.5%-EPI 1:200,000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909309</ndc>
    <ndc_label_name>FENTANYL 100 MCG/2 ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909311</ndc>
    <ndc_label_name>FENTANYL 100 MCG/2 ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909332</ndc>
    <ndc_label_name>FENTANYL 100 MCG/2 ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909335</ndc>
    <ndc_label_name>FENTANYL 250 MCG/5 ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909337</ndc>
    <ndc_label_name>FENTANYL 100 MCG/2 ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909345</ndc>
    <ndc_label_name>FENTANYL 250 MCG/5 ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909412</ndc>
    <ndc_label_name>FENTANYL 100 MCG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909416</ndc>
    <ndc_label_name>FENTANYL 1,000 MCG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909417</ndc>
    <ndc_label_name>FENTANYL 500 MCG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909418</ndc>
    <ndc_label_name>FENTANYL 250 MCG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909422</ndc>
    <ndc_label_name>FENTANYL 100 MCG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909425</ndc>
    <ndc_label_name>FENTANYL 250 MCG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909428</ndc>
    <ndc_label_name>FENTANYL 500 MCG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909431</ndc>
    <ndc_label_name>FENTANYL 1,000 MCG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909441</ndc>
    <ndc_label_name>FENTANYL 2,500 MCG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409909461</ndc>
    <ndc_label_name>FENTANYL 2,500 MCG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409910420</ndc>
    <ndc_label_name>DOPAMINE 400 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409910421</ndc>
    <ndc_label_name>DOPAMINE 400 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409913705</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409913711</ndc>
    <ndc_label_name>LIDOCAINE HCL 1% SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409915701</ndc>
    <ndc_label_name>vitamin K 1 mg/0.5 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409915731</ndc>
    <ndc_label_name>vitamin K 1 mg/0.5 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409915750</ndc>
    <ndc_label_name>vitamin K 1 mg/0.5 mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409915801</ndc>
    <ndc_label_name>Vitamin K1 10 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409915811</ndc>
    <ndc_label_name>Vitamin K1 10 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409915825</ndc>
    <ndc_label_name>Vitamin K1 10 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409915831</ndc>
    <ndc_label_name>Vitamin K1 10 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409915850</ndc>
    <ndc_label_name>Vitamin K1 10 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409915855</ndc>
    <ndc_label_name>Vitamin K1 10 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409955805</ndc>
    <ndc_label_name>ROCURONIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409955810</ndc>
    <ndc_label_name>ROCURONIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409955811</ndc>
    <ndc_label_name>ROCURONIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409955831</ndc>
    <ndc_label_name>ROCURONIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409955849</ndc>
    <ndc_label_name>ROCURONIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409955850</ndc>
    <ndc_label_name>ROCURONIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409955869</ndc>
    <ndc_label_name>ROCURONIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409955870</ndc>
    <ndc_label_name>ROCURONIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409956601</ndc>
    <ndc_label_name>CEFEPIME HCL 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409956610</ndc>
    <ndc_label_name>CEFEPIME HCL 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409963005</ndc>
    <ndc_label_name>ATROPINE 0.25 MG/5 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409963015</ndc>
    <ndc_label_name>ATROPINE 0.25 MG/5 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409963305</ndc>
    <ndc_label_name>VERAPAMIL 10 MG/4 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00409963365</ndc>
    <ndc_label_name>VERAPAMIL 10 MG/4 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409973501</ndc>
    <ndc_label_name>CEFEPIME HCL 2 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00409973510</ndc>
    <ndc_label_name>CEFEPIME HCL 2 GRAM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00430042014</ndc>
    <ndc_label_name>Lo Loestrin Fe 1 mg-10 mcg (24)/10 mcg (2) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00430042095</ndc>
    <ndc_label_name>Lo Loestrin Fe 1 mg-10 mcg (24)/10 mcg (2) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00430047203</ndc>
    <ndc_label_name>Actonel 35 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00430047207</ndc>
    <ndc_label_name>Actonel 35 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00430047801</ndc>
    <ndc_label_name>Actonel 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00430047802</ndc>
    <ndc_label_name>Actonel 150 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00430072024</ndc>
    <ndc_label_name>ESTRACE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00430072124</ndc>
    <ndc_label_name>ESTRACE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00430072224</ndc>
    <ndc_label_name>ESTRACE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00430097903</ndc>
    <ndc_label_name>Atelvia 35 mg tablet,delayed release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00430375414</ndc>
    <ndc_label_name>Estrace 0.01% (0.1 mg/gram) vaginal cream</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00436066916</ndc>
    <ndc_label_name>Di-Dak-Sol 0.0125 % topical solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00436067216</ndc>
    <ndc_label_name>Dakin's Solution 0.125 %</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00436093616</ndc>
    <ndc_label_name>Dakin's Solution 0.25 %</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00436094616</ndc>
    <ndc_label_name>Dakin's Solution 0.5 %</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00436096416</ndc>
    <ndc_label_name>LIQUA SPEN LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00436096428</ndc>
    <ndc_label_name>LIQUA SPEN LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00436960042</ndc>
    <ndc_label_name>Moi-Stir mucosal spray with pump</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00441925110</ndc>
    <ndc_label_name>SULFANILAMIDE CRYSTAL POWD</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00441925150</ndc>
    <ndc_label_name>SULFANILAMIDE CRYSTAL POWD</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450008002</ndc>
    <ndc_label_name>Lactaid 3,000 unit tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00450012230</ndc>
    <ndc_label_name>Infant's Tylenol 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00450012260</ndc>
    <ndc_label_name>Infant's Tylenol 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450013404</ndc>
    <ndc_label_name>Imodium A-D 1 mg/7.5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450013408</ndc>
    <ndc_label_name>Imodium A-D 1 mg/7.5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450013444</ndc>
    <ndc_label_name>Imodium A-D 1 mg/7.5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00450016764</ndc>
    <ndc_label_name>Infant's Tylenol 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450017005</ndc>
    <ndc_label_name>Child Benadryl Plus Congestion 12.5 mg-5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00450018660</ndc>
    <ndc_label_name>Infant's Tylenol 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450019201</ndc>
    <ndc_label_name>Children's Motrin 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450019801</ndc>
    <ndc_label_name>Infant's Motrin 50 mg/1.25 mL oral drops,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450020424</ndc>
    <ndc_label_name>Zyrtec-D 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450020425</ndc>
    <ndc_label_name>Zyrtec 10 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450020427</ndc>
    <ndc_label_name>Zyrtec-D 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450020431</ndc>
    <ndc_label_name>Zyrtec 10 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450020504</ndc>
    <ndc_label_name>Children's Zyrtec Allergy 1 mg/mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450020911</ndc>
    <ndc_label_name>Children's Zyrtec Allergy 1 mg/mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450021212</ndc>
    <ndc_label_name>Imodium Multi-Symptom Relief 2 mg-125 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450021218</ndc>
    <ndc_label_name>Imodium Multi-Symptom Relief 2 mg-125 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450026125</ndc>
    <ndc_label_name>Tylenol Cold Head Congestion Severe 5 mg-325 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00450029532</ndc>
    <ndc_label_name>Imodium A-D 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450040704</ndc>
    <ndc_label_name>Children's Tylenol 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450044406</ndc>
    <ndc_label_name>Tylenol Extra Strength 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450044905</ndc>
    <ndc_label_name>Tylenol Extra Strength 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450044910</ndc>
    <ndc_label_name>Tylenol Extra Strength 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450048102</ndc>
    <ndc_label_name>Motrin IB 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450048152</ndc>
    <ndc_label_name>Motrin IB 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450048830</ndc>
    <ndc_label_name>Tylenol Extra Strength 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450049304</ndc>
    <ndc_label_name>Children's Tylenol 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450049660</ndc>
    <ndc_label_name>Tylenol 325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00450051824</ndc>
    <ndc_label_name>Children's Tylenol 160 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00450051924</ndc>
    <ndc_label_name>Children's Tylenol 160 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450052415</ndc>
    <ndc_label_name>Infant's Motrin 50 mg/1.25 mL oral drops,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450052508</ndc>
    <ndc_label_name>Tylenol Cold and Flu Severe 5 mg-10 mg-325 mg-200 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450053704</ndc>
    <ndc_label_name>Children's Sudafed PE Nasal Decongestant 2.5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450053804</ndc>
    <ndc_label_name>Children's Sudafed PE Cough and Cold 2.5 mg-5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450054724</ndc>
    <ndc_label_name>Sudafed PE Pressure-Pain 5 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450055320</ndc>
    <ndc_label_name>Children's Benadryl Allergy 12.5 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450056320</ndc>
    <ndc_label_name>Motrin PM 200 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450056380</ndc>
    <ndc_label_name>Motrin PM 200 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450058118</ndc>
    <ndc_label_name>Sudafed PE 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450058136</ndc>
    <ndc_label_name>Sudafed PE 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450060340</ndc>
    <ndc_label_name>Children's Motrin 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450083840</ndc>
    <ndc_label_name>Tylenol 8 Hour 650 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450084310</ndc>
    <ndc_label_name>Simply Sleep 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450089504</ndc>
    <ndc_label_name>Nizoral A-D 1 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450091012</ndc>
    <ndc_label_name>Lactaid Fast Act 9,000 unit tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450091032</ndc>
    <ndc_label_name>Lactaid Fast Act 9,000 unit tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450091060</ndc>
    <ndc_label_name>Lactaid Fast Act 9,000 unit tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450093032</ndc>
    <ndc_label_name>Lactaid Fast Act 9,000 unit chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00450093060</ndc>
    <ndc_label_name>Lactaid Fast Act 9,000 unit chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456040001</ndc>
    <ndc_label_name>Teflaro 400 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456040010</ndc>
    <ndc_label_name>Teflaro 400 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456045701</ndc>
    <ndc_label_name>Armour Thyroid 15 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456045801</ndc>
    <ndc_label_name>Armour Thyroid 30 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456045901</ndc>
    <ndc_label_name>Armour Thyroid 60 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456046001</ndc>
    <ndc_label_name>Armour Thyroid 90 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456046101</ndc>
    <ndc_label_name>Armour Thyroid 120 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456046201</ndc>
    <ndc_label_name>Armour Thyroid 180 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456046301</ndc>
    <ndc_label_name>Armour Thyroid 240 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456046401</ndc>
    <ndc_label_name>Armour Thyroid 300 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456052101</ndc>
    <ndc_label_name>Flumadine 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456060001</ndc>
    <ndc_label_name>Teflaro 600 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456060010</ndc>
    <ndc_label_name>Teflaro 600 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456104501</ndc>
    <ndc_label_name>Armour Thyroid 15 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456111030</ndc>
    <ndc_label_name>Viibryd 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456112030</ndc>
    <ndc_label_name>Viibryd 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456114030</ndc>
    <ndc_label_name>Viibryd 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00456120104</ndc>
    <ndc_label_name>Linzess 145 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00456120130</ndc>
    <ndc_label_name>Linzess 145 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00456120204</ndc>
    <ndc_label_name>Linzess 290 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00456120230</ndc>
    <ndc_label_name>Linzess 290 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00456120304</ndc>
    <ndc_label_name>Linzess 72 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00456120330</ndc>
    <ndc_label_name>Linzess 72 mcg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456120730</ndc>
    <ndc_label_name>Namzaric 7 mg-10 mg capsule sprinkle,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456121430</ndc>
    <ndc_label_name>Namzaric 14 mg-10 mg capsule sprinkle,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456122130</ndc>
    <ndc_label_name>Namzaric 21 mg-10 mg capsule sprinkle,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456122830</ndc>
    <ndc_label_name>Namzaric 28 mg-10 mg capsule sprinkle,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456122929</ndc>
    <ndc_label_name>NAMZARIC TITRATION PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456140230</ndc>
    <ndc_label_name>Bystolic 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456140590</ndc>
    <ndc_label_name>Bystolic 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456141090</ndc>
    <ndc_label_name>Bystolic 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456142090</ndc>
    <ndc_label_name>Bystolic 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456150055</ndc>
    <ndc_label_name>Savella 12.5 mg (5)-25 mg(8)-50mg(42) tablets in a dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456151060</ndc>
    <ndc_label_name>Savella 100 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456151260</ndc>
    <ndc_label_name>Savella 12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456152560</ndc>
    <ndc_label_name>Savella 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456155060</ndc>
    <ndc_label_name>Savella 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456200501</ndc>
    <ndc_label_name>Lexapro 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456201001</ndc>
    <ndc_label_name>Lexapro 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456202001</ndc>
    <ndc_label_name>Lexapro 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456220007</ndc>
    <ndc_label_name>FETZIMA 20-40 MG TITRATION PAK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456220228</ndc>
    <ndc_label_name>Fetzima 20 mg (2)-40 mg (26) capsule,extended release,24 hr,dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456221230</ndc>
    <ndc_label_name>Fetzima 120 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456222030</ndc>
    <ndc_label_name>Fetzima 20 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456224030</ndc>
    <ndc_label_name>Fetzima 40 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456228030</ndc>
    <ndc_label_name>Fetzima 80 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456240206</ndc>
    <ndc_label_name>Saphris 2.5 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456240260</ndc>
    <ndc_label_name>Saphris 2.5 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456240506</ndc>
    <ndc_label_name>Saphris 5 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456240511</ndc>
    <ndc_label_name>Saphris 5 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456240560</ndc>
    <ndc_label_name>Saphris 5 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456241006</ndc>
    <ndc_label_name>Saphris 10 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456241011</ndc>
    <ndc_label_name>Saphris 10 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456241060</ndc>
    <ndc_label_name>Saphris 10 mg sublingual tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456270001</ndc>
    <ndc_label_name>Avycaz 2.5 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456270010</ndc>
    <ndc_label_name>Avycaz 2.5 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456340029</ndc>
    <ndc_label_name>Namenda XR 7 mg-14 mg-21 mg-28 mg capsule,sprinkle,ext rel, dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456340733</ndc>
    <ndc_label_name>Namenda XR 7 mg capsule sprinkle,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456401001</ndc>
    <ndc_label_name>Celexa 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456402001</ndc>
    <ndc_label_name>Celexa 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00456404001</ndc>
    <ndc_label_name>Celexa 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00463750010</ndc>
    <ndc_label_name>PHENDIMETRAZINE 35 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00463800010</ndc>
    <ndc_label_name>PHENDIMETRAZINE 35 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469012599</ndc>
    <ndc_label_name>Xtandi 40 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469042001</ndc>
    <ndc_label_name>Cresemba 372 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469052001</ndc>
    <ndc_label_name>Cresemba 186 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469052002</ndc>
    <ndc_label_name>Cresemba 186 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469060773</ndc>
    <ndc_label_name>Prograf 0.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469061773</ndc>
    <ndc_label_name>Prograf 1 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469062599</ndc>
    <ndc_label_name>Xtandi 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469064773</ndc>
    <ndc_label_name>Astagraf XL 0.5 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469065773</ndc>
    <ndc_label_name>Prograf 5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469067773</ndc>
    <ndc_label_name>Astagraf XL 1 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469068773</ndc>
    <ndc_label_name>Astagraf XL 5 mg capsule,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469072560</ndc>
    <ndc_label_name>Xtandi 80 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469123050</ndc>
    <ndc_label_name>Prograf 0.2 mg oral granules in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469133050</ndc>
    <ndc_label_name>Prograf 1 mg oral granules in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469142590</ndc>
    <ndc_label_name>Xospata 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469246007</ndc>
    <ndc_label_name>Veozah 45 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469246028</ndc>
    <ndc_label_name>Veozah 45 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00469260107</ndc>
    <ndc_label_name>Myrbetriq 25 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00469260130</ndc>
    <ndc_label_name>Myrbetriq 25 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00469260190</ndc>
    <ndc_label_name>Myrbetriq 25 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00469260207</ndc>
    <ndc_label_name>Myrbetriq 50 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00469260230</ndc>
    <ndc_label_name>Myrbetriq 50 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00469260290</ndc>
    <ndc_label_name>Myrbetriq 50 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469266030</ndc>
    <ndc_label_name>Veozah 45 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469276007</ndc>
    <ndc_label_name>Veozah 45 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469276028</ndc>
    <ndc_label_name>Veozah 45 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469286001</ndc>
    <ndc_label_name>Cresemba 74.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469286035</ndc>
    <ndc_label_name>Cresemba 74.5 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469301601</ndc>
    <ndc_label_name>Prograf 5 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469305130</ndc>
    <ndc_label_name>AmBisome 50 mg intravenous suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469321110</ndc>
    <ndc_label_name>MYCAMINE 100 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469325010</ndc>
    <ndc_label_name>MYCAMINE 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469342510</ndc>
    <ndc_label_name>Vyloy 100 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469442530</ndc>
    <ndc_label_name>Vyloy 300 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469502099</ndc>
    <ndc_label_name>Myrbetriq 8 mg/mL oral suspension,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00469650189</ndc>
    <ndc_label_name>Lexiscan 0.4 mg/5 mL intravenous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472001304</ndc>
    <ndc_label_name>GRISEOFULVIN 125 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472008216</ndc>
    <ndc_label_name>ACYCLOVIR 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472011720</ndc>
    <ndc_label_name>TRETINOIN 0.025% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472011745</ndc>
    <ndc_label_name>TRETINOIN 0.025% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472012645</ndc>
    <ndc_label_name>ADAPALENE 0.3% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472016615</ndc>
    <ndc_label_name>NYSTATIN 100,000 UNIT/GM OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472016630</ndc>
    <ndc_label_name>NYSTATIN 100,000 UNIT/GM OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472023516</ndc>
    <ndc_label_name>LEVETIRACETAM 100 MG/ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472024260</ndc>
    <ndc_label_name>PERMETHRIN 5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472032126</ndc>
    <ndc_label_name>HYDROCORTISONE 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472033720</ndc>
    <ndc_label_name>HYDROCORTISONE 2.5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472033730</ndc>
    <ndc_label_name>HYDROCORTISONE 2.5% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472037015</ndc>
    <ndc_label_name>BETAMETHASONE VA 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472037045</ndc>
    <ndc_label_name>BETAMETHASONE VA 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472037115</ndc>
    <ndc_label_name>BETAMETHASONE VALER 0.1% OINTM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472037145</ndc>
    <ndc_label_name>BETAMETHASONE VALER 0.1% OINTM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472037915</ndc>
    <ndc_label_name>CLOTRIMAZOLE-BETAMETHASONE CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472037945</ndc>
    <ndc_label_name>CLOTRIMAZOLE-BETAMETHASONE CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472038015</ndc>
    <ndc_label_name>BETAMETHASONE DP 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472038045</ndc>
    <ndc_label_name>BETAMETHASONE DP 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472038115</ndc>
    <ndc_label_name>BETAMETHASONE DP 0.05% OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472038145</ndc>
    <ndc_label_name>BETAMETHASONE DP 0.05% OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472038215</ndc>
    <ndc_label_name>BETAMETHASONE DP AUG 0.05% OIN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472038245</ndc>
    <ndc_label_name>BETAMETHASONE DP AUG 0.05% OIN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472040394</ndc>
    <ndc_label_name>CLOBETASOL 0.05% SHAMPOO</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472040492</ndc>
    <ndc_label_name>CLOBETASOL 0.05% TOPICAL LOTN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472040494</ndc>
    <ndc_label_name>CLOBETASOL 0.05% TOPICAL LOTN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472047815</ndc>
    <ndc_label_name>DESOXIMETASONE 0.25% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472047860</ndc>
    <ndc_label_name>DESOXIMETASONE 0.25% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472047915</ndc>
    <ndc_label_name>DESOXIMETASONE 0.25% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472047960</ndc>
    <ndc_label_name>DESOXIMETASONE 0.25% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472080302</ndc>
    <ndc_label_name>DESONIDE 0.05% LOTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472080304</ndc>
    <ndc_label_name>DESONIDE 0.05% LOTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472080415</ndc>
    <ndc_label_name>DESONIDE 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472080460</ndc>
    <ndc_label_name>DESONIDE 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472082516</ndc>
    <ndc_label_name>ALBUTEROL SULF 2 MG/5 ML SYRUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472103016</ndc>
    <ndc_label_name>Hydromet 5 mg-1.5 mg/5 mL oral solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472173803</ndc>
    <ndc_label_name>Miconazole-3 200 mg vaginal suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472178310</ndc>
    <ndc_label_name>DICLOFENAC SODIUM 3% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472179030</ndc>
    <ndc_label_name>CLINDA-TRETINOIN 1.2%-0.025%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00472179060</ndc>
    <ndc_label_name>CLINDA-TRETINOIN 1.2%-0.025%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472191501</ndc>
    <ndc_label_name>MESALAMINE 1,000 MG SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472191530</ndc>
    <ndc_label_name>MESALAMINE 1,000 MG SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472199208</ndc>
    <ndc_label_name>NITROFURANTOIN 25 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472200216</ndc>
    <ndc_label_name>IBUPROFEN 100 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00472200294</ndc>
    <ndc_label_name>IBUPROFEN 100 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480008305</ndc>
    <ndc_label_name>AMLODIPINE BESYLATE 2.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480008398</ndc>
    <ndc_label_name>AMLODIPINE BESYLATE 2.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480012649</ndc>
    <ndc_label_name>ICOSAPENT ETHYL 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480012789</ndc>
    <ndc_label_name>ICOSAPENT ETHYL 1 GRAM CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480095101</ndc>
    <ndc_label_name>NAPROXEN SOD ER 375 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480095258</ndc>
    <ndc_label_name>NAPROXEN SOD ER 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480095356</ndc>
    <ndc_label_name>NAPROXEN SOD ER 750 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480117522</ndc>
    <ndc_label_name>MYCOPHENOLATE 200 MG/ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480123208</ndc>
    <ndc_label_name>RISPERIDONE ER 25 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480124128</ndc>
    <ndc_label_name>LENALIDOMIDE 2.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480124228</ndc>
    <ndc_label_name>LENALIDOMIDE 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480124328</ndc>
    <ndc_label_name>LENALIDOMIDE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480124421</ndc>
    <ndc_label_name>LENALIDOMIDE 15 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480124521</ndc>
    <ndc_label_name>LENALIDOMIDE 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480124621</ndc>
    <ndc_label_name>LENALIDOMIDE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480134208</ndc>
    <ndc_label_name>RISPERIDONE ER 37.5 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480145308</ndc>
    <ndc_label_name>RISPERIDONE ER 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480155408</ndc>
    <ndc_label_name>RISPERIDONE ER 12.5 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480204356</ndc>
    <ndc_label_name>VILAZODONE HCL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480204456</ndc>
    <ndc_label_name>VILAZODONE HCL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480204556</ndc>
    <ndc_label_name>VILAZODONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480215757</ndc>
    <ndc_label_name>AZELASTIN-FLUTIC 137-50MCG SPR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480229956</ndc>
    <ndc_label_name>PHENTERMINE-TOPIR ER 11.25-69</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480230830</ndc>
    <ndc_label_name>TADALAFIL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480230865</ndc>
    <ndc_label_name>TADALAFIL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480230930</ndc>
    <ndc_label_name>TADALAFIL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480230956</ndc>
    <ndc_label_name>TADALAFIL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480230965</ndc>
    <ndc_label_name>TADALAFIL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480231056</ndc>
    <ndc_label_name>TADALAFIL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480231156</ndc>
    <ndc_label_name>TADALAFIL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480235601</ndc>
    <ndc_label_name>TOPIRAMATE ER 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480235656</ndc>
    <ndc_label_name>TOPIRAMATE ER 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480235701</ndc>
    <ndc_label_name>TOPIRAMATE ER 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480235756</ndc>
    <ndc_label_name>TOPIRAMATE ER 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480235801</ndc>
    <ndc_label_name>TOPIRAMATE ER 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480235856</ndc>
    <ndc_label_name>TOPIRAMATE ER 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480235901</ndc>
    <ndc_label_name>TOPIRAMATE ER 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480235956</ndc>
    <ndc_label_name>TOPIRAMATE ER 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480259634</ndc>
    <ndc_label_name>FIDAXOMICIN 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480260121</ndc>
    <ndc_label_name>POMALIDOMIDE 3 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480268806</ndc>
    <ndc_label_name>TICAGRELOR 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480269506</ndc>
    <ndc_label_name>TICAGRELOR 90 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480299697</ndc>
    <ndc_label_name>FERRIC CITRATE 210 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480315445</ndc>
    <ndc_label_name>ADAPALENE-BNZYL PEROX 0.3-2.5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480315656</ndc>
    <ndc_label_name>TERIFLUNOMIDE 14 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480315756</ndc>
    <ndc_label_name>TERIFLUNOMIDE 7 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480323751</ndc>
    <ndc_label_name>LAPATINIB 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480327356</ndc>
    <ndc_label_name>Alvaiz 9 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480327456</ndc>
    <ndc_label_name>Alvaiz 18 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480327556</ndc>
    <ndc_label_name>Alvaiz 36 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480327656</ndc>
    <ndc_label_name>Alvaiz 54 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480329001</ndc>
    <ndc_label_name>PACLITAXEL PROTEIN-BOUND 100MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480329556</ndc>
    <ndc_label_name>PHENTERMINE-TOPIR ER 15-92 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480329656</ndc>
    <ndc_label_name>PHENTERMINE-TOPIR ER 7.5-46 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480329756</ndc>
    <ndc_label_name>PHENTERMINE-TOPIR ER 3.75-23MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480330901</ndc>
    <ndc_label_name>THEOPHYLLINE ER 450 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480331001</ndc>
    <ndc_label_name>THEOPHYLLINE ER 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480331519</ndc>
    <ndc_label_name>AMPHETAMINE ER 3.1 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480331565</ndc>
    <ndc_label_name>AMPHETAMINE ER 3.1 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480331619</ndc>
    <ndc_label_name>AMPHETAMINE ER 6.3 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480331665</ndc>
    <ndc_label_name>AMPHETAMINE ER 6.3 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480331719</ndc>
    <ndc_label_name>AMPHETAMINE ER 9.4 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480331765</ndc>
    <ndc_label_name>AMPHETAMINE ER 9.4 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480331819</ndc>
    <ndc_label_name>AMPHETAMINE ER 12.5 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480331865</ndc>
    <ndc_label_name>AMPHETAMINE ER 12.5 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480331919</ndc>
    <ndc_label_name>AMPHETAMINE ER 15.7 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480331965</ndc>
    <ndc_label_name>AMPHETAMINE ER 15.7 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480332019</ndc>
    <ndc_label_name>AMPHETAMINE ER 18.8 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480332065</ndc>
    <ndc_label_name>AMPHETAMINE ER 18.8 MG ODT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480332501</ndc>
    <ndc_label_name>DALBAVANCIN HCL 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480347001</ndc>
    <ndc_label_name>NITROFURANTOIN MONO-MCR 100 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480347224</ndc>
    <ndc_label_name>Amethyst (28) 90 mcg-20 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480347516</ndc>
    <ndc_label_name>Nora-BE 0.35 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480347519</ndc>
    <ndc_label_name>Nora-BE 0.35 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480347819</ndc>
    <ndc_label_name>NALOXONE HCL 4 MG NASAL SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480347868</ndc>
    <ndc_label_name>NALOXONE HCL 4 MG NASAL SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480347906</ndc>
    <ndc_label_name>LUBIPROSTONE 8 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480349316</ndc>
    <ndc_label_name>Cryselle (28) 0.3 mg-30 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480349324</ndc>
    <ndc_label_name>Cryselle (28) 0.3 mg-30 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480349405</ndc>
    <ndc_label_name>GABAPENTIN 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480349505</ndc>
    <ndc_label_name>GABAPENTIN 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480352356</ndc>
    <ndc_label_name>DASATINIB 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480352456</ndc>
    <ndc_label_name>DASATINIB 140 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480352756</ndc>
    <ndc_label_name>DAPAGLIFLOZIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480352798</ndc>
    <ndc_label_name>DAPAGLIFLOZIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480352856</ndc>
    <ndc_label_name>DAPAGLIFLOZIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480352898</ndc>
    <ndc_label_name>DAPAGLIFLOZIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480356401</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 70 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480356501</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480356601</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480356701</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480356801</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480356901</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480357001</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480357101</ndc>
    <ndc_label_name>MYCOPHENOLATE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480357105</ndc>
    <ndc_label_name>MYCOPHENOLATE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480358301</ndc>
    <ndc_label_name>CETRORELIX ACETATE 0.25 MG VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480361087</ndc>
    <ndc_label_name>PIRFENIDONE 267 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480361198</ndc>
    <ndc_label_name>PIRFENIDONE 801 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480363198</ndc>
    <ndc_label_name>PITAVASTATIN 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480363298</ndc>
    <ndc_label_name>PITAVASTATIN 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480363398</ndc>
    <ndc_label_name>PITAVASTATIN 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480366719</ndc>
    <ndc_label_name>LIRAGLUTIDE 18 MG/3 ML PEN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480366720</ndc>
    <ndc_label_name>LIRAGLUTIDE 2-PAK 18 MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480366722</ndc>
    <ndc_label_name>LIRAGLUTIDE 3-PAK 18 MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480368301</ndc>
    <ndc_label_name>DEXTROAMPH-AMPHET ER 12.5MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480368401</ndc>
    <ndc_label_name>DEXTROAMPH-AMPHET ER 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480368501</ndc>
    <ndc_label_name>DEXTROAMPH-AMPHET ER 37.5MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480368601</ndc>
    <ndc_label_name>DEXTROAMPH-AMPHET ER 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480372001</ndc>
    <ndc_label_name>PYRIMETHAMINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480372056</ndc>
    <ndc_label_name>PYRIMETHAMINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480377758</ndc>
    <ndc_label_name>GLYCEROL PHENYLBUT 1.1 GRAM/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480400028</ndc>
    <ndc_label_name>Vestura (28) 3 mg-0.02 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480400062</ndc>
    <ndc_label_name>Vestura (28) 3 mg-0.02 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480401821</ndc>
    <ndc_label_name>POMALIDOMIDE 1 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480402221</ndc>
    <ndc_label_name>POMALIDOMIDE 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480403521</ndc>
    <ndc_label_name>POMALIDOMIDE 4 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480405356</ndc>
    <ndc_label_name>GEFITINIB 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480407619</ndc>
    <ndc_label_name>CYCLOSPORINE 0.05% EYE EMULS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480407630</ndc>
    <ndc_label_name>CYCLOSPORINE 0.05% EYE EMULS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480407645</ndc>
    <ndc_label_name>CYCLOSPORINE 0.05% EYE EMULS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480407660</ndc>
    <ndc_label_name>CYCLOSPORINE 0.05% EYE EMULS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480411101</ndc>
    <ndc_label_name>PANTOPRAZOLE SODIUM 40 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480411103</ndc>
    <ndc_label_name>PANTOPRAZOLE SODIUM 40 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480413806</ndc>
    <ndc_label_name>LUBIPROSTONE 24 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480418489</ndc>
    <ndc_label_name>PAZOPANIB HCL 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480432001</ndc>
    <ndc_label_name>PLERIXAFOR 24 MG/1.2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480449056</ndc>
    <ndc_label_name>TASIMELTEON 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480451401</ndc>
    <ndc_label_name>PEMETREXED 500 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480451501</ndc>
    <ndc_label_name>PEMETREXED 1 GM/40 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480451601</ndc>
    <ndc_label_name>PEMETREXED 100 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480510106</ndc>
    <ndc_label_name>DASATINIB 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480510206</ndc>
    <ndc_label_name>DASATINIB 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480510306</ndc>
    <ndc_label_name>DASATINIB 70 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480510456</ndc>
    <ndc_label_name>DASATINIB 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480542589</ndc>
    <ndc_label_name>SORAFENIB 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480579508</ndc>
    <ndc_label_name>CETRORELIX ACETATE 0.25 MG VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480701156</ndc>
    <ndc_label_name>DEFERASIROX 125 MG TB FOR SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480701256</ndc>
    <ndc_label_name>DEFERASIROX 250 MG TB FOR SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480701356</ndc>
    <ndc_label_name>DEFERASIROX 500 MG TB FOR SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480706256</ndc>
    <ndc_label_name>PERAMPANEL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480706356</ndc>
    <ndc_label_name>PERAMPANEL 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480706556</ndc>
    <ndc_label_name>PERAMPANEL 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480706656</ndc>
    <ndc_label_name>PERAMPANEL 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480706756</ndc>
    <ndc_label_name>PERAMPANEL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480706856</ndc>
    <ndc_label_name>PERAMPANEL 12 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480716710</ndc>
    <ndc_label_name>AMLODIPINE BESYLATE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480716798</ndc>
    <ndc_label_name>AMLODIPINE BESYLATE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480716810</ndc>
    <ndc_label_name>AMLODIPINE BESYLATE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480716898</ndc>
    <ndc_label_name>AMLODIPINE BESYLATE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480725019</ndc>
    <ndc_label_name>LIRAGLUTIDE 18 MG/3 ML PEN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480725046</ndc>
    <ndc_label_name>LIRAGLUTIDE 5-PAK 18 MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480727010</ndc>
    <ndc_label_name>PRAVASTATIN SODIUM 80 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480727098</ndc>
    <ndc_label_name>PRAVASTATIN SODIUM 80 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480773606</ndc>
    <ndc_label_name>DARUNAVIR 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480775080</ndc>
    <ndc_label_name>MESALAMINE 800 MG DR TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480782056</ndc>
    <ndc_label_name>FINGOLIMOD 0.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480782498</ndc>
    <ndc_label_name>TIOPRONIN DR 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480868201</ndc>
    <ndc_label_name>LEVOTHYROXINE 25 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480868210</ndc>
    <ndc_label_name>LEVOTHYROXINE 25 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480868298</ndc>
    <ndc_label_name>LEVOTHYROXINE 25 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480868701</ndc>
    <ndc_label_name>LEVOTHYROXINE 50 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480868710</ndc>
    <ndc_label_name>LEVOTHYROXINE 50 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480868798</ndc>
    <ndc_label_name>LEVOTHYROXINE 50 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480869001</ndc>
    <ndc_label_name>LEVOTHYROXINE 75 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480869010</ndc>
    <ndc_label_name>LEVOTHYROXINE 75 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480869098</ndc>
    <ndc_label_name>LEVOTHYROXINE 75 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480869301</ndc>
    <ndc_label_name>LEVOTHYROXINE 88 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480869310</ndc>
    <ndc_label_name>LEVOTHYROXINE 88 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480869398</ndc>
    <ndc_label_name>LEVOTHYROXINE 88 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480870101</ndc>
    <ndc_label_name>LEVOTHYROXINE 100 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480870110</ndc>
    <ndc_label_name>LEVOTHYROXINE 100 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480870198</ndc>
    <ndc_label_name>LEVOTHYROXINE 100 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480870401</ndc>
    <ndc_label_name>LEVOTHYROXINE 112 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480870410</ndc>
    <ndc_label_name>LEVOTHYROXINE 112 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480870498</ndc>
    <ndc_label_name>LEVOTHYROXINE 112 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480870701</ndc>
    <ndc_label_name>LEVOTHYROXINE 125 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480870710</ndc>
    <ndc_label_name>LEVOTHYROXINE 125 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480870798</ndc>
    <ndc_label_name>LEVOTHYROXINE 125 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480871001</ndc>
    <ndc_label_name>LEVOTHYROXINE 137 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480871010</ndc>
    <ndc_label_name>LEVOTHYROXINE 137 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480871098</ndc>
    <ndc_label_name>LEVOTHYROXINE 137 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480871501</ndc>
    <ndc_label_name>LEVOTHYROXINE 150 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480871510</ndc>
    <ndc_label_name>LEVOTHYROXINE 150 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480871598</ndc>
    <ndc_label_name>LEVOTHYROXINE 150 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480871801</ndc>
    <ndc_label_name>LEVOTHYROXINE 175 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480871810</ndc>
    <ndc_label_name>LEVOTHYROXINE 175 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480871898</ndc>
    <ndc_label_name>LEVOTHYROXINE 175 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480872210</ndc>
    <ndc_label_name>LEVOTHYROXINE 200 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480872298</ndc>
    <ndc_label_name>LEVOTHYROXINE 200 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480872501</ndc>
    <ndc_label_name>LEVOTHYROXINE 300 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480872510</ndc>
    <ndc_label_name>LEVOTHYROXINE 300 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480872598</ndc>
    <ndc_label_name>LEVOTHYROXINE 300 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480922755</ndc>
    <ndc_label_name>TIOPRONIN DR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480924201</ndc>
    <ndc_label_name>PROPYLTHIOURACIL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480925601</ndc>
    <ndc_label_name>OCTREOTIDE ACET ER 10 MG IM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480925708</ndc>
    <ndc_label_name>OCTREOTIDE ACET ER 10 MG IM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480925801</ndc>
    <ndc_label_name>OCTREOTIDE ACET ER 20 MG IM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480925908</ndc>
    <ndc_label_name>OCTREOTIDE ACET ER 20 MG IM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480926001</ndc>
    <ndc_label_name>OCTREOTIDE ACET ER 30 MG IM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480926208</ndc>
    <ndc_label_name>OCTREOTIDE ACET ER 30 MG IM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00480927706</ndc>
    <ndc_label_name>Alyq 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480943589</ndc>
    <ndc_label_name>DICLOFENAC POTASSIUM 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480973201</ndc>
    <ndc_label_name>RISPERIDONE ER 12.5 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480973301</ndc>
    <ndc_label_name>RISPERIDONE ER 25 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480973401</ndc>
    <ndc_label_name>RISPERIDONE ER 37.5 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480973501</ndc>
    <ndc_label_name>RISPERIDONE ER 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480973701</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 10 MG TB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480973801</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 20 MG TB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480973901</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 30 MG TB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480974101</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 40 MG TB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480974201</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 50 MG TB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00480974401</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 60 MG TB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00482001608</ndc>
    <ndc_label_name>Apatate Forte oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00482010614</ndc>
    <ndc_label_name>I.L.X. B-12  102 mg iron-10 mcg-98 mg/15mL oral elixir</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00482011614</ndc>
    <ndc_label_name>Therapeutic Liquid oral</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00482011812</ndc>
    <ndc_label_name>Lubrin vaginal insert</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00482011819</ndc>
    <ndc_label_name>Lubrin vaginal insert</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00482013013</ndc>
    <ndc_label_name>Apatate oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00482013014</ndc>
    <ndc_label_name>Apatate oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00482310001</ndc>
    <ndc_label_name>ENTSOL nasal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00482312008</ndc>
    <ndc_label_name>ENTsol Nasal Wash solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00482330020</ndc>
    <ndc_label_name>ENTSOL nasal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00485005708</ndc>
    <ndc_label_name>Ed-APAP 160 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00485008001</ndc>
    <ndc_label_name>RYMED TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00485008201</ndc>
    <ndc_label_name>Ed-Spaz 0.125 mg disintegrating tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00485009816</ndc>
    <ndc_label_name>ED Chlorped Jr 2 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00485015101</ndc>
    <ndc_label_name>Urogesic-Blue 81.6 mg-40.8 mg-0.12 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00485015130</ndc>
    <ndc_label_name>Urogesic-Blue 81.6 mg-40.8 mg-0.12 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00485015516</ndc>
    <ndc_label_name>Ed A-Hist 4 mg-10 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00485017116</ndc>
    <ndc_label_name>Ed A-Hist DM 4 mg-10 mg-15 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00485020216</ndc>
    <ndc_label_name>Rynex PE 1 mg-2.5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00485020404</ndc>
    <ndc_label_name>Rynex DM 1 mg-2.5 mg-5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00485020416</ndc>
    <ndc_label_name>Rynex DM 1 mg-2.5 mg-5 mg/5 mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00485020616</ndc>
    <ndc_label_name>Rynex PSE 1 mg-15 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00485020816</ndc>
    <ndc_label_name>ED Bron GP 5 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00485024001</ndc>
    <ndc_label_name>Ed A-Hist DM 4 mg-10 mg-10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00485025401</ndc>
    <ndc_label_name>Ed A-Hist 4 mg-10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00486111101</ndc>
    <ndc_label_name>K-Phos Original 500 mg soluble tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00486111105</ndc>
    <ndc_label_name>K-Phos Original 500 mg soluble tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00486111401</ndc>
    <ndc_label_name>Uroqid-Acid No.2 500 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00486112501</ndc>
    <ndc_label_name>K-Phos-Neutral 250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00486112505</ndc>
    <ndc_label_name>K-Phos-Neutral 250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00486113201</ndc>
    <ndc_label_name>Beelith 362 mg-20 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00486113401</ndc>
    <ndc_label_name>K-Phos No 2 305 mg-700 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487020100</ndc>
    <ndc_label_name>IPRAT-ALBUT 0.5-3(2.5) MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487020101</ndc>
    <ndc_label_name>IPRAT-ALBUT 0.5-3(2.5) MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487020103</ndc>
    <ndc_label_name>IPRAT-ALBUT 0.5-3(2.5) MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487020160</ndc>
    <ndc_label_name>IPRAT-ALBUT 0.5-3(2.5) MG/3 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487030101</ndc>
    <ndc_label_name>ALBUTEROL SUL 0.63 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00487278401</ndc>
    <ndc_label_name>Asthmanefrin Refill 2.25 % solution for nebulization</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00487430105</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00487430110</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00487430150</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00487590199</ndc>
    <ndc_label_name>S2 Racepinephrine 2.25 % solution for nebulization</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00487610501</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487900330</ndc>
    <ndc_label_name>SODIUM CHLORIDE 3% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487900730</ndc>
    <ndc_label_name>SODIUM CHLORIDE 7% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00487930103</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% INHAL VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00487930133</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% INHAL VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00487930201</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% INHAL VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487950100</ndc>
    <ndc_label_name>ALBUTEROL SUL 2.5 MG/3 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487950101</ndc>
    <ndc_label_name>ALBUTEROL SUL 2.5 MG/3 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487950103</ndc>
    <ndc_label_name>ALBUTEROL SUL 2.5 MG/3 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487950125</ndc>
    <ndc_label_name>ALBUTEROL SUL 2.5 MG/3 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487950160</ndc>
    <ndc_label_name>ALBUTEROL SUL 2.5 MG/3 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487960101</ndc>
    <ndc_label_name>BUDESONIDE 0.25 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487960130</ndc>
    <ndc_label_name>BUDESONIDE 0.25 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487970101</ndc>
    <ndc_label_name>BUDESONIDE 0.5 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487970130</ndc>
    <ndc_label_name>BUDESONIDE 0.5 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487980100</ndc>
    <ndc_label_name>IPRATROPIUM BR 0.02% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487980101</ndc>
    <ndc_label_name>IPRATROPIUM BR 0.02% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487980125</ndc>
    <ndc_label_name>IPRATROPIUM BR 0.02% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487980130</ndc>
    <ndc_label_name>IPRATROPIUM BR 0.02% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487980160</ndc>
    <ndc_label_name>IPRATROPIUM BR 0.02% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487990130</ndc>
    <ndc_label_name>ALBUTEROL 2.5 MG/0.5 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487990401</ndc>
    <ndc_label_name>ALBUTEROL SUL 1.25 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00487990425</ndc>
    <ndc_label_name>ALBUTEROL SUL 1.25 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496048010</ndc>
    <ndc_label_name>HELIOCARE 240 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496048108</ndc>
    <ndc_label_name>HELIOCARE ADVANCED CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496051304</ndc>
    <ndc_label_name>Detachol Adhesive Remover liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496051306</ndc>
    <ndc_label_name>Detachol Adhesive Remover liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496051315</ndc>
    <ndc_label_name>Detachol Adhesive Remover liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496051324</ndc>
    <ndc_label_name>Detachol Adhesive Remover liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496051348</ndc>
    <ndc_label_name>Detachol Adhesive Remover with Sterile Tip Dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496052306</ndc>
    <ndc_label_name>Mastisol Liquid Adhesive</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496052315</ndc>
    <ndc_label_name>Mastisol Stertip liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496052316</ndc>
    <ndc_label_name>Mastisol Stertip spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496052348</ndc>
    <ndc_label_name>Mastisol Adhesive drops in a dropperette topical to intact skin</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496058608</ndc>
    <ndc_label_name>DERMEND ANTI-ITCH 1% LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496074803</ndc>
    <ndc_label_name>Prax 1 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496074804</ndc>
    <ndc_label_name>Prax 1 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496088206</ndc>
    <ndc_label_name>LMX 4 4 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496088207</ndc>
    <ndc_label_name>LMX 4 Plus 4 % topical kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496088215</ndc>
    <ndc_label_name>LMX 4 4 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496088230</ndc>
    <ndc_label_name>LMX 4 4 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496088271</ndc>
    <ndc_label_name>LMX 4 4 % topical kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00496088315</ndc>
    <ndc_label_name>LMX 5 5 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00496088330</ndc>
    <ndc_label_name>LMX 5 5 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00496089215</ndc>
    <ndc_label_name>RECTICARE 5% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00496089230</ndc>
    <ndc_label_name>RECTICARE 5% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00496097765</ndc>
    <ndc_label_name>RECTICARE WIPES</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00516001312</ndc>
    <ndc_label_name>Boules Quies Ear Plugs misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00516012101</ndc>
    <ndc_label_name>AMMONIA AROMATIC AMPUL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517003101</ndc>
    <ndc_label_name>CYANOCOBALAMIN 1,000 MCG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517003125</ndc>
    <ndc_label_name>CYANOCOBALAMIN 1,000 MCG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517003201</ndc>
    <ndc_label_name>CYANOCOBALAMIN 10,000 MCG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517003225</ndc>
    <ndc_label_name>CYANOCOBALAMIN 10,000 MCG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517013001</ndc>
    <ndc_label_name>CYANOCOBALAMIN 30,000 MCG/30ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517013005</ndc>
    <ndc_label_name>CYANOCOBALAMIN 30,000 MCG/30ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517037401</ndc>
    <ndc_label_name>ProvayBlue 5 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517037405</ndc>
    <ndc_label_name>ProvayBlue 5 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517038101</ndc>
    <ndc_label_name>ProvayBlue 5 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517038105</ndc>
    <ndc_label_name>ProvayBlue 5 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517042001</ndc>
    <ndc_label_name>ESTRADIOL VALERATE 100 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517044001</ndc>
    <ndc_label_name>ESTRADIOL VALERATE 200 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517060201</ndc>
    <ndc_label_name>Injectafer 100 mg iron/2 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517062001</ndc>
    <ndc_label_name>Injectafer 50 mg iron/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517065001</ndc>
    <ndc_label_name>Injectafer 50 mg iron/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517071001</ndc>
    <ndc_label_name>FOMEPIZOLE 1.5 GM/1.5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517072001</ndc>
    <ndc_label_name>BETAMETHASONE SP-AC 30 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517073501</ndc>
    <ndc_label_name>NICARDIPINE 25 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517073510</ndc>
    <ndc_label_name>NICARDIPINE 25 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517074001</ndc>
    <ndc_label_name>METHYLERGONOVINE 0.2 MG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517074020</ndc>
    <ndc_label_name>METHYLERGONOVINE 0.2 MG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517079101</ndc>
    <ndc_label_name>BETAMETHASONE SP-AC 30 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517079901</ndc>
    <ndc_label_name>BETAMETHASONE SP-AC 30 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517090101</ndc>
    <ndc_label_name>HYDRALAZINE 20 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517090125</ndc>
    <ndc_label_name>HYDRALAZINE 20 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517095501</ndc>
    <ndc_label_name>OLANZAPINE 10 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517100101</ndc>
    <ndc_label_name>ATROPINE 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517100125</ndc>
    <ndc_label_name>ATROPINE 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517100401</ndc>
    <ndc_label_name>ATROPINE 0.4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517100425</ndc>
    <ndc_label_name>ATROPINE 0.4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517102001</ndc>
    <ndc_label_name>VASOPRESSIN 20 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517102025</ndc>
    <ndc_label_name>VASOPRESSIN 20 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517103001</ndc>
    <ndc_label_name>VASOPRESSIN 200 UNIT/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517104501</ndc>
    <ndc_label_name>LEVOCARNITINE 1 GM/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517104505</ndc>
    <ndc_label_name>LEVOCARNITINE 1 GM/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517107501</ndc>
    <ndc_label_name>LEVOCARNITINE 4 GM/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517182001</ndc>
    <ndc_label_name>CHLOROTHIAZIDE SOD 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517198001</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517198005</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517205101</ndc>
    <ndc_label_name>POTASSIUM PHOSPH 15 MMOL/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517205125</ndc>
    <ndc_label_name>POTASSIUM PHOSPH 15 MMOL/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517210201</ndc>
    <ndc_label_name>POTASSIUM PHOSP 45 MMOL/15 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517210225</ndc>
    <ndc_label_name>POTASSIUM PHOSP 45 MMOL/15 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517231001</ndc>
    <ndc_label_name>Venofer 200 mg iron/10 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517231005</ndc>
    <ndc_label_name>Venofer 200 mg iron/10 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517232501</ndc>
    <ndc_label_name>Venofer 50 mg iron/2.5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517232510</ndc>
    <ndc_label_name>Venofer 50 mg iron/2.5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517234001</ndc>
    <ndc_label_name>Venofer 100 mg iron/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517234010</ndc>
    <ndc_label_name>Venofer 100 mg iron/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517234025</ndc>
    <ndc_label_name>Venofer 100 mg iron/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517234099</ndc>
    <ndc_label_name>Venofer 100 mg iron/5 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517250201</ndc>
    <ndc_label_name>CAFFEINE-SOD BENZOAT 250 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517250210</ndc>
    <ndc_label_name>CAFFEINE-SOD BENZOAT 250 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517250501</ndc>
    <ndc_label_name>POTASSIUM PHOSP 150 MMOL/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517250525</ndc>
    <ndc_label_name>POTASSIUM PHOSP 150 MMOL/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517290101</ndc>
    <ndc_label_name>GVOKE VIALDX 1 MG/0.2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517290110</ndc>
    <ndc_label_name>GVOKE VIALDX 1 MG/0.2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517300501</ndc>
    <ndc_label_name>Sterile Water 100 % for Injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517300525</ndc>
    <ndc_label_name>Sterile Water 100 % for Injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517301001</ndc>
    <ndc_label_name>Sterile Water 100 % for Injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517301025</ndc>
    <ndc_label_name>Sterile Water 100 % for Injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517302001</ndc>
    <ndc_label_name>Sterile Water 100 % for Injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517302025</ndc>
    <ndc_label_name>Sterile Water 100 % for Injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517303001</ndc>
    <ndc_label_name>EPINEPHRINE 30 MG/30 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517400201</ndc>
    <ndc_label_name>PAPAVERINE 60 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517400225</ndc>
    <ndc_label_name>PAPAVERINE 60 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517420101</ndc>
    <ndc_label_name>HYDROXYZINE 25 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517420125</ndc>
    <ndc_label_name>HYDROXYZINE 25 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517430001</ndc>
    <ndc_label_name>PACLITAXEL PROTEIN-BOUND 100MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517460101</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517460125</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517460201</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.4 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517460225</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.4 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517460525</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517462025</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517481001</ndc>
    <ndc_label_name>NITROGLYCERIN 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517481025</ndc>
    <ndc_label_name>NITROGLYCERIN 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517560101</ndc>
    <ndc_label_name>HYDROXYZINE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517560125</ndc>
    <ndc_label_name>HYDROXYZINE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517560201</ndc>
    <ndc_label_name>HYDROXYZINE 100 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517560225</ndc>
    <ndc_label_name>HYDROXYZINE 100 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517610101</ndc>
    <ndc_label_name>ZINC SULFATE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517610125</ndc>
    <ndc_label_name>ZINC SULFATE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517610301</ndc>
    <ndc_label_name>ZINC SULFATE 30 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517610325</ndc>
    <ndc_label_name>ZINC SULFATE 30 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517650201</ndc>
    <ndc_label_name>SELENIOUS ACID 12 MCG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517650210</ndc>
    <ndc_label_name>SELENIOUS ACID 12 MCG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517656001</ndc>
    <ndc_label_name>Selenious Acid 60 mcg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517656005</ndc>
    <ndc_label_name>Selenious Acid 60 mcg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517656025</ndc>
    <ndc_label_name>Selenious Acid 60 mcg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517671001</ndc>
    <ndc_label_name>CALCIUM CHLORIDE 10% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517671010</ndc>
    <ndc_label_name>CALCIUM CHLORIDE 10% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517690201</ndc>
    <ndc_label_name>FOSPHENYTOIN 100 MG PE/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517730501</ndc>
    <ndc_label_name>SODIUM PHOSPHATE 15 MMOL/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517730525</ndc>
    <ndc_label_name>SODIUM PHOSPHATE 15 MMOL/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517731501</ndc>
    <ndc_label_name>SODIUM PHOSPHATE 45 MMOL/15 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517731525</ndc>
    <ndc_label_name>SODIUM PHOSPHATE 45 MMOL/15 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517735001</ndc>
    <ndc_label_name>SODIUM PHOSPHATE 150 MMOL/50ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517735025</ndc>
    <ndc_label_name>SODIUM PHOSPHATE 150 MMOL/50ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517750401</ndc>
    <ndc_label_name>ACETYLCYSTEINE 10% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517750425</ndc>
    <ndc_label_name>ACETYLCYSTEINE 10% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517760401</ndc>
    <ndc_label_name>ACETYLCYSTEINE 20% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00517760425</ndc>
    <ndc_label_name>ACETYLCYSTEINE 20% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517800501</ndc>
    <ndc_label_name>ZINC SULFATE 25 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517800525</ndc>
    <ndc_label_name>ZINC SULFATE 25 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517912001</ndc>
    <ndc_label_name>AMINOCAPROIC ACID 5 G/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517912025</ndc>
    <ndc_label_name>AMINOCAPROIC ACID 5 G/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517919101</ndc>
    <ndc_label_name>AMINOCAPROIC ACID 5 G/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517919125</ndc>
    <ndc_label_name>AMINOCAPROIC ACID 5 G/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517930201</ndc>
    <ndc_label_name>Multrys 1,000mcg-60mcg-3mcg-6mcg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517930225</ndc>
    <ndc_label_name>Multrys 1,000mcg-60mcg-3mcg-6mcg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517930501</ndc>
    <ndc_label_name>Tralement 3 mg-0.3 mg-55 mcg-60 mcg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517930525</ndc>
    <ndc_label_name>Tralement 3 mg-0.3 mg-55 mcg-60 mcg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517970201</ndc>
    <ndc_label_name>DROPERIDOL 5 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00517970225</ndc>
    <ndc_label_name>DROPERIDOL 5 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525031590</ndc>
    <ndc_label_name>NeevoDHA (with algal oil) 27 mg iron-1.13 mg-581.92 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525050190</ndc>
    <ndc_label_name>DEPLIN MA CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525050290</ndc>
    <ndc_label_name>DeplinPRO Mood Health 50 mcg-15 mg-25 mg-250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525050390</ndc>
    <ndc_label_name>Cerefolin 6 mg-5 mg-50 mg-1 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525052590</ndc>
    <ndc_label_name>Cerefolin Brain Wellness 600 mg-2 mg-6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525055590</ndc>
    <ndc_label_name>Cerefolin NAC (algal oil) 6 mg-600 mg-2 mg-90.314 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525096690</ndc>
    <ndc_label_name>Foltx 2 mg-1.13 mg-25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525097160</ndc>
    <ndc_label_name>ZELNORM 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525110290</ndc>
    <ndc_label_name>Deplin (algal oil) 15 mg-90.314 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525113990</ndc>
    <ndc_label_name>Deplin (algal oil) 7.5 mg-90.314 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525115090</ndc>
    <ndc_label_name>Deplin FC 15 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525116090</ndc>
    <ndc_label_name>Deplin FC 7.5 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525804918</ndc>
    <ndc_label_name>Metanx (algal oil) 3 mg-35 mg-2 mg-90.314 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525804990</ndc>
    <ndc_label_name>Metanx (algal oil) 3 mg-35 mg-2 mg-90.314 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525805018</ndc>
    <ndc_label_name>METANX RR CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525805090</ndc>
    <ndc_label_name>METANX RR CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525805218</ndc>
    <ndc_label_name>MetanxPRO Nerve Health 2 mg-3 mg-35 mg-500 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525805290</ndc>
    <ndc_label_name>MetanxPRO Nerve Health 2 mg-3 mg-35 mg-500 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525811018</ndc>
    <ndc_label_name>Metanx FC 2 mg-3 mg-35 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00525811090</ndc>
    <ndc_label_name>Metanx FC 2 mg-3 mg-35 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527058601</ndc>
    <ndc_label_name>DICYCLOMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527058610</ndc>
    <ndc_label_name>DICYCLOMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527076037</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMINE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527076137</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAM 7.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527076237</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527076337</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAM 12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527076437</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527076537</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527076637</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527079037</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527079137</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527079237</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 15 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527079337</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527079437</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527079537</ndc>
    <ndc_label_name>DEXTROAMP-AMPHET ER 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527123101</ndc>
    <ndc_label_name>PRIMIDONE 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527128201</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527128210</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527130101</ndc>
    <ndc_label_name>PRIMIDONE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527130105</ndc>
    <ndc_label_name>PRIMIDONE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527131101</ndc>
    <ndc_label_name>TERBUTALINE SULFATE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527131301</ndc>
    <ndc_label_name>PILOCARPINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527131801</ndc>
    <ndc_label_name>TERBUTALINE SULFATE 2.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527132601</ndc>
    <ndc_label_name>URSODIOL 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527133001</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527133010</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527133301</ndc>
    <ndc_label_name>BACLOFEN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527133501</ndc>
    <ndc_label_name>DOXYCYCLINE MONO 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527133701</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527133705</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527133710</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527133825</ndc>
    <ndc_label_name>DOXYCYCLINE MONO 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527133850</ndc>
    <ndc_label_name>DOXYCYCLINE MONO 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527136701</ndc>
    <ndc_label_name>PROBENECID 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527136710</ndc>
    <ndc_label_name>PROBENECID 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527136801</ndc>
    <ndc_label_name>DANAZOL 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527136901</ndc>
    <ndc_label_name>DANAZOL 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527136906</ndc>
    <ndc_label_name>DANAZOL 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527139201</ndc>
    <ndc_label_name>DANAZOL 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527139401</ndc>
    <ndc_label_name>LOXAPINE 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527139501</ndc>
    <ndc_label_name>LOXAPINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527139601</ndc>
    <ndc_label_name>LOXAPINE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527139701</ndc>
    <ndc_label_name>LOXAPINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527140701</ndc>
    <ndc_label_name>PILOCARPINE HCL 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527143501</ndc>
    <ndc_label_name>METAXALONE 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527147501</ndc>
    <ndc_label_name>DIETHYLPROPION 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527147701</ndc>
    <ndc_label_name>DIETHYLPROPION ER 75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527150037</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMINE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527150237</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527150537</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527155201</ndc>
    <ndc_label_name>BUTALBITAL-ASPIRIN-CAFFEINE CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527163201</ndc>
    <ndc_label_name>TRIAMTERENE-HCTZ 37.5-25 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527163210</ndc>
    <ndc_label_name>TRIAMTERENE-HCTZ 37.5-25 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527169501</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAFF 50-325-40</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527169505</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAFF 50-325-40</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527169801</ndc>
    <ndc_label_name>CODEINE SULFATE 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527178801</ndc>
    <ndc_label_name>FLUPHENAZINE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527178901</ndc>
    <ndc_label_name>FLUPHENAZINE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527179001</ndc>
    <ndc_label_name>FLUPHENAZINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527179005</ndc>
    <ndc_label_name>FLUPHENAZINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527179101</ndc>
    <ndc_label_name>FLUPHENAZINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527179105</ndc>
    <ndc_label_name>FLUPHENAZINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527181843</ndc>
    <ndc_label_name>SUMATRIPTAN 5 MG NASAL SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527183037</ndc>
    <ndc_label_name>ENTACAPONE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527185943</ndc>
    <ndc_label_name>SUMATRIPTAN 20 MG NASAL SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527192736</ndc>
    <ndc_label_name>METHADONE 10 MG/ML ORAL CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527193006</ndc>
    <ndc_label_name>CLARITHROMYCIN ER 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527193106</ndc>
    <ndc_label_name>CLARITHROMYCIN 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527193206</ndc>
    <ndc_label_name>CLARITHROMYCIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527194866</ndc>
    <ndc_label_name>LEVOFLOXACIN 25 MG/ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527194868</ndc>
    <ndc_label_name>LEVOFLOXACIN 25 MG/ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527194870</ndc>
    <ndc_label_name>LEVOFLOXACIN 25 MG/ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527213335</ndc>
    <ndc_label_name>POSACONAZOLE DR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527224432</ndc>
    <ndc_label_name>FEBUXOSTAT 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527224832</ndc>
    <ndc_label_name>FEBUXOSTAT 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527237020</ndc>
    <ndc_label_name>AZITHROMYCIN 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527237032</ndc>
    <ndc_label_name>AZITHROMYCIN 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527239519</ndc>
    <ndc_label_name>AZITHROMYCIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527239532</ndc>
    <ndc_label_name>AZITHROMYCIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527242532</ndc>
    <ndc_label_name>OLMESARTAN MEDOXOMIL 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527242546</ndc>
    <ndc_label_name>OLMESARTAN MEDOXOMIL 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527242632</ndc>
    <ndc_label_name>OLMESARTAN MEDOXOMIL 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527242646</ndc>
    <ndc_label_name>OLMESARTAN MEDOXOMIL 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527242732</ndc>
    <ndc_label_name>OLMESARTAN MEDOXOMIL 40 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527242746</ndc>
    <ndc_label_name>OLMESARTAN MEDOXOMIL 40 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527252437</ndc>
    <ndc_label_name>AMPHETAMINE SULFATE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527252537</ndc>
    <ndc_label_name>AMPHETAMINE SULFATE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527258032</ndc>
    <ndc_label_name>FLUVASTATIN ER 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527258037</ndc>
    <ndc_label_name>FLUVASTATIN ER 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527280032</ndc>
    <ndc_label_name>VARDENAFIL HCL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527280132</ndc>
    <ndc_label_name>VARDENAFIL HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527280232</ndc>
    <ndc_label_name>VARDENAFIL HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527280332</ndc>
    <ndc_label_name>VARDENAFIL HCL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527296137</ndc>
    <ndc_label_name>CHLORPROMAZINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527296237</ndc>
    <ndc_label_name>CHLORPROMAZINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527296337</ndc>
    <ndc_label_name>CHLORPROMAZINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527296437</ndc>
    <ndc_label_name>CHLORPROMAZINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527296537</ndc>
    <ndc_label_name>CHLORPROMAZINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527301248</ndc>
    <ndc_label_name>MESALAMINE DR 1.2 GM TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527323637</ndc>
    <ndc_label_name>LEVORPHANOL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527323737</ndc>
    <ndc_label_name>LEVORPHANOL 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328043</ndc>
    <ndc_label_name>LEVOTHYROXINE 25 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328046</ndc>
    <ndc_label_name>LEVOTHYROXINE 25 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328143</ndc>
    <ndc_label_name>LEVOTHYROXINE 50 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328146</ndc>
    <ndc_label_name>LEVOTHYROXINE 50 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328243</ndc>
    <ndc_label_name>LEVOTHYROXINE 75 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328246</ndc>
    <ndc_label_name>LEVOTHYROXINE 75 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328343</ndc>
    <ndc_label_name>LEVOTHYROXINE 88 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328346</ndc>
    <ndc_label_name>LEVOTHYROXINE 88 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328443</ndc>
    <ndc_label_name>LEVOTHYROXINE 100 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328446</ndc>
    <ndc_label_name>LEVOTHYROXINE 100 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328543</ndc>
    <ndc_label_name>LEVOTHYROXINE 112 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328546</ndc>
    <ndc_label_name>LEVOTHYROXINE 112 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328643</ndc>
    <ndc_label_name>LEVOTHYROXINE 125 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328646</ndc>
    <ndc_label_name>LEVOTHYROXINE 125 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328743</ndc>
    <ndc_label_name>LEVOTHYROXINE 137 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328746</ndc>
    <ndc_label_name>LEVOTHYROXINE 137 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328843</ndc>
    <ndc_label_name>LEVOTHYROXINE 150 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328846</ndc>
    <ndc_label_name>LEVOTHYROXINE 150 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328943</ndc>
    <ndc_label_name>LEVOTHYROXINE 175 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527328946</ndc>
    <ndc_label_name>LEVOTHYROXINE 175 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527329043</ndc>
    <ndc_label_name>LEVOTHYROXINE 200 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527329046</ndc>
    <ndc_label_name>LEVOTHYROXINE 200 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527329146</ndc>
    <ndc_label_name>LEVOTHYROXINE 300 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527409437</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAFF 50-325-40</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527409537</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAFF 50-300-40</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527410737</ndc>
    <ndc_label_name>MEXILETINE 150 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527410837</ndc>
    <ndc_label_name>MEXILETINE 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527411637</ndc>
    <ndc_label_name>PROPRANOLOL ER 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527411737</ndc>
    <ndc_label_name>PROPRANOLOL ER 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527411837</ndc>
    <ndc_label_name>PROPRANOLOL ER 120 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527411937</ndc>
    <ndc_label_name>PROPRANOLOL ER 160 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527457937</ndc>
    <ndc_label_name>METHYLPHENIDATE CD 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527458037</ndc>
    <ndc_label_name>METHYLPHENIDATE CD 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527458137</ndc>
    <ndc_label_name>METHYLPHENIDATE CD 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527458237</ndc>
    <ndc_label_name>METHYLPHENIDATE CD 40 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527458337</ndc>
    <ndc_label_name>METHYLPHENIDATE CD 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527458437</ndc>
    <ndc_label_name>METHYLPHENIDATE CD 60 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527459113</ndc>
    <ndc_label_name>OSELTAMIVIR PHOS 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527459213</ndc>
    <ndc_label_name>OSELTAMIVIR PHOS 45 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527459313</ndc>
    <ndc_label_name>OSELTAMIVIR PHOS 75 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527466137</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527466237</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527466337</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527466437</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527466537</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527466637</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527466737</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 70 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527495132</ndc>
    <ndc_label_name>LEVOTHYROXINE 13 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527495232</ndc>
    <ndc_label_name>LEVOTHYROXINE 25 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527495332</ndc>
    <ndc_label_name>LEVOTHYROXINE 50 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527495432</ndc>
    <ndc_label_name>LEVOTHYROXINE 75 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527495532</ndc>
    <ndc_label_name>LEVOTHYROXINE 88 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527495632</ndc>
    <ndc_label_name>LEVOTHYROXINE 100 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527495732</ndc>
    <ndc_label_name>LEVOTHYROXINE 112 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527495832</ndc>
    <ndc_label_name>LEVOTHYROXINE 125 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527495932</ndc>
    <ndc_label_name>LEVOTHYROXINE 137 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527496032</ndc>
    <ndc_label_name>LEVOTHYROXINE 150 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527496132</ndc>
    <ndc_label_name>LEVOTHYROXINE 175 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527496232</ndc>
    <ndc_label_name>LEVOTHYROXINE 200 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527512570</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527512578</ndc>
    <ndc_label_name>LACTULOSE 10 GM/15 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527513762</ndc>
    <ndc_label_name>OSELTAMIVIR 6 MG/ML SUSPENSION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527516082</ndc>
    <ndc_label_name>MYCOPHENOLATE 200 MG/ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527540668</ndc>
    <ndc_label_name>PREDNISOLONE 15 MG/5 ML SYRUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527540670</ndc>
    <ndc_label_name>PREDNISOLONE 15 MG/5 ML SYRUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527600480</ndc>
    <ndc_label_name>LIDOCAINE HCL 4% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00527612374</ndc>
    <ndc_label_name>SEVOFLURANE INHALATION LIQUID</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527810637</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527810737</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 10 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527810837</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 15 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527810937</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 20 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527811037</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 25 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527811137</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 30 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527811237</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 35 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00527811337</ndc>
    <ndc_label_name>DEXMETHYLPHENIDATE ER 40 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536001583</ndc>
    <ndc_label_name>Almacone-2 400 mg-400 mg-40 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536009185</ndc>
    <ndc_label_name>ALUMINUM HYDROXIDE GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536100601</ndc>
    <ndc_label_name>Aller-Chlor 4 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536100610</ndc>
    <ndc_label_name>Aller-Chlor 4 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536100715</ndc>
    <ndc_label_name>Cal-Gest Antacid 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536100836</ndc>
    <ndc_label_name>ASPIRIN 81 MG CHEWABLE TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536100901</ndc>
    <ndc_label_name>FERROUS SULFATE 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536104610</ndc>
    <ndc_label_name>SODIUM BICARB 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536104710</ndc>
    <ndc_label_name>SODIUM BICARB 650 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536104815</ndc>
    <ndc_label_name>Calcium Antacid 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536104922</ndc>
    <ndc_label_name>Calcium Antacid 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536105022</ndc>
    <ndc_label_name>Calcium Antacid 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536105224</ndc>
    <ndc_label_name>POLYETHYLENE GLYCOL 3350 POWD</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536105227</ndc>
    <ndc_label_name>POLYETHYLENE GLYCOL 3350 POWD</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536105260</ndc>
    <ndc_label_name>POLYETHYLENE GLYCOL 3350 POWD</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536105284</ndc>
    <ndc_label_name>POLYETHYLENE GLYCOL 3350 POWD</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536105429</ndc>
    <ndc_label_name>ASPIRIN 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536105525</ndc>
    <ndc_label_name>Acne Medication 5 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536105556</ndc>
    <ndc_label_name>Acne Medication 5 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536105625</ndc>
    <ndc_label_name>Acne Medication 10 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536105656</ndc>
    <ndc_label_name>Acne Medication 10 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536105775</ndc>
    <ndc_label_name>ACNE MEDICATION 5% LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536105875</ndc>
    <ndc_label_name>ACNE MEDICATION 10% LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536106139</ndc>
    <ndc_label_name>Blue Gel 2 % topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536109306</ndc>
    <ndc_label_name>All Day Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536109311</ndc>
    <ndc_label_name>All Day Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536109406</ndc>
    <ndc_label_name>All Day Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536109411</ndc>
    <ndc_label_name>All Day Relief 220 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536110145</ndc>
    <ndc_label_name>Pain Relieving (methyl salicylate-menthol) 15 %-1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536110301</ndc>
    <ndc_label_name>Alcohol Prep Pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536110688</ndc>
    <ndc_label_name>NICOTINE 7 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536110788</ndc>
    <ndc_label_name>NICOTINE 14 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536110888</ndc>
    <ndc_label_name>NICOTINE 21 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536110945</ndc>
    <ndc_label_name>UREA 20% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536111248</ndc>
    <ndc_label_name>BUDESONIDE 32 MCG NASAL SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536111825</ndc>
    <ndc_label_name>Arthritis Pain Relief (capsaicin) 0.075 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536112925</ndc>
    <ndc_label_name>ACNE MEDICATION 2.5% GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536114263</ndc>
    <ndc_label_name>LEVONORGESTREL 1.5 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536114397</ndc>
    <ndc_label_name>PETROLATUM 42% OINTMENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536114398</ndc>
    <ndc_label_name>PETROLATUM 42% OINTMENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536114730</ndc>
    <ndc_label_name>IBUPROFEN 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536116134</ndc>
    <ndc_label_name>Mucus DM 30 mg-600 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536116137</ndc>
    <ndc_label_name>Mucus DM 30 mg-600 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536116144</ndc>
    <ndc_label_name>Mucus DM 30 mg-600 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536116361</ndc>
    <ndc_label_name>GUAIFENESIN ER 600 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536117201</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536118170</ndc>
    <ndc_label_name>CLOTRIMAZOLE 1% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536118313</ndc>
    <ndc_label_name>FLUTICASONE PROP 50 MCG SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536118321</ndc>
    <ndc_label_name>FLUTICASONE PROP 50 MCG SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536118365</ndc>
    <ndc_label_name>FLUTICASONE PROP 50 MCG SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536118399</ndc>
    <ndc_label_name>FLUTICASONE PROP 50 MCG SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536118612</ndc>
    <ndc_label_name>Hemorrhoidal (phenyleph-cocoa) 0.25 %-88.44 % rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536120207</ndc>
    <ndc_label_name>LIDOCAINE PAIN RELIEF 4% PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536120215</ndc>
    <ndc_label_name>Lidocaine Pain Relief 4 % topical patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536120229</ndc>
    <ndc_label_name>LIDOCAINE PAIN RELIEF 4% PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536120610</ndc>
    <ndc_label_name>CALCIUM CARBONATE 648 MG TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536121195</ndc>
    <ndc_label_name>DIBUCAINE 1% OINTMENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536121277</ndc>
    <ndc_label_name>Infant's Acetaminophen 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536121388</ndc>
    <ndc_label_name>Mucus DM Max ER 60 mg-1,200 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536121429</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 25 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536121794</ndc>
    <ndc_label_name>Eye Drops (tetrahydrozoline) 0.05 %</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536121994</ndc>
    <ndc_label_name>Lubricant Eye (PG-PEG 400) 0.4 %-0.3 % drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536122308</ndc>
    <ndc_label_name>Gas Relief Extra Strength 125 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536122497</ndc>
    <ndc_label_name>Eye Wash (boric acid) eye wash solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536122522</ndc>
    <ndc_label_name>Calcium Antacid 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536122858</ndc>
    <ndc_label_name>Phenaseptic 1.4 % mucosal spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536122922</ndc>
    <ndc_label_name>Antacid Extra Strength 300 mg (as calcium carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536123201</ndc>
    <ndc_label_name>ASPIRIN EC 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536123441</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536123927</ndc>
    <ndc_label_name>NICOTINE 2 MG MINI LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536123981</ndc>
    <ndc_label_name>NICOTINE 2 MG MINI LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536124127</ndc>
    <ndc_label_name>NICOTINE 4 MG MINI LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536124181</ndc>
    <ndc_label_name>NICOTINE 4 MG MINI LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536124701</ndc>
    <ndc_label_name>Senexon-S 8.6 mg-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536124710</ndc>
    <ndc_label_name>Senexon-S 8.6 mg-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536124801</ndc>
    <ndc_label_name>Stimulant Laxative Plus 8.6 mg-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536124810</ndc>
    <ndc_label_name>Stimulant Laxative Plus 8.6 mg-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536124971</ndc>
    <ndc_label_name>Mucus Relief ER 1,200 mg tablet, extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536125240</ndc>
    <ndc_label_name>Eye Itch Relief 0.025 % (0.035 %) drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536125391</ndc>
    <ndc_label_name>SODIUM CHLORIDE 5% EYE OINT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536125494</ndc>
    <ndc_label_name>SODIUM CHLORIDE 5% EYE DROP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536125628</ndc>
    <ndc_label_name>BACITRACIN 500 UNIT/GM OINTMNT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536125919</ndc>
    <ndc_label_name>BENZOYL PEROXIDE 5% WASH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536125963</ndc>
    <ndc_label_name>BENZOYL PEROXIDE 5% WASH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536126163</ndc>
    <ndc_label_name>BENZOYL PEROXIDE 10% WASH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536126328</ndc>
    <ndc_label_name>BACITRACIN ZN 500 UNIT/GM OINT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536126456</ndc>
    <ndc_label_name>CAPSAICIN 0.1% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536126511</ndc>
    <ndc_label_name>CLOTRIMAZOLE 1% TOPICAL CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536126526</ndc>
    <ndc_label_name>CLOTRIMAZOLE 1% TOPICAL CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536126595</ndc>
    <ndc_label_name>CLOTRIMAZOLE 1% TOPICAL CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536126659</ndc>
    <ndc_label_name>senna 8.8 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536126720</ndc>
    <ndc_label_name>LIDOCAINE 4% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536126812</ndc>
    <ndc_label_name>Anti-Itch (menthol-camphor) 0.5 %-0.5 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536126958</ndc>
    <ndc_label_name>Caldyphen Clear 1 %-0.1 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536127180</ndc>
    <ndc_label_name>First Aid Antiseptic (povidone-iodine) 10 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536127211</ndc>
    <ndc_label_name>Antifungal (clotrimazole) 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536127222</ndc>
    <ndc_label_name>Antifungal (clotrimazole) 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536127780</ndc>
    <ndc_label_name>HYDROCORTISONE-ALOE 1% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536127912</ndc>
    <ndc_label_name>CETIRIZINE-PSE ER 5-120 MG TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536127935</ndc>
    <ndc_label_name>CETIRIZINE-PSE ER 5-120 MG TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536128636</ndc>
    <ndc_label_name>Stomach Relief 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536128736</ndc>
    <ndc_label_name>Stomach Relief 525 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536128806</ndc>
    <ndc_label_name>Hemorrhoidal(phenyleph-min oil-petrolat)0.25 %-14 %-74.9 % rectal oint</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536128935</ndc>
    <ndc_label_name>Sinus Congestion and Pain 5 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536129136</ndc>
    <ndc_label_name>PHENYLEPHRINE 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536129229</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG GELCAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536129383</ndc>
    <ndc_label_name>Antacid-Antigas 200 mg-200 mg-20 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536129434</ndc>
    <ndc_label_name>DICLOFENAC SODIUM 1% GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536129497</ndc>
    <ndc_label_name>DICLOFENAC SODIUM 1% GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536129701</ndc>
    <ndc_label_name>MECLIZINE 12.5 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536129710</ndc>
    <ndc_label_name>MECLIZINE 12.5 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536129801</ndc>
    <ndc_label_name>FAMOTIDINE 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536129901</ndc>
    <ndc_label_name>MECLIZINE 25 MG TABLET CHEW</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536129910</ndc>
    <ndc_label_name>MECLIZINE 25 MG TABLET CHEW</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536130297</ndc>
    <ndc_label_name>Anti-Nausea oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536130375</ndc>
    <ndc_label_name>Infants Simethicone 40 mg/0.6 mL oral drops,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536130485</ndc>
    <ndc_label_name>DOCUSATE SODIUM 50 MG/5 ML LIQ</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536130608</ndc>
    <ndc_label_name>SIMETHICONE 180 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536130723</ndc>
    <ndc_label_name>OLOPATADINE HCL 0.2% EYE DROP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536130840</ndc>
    <ndc_label_name>OLOPATADINE HCL 0.1% EYE DROPS</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536130907</ndc>
    <ndc_label_name>Chest Congestion Relief PE 10 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536130908</ndc>
    <ndc_label_name>Chest Congestion Relief PE 10 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536131108</ndc>
    <ndc_label_name>Chest Congestion Relief 400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536131208</ndc>
    <ndc_label_name>Chest Congestion Relief DM 20 mg-400 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536131385</ndc>
    <ndc_label_name>Chest Congestion Relief DM 10 mg-100 mg/5 mL oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536131485</ndc>
    <ndc_label_name>Chest Congestion Relief 100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536131543</ndc>
    <ndc_label_name>TOLNAFTATE 1% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536131625</ndc>
    <ndc_label_name>ZINC OXIDE 20% OINTMENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536131628</ndc>
    <ndc_label_name>ZINC OXIDE 20% OINTMENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536131698</ndc>
    <ndc_label_name>ZINC OXIDE 20% OINTMENT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536131783</ndc>
    <ndc_label_name>Antacid-Antigas 200 mg-200 mg-20 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536131983</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536132197</ndc>
    <ndc_label_name>Children's Acetaminophen 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536132213</ndc>
    <ndc_label_name>OMEPRAZOLE MAG DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536132271</ndc>
    <ndc_label_name>OMEPRAZOLE MAG DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536132288</ndc>
    <ndc_label_name>OMEPRAZOLE MAG DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536132601</ndc>
    <ndc_label_name>Pain Reliever Plus 250 mg-250 mg-65 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536132701</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536132706</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536132710</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536132926</ndc>
    <ndc_label_name>TOLNAFTATE 1% POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536133215</ndc>
    <ndc_label_name>Cold and Hot (menthol) 5 % topical patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536133321</ndc>
    <ndc_label_name>GUAIFENESIN-PSE ER 600-60 MG</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536133336</ndc>
    <ndc_label_name>GUAIFENESIN-PSE ER 600-60 MG</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536133434</ndc>
    <ndc_label_name>DEXTROMETHORPHAN 15 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536133559</ndc>
    <ndc_label_name>SENNA 176 MG/5 ML SYRUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536133632</ndc>
    <ndc_label_name>CALCIUM ACETATE 667 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536133709</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536133735</ndc>
    <ndc_label_name>NICOTINE 2 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536133809</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536133835</ndc>
    <ndc_label_name>NICOTINE 4 MG LOZENGE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536134201</ndc>
    <ndc_label_name>SODIUM CHLORIDE 1 GM TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536134380</ndc>
    <ndc_label_name>VITAMIN D3 10 MCG/ML DROP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536134480</ndc>
    <ndc_label_name>INFANT IRON 15 MG/ML DROP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536134580</ndc>
    <ndc_label_name>Infant-Toddler Multivit 250 mcg-50 mg-10 mcg/mL oral drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536134680</ndc>
    <ndc_label_name>Infant-Toddler Multivitamin-Iron 11 mg iron/mL oral drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536134780</ndc>
    <ndc_label_name>INFANT-TODDLER VIT A-C-D DROP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536134897</ndc>
    <ndc_label_name>Cough Syrup DM 5 mg-50 mg/5 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536134957</ndc>
    <ndc_label_name>Muscle Rub 15 %-10 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536135142</ndc>
    <ndc_label_name>BENZOYL PEROXIDE 10% WASH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536135201</ndc>
    <ndc_label_name>VITAMIN E 180MG(400 UNIT) SFGL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536135301</ndc>
    <ndc_label_name>VITAMIN D3 50 MCG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536135795</ndc>
    <ndc_label_name>LIDOCAINE 4% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536135807</ndc>
    <ndc_label_name>COENZYME Q-10  30 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536136206</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536136223</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536136225</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536136234</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536136307</ndc>
    <ndc_label_name>COENZYME Q-10 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536136601</ndc>
    <ndc_label_name>VITAMIN B-12 1,000 MCG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536136707</ndc>
    <ndc_label_name>LORATADINE 10 MG ODT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536136813</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536136888</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 15 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536137206</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536137223</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536137225</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536137234</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536137575</ndc>
    <ndc_label_name>MICONAZOLE 2% TOPICAL CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536137636</ndc>
    <ndc_label_name>ACETAMIN-IBUPROFN 250-125MG TB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536137785</ndc>
    <ndc_label_name>SODIUM CHLORIDE 23.4% ORAL SOL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536137801</ndc>
    <ndc_label_name>VITAMIN B COMPLEX SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536137904</ndc>
    <ndc_label_name>DOCOSANOL 10% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536138130</ndc>
    <ndc_label_name>MOMETASONE FUROATE 50 MCG SPRY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536138170</ndc>
    <ndc_label_name>MOMETASONE FUROATE 50 MCG SPRY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536138635</ndc>
    <ndc_label_name>CARBOXYMETHYLCELL 0.5% EYE DRP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536138694</ndc>
    <ndc_label_name>CARBOXYMETHYLCELL 0.5% EYE DRP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536138792</ndc>
    <ndc_label_name>Lubricant Eye Drops 0.5 % drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536138793</ndc>
    <ndc_label_name>Lubricant Eye Drops 0.5 % drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536139047</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536139048</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536139288</ndc>
    <ndc_label_name>GUAIFENESIN ER 1,200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536139619</ndc>
    <ndc_label_name>HYDRATING ELECTROLYTE PWDR PKT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536139708</ndc>
    <ndc_label_name>MELATONIN 10 MG QUICK DISSOLVE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536140085</ndc>
    <ndc_label_name>FERROUS SULF 220 MG/5 ML ELIX</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536140117</ndc>
    <ndc_label_name>Oralyte oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536140317</ndc>
    <ndc_label_name>Oralyte oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536140417</ndc>
    <ndc_label_name>Oralyte oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536140517</ndc>
    <ndc_label_name>Oralyte oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536140619</ndc>
    <ndc_label_name>HYDRATING ELECTROLYTE PWDR PKT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536140795</ndc>
    <ndc_label_name>HYDROCORTISONE-ALOE 1% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536140894</ndc>
    <ndc_label_name>POLYVINYL ALCOHOL 1.4% EYEDROP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536141107</ndc>
    <ndc_label_name>PHENAZOPYRIDINE HCL 95 MG TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536141220</ndc>
    <ndc_label_name>ADAPALENE 0.1% GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536141226</ndc>
    <ndc_label_name>ADAPALENE 0.1% GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536141347</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536141348</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536141401</ndc>
    <ndc_label_name>VITAMIN B COMPLEX TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536141501</ndc>
    <ndc_label_name>Nephro-Vite 0.8 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536141638</ndc>
    <ndc_label_name>VITAMIN B-12 250 MCG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536142108</ndc>
    <ndc_label_name>SIMETHICONE 180 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536142201</ndc>
    <ndc_label_name>ACIDOPHILUS-BACILLUS COAGULANS</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536142401</ndc>
    <ndc_label_name>ACIDOPHILUS-PECTIN CAPTAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536142541</ndc>
    <ndc_label_name>MICONAZOLE 3 COMBO PACK</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536142677</ndc>
    <ndc_label_name>Infant's Acetaminophen 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536142704</ndc>
    <ndc_label_name>DOCOSANOL 10% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536143097</ndc>
    <ndc_label_name>Mucus-Chest Congestion 100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536143363</ndc>
    <ndc_label_name>LEVONORGESTREL 1.5 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536143405</ndc>
    <ndc_label_name>COENZYME Q-10 100 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536143407</ndc>
    <ndc_label_name>COENZYME Q-10 100 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536143507</ndc>
    <ndc_label_name>COENZYME Q-10 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536143607</ndc>
    <ndc_label_name>COENZYME Q-10 30 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536143901</ndc>
    <ndc_label_name>COPPER 2 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536144201</ndc>
    <ndc_label_name>Probiotic Acidophilus (4 strain) 1 billion cell-250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536144370</ndc>
    <ndc_label_name>CLOTRIMAZOLE 1% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536144540</ndc>
    <ndc_label_name>OLOPATADINE HCL 0.1% EYE DROPS</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536144634</ndc>
    <ndc_label_name>Mucus DM 30 mg-600 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536144788</ndc>
    <ndc_label_name>Mucus DM Max ER 60 mg-1,200 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536144813</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536144888</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536144921</ndc>
    <ndc_label_name>Mucus Relief D (pseudoephed) 60 mg-600 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536144936</ndc>
    <ndc_label_name>Mucus Relief D (pseudoephed) 60 mg-600 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536145188</ndc>
    <ndc_label_name>Mucus Relief ER 1,200 mg tablet, extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536145206</ndc>
    <ndc_label_name>LACTOBACILLUS 1 MILLION CFU TB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536145326</ndc>
    <ndc_label_name>TOLNAFTATE 1% POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536145408</ndc>
    <ndc_label_name>MAGNESIUM GLYCINATE 100 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536145585</ndc>
    <ndc_label_name>SODIUM CHLORIDE 23.4% ORAL SOL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536145684</ndc>
    <ndc_label_name>BUDESONIDE 32 MCG NASAL SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536145769</ndc>
    <ndc_label_name>Nasal Allergy 55 mcg spray aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536145829</ndc>
    <ndc_label_name>VITAMIN E 180 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536145925</ndc>
    <ndc_label_name>BENZOYL PEROXIDE 10% GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536146625</ndc>
    <ndc_label_name>BENZOYL PEROXIDE 2.5% GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536146725</ndc>
    <ndc_label_name>BENZOYL PEROXIDE 5% GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536147117</ndc>
    <ndc_label_name>Oralyte oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536147217</ndc>
    <ndc_label_name>Oralyte oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536147317</ndc>
    <ndc_label_name>Oralyte oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536147442</ndc>
    <ndc_label_name>BENZOYL PEROXIDE 10% WASH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536147823</ndc>
    <ndc_label_name>OLOPATADINE HCL 0.7% EYE DROPS</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536147908</ndc>
    <ndc_label_name>I-Vite 300 mcg-200 mg-27 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536196297</ndc>
    <ndc_label_name>Sebex 2 %-2 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536199553</ndc>
    <ndc_label_name>Anti-Dandruff 1 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536247085</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536250676</ndc>
    <ndc_label_name>Saline Mist 0.65 % nasal spray aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536252525</ndc>
    <ndc_label_name>CAPSAICIN 0.025% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536302906</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536302923</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536302925</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536302934</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536303006</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536303023</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536303025</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536311201</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536311225</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536311237</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536311301</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536311337</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536322301</ndc>
    <ndc_label_name>CALCIUM CIT 200 MG-D3 6.25 MCG</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536329210</ndc>
    <ndc_label_name>ASCORBIC ACID 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536338601</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536338701</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536340401</ndc>
    <ndc_label_name>NICOTINE 2 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536340501</ndc>
    <ndc_label_name>NICOTINE 4 MG CHEWING GUM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536344308</ndc>
    <ndc_label_name>Cerovite Jr 18 mg iron-10 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536344508</ndc>
    <ndc_label_name>Cerovite Senior 0.4 mg-300 mcg-250 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536354710</ndc>
    <ndc_label_name>Daily-Vite (with folic acid) 400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536360735</ndc>
    <ndc_label_name>Nasal Decongestant (pseudoephedrine) 30 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536406301</ndc>
    <ndc_label_name>Classic Prenatal 28 mg iron-800 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536407810</ndc>
    <ndc_label_name>NIACIN 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536408501</ndc>
    <ndc_label_name>Prenatal 28 mg iron-800 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536430605</ndc>
    <ndc_label_name>Fiber-Lax 625 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536430608</ndc>
    <ndc_label_name>Fiber-Lax 625 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536430611</ndc>
    <ndc_label_name>Fiber-Lax 625 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536440601</ndc>
    <ndc_label_name>Vitamin B-6 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536509008</ndc>
    <ndc_label_name>I-VITE TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536589453</ndc>
    <ndc_label_name>NICOTINE 7 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536589488</ndc>
    <ndc_label_name>NICOTINE 7 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536589553</ndc>
    <ndc_label_name>NICOTINE 14 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536589571</ndc>
    <ndc_label_name>NICOTINE 14 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536589588</ndc>
    <ndc_label_name>NICOTINE 14 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536589653</ndc>
    <ndc_label_name>NICOTINE 21 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536589671</ndc>
    <ndc_label_name>NICOTINE 21 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536589688</ndc>
    <ndc_label_name>NICOTINE 21 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536703801</ndc>
    <ndc_label_name>NIACIN ER 1,000 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536718701</ndc>
    <ndc_label_name>FISH OIL 1,000 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00536718706</ndc>
    <ndc_label_name>FISH OIL 1,000 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536741551</ndc>
    <ndc_label_name>Enema Disposable 19 gram-7 gram/118 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536781708</ndc>
    <ndc_label_name>Oysco 500/D 500 mg-5 mcg (200 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00536781710</ndc>
    <ndc_label_name>Oysco 500/D 500 mg-5 mcg (200 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548231100</ndc>
    <ndc_label_name>TERIPARATIDE 560MCG/2.24ML PEN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00548500100</ndc>
    <ndc_label_name>GANIRELIX ACET 250 MCG/0.5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548540000</ndc>
    <ndc_label_name>MEDROXYPROGESTERONE 150 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548540025</ndc>
    <ndc_label_name>MEDROXYPROGESTERONE 150 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548541000</ndc>
    <ndc_label_name>MEDROXYPROGESTERONE 150 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548541025</ndc>
    <ndc_label_name>MEDROXYPROGESTERONE 150 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548560100</ndc>
    <ndc_label_name>ENOXAPARIN 30 MG/0.3 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548560200</ndc>
    <ndc_label_name>ENOXAPARIN 40 MG/0.4 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548560300</ndc>
    <ndc_label_name>ENOXAPARIN 60 MG/0.6 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548560400</ndc>
    <ndc_label_name>ENOXAPARIN 80 MG/0.8 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548560500</ndc>
    <ndc_label_name>ENOXAPARIN 100 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548560600</ndc>
    <ndc_label_name>ENOXAPARIN 120 MG/0.8 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548560700</ndc>
    <ndc_label_name>ENOXAPARIN 150 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548560800</ndc>
    <ndc_label_name>ENOXAPARIN 300 MG/3 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548570100</ndc>
    <ndc_label_name>MEDROXYPROGESTERONE 150 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548571100</ndc>
    <ndc_label_name>MEDROXYPROGESTERONE 150 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00548583100</ndc>
    <ndc_label_name>Diluent For Glucagon Emergency Kit injection syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548585000</ndc>
    <ndc_label_name>Glucagon Emergency Kit 1 mg solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00548590000</ndc>
    <ndc_label_name>Cortrosyn 0.25 mg solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548590500</ndc>
    <ndc_label_name>Glucagon Emergency Kit 1 mg solution for injection</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548835101</ndc>
    <ndc_label_name>Baqsimi 3 mg/actuation nasal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548835112</ndc>
    <ndc_label_name>Baqsimi 3 mg/actuation nasal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00548835202</ndc>
    <ndc_label_name>Baqsimi 3 mg/actuation nasal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00548909010</ndc>
    <ndc_label_name>Amphadase 150 unit/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00548950100</ndc>
    <ndc_label_name>ISOPROTERENOL 0.2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00548950200</ndc>
    <ndc_label_name>ISOPROTERENOL 1 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00548960100</ndc>
    <ndc_label_name>NEOSTIGMINE 5 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00548960200</ndc>
    <ndc_label_name>NEOSTIGMINE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00548970100</ndc>
    <ndc_label_name>VASOPRESSIN 20 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555003302</ndc>
    <ndc_label_name>CHLORDIAZEPOXIDE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555003305</ndc>
    <ndc_label_name>CHLORDIAZEPOXIDE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555006602</ndc>
    <ndc_label_name>ISONIAZID 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555007101</ndc>
    <ndc_label_name>ISONIAZID 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555007102</ndc>
    <ndc_label_name>ISONIAZID 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555015802</ndc>
    <ndc_label_name>CHLORDIAZEPOXIDE 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555015804</ndc>
    <ndc_label_name>CHLORDIAZEPOXIDE 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555015902</ndc>
    <ndc_label_name>CHLORDIAZEPOXIDE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555015904</ndc>
    <ndc_label_name>CHLORDIAZEPOXIDE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555017178</ndc>
    <ndc_label_name>MEFLOQUINE HCL 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555017188</ndc>
    <ndc_label_name>MEFLOQUINE HCL 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555021110</ndc>
    <ndc_label_name>NORETHINDRONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555030202</ndc>
    <ndc_label_name>HYDROXYZINE PAM 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555030204</ndc>
    <ndc_label_name>HYDROXYZINE PAM 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555032302</ndc>
    <ndc_label_name>HYDROXYZINE PAM 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555032304</ndc>
    <ndc_label_name>HYDROXYZINE PAM 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555032402</ndc>
    <ndc_label_name>HYDROXYZINE PAM 100 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555048302</ndc>
    <ndc_label_name>AMILORIDE HCL-HCTZ 5-50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555048305</ndc>
    <ndc_label_name>AMILORIDE HCL-HCTZ 5-50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555048401</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555048402</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555048527</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555057202</ndc>
    <ndc_label_name>METHOTREXATE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555057235</ndc>
    <ndc_label_name>METHOTREXATE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555060602</ndc>
    <ndc_label_name>MEGESTROL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555060702</ndc>
    <ndc_label_name>MEGESTROL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555063302</ndc>
    <ndc_label_name>DANAZOL 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555063402</ndc>
    <ndc_label_name>DANAZOL 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555063502</ndc>
    <ndc_label_name>DANAZOL 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555063509</ndc>
    <ndc_label_name>DANAZOL 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555071102</ndc>
    <ndc_label_name>TRAZODONE 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555077502</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAM 7.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555077602</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAM 12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555077702</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555077902</ndc>
    <ndc_label_name>MEDROXYPROGESTERONE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555077904</ndc>
    <ndc_label_name>MEDROXYPROGESTERONE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00555080802</ndc>
    <ndc_label_name>TRETINOIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555087202</ndc>
    <ndc_label_name>MEDROXYPROGESTERONE 2.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555087204</ndc>
    <ndc_label_name>MEDROXYPROGESTERONE 2.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555087302</ndc>
    <ndc_label_name>MEDROXYPROGESTERONE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555087304</ndc>
    <ndc_label_name>MEDROXYPROGESTERONE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555088202</ndc>
    <ndc_label_name>HYDROXYUREA 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555088602</ndc>
    <ndc_label_name>ESTRADIOL 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555088604</ndc>
    <ndc_label_name>ESTRADIOL 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555088702</ndc>
    <ndc_label_name>ESTRADIOL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555088704</ndc>
    <ndc_label_name>ESTRADIOL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555089902</ndc>
    <ndc_label_name>ESTRADIOL 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555095202</ndc>
    <ndc_label_name>DEXTROAMPHETAMINE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555095302</ndc>
    <ndc_label_name>DEXTROAMPHETAMINE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555097102</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMINE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555097202</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555097302</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555097402</ndc>
    <ndc_label_name>DEXTROAMP-AMPHETAMIN 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555099702</ndc>
    <ndc_label_name>FLUDROCORTISONE 0.1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555105456</ndc>
    <ndc_label_name>Claravis 10 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555105460</ndc>
    <ndc_label_name>Claravis 10 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555105486</ndc>
    <ndc_label_name>Claravis 10 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555105556</ndc>
    <ndc_label_name>Claravis 20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555105560</ndc>
    <ndc_label_name>Claravis 20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555105586</ndc>
    <ndc_label_name>Claravis 20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555105660</ndc>
    <ndc_label_name>Claravis 30 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555105686</ndc>
    <ndc_label_name>Claravis 30 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555105756</ndc>
    <ndc_label_name>Claravis 40 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555105760</ndc>
    <ndc_label_name>Claravis 40 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555105786</ndc>
    <ndc_label_name>Claravis 40 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555900867</ndc>
    <ndc_label_name>Nortrel 0.5/35 (28) 0.5 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555900879</ndc>
    <ndc_label_name>Nortrel 0.5/35 (28) 0.5 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555900942</ndc>
    <ndc_label_name>Nortrel 1/35 (21) 1 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555900980</ndc>
    <ndc_label_name>Nortrel 1/35 (21) 1 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555901058</ndc>
    <ndc_label_name>Nortrel 1/35 (28) 1 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555901079</ndc>
    <ndc_label_name>Nortrel 1/35 (28) 1 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555901258</ndc>
    <ndc_label_name>Nortrel 7/7/7 (28) 0.5 mg/0.75 mg/1 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555901279</ndc>
    <ndc_label_name>Nortrel 7/7/7 (28) 0.5 mg/0.75 mg/1 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555901467</ndc>
    <ndc_label_name>Lessina 0.1 mg-20 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555901479</ndc>
    <ndc_label_name>Lessina 0.1 mg-20 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555901658</ndc>
    <ndc_label_name>Sprintec (28) 0.25 mg-0.035 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555901858</ndc>
    <ndc_label_name>Tri-Sprintec (28) 0.18 mg(7)/0.215 mg(7)/0.25 mg(7)-0.035 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555902058</ndc>
    <ndc_label_name>Portia 28 0.15 mg-0.03 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555902079</ndc>
    <ndc_label_name>Portia 28 0.15 mg-0.03 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555902542</ndc>
    <ndc_label_name>Junel 1/20 (21) 1 mg-20 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555902658</ndc>
    <ndc_label_name>Junel FE 1/20 (28) 1 mg-20 mcg (21)/75 mg (7) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555902742</ndc>
    <ndc_label_name>Junel 1.5/30 (21) 1.5 mg-30 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555902858</ndc>
    <ndc_label_name>Junel FE 1.5/30 (28) 1.5 mg-30 mcg (21)/75 mg (7) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555903270</ndc>
    <ndc_label_name>Tri-Legest Fe 1-20 (5)/1-30(7)/1mg-35mcg(9) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555903458</ndc>
    <ndc_label_name>Balziva (28) 0.4 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555903479</ndc>
    <ndc_label_name>Balziva (28) 0.4 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555904358</ndc>
    <ndc_label_name>Apri 0.15 mg-0.03 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555904379</ndc>
    <ndc_label_name>Apri 0.15 mg-0.03 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555904558</ndc>
    <ndc_label_name>Aviane 0.1 mg-20 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555904579</ndc>
    <ndc_label_name>Aviane 0.1 mg-20 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555904758</ndc>
    <ndc_label_name>Enpresse 50-30 (6)/75-40(5)/125-30(10) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555904958</ndc>
    <ndc_label_name>Cryselle (28) 0.3 mg-30 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555904979</ndc>
    <ndc_label_name>Cryselle (28) 0.3 mg-30 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555905058</ndc>
    <ndc_label_name>Kariva (28) 0.15 mg-0.02 mg (21)/0.01 mg (5) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555905079</ndc>
    <ndc_label_name>Kariva (28) 0.15 mg-0.02 mg (21)/0.01 mg (5) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555905167</ndc>
    <ndc_label_name>Velivet Triphasic Regimen (28) 0.1 mg/0.125 mg/0.15 mg-25 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555905179</ndc>
    <ndc_label_name>Velivet Triphasic Regimen (28) 0.1 mg/0.125 mg/0.15 mg-25 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555906458</ndc>
    <ndc_label_name>Kelnor 1/35 (28) 1 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555906479</ndc>
    <ndc_label_name>Kelnor 1/35 (28) 1 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555906667</ndc>
    <ndc_label_name>Aranelle (28) 0.5 mg/1 mg/0.5 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555906679</ndc>
    <ndc_label_name>Aranelle (28) 0.5 mg/1 mg/0.5 mg-35 mcg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555912366</ndc>
    <ndc_label_name>Jolessa 0.15 mg-30 mcg (91) tablets,3 month dose pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555913167</ndc>
    <ndc_label_name>Ocella 3 mg-0.03 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00555913179</ndc>
    <ndc_label_name>Ocella 3 mg-0.03 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00562780500</ndc>
    <ndc_label_name>RhoGAM Ultra-Filtered PLUS 1,500 unit (300 mcg) intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00562780501</ndc>
    <ndc_label_name>RhoGAM Ultra-Filtered PLUS 1,500 unit (300 mcg) intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00562780505</ndc>
    <ndc_label_name>RhoGAM Ultra-Filtered PLUS 1,500 unit (300 mcg) intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00562780525</ndc>
    <ndc_label_name>RhoGAM Ultra-Filtered PLUS 1,500 unit (300 mcg) intramuscular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573014518</ndc>
    <ndc_label_name>Advil Dual Action 125 mg-250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573014572</ndc>
    <ndc_label_name>Advil Dual Action 125 mg-250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573014718</ndc>
    <ndc_label_name>Advil Dual Action 125 mg-250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573014736</ndc>
    <ndc_label_name>Advil Dual Action 125 mg-250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573014772</ndc>
    <ndc_label_name>Advil Dual Action 125 mg-250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573014794</ndc>
    <ndc_label_name>Advil Dual Action 125 mg-250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573014795</ndc>
    <ndc_label_name>Advil Dual Action 125 mg-250 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573014966</ndc>
    <ndc_label_name>Advil Liqui-Gel 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573015020</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573015030</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573015040</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573015110</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573015112</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573015120</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573015121</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573015130</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573015460</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573015475</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573015489</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573015498</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016020</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016030</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016040</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016151</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016408</ndc>
    <ndc_label_name>Advil PM 200 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016420</ndc>
    <ndc_label_name>Advil PM 200 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016430</ndc>
    <ndc_label_name>Advil PM 200 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016440</ndc>
    <ndc_label_name>Advil PM 200 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016443</ndc>
    <ndc_label_name>Advil PM 200 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016449</ndc>
    <ndc_label_name>Advil PM 200 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016455</ndc>
    <ndc_label_name>Advil PM 200 mg-38 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016530</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016540</ndc>
    <ndc_label_name>Advil 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016725</ndc>
    <ndc_label_name>Advil PM Liqui-Gels 200 mg-25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016743</ndc>
    <ndc_label_name>Advil PM Liqui-Gels 200 mg-25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016755</ndc>
    <ndc_label_name>Advil PM Liqui-Gels 200 mg-25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016820</ndc>
    <ndc_label_name>Advil Migraine 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016840</ndc>
    <ndc_label_name>Advil Migraine 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016902</ndc>
    <ndc_label_name>Advil Liqui-Gel 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016908</ndc>
    <ndc_label_name>Advil Liqui-Gel 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016920</ndc>
    <ndc_label_name>Advil Liqui-Gel 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016930</ndc>
    <ndc_label_name>Advil Liqui-Gel 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016940</ndc>
    <ndc_label_name>Advil Liqui-Gel 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016949</ndc>
    <ndc_label_name>Advil Liqui-Gel 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573016989</ndc>
    <ndc_label_name>Advil Liqui-Gel 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573017030</ndc>
    <ndc_label_name>Children's Advil 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573017130</ndc>
    <ndc_label_name>Children's Advil 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573017920</ndc>
    <ndc_label_name>Advil Junior Strength 100 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573018010</ndc>
    <ndc_label_name>Advil Cold and Sinus 30 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573018021</ndc>
    <ndc_label_name>Advil Cold and Sinus 30 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573018432</ndc>
    <ndc_label_name>Advil Cold and Sinus 30 mg-200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573018810</ndc>
    <ndc_label_name>Advil Allergy Sinus 2 mg-30 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573019010</ndc>
    <ndc_label_name>Advil Multi-Symptom Cold-Flu 4 mg-10 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573019020</ndc>
    <ndc_label_name>Advil Multi-Symptom Cold-Flu 4 mg-10 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573019120</ndc>
    <ndc_label_name>Infant's Advil 50 mg/1.25 mL oral drops,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573019601</ndc>
    <ndc_label_name>Advil Allergy-Congestion Relief 4 mg-10 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573019610</ndc>
    <ndc_label_name>Advil Allergy-Congestion Relief 4 mg-10 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573019620</ndc>
    <ndc_label_name>Advil Allergy-Congestion Relief 4 mg-10 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573019901</ndc>
    <ndc_label_name>Advil Sinus Congestion-Pain 200 mg-10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573019911</ndc>
    <ndc_label_name>Advil Sinus Congestion-Pain 200 mg-10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573019921</ndc>
    <ndc_label_name>Advil Sinus Congestion-Pain 200 mg-10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573020730</ndc>
    <ndc_label_name>Children's Advil 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573021341</ndc>
    <ndc_label_name>Anbesol (benzocaine) 10 % oral mucosal liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573021541</ndc>
    <ndc_label_name>Anbesol (benzocaine) Maximum Strength 20 % oral mucosal liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573021825</ndc>
    <ndc_label_name>Anbesol (benzocaine) 10 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573022567</ndc>
    <ndc_label_name>Anbesol (benzocaine) Maximum Strength 20 % mucosal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573023230</ndc>
    <ndc_label_name>Children's Advil 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573024625</ndc>
    <ndc_label_name>Anbesol Cold Sore 20 %-3 %-1 %-64.9 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573029030</ndc>
    <ndc_label_name>Children's Advil 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573050375</ndc>
    <ndc_label_name>Centrum Women Immune Minis 9 mg iron-200 mcg-25 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573051330</ndc>
    <ndc_label_name>Centrum 9 mg iron/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573051425</ndc>
    <ndc_label_name>Centrum Silver Men 300 mcg-60 mcg-600 mcg-300 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573055211</ndc>
    <ndc_label_name>Preparation H Hydrocortisone 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573055420</ndc>
    <ndc_label_name>Preparation H Rapid Relief Wipes 5 %-0.25 %-20 % topical pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573055620</ndc>
    <ndc_label_name>Preparation H (Witch Hazel) 50 % topical pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573055695</ndc>
    <ndc_label_name>Preparation H (Witch Hazel) 50 % topical pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573055696</ndc>
    <ndc_label_name>Preparation H (Witch Hazel) 50 % topical pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573055807</ndc>
    <ndc_label_name>Preparation H (Witch Hazel) 50 % topical pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573055940</ndc>
    <ndc_label_name>Preparation H (Witch Hazel) 20 % topical pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573117412</ndc>
    <ndc_label_name>Children's Advil 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573119120</ndc>
    <ndc_label_name>Dristan Long Lasting 0.05 % nasal mist</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573123821</ndc>
    <ndc_label_name>DRISTAN COLD MULTI-SYMP TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128424</ndc>
    <ndc_label_name>Centrum Adult 50 Plus 80 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128432</ndc>
    <ndc_label_name>Centrum Multi Plus Omega-3 80 mcg-12.5 mcg-23.5 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128434</ndc>
    <ndc_label_name>Centrum Adults 12 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128633</ndc>
    <ndc_label_name>Centrum Multi Plus Beauty 80 mcg-1,250 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128634</ndc>
    <ndc_label_name>Centrum MultiGummies Women 80 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128635</ndc>
    <ndc_label_name>Centrum MultiGummies Men 12 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128673</ndc>
    <ndc_label_name>Centrum MultiGummies Men 12 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128674</ndc>
    <ndc_label_name>Centrum Adults 12 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128675</ndc>
    <ndc_label_name>Centrum MultiGummies Women 80 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128676</ndc>
    <ndc_label_name>Centrum MultiGummies Men 80 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128677</ndc>
    <ndc_label_name>Centrum MultiGummies Women 80 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128849</ndc>
    <ndc_label_name>Centrum MultiGummies Women 80 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128852</ndc>
    <ndc_label_name>Centrum MultiGummies Men 12 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128853</ndc>
    <ndc_label_name>Centrum MultiGummies Men 80 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573128854</ndc>
    <ndc_label_name>Centrum MultiGummies Women 80 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573132125</ndc>
    <ndc_label_name>Preparation H Rapid Relief Spray 5 %-0.25 % topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573134762</ndc>
    <ndc_label_name>Centrum MultiGummies Men 42 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573134806</ndc>
    <ndc_label_name>Centrum MultiGummies Women 42 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573134814</ndc>
    <ndc_label_name>Centrum Kids Multigummy chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573134836</ndc>
    <ndc_label_name>Centrum Kids Multigummy chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573136901</ndc>
    <ndc_label_name>Centrum MultiGummies Men 80 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573136915</ndc>
    <ndc_label_name>Centrum MultiGummies Women 80 mcg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573137801</ndc>
    <ndc_label_name>Preparation H (pe) 0.25 % rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573137806</ndc>
    <ndc_label_name>Preparation H (pe) 0.25 % rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573176909</ndc>
    <ndc_label_name>Advil Liqui-Gels Minis 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573176913</ndc>
    <ndc_label_name>Advil Liqui-Gels Minis 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573176920</ndc>
    <ndc_label_name>Advil Liqui-Gels Minis 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573176980</ndc>
    <ndc_label_name>Advil Liqui-Gels Minis 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573176989</ndc>
    <ndc_label_name>Advil Liqui-Gels Minis 200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573206046</ndc>
    <ndc_label_name>Preparation H (Witch Hazel) 50 % topical pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573216074</ndc>
    <ndc_label_name>Advil Cold and Sinus 30 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573245014</ndc>
    <ndc_label_name>Nexium 24HR 20 mg capsule,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573245015</ndc>
    <ndc_label_name>Nexium 24HR 20 mg capsule,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573245028</ndc>
    <ndc_label_name>Nexium 24HR 20 mg capsule,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573245042</ndc>
    <ndc_label_name>Nexium 24HR 20 mg capsule,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573245043</ndc>
    <ndc_label_name>Nexium 24HR 20 mg capsule,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573245114</ndc>
    <ndc_label_name>Nexium 24HR 20 mg tablet,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573245142</ndc>
    <ndc_label_name>Nexium 24HR 20 mg tablet,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573245214</ndc>
    <ndc_label_name>Nexium 24HR 20 mg capsule,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573245242</ndc>
    <ndc_label_name>Nexium 24HR 20 mg capsule,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573262065</ndc>
    <ndc_label_name>Alavert 10 mg disintegrating tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573262119</ndc>
    <ndc_label_name>Alavert 10 mg disintegrating tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573262165</ndc>
    <ndc_label_name>Alavert 10 mg disintegrating tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573266012</ndc>
    <ndc_label_name>Alavert D-12 Allergy-Sinus 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573266024</ndc>
    <ndc_label_name>Alavert D-12 Allergy-Sinus 5 mg-120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573283011</ndc>
    <ndc_label_name>Preparation H Hydrocortisone 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573284020</ndc>
    <ndc_label_name>Preparation H (phenylephrine,witch hazel) 0.25 %-50 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573284021</ndc>
    <ndc_label_name>Preparation H (phenylephrine,witch hazel) 0.25 %-50 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573284093</ndc>
    <ndc_label_name>Preparation H (phenylephrine,witch hazel) 0.25 %-50 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573284301</ndc>
    <ndc_label_name>Preparation H Rapid Relief-Lidocaine 5 %-0.25 %-14.4 %-15 % top cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573284310</ndc>
    <ndc_label_name>Preparation H Rapid Relief-Lidocaine 5 %-0.25 %-14.4 %-15 % top cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573286893</ndc>
    <ndc_label_name>Preparation H Maximum Strength 0.25 %-1 % rectal cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573286898</ndc>
    <ndc_label_name>Preparation H Maximum Strength 0.25 %-1 % rectal cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573287193</ndc>
    <ndc_label_name>Preparation H 0.25 %-14 %-74.9 % ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573287194</ndc>
    <ndc_label_name>Preparation H 0.25 %-14 %-74.9 % ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573288031</ndc>
    <ndc_label_name>Preparation H(phenyleph,cocoa buttr) 0.25 %-88.44 % rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573288311</ndc>
    <ndc_label_name>Preparation H(phenyleph,cocoa buttr) 0.25 %-88.44 % rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573288320</ndc>
    <ndc_label_name>Preparation H(phenyleph,cocoa buttr) 0.25 %-88.44 % rectal suppository</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573288712</ndc>
    <ndc_label_name>Preparation H (Witch Hazel) 20 % topical spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573295210</ndc>
    <ndc_label_name>Primatene Asthma 12.5 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573295220</ndc>
    <ndc_label_name>Primatene Asthma 12.5 mg-200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573417990</ndc>
    <ndc_label_name>Centrum Silver 0.4 mg-300 mcg-250 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573445160</ndc>
    <ndc_label_name>Centrum 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573445174</ndc>
    <ndc_label_name>Centrum 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573445176</ndc>
    <ndc_label_name>Centrum 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573446381</ndc>
    <ndc_label_name>Centrum Silver 0.4 mg-300 mcg-250 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573446391</ndc>
    <ndc_label_name>Centrum Silver 0.4 mg-300 mcg-250 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573475565</ndc>
    <ndc_label_name>Centrum Women 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573475571</ndc>
    <ndc_label_name>Centrum Women 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573475592</ndc>
    <ndc_label_name>Centrum Women 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573475630</ndc>
    <ndc_label_name>Centrum Silver Women 8 mg iron-400 mcg-50 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573475652</ndc>
    <ndc_label_name>Centrum Silver Women 8 mg iron-400 mcg-50 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573475665</ndc>
    <ndc_label_name>Centrum Silver Women 8 mg iron-400 mcg-50 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573475671</ndc>
    <ndc_label_name>Centrum Silver Women 8 mg iron-400 mcg-50 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573475765</ndc>
    <ndc_label_name>Centrum Men 8 mg iron-200 mcg-600 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573475770</ndc>
    <ndc_label_name>Centrum Men 8 mg iron-200 mcg-600 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573475792</ndc>
    <ndc_label_name>Centrum Men 8 mg iron-200 mcg-600 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573475830</ndc>
    <ndc_label_name>Centrum Silver Men 300 mcg-60 mcg-600 mcg-300 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573475850</ndc>
    <ndc_label_name>Centrum Silver Men 300 mcg-60 mcg-600 mcg-300 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573475870</ndc>
    <ndc_label_name>Centrum Silver Men 300 mcg-60 mcg-600 mcg-300 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573478199</ndc>
    <ndc_label_name>Centrum Minis Women 50 Plus 4 mg iron-200 mcg-25 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573478299</ndc>
    <ndc_label_name>Centrum Minis Men 50 Plus 150 mcg-30 mcg-300 mcg-150 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573478399</ndc>
    <ndc_label_name>Centrum Minis Adults 50 Plus 200 mcg-15 mcg-150 mcg-125mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573550919</ndc>
    <ndc_label_name>Caltrate with Vitamin D3 600 mg-20 mcg (800 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573550924</ndc>
    <ndc_label_name>Caltrate with Vitamin D3 600 mg-20 mcg (800 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573550925</ndc>
    <ndc_label_name>Caltrate with Vitamin D3 600 mg-20 mcg (800 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573551210</ndc>
    <ndc_label_name>Caltrate-D3 Plus Minerals 300 mg-20 mcg-25 mg-0.5 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573551750</ndc>
    <ndc_label_name>Caltrate Gummy Bites 250 mg-10 mcg (400 unit) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573555619</ndc>
    <ndc_label_name>Caltrate-D3 Plus Minerals 600 mg-20 mcg-50 mg-1 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573555623</ndc>
    <ndc_label_name>Caltrate-D3 Plus Minerals 600 mg-20 mcg-50 mg-1 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573555690</ndc>
    <ndc_label_name>Caltrate-D3 Plus Minerals 600 mg-20 mcg-50 mg-1 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573556711</ndc>
    <ndc_label_name>Caltrate-D3 Plus Minerals 600 mg-20 mcg-40 mg-0.25 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573556720</ndc>
    <ndc_label_name>Caltrate-D3 Plus Minerals 600 mg-20 mcg-40 mg-0.25 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573556764</ndc>
    <ndc_label_name>Caltrate-D3 Plus Minerals 600 mg-20 mcg-40 mg-0.25 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573556819</ndc>
    <ndc_label_name>Caltrate plus D  600 mg (carbonate)-20 mcg (800 unit) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573556919</ndc>
    <ndc_label_name>Caltrate plus D  600 mg (carbonate)-20 mcg (800 unit) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655204</ndc>
    <ndc_label_name>Advil PM Liqui-Gels 200 mg-25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655296</ndc>
    <ndc_label_name>Centrum Prenatal 180 mcg-35 mg-25 mg-5 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655299</ndc>
    <ndc_label_name>Centrum Morning Sickness Relief 25 mg-10 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655302</ndc>
    <ndc_label_name>Centrum Postnatal 115 mcg-35 mg-25 mg-5 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655308</ndc>
    <ndc_label_name>Centrum Multi Mental Focus 80 mcg-25 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573655471</ndc>
    <ndc_label_name>Centrum Men 8 mg iron-200 mcg-600 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573655476</ndc>
    <ndc_label_name>Centrum Women 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655545</ndc>
    <ndc_label_name>Advil Targeted Relief 0.025 %-15 %-10 %-3.1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655551</ndc>
    <ndc_label_name>Advil Targeted Relief 0.025 %-15 %-10 %-3.1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655554</ndc>
    <ndc_label_name>Advil Targeted Relief 0.025 %-15 %-10 %-3.1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655644</ndc>
    <ndc_label_name>Centrum Menopause Sleep 30 mg-485 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655668</ndc>
    <ndc_label_name>Centrum Menopause Multivitamin 400 mcg-30 mcg-30 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655671</ndc>
    <ndc_label_name>Centrum Menopause Support 1.7 mg-2.4 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655756</ndc>
    <ndc_label_name>Advil PM Liqui-Gels 200 mg-25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00573655759</ndc>
    <ndc_label_name>Advil PM Liqui-Gels 200 mg-25 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00573887830</ndc>
    <ndc_label_name>Centrum Men 8 mg iron-200 mcg-600 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574006905</ndc>
    <ndc_label_name>Glutose-5 40 % oral gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574006915</ndc>
    <ndc_label_name>Glutose-15 40 % oral gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574006924</ndc>
    <ndc_label_name>Glutose-5 40 % oral gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574006930</ndc>
    <ndc_label_name>Glutose-15 40 % oral gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574006945</ndc>
    <ndc_label_name>Glutose-45 40 % oral gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574007030</ndc>
    <ndc_label_name>Glutose-15 40 % oral gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574007116</ndc>
    <ndc_label_name>DERMABASE CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574007216</ndc>
    <ndc_label_name>PROPYLENE GLYCOL LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574010601</ndc>
    <ndc_label_name>BROMOCRIPTINE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574010603</ndc>
    <ndc_label_name>BROMOCRIPTINE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574010714</ndc>
    <ndc_label_name>CLOTRIMAZOLE 10 MG TROCHE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574010770</ndc>
    <ndc_label_name>CLOTRIMAZOLE 10 MG TROCHE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574010777</ndc>
    <ndc_label_name>CLOTRIMAZOLE 10 MG TROCHE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574011302</ndc>
    <ndc_label_name>CALCIUM ACETATE 667 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574011501</ndc>
    <ndc_label_name>FLAVOXATE HCL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574011830</ndc>
    <ndc_label_name>TROSPIUM CHLORIDE ER 60 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574012225</ndc>
    <ndc_label_name>EZ CHAR PELLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574014560</ndc>
    <ndc_label_name>TROSPIUM CHLORIDE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574015004</ndc>
    <ndc_label_name>MIDAZOLAM HCL 2 MG/ML SYRUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574015710</ndc>
    <ndc_label_name>TAVABOROLE 5% TOPICAL SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574016712</ndc>
    <ndc_label_name>DICLOFENAC 2% SOLUTION PUMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574022701</ndc>
    <ndc_label_name>BENAZEPRIL-HCTZ 10-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574022801</ndc>
    <ndc_label_name>BENAZEPRIL-HCTZ 20-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574022901</ndc>
    <ndc_label_name>BENAZEPRIL-HCTZ 20-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574024001</ndc>
    <ndc_label_name>REPAGLINIDE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574024101</ndc>
    <ndc_label_name>REPAGLINIDE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574024201</ndc>
    <ndc_label_name>REPAGLINIDE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574027500</ndc>
    <ndc_label_name>POTASSIUM CL ER 10 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574027511</ndc>
    <ndc_label_name>POTASSIUM CL ER 10 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574027930</ndc>
    <ndc_label_name>PAROXETINE MESYLATE 7.5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574029201</ndc>
    <ndc_label_name>AMILORIDE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574029301</ndc>
    <ndc_label_name>HYDROMORPHONE HCL ER 8 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574029401</ndc>
    <ndc_label_name>HYDROMORPHONE HCL ER 12 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574029501</ndc>
    <ndc_label_name>HYDROMORPHONE HCL ER 16 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574030216</ndc>
    <ndc_label_name>Ora-Sweet SF oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574030316</ndc>
    <ndc_label_name>Ora-Plus oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574030416</ndc>
    <ndc_label_name>Ora-Sweet oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574031116</ndc>
    <ndc_label_name>Ora-Blend oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574031216</ndc>
    <ndc_label_name>Ora-Blend SF oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574042001</ndc>
    <ndc_label_name>HYDROCORTISONE POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574050801</ndc>
    <ndc_label_name>FERROUS GLUCONATE 324 MG TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574050810</ndc>
    <ndc_label_name>FERROUS GLUCONATE 324 MG TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574050811</ndc>
    <ndc_label_name>FERROUS GLUCONATE 324 MG TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574052074</ndc>
    <ndc_label_name>Actidose/Sorbitol 25 gram/120 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574052076</ndc>
    <ndc_label_name>Actidose/Sorbitol 50 gram/240 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574052125</ndc>
    <ndc_label_name>Actidose-Aqua 15 g/72 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574052174</ndc>
    <ndc_label_name>Actidose-Aqua 25 gram/120 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574052176</ndc>
    <ndc_label_name>Actidose-Aqua 50 gram/240 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574060115</ndc>
    <ndc_label_name>Podocon 25 % topical liquid</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574060801</ndc>
    <ndc_label_name>FERROUS SULF EC 324 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574060810</ndc>
    <ndc_label_name>FERROUS SULF EC 324 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574060811</ndc>
    <ndc_label_name>FERROUS SULF EC 324 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574061105</ndc>
    <ndc_label_name>PODOFILOX 0.5% TOPICAL SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574062105</ndc>
    <ndc_label_name>PODOFILOX 0.5% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574079001</ndc>
    <ndc_label_name>METHAZOLAMIDE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574079101</ndc>
    <ndc_label_name>METHAZOLAMIDE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574079201</ndc>
    <ndc_label_name>PILOCARPINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574080500</ndc>
    <ndc_label_name>ACETYLCYSTEINE 6 GRAM/30 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574080530</ndc>
    <ndc_label_name>ACETYLCYSTEINE 6 GRAM/30 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574082001</ndc>
    <ndc_label_name>TESTOSTERONE CYP 200 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574082010</ndc>
    <ndc_label_name>TESTOSTERONE CYP 2,000 MG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574082701</ndc>
    <ndc_label_name>TESTOSTERONE CYP 200 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574082710</ndc>
    <ndc_label_name>TESTOSTERONE CYP 2,000 MG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574085005</ndc>
    <ndc_label_name>DIHYDROERGOTAMINE 1 MG/ML AMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574085010</ndc>
    <ndc_label_name>DIHYDROERGOTAMINE 1 MG/ML AMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574086601</ndc>
    <ndc_label_name>CYCLOSPORINE 250 MG/5 ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574086610</ndc>
    <ndc_label_name>CYCLOSPORINE 250 MG/5 ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574110404</ndc>
    <ndc_label_name>BROMPHEN-PSE-DM 2-30-10 MG/5ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574110416</ndc>
    <ndc_label_name>BROMPHEN-PSE-DM 2-30-10 MG/5ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574113304</ndc>
    <ndc_label_name>SPIRONOLACTONE 25 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574113316</ndc>
    <ndc_label_name>SPIRONOLACTONE 25 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574140228</ndc>
    <ndc_label_name>LENALIDOMIDE 2.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574140528</ndc>
    <ndc_label_name>LENALIDOMIDE 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574141028</ndc>
    <ndc_label_name>LENALIDOMIDE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574141521</ndc>
    <ndc_label_name>LENALIDOMIDE 15 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574142021</ndc>
    <ndc_label_name>LENALIDOMIDE 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574142521</ndc>
    <ndc_label_name>LENALIDOMIDE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574195906</ndc>
    <ndc_label_name>GLUTOL GEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574200802</ndc>
    <ndc_label_name>Nystop 100,000 unit/gram topical powder</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574200815</ndc>
    <ndc_label_name>Nystop 100,000 unit/gram topical powder</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574200830</ndc>
    <ndc_label_name>Nystop 100,000 unit/gram topical powder</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574204205</ndc>
    <ndc_label_name>LIDOCAINE-PRILOCAINE CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574204213</ndc>
    <ndc_label_name>LIDOCAINE-PRILOCAINE CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574204230</ndc>
    <ndc_label_name>LIDOCAINE-PRILOCAINE CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574206101</ndc>
    <ndc_label_name>CICLOPIROX 0.77% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574206130</ndc>
    <ndc_label_name>CICLOPIROX 0.77% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574206145</ndc>
    <ndc_label_name>CICLOPIROX 0.77% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574206727</ndc>
    <ndc_label_name>Evamist 1.53 mg/spray (1.7 %) transdermal spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574210745</ndc>
    <ndc_label_name>IVERMECTIN 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574220120</ndc>
    <ndc_label_name>TRETINOIN 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574220145</ndc>
    <ndc_label_name>TRETINOIN 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574220520</ndc>
    <ndc_label_name>TRETINOIN 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574220545</ndc>
    <ndc_label_name>TRETINOIN 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574222520</ndc>
    <ndc_label_name>TRETINOIN 0.025% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574222545</ndc>
    <ndc_label_name>TRETINOIN 0.025% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574230115</ndc>
    <ndc_label_name>TRETINOIN 0.01% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574230145</ndc>
    <ndc_label_name>TRETINOIN 0.01% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574232515</ndc>
    <ndc_label_name>TRETINOIN 0.025% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574232545</ndc>
    <ndc_label_name>TRETINOIN 0.025% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574241001</ndc>
    <ndc_label_name>METHYLPHENIDATE 10 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574241065</ndc>
    <ndc_label_name>METHYLPHENIDATE 10 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574241501</ndc>
    <ndc_label_name>METHYLPHENIDATE 15 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574241565</ndc>
    <ndc_label_name>METHYLPHENIDATE 15 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574242001</ndc>
    <ndc_label_name>METHYLPHENIDATE 20 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574242065</ndc>
    <ndc_label_name>METHYLPHENIDATE 20 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574243001</ndc>
    <ndc_label_name>METHYLPHENIDATE 30 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574243065</ndc>
    <ndc_label_name>METHYLPHENIDATE 30 MG/9HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574401210</ndc>
    <ndc_label_name>BRINZOLAMIDE 1% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574401215</ndc>
    <ndc_label_name>BRINZOLAMIDE 1% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574402135</ndc>
    <ndc_label_name>Polycin 500 unit-10,000 unit/gram eye ointment</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574402235</ndc>
    <ndc_label_name>BACITRACIN 500 UNIT/GM OPHTH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574402411</ndc>
    <ndc_label_name>ERYTHROMYCIN 0.5% EYE OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574402435</ndc>
    <ndc_label_name>ERYTHROMYCIN 0.5% EYE OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574402439</ndc>
    <ndc_label_name>ERYTHROMYCIN 0.5% EYE OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574402450</ndc>
    <ndc_label_name>ERYTHROMYCIN 0.5% EYE OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574403105</ndc>
    <ndc_label_name>TOBRAMYCIN-DEXAMETH OPHTH SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574403110</ndc>
    <ndc_label_name>TOBRAMYCIN-DEXAMETH OPHTH SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574403125</ndc>
    <ndc_label_name>TOBRAMYCIN-DEXAMETH OPHTH SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574408005</ndc>
    <ndc_label_name>LOTEPREDNOL ETABONATE 0.2% DRP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574408010</ndc>
    <ndc_label_name>LOTEPREDNOL ETABONATE 0.2% DRP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574413505</ndc>
    <ndc_label_name>LOTEPREDNOL ETABONATE 0.5% DRP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574413510</ndc>
    <ndc_label_name>LOTEPREDNOL ETABONATE 0.5% DRP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574413515</ndc>
    <ndc_label_name>LOTEPREDNOL ETABONATE 0.5% DRP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574414435</ndc>
    <ndc_label_name>Neo-Polycin HC 3.5 mg-400-10,000 unit/g-1 % eye ointment</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574416035</ndc>
    <ndc_label_name>NEOMYC-POLYM-DEXAMET EYE OINTM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574419035</ndc>
    <ndc_label_name>SULFACETAMIDE 10% EYE OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574425035</ndc>
    <ndc_label_name>Neo-Polycin 3.5 mg-400 unit-10,000 unit/g eye ointment</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574703412</ndc>
    <ndc_label_name>ASPIRIN 300 MG SUPPOSITORY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574704001</ndc>
    <ndc_label_name>BELLADONNA-OPIUM 16.2-60 SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574704012</ndc>
    <ndc_label_name>BELLADONNA-OPIUM 16.2-60 SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574704501</ndc>
    <ndc_label_name>BELLADONNA-OPIUM 16.2-30 SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574704512</ndc>
    <ndc_label_name>BELLADONNA-OPIUM 16.2-30 SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574705012</ndc>
    <ndc_label_name>BISACODYL 10 MG SUPPOSITORY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574705050</ndc>
    <ndc_label_name>BISACODYL 10 MG SUPPOSITORY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574709012</ndc>
    <ndc_label_name>HYDROCORTISONE AC 25 MG SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574709312</ndc>
    <ndc_label_name>HYDROCORTISONE AC 30 MG SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574711012</ndc>
    <ndc_label_name>MORPHINE SULF 5 MG SUPPOS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574711212</ndc>
    <ndc_label_name>MORPHINE SULF 10 MG SUPPOS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574711412</ndc>
    <ndc_label_name>MORPHINE SULF 20 MG SUPPOS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574711612</ndc>
    <ndc_label_name>MORPHINE SULF 30 MG SUPPOS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574722406</ndc>
    <ndc_label_name>HYDROMORPHONE 3 MG SUPPOS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00574722612</ndc>
    <ndc_label_name>Compro 25 mg rectal suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00574985510</ndc>
    <ndc_label_name>BUDESONIDE DR 3 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00575100408</ndc>
    <ndc_label_name>X-Seb T Pearl 10 %-4 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00575620030</ndc>
    <ndc_label_name>Proglycem 50 mg/mL oral suspension</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591034301</ndc>
    <ndc_label_name>VERAPAMIL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591034305</ndc>
    <ndc_label_name>VERAPAMIL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591034310</ndc>
    <ndc_label_name>VERAPAMIL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591034501</ndc>
    <ndc_label_name>VERAPAMIL 120 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591034505</ndc>
    <ndc_label_name>VERAPAMIL 120 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591034510</ndc>
    <ndc_label_name>VERAPAMIL 120 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591034701</ndc>
    <ndc_label_name>HYDROCHLOROTHIAZIDE 12.5 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591034705</ndc>
    <ndc_label_name>HYDROCHLOROTHIAZIDE 12.5 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591034801</ndc>
    <ndc_label_name>TRIAMTERENE-HCTZ 75-50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591034805</ndc>
    <ndc_label_name>TRIAMTERENE-HCTZ 75-50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591034810</ndc>
    <ndc_label_name>TRIAMTERENE-HCTZ 75-50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591036901</ndc>
    <ndc_label_name>LOXAPINE 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591037001</ndc>
    <ndc_label_name>LOXAPINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591037101</ndc>
    <ndc_label_name>LOXAPINE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591037201</ndc>
    <ndc_label_name>LOXAPINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591039501</ndc>
    <ndc_label_name>PENTAZOCINE-NALOXONE TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591039719</ndc>
    <ndc_label_name>DICLOFENAC-MISOPROST 50-0.2 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591039760</ndc>
    <ndc_label_name>DICLOFENAC-MISOPROST 50-0.2 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591039860</ndc>
    <ndc_label_name>DICLOFENAC-MISOPROST 75-0.2 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591040401</ndc>
    <ndc_label_name>VERAPAMIL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591040501</ndc>
    <ndc_label_name>LISINOPRIL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591040505</ndc>
    <ndc_label_name>LISINOPRIL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591040601</ndc>
    <ndc_label_name>LISINOPRIL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591040610</ndc>
    <ndc_label_name>LISINOPRIL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591040701</ndc>
    <ndc_label_name>LISINOPRIL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591040710</ndc>
    <ndc_label_name>LISINOPRIL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591040801</ndc>
    <ndc_label_name>LISINOPRIL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591040810</ndc>
    <ndc_label_name>LISINOPRIL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591040901</ndc>
    <ndc_label_name>LISINOPRIL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591040905</ndc>
    <ndc_label_name>LISINOPRIL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591042401</ndc>
    <ndc_label_name>TRIAMTERENE-HCTZ 37.5-25 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591042405</ndc>
    <ndc_label_name>TRIAMTERENE-HCTZ 37.5-25 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591044401</ndc>
    <ndc_label_name>GUANFACINE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591045301</ndc>
    <ndc_label_name>GUANFACINE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591046001</ndc>
    <ndc_label_name>GLIPIZIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591046005</ndc>
    <ndc_label_name>GLIPIZIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591046010</ndc>
    <ndc_label_name>GLIPIZIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591046101</ndc>
    <ndc_label_name>GLIPIZIDE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591046105</ndc>
    <ndc_label_name>GLIPIZIDE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591046110</ndc>
    <ndc_label_name>GLIPIZIDE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591058201</ndc>
    <ndc_label_name>PROPAFENONE HCL 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591058301</ndc>
    <ndc_label_name>PROPAFENONE HCL 225 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591060501</ndc>
    <ndc_label_name>LABETALOL HCL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591060505</ndc>
    <ndc_label_name>LABETALOL HCL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591060601</ndc>
    <ndc_label_name>LABETALOL HCL 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591060605</ndc>
    <ndc_label_name>LABETALOL HCL 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591060701</ndc>
    <ndc_label_name>LABETALOL HCL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591074401</ndc>
    <ndc_label_name>ESTAZOLAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591074501</ndc>
    <ndc_label_name>ESTAZOLAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591079401</ndc>
    <ndc_label_name>DICYCLOMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591079410</ndc>
    <ndc_label_name>DICYCLOMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591079501</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591079510</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591084401</ndc>
    <ndc_label_name>GLIPIZIDE ER 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591084410</ndc>
    <ndc_label_name>GLIPIZIDE ER 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591084501</ndc>
    <ndc_label_name>GLIPIZIDE ER 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591084510</ndc>
    <ndc_label_name>GLIPIZIDE ER 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591086001</ndc>
    <ndc_label_name>LISINOPRIL-HCTZ 10-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591086005</ndc>
    <ndc_label_name>LISINOPRIL-HCTZ 10-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591086101</ndc>
    <ndc_label_name>LISINOPRIL-HCTZ 20-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591086105</ndc>
    <ndc_label_name>LISINOPRIL-HCTZ 20-12.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591086201</ndc>
    <ndc_label_name>LISINOPRIL-HCTZ 20-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591086205</ndc>
    <ndc_label_name>LISINOPRIL-HCTZ 20-25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591088501</ndc>
    <ndc_label_name>LISINOPRIL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591090030</ndc>
    <ndc_label_name>GLIPIZIDE ER 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591115930</ndc>
    <ndc_label_name>ACYCLOVIR 5% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591211481</ndc>
    <ndc_label_name>TESTOSTERONE 30 MG/1.5 ML PUMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591212712</ndc>
    <ndc_label_name>BRINZOLAMIDE 1% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591212779</ndc>
    <ndc_label_name>BRINZOLAMIDE 1% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591213155</ndc>
    <ndc_label_name>AZELAIC ACID 15% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591213201</ndc>
    <ndc_label_name>DOXYLAMINE-PYRIDOXINE 10-10 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591215990</ndc>
    <ndc_label_name>CICLOPIROX 1% SHAMPOO</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591219101</ndc>
    <ndc_label_name>RAMELTEON 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591219130</ndc>
    <ndc_label_name>RAMELTEON 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591224522</ndc>
    <ndc_label_name>MESALAMINE DR 1.2 GM TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591225804</ndc>
    <ndc_label_name>SCOPOLAMINE 1 MG/3 DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591225823</ndc>
    <ndc_label_name>SCOPOLAMINE 1 MG/3 DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591225854</ndc>
    <ndc_label_name>SCOPOLAMINE 1 MG/3 DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591225879</ndc>
    <ndc_label_name>SCOPOLAMINE 1 MG/3 DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591228560</ndc>
    <ndc_label_name>PROPAFENONE HCL ER 225 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591228660</ndc>
    <ndc_label_name>PROPAFENONE HCL ER 325 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591228760</ndc>
    <ndc_label_name>PROPAFENONE HCL ER 425 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591231215</ndc>
    <ndc_label_name>ALVIMOPAN 12 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591231245</ndc>
    <ndc_label_name>ALVIMOPAN 12 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591234101</ndc>
    <ndc_label_name>METAXALONE 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591236360</ndc>
    <ndc_label_name>TESTOSTERONE 10 MG GEL PUMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591240530</ndc>
    <ndc_label_name>AMBRISENTAN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591240630</ndc>
    <ndc_label_name>AMBRISENTAN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591241101</ndc>
    <ndc_label_name>METFORMIN ER 500 MG GASTRC-TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591241219</ndc>
    <ndc_label_name>METFORMIN ER 1,000 MG GASTR-TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591242212</ndc>
    <ndc_label_name>BRIMONIDINE-TIMOLOL 0.2%-0.5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591242226</ndc>
    <ndc_label_name>BRIMONIDINE-TIMOLOL 0.2%-0.5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591242279</ndc>
    <ndc_label_name>BRIMONIDINE-TIMOLOL 0.2%-0.5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591243315</ndc>
    <ndc_label_name>ISOTRETINOIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591243345</ndc>
    <ndc_label_name>ISOTRETINOIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591243415</ndc>
    <ndc_label_name>ISOTRETINOIN 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591243445</ndc>
    <ndc_label_name>ISOTRETINOIN 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591243515</ndc>
    <ndc_label_name>ISOTRETINOIN 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591243545</ndc>
    <ndc_label_name>ISOTRETINOIN 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591243615</ndc>
    <ndc_label_name>ISOTRETINOIN 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591243645</ndc>
    <ndc_label_name>ISOTRETINOIN 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591245115</ndc>
    <ndc_label_name>ISOTRETINOIN 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591245145</ndc>
    <ndc_label_name>ISOTRETINOIN 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591247218</ndc>
    <ndc_label_name>TAMOXIFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591247260</ndc>
    <ndc_label_name>TAMOXIFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591247319</ndc>
    <ndc_label_name>TAMOXIFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591247330</ndc>
    <ndc_label_name>TAMOXIFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591247401</ndc>
    <ndc_label_name>TETRACYCLINE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591247501</ndc>
    <ndc_label_name>TETRACYCLINE 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591250115</ndc>
    <ndc_label_name>ISOTRETINOIN 35 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591250145</ndc>
    <ndc_label_name>ISOTRETINOIN 35 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591251030</ndc>
    <ndc_label_name>BUDESONIDE ER 9 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591251160</ndc>
    <ndc_label_name>BOSENTAN 62.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591251260</ndc>
    <ndc_label_name>BOSENTAN 125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591252001</ndc>
    <ndc_label_name>CHLORZOXAZONE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591252005</ndc>
    <ndc_label_name>CHLORZOXAZONE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591253360</ndc>
    <ndc_label_name>DALFAMPRIDINE ER 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591256201</ndc>
    <ndc_label_name>COLCHICINE 0.6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591256230</ndc>
    <ndc_label_name>COLCHICINE 0.6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591257920</ndc>
    <ndc_label_name>VALGANCICLOVIR HCL 50 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591264001</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAFF 50-300-40</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591264005</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAFF 50-300-40</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591264101</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAF-COD 50-300</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591267911</ndc>
    <ndc_label_name>LIDOCAINE 5% PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591267930</ndc>
    <ndc_label_name>LIDOCAINE 5% PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591268201</ndc>
    <ndc_label_name>POTASSIUM CITRATE ER 5 MEQ TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591271202</ndc>
    <ndc_label_name>ALBENDAZOLE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591271960</ndc>
    <ndc_label_name>METFORMIN ER 500 MG OSMOTIC TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591272060</ndc>
    <ndc_label_name>METFORMIN ER 1,000 MG OSM-TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591272901</ndc>
    <ndc_label_name>POTASSIUM CITRATE ER 10 MEQ TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591274201</ndc>
    <ndc_label_name>POTASSIUM CITRATE ER 15 MEQ TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591278886</ndc>
    <ndc_label_name>TIZANIDINE HCL 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591278986</ndc>
    <ndc_label_name>TIZANIDINE HCL 4 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591279086</ndc>
    <ndc_label_name>TIZANIDINE HCL 6 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591280560</ndc>
    <ndc_label_name>CLARITHROMYCIN ER 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591283201</ndc>
    <ndc_label_name>BEXAROTENE 75 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591288001</ndc>
    <ndc_label_name>VERAPAMIL SR 120 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591288201</ndc>
    <ndc_label_name>VERAPAMIL SR 180 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591288401</ndc>
    <ndc_label_name>VERAPAMIL SR 240 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591288601</ndc>
    <ndc_label_name>VERAPAMIL SR 360 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591288830</ndc>
    <ndc_label_name>HYDROXOCOBALAMIN 1,000 MCG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591292102</ndc>
    <ndc_label_name>TESTOSTERONE 12.5 MG/1.25 GRAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591292118</ndc>
    <ndc_label_name>TESTOSTERONE 12.5 MG/1.25 GRAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591292418</ndc>
    <ndc_label_name>TESTOSTERONE 1.62% GEL PUMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591292530</ndc>
    <ndc_label_name>TESTOSTERONE 1.62%(1.25 G) PKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591292532</ndc>
    <ndc_label_name>TESTOSTERONE 1.62%(1.25 G) PKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591292625</ndc>
    <ndc_label_name>TESTOSTERONE 1.62% (2.5 G) PKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591292630</ndc>
    <ndc_label_name>TESTOSTERONE 1.62% (2.5 G) PKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591292754</ndc>
    <ndc_label_name>LEVALBUTEROL TAR HFA 45MCG INH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591294430</ndc>
    <ndc_label_name>PIMECROLIMUS 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591294460</ndc>
    <ndc_label_name>PIMECROLIMUS 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591294487</ndc>
    <ndc_label_name>PIMECROLIMUS 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591299801</ndc>
    <ndc_label_name>URSODIOL 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591300501</ndc>
    <ndc_label_name>URSODIOL 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591312879</ndc>
    <ndc_label_name>PROGESTERONE 500 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591313760</ndc>
    <ndc_label_name>NIZATIDINE 150 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591313830</ndc>
    <ndc_label_name>NIZATIDINE 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591315301</ndc>
    <ndc_label_name>MINOCYCLINE 75 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591315901</ndc>
    <ndc_label_name>URSODIOL 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591321617</ndc>
    <ndc_label_name>TESTOSTERONE 1% (25MG/2.5G) PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591321630</ndc>
    <ndc_label_name>TESTOSTERONE 1% (25MG/2.5G) PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591321726</ndc>
    <ndc_label_name>TESTOSTERONE 1% (50 MG/5 G) PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591321730</ndc>
    <ndc_label_name>TESTOSTERONE 1% (50 MG/5 G) PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591322001</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAF-COD 50-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591322126</ndc>
    <ndc_label_name>TESTOSTERONE ENAN 200 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591333105</ndc>
    <ndc_label_name>BUPROPION HCL XL 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591333119</ndc>
    <ndc_label_name>BUPROPION HCL XL 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591333130</ndc>
    <ndc_label_name>BUPROPION HCL XL 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591335501</ndc>
    <ndc_label_name>NATEGLINIDE 120 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591336901</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAFF 50-325-40</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591336905</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAFF 50-325-40</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591346753</ndc>
    <ndc_label_name>ALBUTEROL SUL 0.63 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591346853</ndc>
    <ndc_label_name>ALBUTEROL SUL 1.25 MG/3 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591350804</ndc>
    <ndc_label_name>CLONIDINE 0.1 MG/DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591350854</ndc>
    <ndc_label_name>CLONIDINE 0.1 MG/DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591350904</ndc>
    <ndc_label_name>CLONIDINE 0.2 MG/DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591350954</ndc>
    <ndc_label_name>CLONIDINE 0.2 MG/DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591351004</ndc>
    <ndc_label_name>CLONIDINE 0.3 MG/DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591351054</ndc>
    <ndc_label_name>CLONIDINE 0.3 MG/DAY PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591352426</ndc>
    <ndc_label_name>TESTOSTERONE 50 MG/5 GRAM GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591352430</ndc>
    <ndc_label_name>TESTOSTERONE 50 MG/5 GRAM GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591352511</ndc>
    <ndc_label_name>LIDOCAINE 5% PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591352530</ndc>
    <ndc_label_name>LIDOCAINE 5% PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591354005</ndc>
    <ndc_label_name>BUPROPION HCL SR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591354060</ndc>
    <ndc_label_name>BUPROPION HCL SR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591354105</ndc>
    <ndc_label_name>BUPROPION HCL SR 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591354125</ndc>
    <ndc_label_name>BUPROPION HCL SR 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591354160</ndc>
    <ndc_label_name>BUPROPION HCL SR 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591354260</ndc>
    <ndc_label_name>BUPROPION HCL SR 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591354360</ndc>
    <ndc_label_name>BUPROPION HCL SR 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591354376</ndc>
    <ndc_label_name>BUPROPION HCL SR 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591363630</ndc>
    <ndc_label_name>TROSPIUM CHLORIDE ER 60 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591365801</ndc>
    <ndc_label_name>NITROFURANTOIN MONO-MCR 100 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591365930</ndc>
    <ndc_label_name>DESVENLAFAXINE SUCCNT ER 50 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591366030</ndc>
    <ndc_label_name>DESVENLAFAXINE SUCCNT ER 100MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591367001</ndc>
    <ndc_label_name>NABUMETONE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591367005</ndc>
    <ndc_label_name>NABUMETONE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591367101</ndc>
    <ndc_label_name>NABUMETONE 750 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591367105</ndc>
    <ndc_label_name>NABUMETONE 750 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591369230</ndc>
    <ndc_label_name>PALIPERIDONE ER 1.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591369319</ndc>
    <ndc_label_name>PALIPERIDONE ER 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591369330</ndc>
    <ndc_label_name>PALIPERIDONE ER 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591369419</ndc>
    <ndc_label_name>PALIPERIDONE ER 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591369430</ndc>
    <ndc_label_name>PALIPERIDONE ER 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591369519</ndc>
    <ndc_label_name>PALIPERIDONE ER 9 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591369530</ndc>
    <ndc_label_name>PALIPERIDONE ER 9 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591371305</ndc>
    <ndc_label_name>EZETIMIBE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591371319</ndc>
    <ndc_label_name>EZETIMIBE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591371330</ndc>
    <ndc_label_name>EZETIMIBE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591372030</ndc>
    <ndc_label_name>TRANEXAMIC ACID 650 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591379519</ndc>
    <ndc_label_name>SOLIFENACIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591379530</ndc>
    <ndc_label_name>SOLIFENACIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591379619</ndc>
    <ndc_label_name>SOLIFENACIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591379630</ndc>
    <ndc_label_name>SOLIFENACIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591385101</ndc>
    <ndc_label_name>VIGABATRIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591385419</ndc>
    <ndc_label_name>METHYLPHENIDATE ER 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591386219</ndc>
    <ndc_label_name>METHYLPHENIDATE ER 15 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591386919</ndc>
    <ndc_label_name>METHYLPHENIDATE ER 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591387044</ndc>
    <ndc_label_name>MEMANTINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591387045</ndc>
    <ndc_label_name>MEMANTINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591387060</ndc>
    <ndc_label_name>MEMANTINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591387154</ndc>
    <ndc_label_name>NALOXONE HCL 4 MG NASAL SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591387199</ndc>
    <ndc_label_name>NALOXONE HCL 4 MG NASAL SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591387319</ndc>
    <ndc_label_name>METHYLPHENIDATE ER 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591387544</ndc>
    <ndc_label_name>MEMANTINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591387545</ndc>
    <ndc_label_name>MEMANTINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591387560</ndc>
    <ndc_label_name>MEMANTINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591389119</ndc>
    <ndc_label_name>METHYLPHENIDATE ER 40 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591389519</ndc>
    <ndc_label_name>METHYLPHENIDATE ER 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591390087</ndc>
    <ndc_label_name>MEMANTINE 5-10 MG TITRATION PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591390219</ndc>
    <ndc_label_name>METHYLPHENIDATE ER 60 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591391668</ndc>
    <ndc_label_name>CLIND PH-BENZOYL PERO 1.2-2.5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591395511</ndc>
    <ndc_label_name>VIGABATRIN 500 MG POWDER PACKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591395550</ndc>
    <ndc_label_name>VIGABATRIN 500 MG POWDER PACKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591398260</ndc>
    <ndc_label_name>CELECOXIB 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591398301</ndc>
    <ndc_label_name>CELECOXIB 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591398305</ndc>
    <ndc_label_name>CELECOXIB 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591398401</ndc>
    <ndc_label_name>CELECOXIB 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591398405</ndc>
    <ndc_label_name>CELECOXIB 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591398560</ndc>
    <ndc_label_name>CELECOXIB 400 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591401201</ndc>
    <ndc_label_name>VALPROIC ACID 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591403946</ndc>
    <ndc_label_name>CLOBETASOL PROP 0.05% SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591403974</ndc>
    <ndc_label_name>CLOBETASOL PROP 0.05% SPRAY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591405094</ndc>
    <ndc_label_name>SILDENAFIL 10 MG/ML ORAL SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591405289</ndc>
    <ndc_label_name>IVERMECTIN 1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591406030</ndc>
    <ndc_label_name>DESVENLAFAXINE SUCCNT ER 25 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591410101</ndc>
    <ndc_label_name>PERPHENAZINE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591410201</ndc>
    <ndc_label_name>PERPHENAZINE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591410301</ndc>
    <ndc_label_name>PERPHENAZINE 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591410401</ndc>
    <ndc_label_name>PERPHENAZINE 16 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591417101</ndc>
    <ndc_label_name>PENICILLAMINE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591436560</ndc>
    <ndc_label_name>ABIRATERONE ACETATE 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591438579</ndc>
    <ndc_label_name>FOSAPREPITANT 150 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591439096</ndc>
    <ndc_label_name>MIFEPRISTONE 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591455022</ndc>
    <ndc_label_name>DOXYCYCLINE HYC DR 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591457560</ndc>
    <ndc_label_name>DOXYCYCLINE HYC DR 200 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591473030</ndc>
    <ndc_label_name>DEFERASIROX 90 MG GRANULE PKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591473054</ndc>
    <ndc_label_name>DEFERASIROX 90 MG GRANULE PKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591473530</ndc>
    <ndc_label_name>DEFERASIROX 180 MG GRANULE PKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591473554</ndc>
    <ndc_label_name>DEFERASIROX 180 MG GRANULE PKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591474030</ndc>
    <ndc_label_name>DEFERASIROX 360 MG GRANULE PKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591474054</ndc>
    <ndc_label_name>DEFERASIROX 360 MG GRANULE PKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591491001</ndc>
    <ndc_label_name>TRIENTINE HCL 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591492001</ndc>
    <ndc_label_name>AMANTADINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591492005</ndc>
    <ndc_label_name>AMANTADINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591505201</ndc>
    <ndc_label_name>PREDNISONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591505210</ndc>
    <ndc_label_name>PREDNISONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591505221</ndc>
    <ndc_label_name>PREDNISONE 5 MG TAB DOSE PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591505243</ndc>
    <ndc_label_name>PREDNISONE 5 MG TAB DOSE PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591530701</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591530710</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591531901</ndc>
    <ndc_label_name>PROMETHAZINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591532101</ndc>
    <ndc_label_name>PRIMIDONE 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591533501</ndc>
    <ndc_label_name>TRIHEXYPHENIDYL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591533510</ndc>
    <ndc_label_name>TRIHEXYPHENIDYL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591533701</ndc>
    <ndc_label_name>TRIHEXYPHENIDYL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591533710</ndc>
    <ndc_label_name>TRIHEXYPHENIDYL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591534701</ndc>
    <ndc_label_name>PROBENECID 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591534710</ndc>
    <ndc_label_name>PROBENECID 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591544201</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591544205</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591544210</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591544221</ndc>
    <ndc_label_name>PREDNISONE 10 MG TAB DOSE PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591544243</ndc>
    <ndc_label_name>PREDNISONE 10 MG TAB DOSE PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591544301</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591544305</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591544310</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591551301</ndc>
    <ndc_label_name>CARISOPRODOL 350 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591551305</ndc>
    <ndc_label_name>CARISOPRODOL 350 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591551310</ndc>
    <ndc_label_name>CARISOPRODOL 350 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591554301</ndc>
    <ndc_label_name>ALLOPURINOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591554310</ndc>
    <ndc_label_name>ALLOPURINOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591554401</ndc>
    <ndc_label_name>ALLOPURINOL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591554405</ndc>
    <ndc_label_name>ALLOPURINOL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591555305</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591555350</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591555401</ndc>
    <ndc_label_name>PROPRANOLOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591555410</ndc>
    <ndc_label_name>PROPRANOLOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591555501</ndc>
    <ndc_label_name>PROPRANOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591555510</ndc>
    <ndc_label_name>PROPRANOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591555601</ndc>
    <ndc_label_name>PROPRANOLOL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591555610</ndc>
    <ndc_label_name>PROPRANOLOL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591555701</ndc>
    <ndc_label_name>PROPRANOLOL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591555705</ndc>
    <ndc_label_name>PROPRANOLOL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00591559001</ndc>
    <ndc_label_name>TRANYLCYPROMINE SULF 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591564201</ndc>
    <ndc_label_name>MINOXIDIL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591564205</ndc>
    <ndc_label_name>MINOXIDIL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591564301</ndc>
    <ndc_label_name>MINOXIDIL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591564305</ndc>
    <ndc_label_name>MINOXIDIL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591566001</ndc>
    <ndc_label_name>SULINDAC 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591566005</ndc>
    <ndc_label_name>SULINDAC 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591566101</ndc>
    <ndc_label_name>SULINDAC 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591566105</ndc>
    <ndc_label_name>SULINDAC 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591569401</ndc>
    <ndc_label_name>MINOCYCLINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591569460</ndc>
    <ndc_label_name>MINOCYCLINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591569550</ndc>
    <ndc_label_name>MINOCYCLINE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591571301</ndc>
    <ndc_label_name>AMOXAPINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591571401</ndc>
    <ndc_label_name>AMOXAPINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591571501</ndc>
    <ndc_label_name>AMOXAPINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591571630</ndc>
    <ndc_label_name>AMOXAPINE 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591578201</ndc>
    <ndc_label_name>ATENOLOL-CHLORTHALIDONE 50-25</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00591578301</ndc>
    <ndc_label_name>ATENOLOL-CHLORTHALIDONE 100-25</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597000302</ndc>
    <ndc_label_name>Aptivus 250 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597002402</ndc>
    <ndc_label_name>Combivent Respimat 20 mcg-100 mcg/actuation solution for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597003510</ndc>
    <ndc_label_name>Spevigo 60 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597003937</ndc>
    <ndc_label_name>MICARDIS 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597004037</ndc>
    <ndc_label_name>Micardis 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597004137</ndc>
    <ndc_label_name>Micardis 80 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597004237</ndc>
    <ndc_label_name>Micardis HCT 80 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597004337</ndc>
    <ndc_label_name>Micardis HCT 40 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597004437</ndc>
    <ndc_label_name>Micardis HCT 80 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597007541</ndc>
    <ndc_label_name>Spiriva with HandiHaler 18 mcg and inhalation capsules</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597007547</ndc>
    <ndc_label_name>Spiriva with HandiHaler 18 mcg and inhalation capsules</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597007575</ndc>
    <ndc_label_name>Spiriva with HandiHaler 18 mcg and inhalation capsules</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597008717</ndc>
    <ndc_label_name>Atrovent HFA 17 mcg/actuation aerosol inhaler</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597010028</ndc>
    <ndc_label_name>Spiriva Respimat 2.5 mcg/actuation solution for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597010051</ndc>
    <ndc_label_name>Spiriva Respimat 2.5 mcg/actuation solution for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597010061</ndc>
    <ndc_label_name>Spiriva Respimat 2.5 mcg/actuation solution for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597010854</ndc>
    <ndc_label_name>Pradaxa 110 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597010860</ndc>
    <ndc_label_name>Pradaxa 110 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597010930</ndc>
    <ndc_label_name>MIRAPEX ER 0.375 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597011330</ndc>
    <ndc_label_name>Mirapex ER 1.5 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597011530</ndc>
    <ndc_label_name>Mirapex ER 3 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597011630</ndc>
    <ndc_label_name>MIRAPEX ER 4.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597013730</ndc>
    <ndc_label_name>Gilotrif 30 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597013830</ndc>
    <ndc_label_name>Gilotrif 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597014030</ndc>
    <ndc_label_name>Tradjenta 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597014061</ndc>
    <ndc_label_name>Tradjenta 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597014070</ndc>
    <ndc_label_name>Tradjenta 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597014090</ndc>
    <ndc_label_name>Tradjenta 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597014130</ndc>
    <ndc_label_name>Gilotrif 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597014360</ndc>
    <ndc_label_name>Ofev 100 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597014560</ndc>
    <ndc_label_name>Ofev 150 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597014618</ndc>
    <ndc_label_name>Jentadueto 2.5 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597014660</ndc>
    <ndc_label_name>Jentadueto 2.5 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597014718</ndc>
    <ndc_label_name>Jentadueto 2.5 mg-850 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597014760</ndc>
    <ndc_label_name>Jentadueto 2.5 mg-850 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597014818</ndc>
    <ndc_label_name>Jentadueto 2.5 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597014860</ndc>
    <ndc_label_name>Jentadueto 2.5 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597015207</ndc>
    <ndc_label_name>Jardiance 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597015230</ndc>
    <ndc_label_name>Jardiance 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597015237</ndc>
    <ndc_label_name>Jardiance 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597015290</ndc>
    <ndc_label_name>Jardiance 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597015307</ndc>
    <ndc_label_name>Jardiance 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597015330</ndc>
    <ndc_label_name>Jardiance 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597015337</ndc>
    <ndc_label_name>Jardiance 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597015390</ndc>
    <ndc_label_name>Jardiance 25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597015528</ndc>
    <ndc_label_name>Stiolto Respimat 2.5 mcg-2.5 mcg/actuation solution for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597015561</ndc>
    <ndc_label_name>Stiolto Respimat 2.5 mcg-2.5 mcg/actuation solution for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597015570</ndc>
    <ndc_label_name>Stiolto Respimat 2.5 mcg-2.5 mcg/actuation solution for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597015918</ndc>
    <ndc_label_name>Synjardy 5 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597015960</ndc>
    <ndc_label_name>Synjardy 5 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597016061</ndc>
    <ndc_label_name>Spiriva Respimat 1.25 mcg/actuation solution for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597016407</ndc>
    <ndc_label_name>Glyxambi 25 mg-5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597016430</ndc>
    <ndc_label_name>Glyxambi 25 mg-5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597016439</ndc>
    <ndc_label_name>Glyxambi 25 mg-5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597016490</ndc>
    <ndc_label_name>Glyxambi 25 mg-5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597016818</ndc>
    <ndc_label_name>Synjardy 12.5 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597016860</ndc>
    <ndc_label_name>Synjardy 12.5 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597017518</ndc>
    <ndc_label_name>Synjardy 5 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597017560</ndc>
    <ndc_label_name>Synjardy 5 mg-1,000 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597018018</ndc>
    <ndc_label_name>Synjardy 12.5 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597018060</ndc>
    <ndc_label_name>Synjardy 12.5 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597018066</ndc>
    <ndc_label_name>Synjardy 12.5 mg-500 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597018207</ndc>
    <ndc_label_name>Glyxambi 10 mg-5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597018230</ndc>
    <ndc_label_name>Glyxambi 10 mg-5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597018239</ndc>
    <ndc_label_name>Glyxambi 10 mg-5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597018290</ndc>
    <ndc_label_name>Glyxambi 10 mg-5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597019261</ndc>
    <ndc_label_name>Striverdi Respimat 2.5 mcg/actuation solution for inhalation</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597019705</ndc>
    <ndc_label_name>Praxbind 2.5 gram/50 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597027073</ndc>
    <ndc_label_name>Jentadueto XR 2.5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597027094</ndc>
    <ndc_label_name>Jentadueto XR 2.5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597027533</ndc>
    <ndc_label_name>Jentadueto XR 5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597027581</ndc>
    <ndc_label_name>Jentadueto XR 5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597028036</ndc>
    <ndc_label_name>Synjardy XR 10 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597028073</ndc>
    <ndc_label_name>Synjardy XR 10 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597028090</ndc>
    <ndc_label_name>Synjardy XR 10 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597028530</ndc>
    <ndc_label_name>MIRAPEX ER 0.75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597028630</ndc>
    <ndc_label_name>Mirapex ER 2.25 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597028730</ndc>
    <ndc_label_name>Mirapex ER 3.75 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597029020</ndc>
    <ndc_label_name>Synjardy XR 5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597029059</ndc>
    <ndc_label_name>Synjardy XR 5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597029074</ndc>
    <ndc_label_name>Synjardy XR 5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597029561</ndc>
    <ndc_label_name>Synjardy XR 25 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597029578</ndc>
    <ndc_label_name>Synjardy XR 25 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597029588</ndc>
    <ndc_label_name>Synjardy XR 25 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597030020</ndc>
    <ndc_label_name>Synjardy XR 12.5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597030045</ndc>
    <ndc_label_name>Synjardy XR 12.5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597030093</ndc>
    <ndc_label_name>Synjardy XR 12.5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597035509</ndc>
    <ndc_label_name>Pradaxa 75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597035556</ndc>
    <ndc_label_name>Pradaxa 75 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597036055</ndc>
    <ndc_label_name>Pradaxa 150 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00597036082</ndc>
    <ndc_label_name>Pradaxa 150 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597037082</ndc>
    <ndc_label_name>Cyltezo(CF) 40 mg/0.8 mL subcutaneous syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597037516</ndc>
    <ndc_label_name>CYLTEZO(CF) PEN CRH-UC-HS 40MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597037523</ndc>
    <ndc_label_name>CYLTEZO(CF) PEN PSORIA-UV 40MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597037597</ndc>
    <ndc_label_name>Cyltezo(CF) Pen 40 mg/0.8 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597038013</ndc>
    <ndc_label_name>Trijardy XR 10 mg-5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597038022</ndc>
    <ndc_label_name>Trijardy XR 10 mg-5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597038068</ndc>
    <ndc_label_name>Trijardy XR 10 mg-5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597038577</ndc>
    <ndc_label_name>Trijardy XR 12.5 mg-2.5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597038586</ndc>
    <ndc_label_name>Trijardy XR 12.5 mg-2.5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597038588</ndc>
    <ndc_label_name>Trijardy XR 12.5 mg-2.5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597039013</ndc>
    <ndc_label_name>Trijardy XR 25 mg-5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597039031</ndc>
    <ndc_label_name>Trijardy XR 25 mg-5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597039071</ndc>
    <ndc_label_name>Trijardy XR 25 mg-5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597039523</ndc>
    <ndc_label_name>Trijardy XR 5 mg-2.5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597039552</ndc>
    <ndc_label_name>Trijardy XR 5 mg-2.5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597039582</ndc>
    <ndc_label_name>Trijardy XR 5 mg-2.5 mg-1,000 mg tablet, extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597040089</ndc>
    <ndc_label_name>Cyltezo(CF) 10 mg/0.2 mL subcutaneous syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597040580</ndc>
    <ndc_label_name>Cyltezo(CF) 20 mg/0.4 mL subcutaneous syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597042578</ndc>
    <ndc_label_name>Pradaxa 20 mg oral pellets in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597043018</ndc>
    <ndc_label_name>Pradaxa 30 mg oral pellets in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597043596</ndc>
    <ndc_label_name>Pradaxa 40 mg oral pellets in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597044053</ndc>
    <ndc_label_name>Pradaxa 50 mg oral pellets in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597044587</ndc>
    <ndc_label_name>Pradaxa 110 mg oral pellets in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597045016</ndc>
    <ndc_label_name>Pradaxa 150 mg oral pellets in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597048520</ndc>
    <ndc_label_name>Cyltezo(CF) 40 mg/0.4 mL subcutaneous syringe kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597049540</ndc>
    <ndc_label_name>CYLTEZO(CF) PEN PSORIA-UV 40MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597049550</ndc>
    <ndc_label_name>Cyltezo(CF) Pen 40 mg/0.4 mL subcutaneous kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597049560</ndc>
    <ndc_label_name>CYLTEZO(CF) PEN CRH-UC-HS 40MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597054522</ndc>
    <ndc_label_name>ADALIMUMAB-ADBM(CF) PEN 40 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597054544</ndc>
    <ndc_label_name>ADALIMUMAB-ADBM(CF) PS-UV 40MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597054566</ndc>
    <ndc_label_name>ADALIMUMAB-ADBM(CF) CRHN 40MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597055580</ndc>
    <ndc_label_name>ADALIMUMAB-ADBM(CF) 20 MG SYRG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597056520</ndc>
    <ndc_label_name>ADALIMUMAB-ADBM(CF) 40 MG SYRG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597057540</ndc>
    <ndc_label_name>ADALIMUMAB-ADBM(CF) PS-UV 40MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597057550</ndc>
    <ndc_label_name>ADALIMUMAB-ADBM(CF) PEN 40 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597057560</ndc>
    <ndc_label_name>ADALIMUMAB-ADBM(CF) CRHN 40MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597058589</ndc>
    <ndc_label_name>ADALIMUMAB-ADBM(CF) 10 MG SYRG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597059520</ndc>
    <ndc_label_name>ADALIMUMAB-ADBM(CF) 40 MG SYRG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597062010</ndc>
    <ndc_label_name>Spevigo 150 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597062020</ndc>
    <ndc_label_name>Spevigo 150 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597246541</ndc>
    <ndc_label_name>Jascayd 9 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597731321</ndc>
    <ndc_label_name>Jascayd 18 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597770538</ndc>
    <ndc_label_name>Spevigo 300 mg/2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597770541</ndc>
    <ndc_label_name>Spevigo 300 mg/2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597770572</ndc>
    <ndc_label_name>Spevigo 300 mg/2 mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597925759</ndc>
    <ndc_label_name>Hernexeos 60 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00597925786</ndc>
    <ndc_label_name>Hernexeos 60 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603020922</ndc>
    <ndc_label_name>MAGNESIUM OXIDE 400 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00603021321</ndc>
    <ndc_label_name>MAGNESIUM OXIDE 420 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603116158</ndc>
    <ndc_label_name>DICYCLOMINE 10 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603154258</ndc>
    <ndc_label_name>POTASSIUM CL 10% (20 MEQ/15ML)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603154358</ndc>
    <ndc_label_name>POTASSIUM CL 20% (40 MEQ/15ML)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603155404</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603155410</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603155416</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ PACKET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00603188010</ndc>
    <ndc_label_name>LIDOCAINE 5% PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00603188016</ndc>
    <ndc_label_name>LIDOCAINE 5% PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603211521</ndc>
    <ndc_label_name>ALLOPURINOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603211532</ndc>
    <ndc_label_name>ALLOPURINOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603211621</ndc>
    <ndc_label_name>ALLOPURINOL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603211628</ndc>
    <ndc_label_name>ALLOPURINOL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603211632</ndc>
    <ndc_label_name>ALLOPURINOL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603240621</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603240628</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603240632</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603240721</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603240728</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603240732</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603243321</ndc>
    <ndc_label_name>BENZTROPINE MES 0.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603243332</ndc>
    <ndc_label_name>BENZTROPINE MES 0.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603243421</ndc>
    <ndc_label_name>BENZTROPINE MES 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603243432</ndc>
    <ndc_label_name>BENZTROPINE MES 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603243521</ndc>
    <ndc_label_name>BENZTROPINE MES 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603243532</ndc>
    <ndc_label_name>BENZTROPINE MES 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603243932</ndc>
    <ndc_label_name>BENZTROPINE MES 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603254021</ndc>
    <ndc_label_name>BUTALBITAL-ACETAMINOPHN 50-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603358121</ndc>
    <ndc_label_name>FELODIPINE ER 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603358128</ndc>
    <ndc_label_name>FELODIPINE ER 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603358221</ndc>
    <ndc_label_name>FELODIPINE ER 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603358228</ndc>
    <ndc_label_name>FELODIPINE ER 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603358321</ndc>
    <ndc_label_name>FELODIPINE ER 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603358328</ndc>
    <ndc_label_name>FELODIPINE ER 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00603371834</ndc>
    <ndc_label_name>FROVATRIPTAN SUCC 2.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603459315</ndc>
    <ndc_label_name>METHYLPREDNISOLONE 4 MG DOSEPK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603459321</ndc>
    <ndc_label_name>METHYLPREDNISOLONE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603506021</ndc>
    <ndc_label_name>PERPHENAZINE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603506121</ndc>
    <ndc_label_name>PERPHENAZINE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603506128</ndc>
    <ndc_label_name>PERPHENAZINE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603506221</ndc>
    <ndc_label_name>PERPHENAZINE 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603506228</ndc>
    <ndc_label_name>PERPHENAZINE 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603506321</ndc>
    <ndc_label_name>PERPHENAZINE 16 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603516521</ndc>
    <ndc_label_name>PHENOBARBITAL 16.2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603516532</ndc>
    <ndc_label_name>PHENOBARBITAL 16.2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603516621</ndc>
    <ndc_label_name>PHENOBARBITAL 32.4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603516632</ndc>
    <ndc_label_name>PHENOBARBITAL 32.4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603516721</ndc>
    <ndc_label_name>PHENOBARBITAL 64.8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603516732</ndc>
    <ndc_label_name>PHENOBARBITAL 64.8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603516821</ndc>
    <ndc_label_name>PHENOBARBITAL 97.2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603516832</ndc>
    <ndc_label_name>PHENOBARBITAL 97.2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533521</ndc>
    <ndc_label_name>PREDNISONE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533532</ndc>
    <ndc_label_name>PREDNISONE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533621</ndc>
    <ndc_label_name>PREDNISONE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533715</ndc>
    <ndc_label_name>PREDNISONE 5 MG TAB DOSE PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533721</ndc>
    <ndc_label_name>PREDNISONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533731</ndc>
    <ndc_label_name>PREDNISONE 5 MG TAB DOSE PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533732</ndc>
    <ndc_label_name>PREDNISONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533815</ndc>
    <ndc_label_name>PREDNISONE 10 MG TAB DOSE PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533821</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533828</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533831</ndc>
    <ndc_label_name>PREDNISONE 10 MG TAB DOSE PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533832</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533921</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533928</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603533932</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603548221</ndc>
    <ndc_label_name>PROPRANOLOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603548232</ndc>
    <ndc_label_name>PROPRANOLOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603548321</ndc>
    <ndc_label_name>PROPRANOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603548332</ndc>
    <ndc_label_name>PROPRANOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603548421</ndc>
    <ndc_label_name>PROPRANOLOL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603548432</ndc>
    <ndc_label_name>PROPRANOLOL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603548521</ndc>
    <ndc_label_name>PROPRANOLOL 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603548621</ndc>
    <ndc_label_name>PROPRANOLOL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00603548628</ndc>
    <ndc_label_name>PROPRANOLOL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641036721</ndc>
    <ndc_label_name>DEXAMETHASONE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641036725</ndc>
    <ndc_label_name>DEXAMETHASONE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641037621</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641037625</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641039112</ndc>
    <ndc_label_name>HEPARIN SOD 1,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641039137</ndc>
    <ndc_label_name>HEPARIN SOD 1,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641040012</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641040037</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641041012</ndc>
    <ndc_label_name>HEPARIN SOD 10,000 UNIT/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641041037</ndc>
    <ndc_label_name>HEPARIN SOD 10,000 UNIT/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641047621</ndc>
    <ndc_label_name>PHENOBARBITAL 65 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641047625</ndc>
    <ndc_label_name>PHENOBARBITAL 65 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641047721</ndc>
    <ndc_label_name>PHENOBARBITAL 130 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641047725</ndc>
    <ndc_label_name>PHENOBARBITAL 130 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641049321</ndc>
    <ndc_label_name>PHENYTOIN 100 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641049325</ndc>
    <ndc_label_name>PHENYTOIN 100 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641049717</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641049725</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641092821</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641092825</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641092921</ndc>
    <ndc_label_name>PROMETHAZINE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641092925</ndc>
    <ndc_label_name>PROMETHAZINE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641094831</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641094835</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641094931</ndc>
    <ndc_label_name>PROMETHAZINE 50 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641094935</ndc>
    <ndc_label_name>PROMETHAZINE 50 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641095521</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641095525</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641095621</ndc>
    <ndc_label_name>PROMETHAZINE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641095625</ndc>
    <ndc_label_name>PROMETHAZINE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641139731</ndc>
    <ndc_label_name>CHLORPROMAZINE 25 MG/ML AMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641139735</ndc>
    <ndc_label_name>CHLORPROMAZINE 25 MG/ML AMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641139831</ndc>
    <ndc_label_name>CHLORPROMAZINE 25 MG/ML AMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641139835</ndc>
    <ndc_label_name>CHLORPROMAZINE 25 MG/ML AMP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641141031</ndc>
    <ndc_label_name>DIGOXIN 500 MCG/2 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641141035</ndc>
    <ndc_label_name>DIGOXIN 500 MCG/2 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641149531</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641149535</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641149631</ndc>
    <ndc_label_name>PROMETHAZINE 50 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641149635</ndc>
    <ndc_label_name>PROMETHAZINE 50 MG/ML AMPUL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641234139</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641234141</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641245030</ndc>
    <ndc_label_name>HEPARIN 30,000 UNIT/30 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641245055</ndc>
    <ndc_label_name>HEPARIN 30,000 UNIT/30 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641246030</ndc>
    <ndc_label_name>HEPARIN 50,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641246055</ndc>
    <ndc_label_name>HEPARIN 50,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641255510</ndc>
    <ndc_label_name>PHENYTOIN 250 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641255541</ndc>
    <ndc_label_name>PHENYTOIN 250 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641255545</ndc>
    <ndc_label_name>PHENYTOIN 250 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641256941</ndc>
    <ndc_label_name>DIPYRIDAMOLE 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641256944</ndc>
    <ndc_label_name>DIPYRIDAMOLE 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600001</ndc>
    <ndc_label_name>Ativan 2 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600010</ndc>
    <ndc_label_name>Ativan 2 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600101</ndc>
    <ndc_label_name>Ativan 2 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600125</ndc>
    <ndc_label_name>Ativan 2 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600201</ndc>
    <ndc_label_name>Ativan 4 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600210</ndc>
    <ndc_label_name>Ativan 4 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600301</ndc>
    <ndc_label_name>Ativan 4 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600325</ndc>
    <ndc_label_name>Ativan 4 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600601</ndc>
    <ndc_label_name>ATROPINE 8 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600610</ndc>
    <ndc_label_name>ATROPINE 8 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600701</ndc>
    <ndc_label_name>BUMETANIDE 2.5 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600710</ndc>
    <ndc_label_name>BUMETANIDE 2.5 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600801</ndc>
    <ndc_label_name>BUMETANIDE 1 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641600810</ndc>
    <ndc_label_name>BUMETANIDE 1 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641601301</ndc>
    <ndc_label_name>DILTIAZEM 25 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641601310</ndc>
    <ndc_label_name>DILTIAZEM 25 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641601401</ndc>
    <ndc_label_name>DILTIAZEM 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641601410</ndc>
    <ndc_label_name>DILTIAZEM 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641601501</ndc>
    <ndc_label_name>DILTIAZEM 125 MG/25 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641601510</ndc>
    <ndc_label_name>DILTIAZEM 125 MG/25 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641601801</ndc>
    <ndc_label_name>Dopram 20 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641601901</ndc>
    <ndc_label_name>Duramorph (PF) 1 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641601910</ndc>
    <ndc_label_name>Duramorph (PF) 1 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602001</ndc>
    <ndc_label_name>Duramorph (PF) 0.5 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602010</ndc>
    <ndc_label_name>Duramorph (PF) 0.5 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602101</ndc>
    <ndc_label_name>FAMOTIDINE 200 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602110</ndc>
    <ndc_label_name>FAMOTIDINE 200 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602201</ndc>
    <ndc_label_name>FAMOTIDINE 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602225</ndc>
    <ndc_label_name>FAMOTIDINE 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602301</ndc>
    <ndc_label_name>FAMOTIDINE 40 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602310</ndc>
    <ndc_label_name>FAMOTIDINE 40 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602325</ndc>
    <ndc_label_name>FAMOTIDINE 40 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602701</ndc>
    <ndc_label_name>FENTANYL 100 MCG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602725</ndc>
    <ndc_label_name>FENTANYL 100 MCG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602801</ndc>
    <ndc_label_name>FENTANYL 250 MCG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602810</ndc>
    <ndc_label_name>FENTANYL 250 MCG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602825</ndc>
    <ndc_label_name>FENTANYL 250 MCG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641602901</ndc>
    <ndc_label_name>FENTANYL 1,000 MCG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641603001</ndc>
    <ndc_label_name>FENTANYL 2,500 MCG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641603901</ndc>
    <ndc_label_name>Infumorph P/F 10 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604001</ndc>
    <ndc_label_name>Infumorph P/F 25 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604101</ndc>
    <ndc_label_name>KETOROLAC 15 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604125</ndc>
    <ndc_label_name>KETOROLAC 15 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604201</ndc>
    <ndc_label_name>KETOROLAC 30 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604225</ndc>
    <ndc_label_name>KETOROLAC 30 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604401</ndc>
    <ndc_label_name>LORAZEPAM 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604425</ndc>
    <ndc_label_name>LORAZEPAM 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604501</ndc>
    <ndc_label_name>LORAZEPAM 4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604525</ndc>
    <ndc_label_name>LORAZEPAM 4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604601</ndc>
    <ndc_label_name>LORAZEPAM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604610</ndc>
    <ndc_label_name>LORAZEPAM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604701</ndc>
    <ndc_label_name>LORAZEPAM 40 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604710</ndc>
    <ndc_label_name>LORAZEPAM 40 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604801</ndc>
    <ndc_label_name>LORAZEPAM 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604825</ndc>
    <ndc_label_name>LORAZEPAM 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604901</ndc>
    <ndc_label_name>LORAZEPAM 4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641604925</ndc>
    <ndc_label_name>LORAZEPAM 4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605001</ndc>
    <ndc_label_name>LORAZEPAM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605010</ndc>
    <ndc_label_name>LORAZEPAM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605101</ndc>
    <ndc_label_name>LORAZEPAM 40 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605110</ndc>
    <ndc_label_name>LORAZEPAM 40 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605201</ndc>
    <ndc_label_name>MEPERIDINE 25 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605225</ndc>
    <ndc_label_name>MEPERIDINE 25 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605301</ndc>
    <ndc_label_name>MEPERIDINE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605325</ndc>
    <ndc_label_name>MEPERIDINE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605401</ndc>
    <ndc_label_name>MEPERIDINE 100 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605425</ndc>
    <ndc_label_name>MEPERIDINE 100 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605601</ndc>
    <ndc_label_name>MIDAZOLAM HCL 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605610</ndc>
    <ndc_label_name>MIDAZOLAM HCL 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605701</ndc>
    <ndc_label_name>MIDAZOLAM HCL 2 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605725</ndc>
    <ndc_label_name>MIDAZOLAM HCL 2 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605901</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641605910</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641606001</ndc>
    <ndc_label_name>MIDAZOLAM HCL 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641606010</ndc>
    <ndc_label_name>MIDAZOLAM HCL 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641606101</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641606125</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641606301</ndc>
    <ndc_label_name>MIDAZOLAM HCL 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641606325</ndc>
    <ndc_label_name>MIDAZOLAM HCL 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641607801</ndc>
    <ndc_label_name>ONDANSETRON HCL 4 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641607825</ndc>
    <ndc_label_name>ONDANSETRON HCL 4 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641607901</ndc>
    <ndc_label_name>ONDANSETRON 40 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641608001</ndc>
    <ndc_label_name>ONDANSETRON HCL 4 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641608025</ndc>
    <ndc_label_name>ONDANSETRON HCL 4 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641608201</ndc>
    <ndc_label_name>Phenergan 25 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641608225</ndc>
    <ndc_label_name>Phenergan 25 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641608301</ndc>
    <ndc_label_name>Phenergan 50 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641608325</ndc>
    <ndc_label_name>Phenergan 50 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641608401</ndc>
    <ndc_label_name>Phenergan 25 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641608425</ndc>
    <ndc_label_name>Phenergan 25 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641608501</ndc>
    <ndc_label_name>Phenergan 50 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641608525</ndc>
    <ndc_label_name>Phenergan 50 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641610301</ndc>
    <ndc_label_name>Robaxin 100 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641610310</ndc>
    <ndc_label_name>Robaxin 100 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641610325</ndc>
    <ndc_label_name>Robaxin 100 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641611601</ndc>
    <ndc_label_name>AMPICILLIN-SULBACTAM 1.5 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641611610</ndc>
    <ndc_label_name>AMPICILLIN-SULBACTAM 1.5 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641611701</ndc>
    <ndc_label_name>AMPICILLIN-SULBACTAM 3 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641611710</ndc>
    <ndc_label_name>AMPICILLIN-SULBACTAM 3 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641611801</ndc>
    <ndc_label_name>AMPICILLIN-SULBACTAM 15 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641612501</ndc>
    <ndc_label_name>MORPHINE SULFATE 4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641612525</ndc>
    <ndc_label_name>MORPHINE SULFATE 4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641612601</ndc>
    <ndc_label_name>MORPHINE SULFATE 8 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641612625</ndc>
    <ndc_label_name>MORPHINE SULFATE 8 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641612701</ndc>
    <ndc_label_name>MORPHINE SULFATE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641612725</ndc>
    <ndc_label_name>MORPHINE SULFATE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641613201</ndc>
    <ndc_label_name>NALOXONE 0.4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641613225</ndc>
    <ndc_label_name>NALOXONE 0.4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641613501</ndc>
    <ndc_label_name>PROCHLORPERAZINE 10 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641613525</ndc>
    <ndc_label_name>PROCHLORPERAZINE 10 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641613601</ndc>
    <ndc_label_name>FOSPHENYTOIN 100 MG PE/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641613625</ndc>
    <ndc_label_name>FOSPHENYTOIN 100 MG PE/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641613701</ndc>
    <ndc_label_name>FOSPHENYTOIN 500 MG PE/10 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641613710</ndc>
    <ndc_label_name>FOSPHENYTOIN 500 MG PE/10 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641613801</ndc>
    <ndc_label_name>PHENYTOIN 100 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641613825</ndc>
    <ndc_label_name>PHENYTOIN 100 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641613901</ndc>
    <ndc_label_name>PHENYTOIN 250 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641613910</ndc>
    <ndc_label_name>PHENYTOIN 250 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641613925</ndc>
    <ndc_label_name>PHENYTOIN 250 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641614201</ndc>
    <ndc_label_name>PHENYLEPHRINE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641614225</ndc>
    <ndc_label_name>PHENYLEPHRINE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641614501</ndc>
    <ndc_label_name>DEXAMETHASONE 4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641614525</ndc>
    <ndc_label_name>DEXAMETHASONE 4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641614601</ndc>
    <ndc_label_name>DEXAMETHASONE 20 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641614610</ndc>
    <ndc_label_name>DEXAMETHASONE 20 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641614625</ndc>
    <ndc_label_name>DEXAMETHASONE 20 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641614701</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641614710</ndc>
    <ndc_label_name>WATER FOR INJECTION VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641614901</ndc>
    <ndc_label_name>NEOSTIGMINE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641614910</ndc>
    <ndc_label_name>NEOSTIGMINE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641615001</ndc>
    <ndc_label_name>NEOSTIGMINE 5 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641615010</ndc>
    <ndc_label_name>NEOSTIGMINE 5 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641615101</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641615125</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641616401</ndc>
    <ndc_label_name>Cafcit 60 mg/3 mL (20 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641616410</ndc>
    <ndc_label_name>Cafcit 60 mg/3 mL (20 mg/mL) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641616601</ndc>
    <ndc_label_name>AMIKACIN SULF 1 GRAM/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641616610</ndc>
    <ndc_label_name>AMIKACIN SULF 1 GRAM/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641616701</ndc>
    <ndc_label_name>AMIKACIN SULF 500 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641616710</ndc>
    <ndc_label_name>AMIKACIN SULF 500 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641616901</ndc>
    <ndc_label_name>HYDROMORPHONE 1 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641616910</ndc>
    <ndc_label_name>HYDROMORPHONE 1 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641617001</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641617010</ndc>
    <ndc_label_name>HYDROMORPHONE 2 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641617301</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641617310</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641617401</ndc>
    <ndc_label_name>OCTREOTIDE ACET 50 MCG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641617410</ndc>
    <ndc_label_name>OCTREOTIDE ACET 50 MCG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641617501</ndc>
    <ndc_label_name>OCTREOTIDE ACET 100 MCG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641617510</ndc>
    <ndc_label_name>OCTREOTIDE ACET 100 MCG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641617601</ndc>
    <ndc_label_name>OCTREOTIDE ACET 500 MCG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641617610</ndc>
    <ndc_label_name>OCTREOTIDE ACET 500 MCG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641617701</ndc>
    <ndc_label_name>OCTREOTIDE 1,000 MCG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641617801</ndc>
    <ndc_label_name>OCTREOTIDE 5,000 MCG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641618201</ndc>
    <ndc_label_name>ORPHENADRINE 60 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641618210</ndc>
    <ndc_label_name>ORPHENADRINE 60 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641618225</ndc>
    <ndc_label_name>ORPHENADRINE 60 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641618401</ndc>
    <ndc_label_name>DIGOXIN 500 MCG/2 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641618425</ndc>
    <ndc_label_name>DIGOXIN 500 MCG/2 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641618801</ndc>
    <ndc_label_name>PHENYLEPHRINE 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641618810</ndc>
    <ndc_label_name>PHENYLEPHRINE 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641618901</ndc>
    <ndc_label_name>PHENYLEPHRINE 100 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641618910</ndc>
    <ndc_label_name>PHENYLEPHRINE 100 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641619001</ndc>
    <ndc_label_name>MIDAZOLAM HCL 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641619010</ndc>
    <ndc_label_name>MIDAZOLAM HCL 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641619101</ndc>
    <ndc_label_name>MORPHINE 2 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641619110</ndc>
    <ndc_label_name>MORPHINE 2 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641619201</ndc>
    <ndc_label_name>MORPHINE 4 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641619210</ndc>
    <ndc_label_name>MORPHINE 4 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641619301</ndc>
    <ndc_label_name>NALOXONE 0.4 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641619310</ndc>
    <ndc_label_name>NALOXONE 0.4 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641619401</ndc>
    <ndc_label_name>PROPOFOL 200 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641619410</ndc>
    <ndc_label_name>PROPOFOL 200 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641619501</ndc>
    <ndc_label_name>PROPOFOL 500 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641619520</ndc>
    <ndc_label_name>PROPOFOL 500 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641619601</ndc>
    <ndc_label_name>PROPOFOL 1,000 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641619610</ndc>
    <ndc_label_name>PROPOFOL 1,000 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641619901</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/ML SYRG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641619910</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/ML SYRG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641620401</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/0.5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641620410</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/0.5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641620501</ndc>
    <ndc_label_name>NALOXONE 2 MG/2 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641620510</ndc>
    <ndc_label_name>NALOXONE 2 MG/2 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641620601</ndc>
    <ndc_label_name>HYDROMORPHONE 0.5 MG/0.5ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641620610</ndc>
    <ndc_label_name>HYDROMORPHONE 0.5 MG/0.5ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641620701</ndc>
    <ndc_label_name>LORAZEPAM 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641620725</ndc>
    <ndc_label_name>LORAZEPAM 2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641620801</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00641620825</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641620901</ndc>
    <ndc_label_name>MIDAZOLAM HCL 2 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641620925</ndc>
    <ndc_label_name>MIDAZOLAM HCL 2 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621001</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621010</ndc>
    <ndc_label_name>MIDAZOLAM HCL 5 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621101</ndc>
    <ndc_label_name>MIDAZOLAM HCL 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621110</ndc>
    <ndc_label_name>MIDAZOLAM HCL 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621201</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.2 MG/ML SYRNG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621210</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.2 MG/ML SYRNG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621301</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.4 MG/2 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621310</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.4 MG/2 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621701</ndc>
    <ndc_label_name>Robaxin 100 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621710</ndc>
    <ndc_label_name>Robaxin 100 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621725</ndc>
    <ndc_label_name>Robaxin 100 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621901</ndc>
    <ndc_label_name>MIDAZOLAM 10 MG/2 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641621910</ndc>
    <ndc_label_name>MIDAZOLAM 10 MG/2 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641622001</ndc>
    <ndc_label_name>MIDAZOLAM 2 MG/2 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641622010</ndc>
    <ndc_label_name>MIDAZOLAM 2 MG/2 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641622801</ndc>
    <ndc_label_name>THIAMINE 200 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641622825</ndc>
    <ndc_label_name>THIAMINE 200 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641622901</ndc>
    <ndc_label_name>PHENYLEPHRINE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641622925</ndc>
    <ndc_label_name>PHENYLEPHRINE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641623101</ndc>
    <ndc_label_name>HYDRALAZINE 20 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641623125</ndc>
    <ndc_label_name>HYDRALAZINE 20 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641623401</ndc>
    <ndc_label_name>SUCCINYLCHOLINE 100 MG/5ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641623410</ndc>
    <ndc_label_name>SUCCINYLCHOLINE 100 MG/5ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641623601</ndc>
    <ndc_label_name>EPHEDRINE SULF 25 MG/5 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641623610</ndc>
    <ndc_label_name>EPHEDRINE SULF 25 MG/5 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641623801</ndc>
    <ndc_label_name>EPHEDRINE SULFATE 50 MG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641623825</ndc>
    <ndc_label_name>EPHEDRINE SULFATE 50 MG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624001</ndc>
    <ndc_label_name>NEOSTIGMINE 3 MG/3 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624010</ndc>
    <ndc_label_name>NEOSTIGMINE 3 MG/3 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624301</ndc>
    <ndc_label_name>DIAZEPAM 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624310</ndc>
    <ndc_label_name>DIAZEPAM 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624401</ndc>
    <ndc_label_name>DIAZEPAM 10 MG/2 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624410</ndc>
    <ndc_label_name>DIAZEPAM 10 MG/2 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624501</ndc>
    <ndc_label_name>Immphentiv 0.1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624510</ndc>
    <ndc_label_name>Immphentiv 0.1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624601</ndc>
    <ndc_label_name>Immphentiv 0.1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624610</ndc>
    <ndc_label_name>Immphentiv 0.1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624701</ndc>
    <ndc_label_name>FENTANYL 50 MCG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624725</ndc>
    <ndc_label_name>FENTANYL 50 MCG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624801</ndc>
    <ndc_label_name>FENTANYL 50 MCG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624810</ndc>
    <ndc_label_name>FENTANYL 50 MCG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624901</ndc>
    <ndc_label_name>FENTANYL 25 MCG/0.5 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641624910</ndc>
    <ndc_label_name>FENTANYL 25 MCG/0.5 ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641625101</ndc>
    <ndc_label_name>ATROPINE 8 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641625110</ndc>
    <ndc_label_name>ATROPINE 8 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641625201</ndc>
    <ndc_label_name>LABETALOL HCL 10 MG/2 ML SYRNG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641625210</ndc>
    <ndc_label_name>LABETALOL HCL 10 MG/2 ML SYRNG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641625301</ndc>
    <ndc_label_name>REGADENOSON 0.4 MG/5 ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641625401</ndc>
    <ndc_label_name>HYDROMORPHONE 40 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641625901</ndc>
    <ndc_label_name>HYDROMORPHONE 0.2 MG/ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641625910</ndc>
    <ndc_label_name>HYDROMORPHONE 0.2 MG/ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641626101</ndc>
    <ndc_label_name>SODIUM ACETATE 40 MEQ/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641626201</ndc>
    <ndc_label_name>SODIUM ACETATE 100 MEQ/50 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641626401</ndc>
    <ndc_label_name>NEOSTIGMINE 5 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641626410</ndc>
    <ndc_label_name>NEOSTIGMINE 5 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641626501</ndc>
    <ndc_label_name>NEOSTIGMINE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641626510</ndc>
    <ndc_label_name>NEOSTIGMINE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641626601</ndc>
    <ndc_label_name>METHADONE HCL 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641626701</ndc>
    <ndc_label_name>CAFFEINE CIT 60 MG/3 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641626710</ndc>
    <ndc_label_name>CAFFEINE CIT 60 MG/3 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641627401</ndc>
    <ndc_label_name>ATROPINE 0.4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641627425</ndc>
    <ndc_label_name>ATROPINE 0.4 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641627501</ndc>
    <ndc_label_name>ATROPINE 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641627525</ndc>
    <ndc_label_name>ATROPINE 1 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641627701</ndc>
    <ndc_label_name>NEOSTIGMINE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641627710</ndc>
    <ndc_label_name>NEOSTIGMINE 10 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641628101</ndc>
    <ndc_label_name>MIDAZOLAM HCL 2 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641628125</ndc>
    <ndc_label_name>MIDAZOLAM HCL 2 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641628201</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641628225</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 50 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641628401</ndc>
    <ndc_label_name>BUMETANIDE 1 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641628410</ndc>
    <ndc_label_name>BUMETANIDE 1 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641628501</ndc>
    <ndc_label_name>BUMETANIDE 2.5 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641628510</ndc>
    <ndc_label_name>BUMETANIDE 2.5 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641628601</ndc>
    <ndc_label_name>ONDANSETRON 40 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641921701</ndc>
    <ndc_label_name>DILTIAZEM 25 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641921710</ndc>
    <ndc_label_name>DILTIAZEM 25 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641921801</ndc>
    <ndc_label_name>DILTIAZEM 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641921810</ndc>
    <ndc_label_name>DILTIAZEM 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641921901</ndc>
    <ndc_label_name>DILTIAZEM 125 MG/25 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00641921910</ndc>
    <ndc_label_name>DILTIAZEM 125 MG/25 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642007030</ndc>
    <ndc_label_name>Vitafol-One 29 mg iron-1 mg-200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642007212</ndc>
    <ndc_label_name>Vitafol 65 mg-1 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642007530</ndc>
    <ndc_label_name>Select-OB + DHA 29 mg iron-1 mg-250 mg oral pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642007630</ndc>
    <ndc_label_name>Vitafol-OB+DHA 65 mg-1 mg-250 mg oral pack</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642007790</ndc>
    <ndc_label_name>Select-OB (folic acid) 29 mg iron-1 mg chewable tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642007912</ndc>
    <ndc_label_name>Vitafol-OB 65 mg-1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642009330</ndc>
    <ndc_label_name>Vitafol Ultra 29 mg iron-1 mg-200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642012090</ndc>
    <ndc_label_name>Select-OB 29 mg iron-1 mg chewable tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642012360</ndc>
    <ndc_label_name>Pregnitude 200 mcg-2,000 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642012590</ndc>
    <ndc_label_name>Vitafol Gummies 3.33 mg iron-0.33 mg chewable tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642020410</ndc>
    <ndc_label_name>Strovite Forte 10 mg-1 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642020790</ndc>
    <ndc_label_name>Strovite One 1 mg-1,000 unit-15 mg-5 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642401604</ndc>
    <ndc_label_name>Blues Away Postpartum Support 2 gram-10 gram-4 gram/236 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00642403030</ndc>
    <ndc_label_name>Stuart One 27 mg iron-800 mcg-200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00642746312</ndc>
    <ndc_label_name>BENZNIDAZOLE 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00642746410</ndc>
    <ndc_label_name>BENZNIDAZOLE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642746605</ndc>
    <ndc_label_name>Nuvessa 1.3 % (65 mg/5 gram) vaginal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642746606</ndc>
    <ndc_label_name>Nuvessa 1.3 % (65 mg/5 gram) vaginal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00642747001</ndc>
    <ndc_label_name>Slynd 4 mg (28) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00642747002</ndc>
    <ndc_label_name>Slynd 4 mg (28) tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642747101</ndc>
    <ndc_label_name>Tyblume 0.1 mg-20 mcg chewable tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00642747330</ndc>
    <ndc_label_name>Vitafol Fe Plus 90 mg iron-1 mg-200 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00650048110</ndc>
    <ndc_label_name>Systane Complete 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00650048111</ndc>
    <ndc_label_name>Systane Complete 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00650048155</ndc>
    <ndc_label_name>Systane Complete 0.6 % eye drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00651043206</ndc>
    <ndc_label_name>Systane Ultra (PF) 0.4 %-0.3 % eye drops in a dropperette</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00671011762</ndc>
    <ndc_label_name>Theraflu Nighttime PowerPod 25 mg-10 mg-650 mg oral powdr in container</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00682004801</ndc>
    <ndc_label_name>Hyclodex 0.012 %-0.002 %-0.046 % topical spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00682004901</ndc>
    <ndc_label_name>Hyclodex 0.012 %-0.002 %-0.046 % topical spray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00682005110</ndc>
    <ndc_label_name>Crotan 10 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00682005120</ndc>
    <ndc_label_name>Crotan 10 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00682005130</ndc>
    <ndc_label_name>Crotan 10 % lotion</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00682015060</ndc>
    <ndc_label_name>KETOPROFEN 75 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00682047516</ndc>
    <ndc_label_name>Mar-Cof CG 7.5 mg-225 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00682048016</ndc>
    <ndc_label_name>Mar-Cof BP 2 mg-30 mg-7.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00682157001</ndc>
    <ndc_label_name>Marnatal-F 60 mg iron-1 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00682300101</ndc>
    <ndc_label_name>Bacmin 27 mg iron-1 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703001801</ndc>
    <ndc_label_name>HYDROMORPHONE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703011001</ndc>
    <ndc_label_name>HYDROMORPHONE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703011003</ndc>
    <ndc_label_name>HYDROMORPHONE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703011301</ndc>
    <ndc_label_name>HYDROMORPHONE 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703011303</ndc>
    <ndc_label_name>HYDROMORPHONE 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703024101</ndc>
    <ndc_label_name>TRIAMCINOLONE ACET 40 MG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703024301</ndc>
    <ndc_label_name>TRIAMCINOLONE ACET 200 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703024501</ndc>
    <ndc_label_name>TRIAMCINOLONE ACET 400 MG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703066601</ndc>
    <ndc_label_name>TREPROSTINIL 20 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703067601</ndc>
    <ndc_label_name>TREPROSTINIL 50 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703068601</ndc>
    <ndc_label_name>TREPROSTINIL 100 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703069601</ndc>
    <ndc_label_name>TREPROSTINIL 200 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703203301</ndc>
    <ndc_label_name>CISATRACURIUM 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703203303</ndc>
    <ndc_label_name>CISATRACURIUM 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703204501</ndc>
    <ndc_label_name>CISATRACURIUM 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703204503</ndc>
    <ndc_label_name>CISATRACURIUM 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703205601</ndc>
    <ndc_label_name>CISATRACURIUM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703205603</ndc>
    <ndc_label_name>CISATRACURIUM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703301811</ndc>
    <ndc_label_name>Adrucil 2.5 gram/50 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703321301</ndc>
    <ndc_label_name>PACLITAXEL 30 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703321381</ndc>
    <ndc_label_name>PACLITAXEL 30 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703321601</ndc>
    <ndc_label_name>PACLITAXEL 100 MG/16.7 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703321681</ndc>
    <ndc_label_name>PACLITAXEL 100 MG/16.7 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703321701</ndc>
    <ndc_label_name>PACLITAXEL 150 MG/25 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703321801</ndc>
    <ndc_label_name>PACLITAXEL 300 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703321881</ndc>
    <ndc_label_name>PACLITAXEL 300 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00703367101</ndc>
    <ndc_label_name>METHOTREXATE 50 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00703367501</ndc>
    <ndc_label_name>METHOTREXATE 250 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00703367801</ndc>
    <ndc_label_name>METHOTREXATE 1 GRAM/40 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00703367881</ndc>
    <ndc_label_name>METHOTREXATE 1 GRAM/40 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703398501</ndc>
    <ndc_label_name>OXALIPLATIN 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703398601</ndc>
    <ndc_label_name>OXALIPLATIN 100 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703400401</ndc>
    <ndc_label_name>ROMIDEPSIN 27.5 MG/5.5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703409401</ndc>
    <ndc_label_name>PALONOSETRON 0.25 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703423901</ndc>
    <ndc_label_name>CARBOPLATIN 600 MG/60 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703423981</ndc>
    <ndc_label_name>CARBOPLATIN 600 MG/60 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703424401</ndc>
    <ndc_label_name>CARBOPLATIN 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703424481</ndc>
    <ndc_label_name>CARBOPLATIN 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703424601</ndc>
    <ndc_label_name>CARBOPLATIN 150 MG/15 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703424681</ndc>
    <ndc_label_name>CARBOPLATIN 150 MG/15 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703424801</ndc>
    <ndc_label_name>CARBOPLATIN 450 MG/45 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703424881</ndc>
    <ndc_label_name>CARBOPLATIN 450 MG/45 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703440211</ndc>
    <ndc_label_name>Vincasar PFS 1 mg/mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703441211</ndc>
    <ndc_label_name>Vincasar PFS 2 mg/2 mL intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703450201</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703450204</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703450291</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703450293</ndc>
    <ndc_label_name>METOCLOPRAMIDE 10 MG/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703463601</ndc>
    <ndc_label_name>Zanosar 1 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703574711</ndc>
    <ndc_label_name>CISPLATIN 50 MG/50 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703574811</ndc>
    <ndc_label_name>CISPLATIN 100 MG/100 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703950301</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP IV VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703950303</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP IV VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703951401</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP IV VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703951403</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP IV VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703951481</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP IV VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703951483</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP IV VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703951491</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP IV VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703951493</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP IV VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703952601</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP IV VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00703952681</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP IV VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713013206</ndc>
    <ndc_label_name>Promethegan 50 mg rectal suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713013212</ndc>
    <ndc_label_name>Promethegan 50 mg rectal suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713013506</ndc>
    <ndc_label_name>PROCHLORPERAZINE 25 MG SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713013512</ndc>
    <ndc_label_name>PROCHLORPERAZINE 25 MG SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713016612</ndc>
    <ndc_label_name>Migergot 2 mg-100 mg rectal suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022315</ndc>
    <ndc_label_name>FLUOCINOLONE 0.01% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022360</ndc>
    <ndc_label_name>FLUOCINOLONE 0.01% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022415</ndc>
    <ndc_label_name>FLUOCINOLONE 0.025% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022460</ndc>
    <ndc_label_name>FLUOCINOLONE 0.025% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022515</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022531</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022580</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022615</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.025% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022680</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.025% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022815</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022831</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022880</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022915</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.025% OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713022980</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.025% OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713026831</ndc>
    <ndc_label_name>Triple Antibiotic 3.5 mg-400 unit-5,000 unit/gram topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713028031</ndc>
    <ndc_label_name>BACITRACIN 500 UNIT/GM OINTMNT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713031853</ndc>
    <ndc_label_name>CALCIPOTRIENE 0.005% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713032615</ndc>
    <ndc_label_name>BETAMETHASONE VA 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713032637</ndc>
    <ndc_label_name>BETAMETHASONE VA 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713032715</ndc>
    <ndc_label_name>BETAMETHASONE VALER 0.1% OINTM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713032737</ndc>
    <ndc_label_name>BETAMETHASONE VALER 0.1% OINTM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713033915</ndc>
    <ndc_label_name>HALOBETASOL PROP 0.05% OINTMNT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713033986</ndc>
    <ndc_label_name>HALOBETASOL PROP 0.05% OINTMNT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713035102</ndc>
    <ndc_label_name>PROCHLORPERAZINE 10 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713035109</ndc>
    <ndc_label_name>PROCHLORPERAZINE 10 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713035125</ndc>
    <ndc_label_name>PROCHLORPERAZINE 10 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713035281</ndc>
    <ndc_label_name>BETAINE 1 GRAM/SCOOP POWDER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713035302</ndc>
    <ndc_label_name>DOCOSANOL 10% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713035362</ndc>
    <ndc_label_name>DOCOSANOL 10% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713049312</ndc>
    <ndc_label_name>HYDROCORTISONE AC 30 MG SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713050301</ndc>
    <ndc_label_name>Anucort-HC 25 mg suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713050306</ndc>
    <ndc_label_name>Anucort-HC 25 mg suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713050312</ndc>
    <ndc_label_name>Anucort-HC 25 mg suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713050324</ndc>
    <ndc_label_name>Anucort-HC 25 mg suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713052606</ndc>
    <ndc_label_name>Promethegan 25 mg rectal suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713052612</ndc>
    <ndc_label_name>Promethegan 25 mg rectal suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713053606</ndc>
    <ndc_label_name>Promethegan 12.5 mg rectal suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713053612</ndc>
    <ndc_label_name>Promethegan 12.5 mg rectal suppository</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713055273</ndc>
    <ndc_label_name>TERCONAZOLE 80 MG SUPPOSITORY</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713056015</ndc>
    <ndc_label_name>HYDROCORTISONE VAL 0.2% OINTMT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713056037</ndc>
    <ndc_label_name>HYDROCORTISONE VAL 0.2% OINTMT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713056060</ndc>
    <ndc_label_name>HYDROCORTISONE VAL 0.2% OINTMT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713056431</ndc>
    <ndc_label_name>NITROGLYCERIN 0.4% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713057460</ndc>
    <ndc_label_name>METRONIDAZOLE TOPICAL 1% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713057571</ndc>
    <ndc_label_name>METRONIDAZOLE VAGINAL 0.75% GL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713059204</ndc>
    <ndc_label_name>KETOCONAZOLE 2% SHAMPOO</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713059377</ndc>
    <ndc_label_name>MICONAZOLE 3-DAY COMBO PACK</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713062231</ndc>
    <ndc_label_name>Triple Antibiotic Plus 3.5 mg-500 unit-10,000 unit/gram top ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063115</ndc>
    <ndc_label_name>FLUTICASONE PROP 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063131</ndc>
    <ndc_label_name>FLUTICASONE PROP 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063160</ndc>
    <ndc_label_name>FLUTICASONE PROP 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063215</ndc>
    <ndc_label_name>FLUTICASONE PROP 0.005% OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063231</ndc>
    <ndc_label_name>FLUTICASONE PROP 0.005% OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063260</ndc>
    <ndc_label_name>FLUTICASONE PROP 0.005% OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063337</ndc>
    <ndc_label_name>METRONIDAZOLE 0.75% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063415</ndc>
    <ndc_label_name>MOMETASONE FUROATE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063437</ndc>
    <ndc_label_name>MOMETASONE FUROATE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063515</ndc>
    <ndc_label_name>MOMETASONE FUROATE 0.1% OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063537</ndc>
    <ndc_label_name>MOMETASONE FUROATE 0.1% OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063737</ndc>
    <ndc_label_name>METRONIDAZOLE TOPICAL 0.75% GL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063815</ndc>
    <ndc_label_name>CICLOPIROX 0.77% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063818</ndc>
    <ndc_label_name>CICLOPIROX 0.77% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713063831</ndc>
    <ndc_label_name>CICLOPIROX 0.77% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713064015</ndc>
    <ndc_label_name>HALOBETASOL PROP 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713064086</ndc>
    <ndc_label_name>HALOBETASOL PROP 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713065540</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% PASTE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713065615</ndc>
    <ndc_label_name>CLOBETASOL 0.05% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713065631</ndc>
    <ndc_label_name>CLOBETASOL 0.05% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713065637</ndc>
    <ndc_label_name>CLOBETASOL 0.05% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713065660</ndc>
    <ndc_label_name>CLOBETASOL 0.05% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713065915</ndc>
    <ndc_label_name>BETAMETHASONE DP 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713065937</ndc>
    <ndc_label_name>BETAMETHASONE DP 0.05% CRM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713066115</ndc>
    <ndc_label_name>DESONIDE 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713066160</ndc>
    <ndc_label_name>DESONIDE 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713066315</ndc>
    <ndc_label_name>FLUOCINONIDE 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713066331</ndc>
    <ndc_label_name>FLUOCINONIDE 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713066360</ndc>
    <ndc_label_name>FLUOCINONIDE 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713066415</ndc>
    <ndc_label_name>FLUOCINONIDE-E 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713066431</ndc>
    <ndc_label_name>FLUOCINONIDE-E 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713066460</ndc>
    <ndc_label_name>FLUOCINONIDE-E 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713067031</ndc>
    <ndc_label_name>TAZAROTENE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713067060</ndc>
    <ndc_label_name>TAZAROTENE 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713067653</ndc>
    <ndc_label_name>TRIAMCINOLONE 0.1% LOTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713067815</ndc>
    <ndc_label_name>NYSTATIN 100,000 UNIT/GM CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713067831</ndc>
    <ndc_label_name>NYSTATIN 100,000 UNIT/GM CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713068215</ndc>
    <ndc_label_name>GENTAMICIN 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713068231</ndc>
    <ndc_label_name>GENTAMICIN 0.1% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713068315</ndc>
    <ndc_label_name>GENTAMICIN 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713068331</ndc>
    <ndc_label_name>GENTAMICIN 0.1% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713068615</ndc>
    <ndc_label_name>NYSTATIN 100,000 UNIT/GM OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713068631</ndc>
    <ndc_label_name>NYSTATIN 100,000 UNIT/GM OINT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713070915</ndc>
    <ndc_label_name>FLUOCINOLONE 0.025% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713070960</ndc>
    <ndc_label_name>FLUOCINOLONE 0.025% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713072015</ndc>
    <ndc_label_name>HYDROCORTISONE VAL 0.2% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713072037</ndc>
    <ndc_label_name>HYDROCORTISONE VAL 0.2% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713072060</ndc>
    <ndc_label_name>HYDROCORTISONE VAL 0.2% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713076531</ndc>
    <ndc_label_name>TAZAROTENE 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713076560</ndc>
    <ndc_label_name>TAZAROTENE 0.05% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713078075</ndc>
    <ndc_label_name>PROMETHAZINE-DM 6.25-15 MG/5ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713079175</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713080431</ndc>
    <ndc_label_name>TAZAROTENE 0.1% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713080499</ndc>
    <ndc_label_name>TAZAROTENE 0.1% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713080531</ndc>
    <ndc_label_name>TAZAROTENE 0.05% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713080599</ndc>
    <ndc_label_name>TAZAROTENE 0.05% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713080753</ndc>
    <ndc_label_name>BETAMETHASONE DP 0.05% LOT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713082375</ndc>
    <ndc_label_name>PROMETHAZINE-CODEINE SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713084860</ndc>
    <ndc_label_name>CALCIPOTRIENE-BETAMETH DP SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713084892</ndc>
    <ndc_label_name>CALCIPOTRIENE-BETAMETH DP SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713084909</ndc>
    <ndc_label_name>HYDROCORTISONE-ACETIC EAR DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00713085004</ndc>
    <ndc_label_name>GRISEOFULVIN 125 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713085109</ndc>
    <ndc_label_name>CIPROFLOXACIN-HYDROCORT 0.2-1%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713086030</ndc>
    <ndc_label_name>Benicar 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713086130</ndc>
    <ndc_label_name>Benicar 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713086230</ndc>
    <ndc_label_name>Benicar 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713086330</ndc>
    <ndc_label_name>Benicar HCT 20 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713086430</ndc>
    <ndc_label_name>Benicar HCT 40 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713086530</ndc>
    <ndc_label_name>Benicar HCT 40 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713087030</ndc>
    <ndc_label_name>Azor 5 mg-20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713087130</ndc>
    <ndc_label_name>Azor 10 mg-20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713087230</ndc>
    <ndc_label_name>Azor 5 mg-40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713087330</ndc>
    <ndc_label_name>Azor 10 mg-40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713087430</ndc>
    <ndc_label_name>Tribenzor 20 mg-5 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713087530</ndc>
    <ndc_label_name>Tribenzor 40 mg-5 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713087630</ndc>
    <ndc_label_name>Tribenzor 40 mg-5 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713087730</ndc>
    <ndc_label_name>Tribenzor 40 mg-10 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713087830</ndc>
    <ndc_label_name>Tribenzor 40 mg-10 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713087981</ndc>
    <ndc_label_name>WelChol 625 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713088030</ndc>
    <ndc_label_name>WelChol 3.75 gram oral powder packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713088130</ndc>
    <ndc_label_name>Effient 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713088230</ndc>
    <ndc_label_name>Effient 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713088301</ndc>
    <ndc_label_name>Evoxac 30 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713088506</ndc>
    <ndc_label_name>Clomid 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713088509</ndc>
    <ndc_label_name>Clomid 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713088530</ndc>
    <ndc_label_name>Clomid 50 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713088618</ndc>
    <ndc_label_name>DAPSONE 5% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713088660</ndc>
    <ndc_label_name>DAPSONE 5% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713089704</ndc>
    <ndc_label_name>Vyleesi 1.75 mg/0.3 mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713089706</ndc>
    <ndc_label_name>Vyleesi 1.75 mg/0.3 mL subcutaneous auto-injector</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713093681</ndc>
    <ndc_label_name>COLESEVELAM 625 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713093701</ndc>
    <ndc_label_name>CEVIMELINE HCL 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713094030</ndc>
    <ndc_label_name>Benicar 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713094130</ndc>
    <ndc_label_name>Benicar 20 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713094230</ndc>
    <ndc_label_name>Benicar 40 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713094330</ndc>
    <ndc_label_name>Benicar HCT 20 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713094430</ndc>
    <ndc_label_name>Benicar HCT 40 mg-12.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713094530</ndc>
    <ndc_label_name>Benicar HCT 40 mg-25 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713540101</ndc>
    <ndc_label_name>Ambien 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713542101</ndc>
    <ndc_label_name>Ambien 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713550101</ndc>
    <ndc_label_name>Ambien CR 6.25 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00713552101</ndc>
    <ndc_label_name>Ambien CR 12.5 mg tablet,extended release</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00731040106</ndc>
    <ndc_label_name>Zinc-220 50 mg zinc (220 mg) capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761001920</ndc>
    <ndc_label_name>CALCIUM-MAG-ZINC-VIT D TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761002120</ndc>
    <ndc_label_name>SELENIUM 50 MCG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761007820</ndc>
    <ndc_label_name>ZINC 50 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761008624</ndc>
    <ndc_label_name>BIOTIN 5,000 MCG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761009420</ndc>
    <ndc_label_name>VITAMIN C 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761009450</ndc>
    <ndc_label_name>VITAMIN C 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761010230</ndc>
    <ndc_label_name>VITAMIN B COMPLEX-VIT C CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761011110</ndc>
    <ndc_label_name>ZINC 15 MG-VIT A-VIT C LOZ</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761011210</ndc>
    <ndc_label_name>L-ARGININE 500 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761015540</ndc>
    <ndc_label_name>MELATONIN 5 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761021736</ndc>
    <ndc_label_name>GLUCOSAMINE 500 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761022020</ndc>
    <ndc_label_name>Senna Laxative 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761022120</ndc>
    <ndc_label_name>VITAMIN B-12 TR 1,000 MCG TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761022520</ndc>
    <ndc_label_name>B-COMPLEX TR 100 TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761023408</ndc>
    <ndc_label_name>NATURAL LUTEIN 20 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761023920</ndc>
    <ndc_label_name>NIACIN 100 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761029220</ndc>
    <ndc_label_name>GARLIC OIL 1000 SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761030020</ndc>
    <ndc_label_name>VITAMIN E 45 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761030220</ndc>
    <ndc_label_name>VITAMIN E 180 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761035920</ndc>
    <ndc_label_name>Senna-S 8.6 mg-50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761036150</ndc>
    <ndc_label_name>DAILY MULTIVITAMIN WITH D3 TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761036250</ndc>
    <ndc_label_name>Daily Multivitamin with Iron 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761037920</ndc>
    <ndc_label_name>VITAMIN C 1,000 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761041420</ndc>
    <ndc_label_name>Laxa Basic 100 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761043310</ndc>
    <ndc_label_name>VITAMIN A 3,000 MCG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761043620</ndc>
    <ndc_label_name>VITAMIN B-6 50 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761044020</ndc>
    <ndc_label_name>VITAMIN B-12 500 MCG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761044110</ndc>
    <ndc_label_name>Sleep Tonite Valerian 750 mg-100 mg-25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761051520</ndc>
    <ndc_label_name>ACIDOPHILUS 30 MILLION CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761055520</ndc>
    <ndc_label_name>VITAMIN B-1 100 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761061516</ndc>
    <ndc_label_name>GELATIN 10 GR CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761081212</ndc>
    <ndc_label_name>CALCIUM 600-VIT D3 200 TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00761083920</ndc>
    <ndc_label_name>Super B-50 Complex 400 mcg-20 mg-50 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761084420</ndc>
    <ndc_label_name>VITAMIN C 500 MG TABLET CHEW</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761087840</ndc>
    <ndc_label_name>FOLIC ACID 400 MCG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00761094020</ndc>
    <ndc_label_name>IRON 65 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766041976</ndc>
    <ndc_label_name>Citrucel 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766041978</ndc>
    <ndc_label_name>Citrucel 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766041980</ndc>
    <ndc_label_name>Citrucel 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766049358</ndc>
    <ndc_label_name>Abreva 10 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766073966</ndc>
    <ndc_label_name>Tums E-X 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766074020</ndc>
    <ndc_label_name>Tums 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766074062</ndc>
    <ndc_label_name>Tums 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766074120</ndc>
    <ndc_label_name>Tums 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766074152</ndc>
    <ndc_label_name>Tums 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766074610</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766074650</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766074655</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766074670</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766074680</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766074772</ndc>
    <ndc_label_name>Tums 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766080155</ndc>
    <ndc_label_name>Abreva 10 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766117314</ndc>
    <ndc_label_name>Gaviscon Extra Strength 254 mg-237.5 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766117325</ndc>
    <ndc_label_name>Gaviscon Extra Strength 160 mg-105 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766131246</ndc>
    <ndc_label_name>Nicorette 2 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766140015</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766140017</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766140025</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766142020</ndc>
    <ndc_label_name>Nicoderm CQ 21 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766143020</ndc>
    <ndc_label_name>Nicoderm CQ 14 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766143050</ndc>
    <ndc_label_name>Nicoderm CQ 14 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766144020</ndc>
    <ndc_label_name>Nicoderm CQ 7 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766145020</ndc>
    <ndc_label_name>Nicoderm CQ 21 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766147020</ndc>
    <ndc_label_name>Nicoderm CQ 21 mg/24 hr daily transdermal patch</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766150010</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766150012</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766150020</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766150022</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766155130</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766155132</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766155170</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766155172</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766157265</ndc>
    <ndc_label_name>Nicorette 2 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766157285</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766286210</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766286220</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766287589</ndc>
    <ndc_label_name>Citrucel Sugar Free oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766307210</ndc>
    <ndc_label_name>Tums E-X 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766307214</ndc>
    <ndc_label_name>Tums Ultra 400 mg (as calcium carbonate 1,000 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766307278</ndc>
    <ndc_label_name>Abreva Rapid Pain Relief 4 %-20 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766307295</ndc>
    <ndc_label_name>Tums-Gas Relief (calcium carb-simethicone) 750 mg-80mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766307298</ndc>
    <ndc_label_name>Tums-Gas Relief (calcium carb-simethicone) 750 mg-80mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766307419</ndc>
    <ndc_label_name>Tums Gummy 250 mg calcium chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766307425</ndc>
    <ndc_label_name>Tums Plus Ginger 167 mg-16.7 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766307457</ndc>
    <ndc_label_name>Abreva Rapid Pain Relief 4 %-20 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766307480</ndc>
    <ndc_label_name>Eroxon topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766307554</ndc>
    <ndc_label_name>Tums-Gas Relief (calcium carb-simethicone) 750 mg-80mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766307557</ndc>
    <ndc_label_name>Tums-Gas Relief (calcium carb-simethicone) 750 mg-80mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766725000</ndc>
    <ndc_label_name>Tums Extra Strength Smoothies 300 mg (as carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766738808</ndc>
    <ndc_label_name>Tums E-X 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766739070</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766739274</ndc>
    <ndc_label_name>Tums Extra Strength Smoothies 300 mg (as carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766739287</ndc>
    <ndc_label_name>Tums Extra Strength Smoothies 300 mg (as carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766742991</ndc>
    <ndc_label_name>Tums Extra Strength Smoothies 300 mg (as carb 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766775000</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766775025</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766775030</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766775052</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766775054</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766776000</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766776030</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766776052</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766776054</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784340</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784420</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784440</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784508</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784560</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784708</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784714</ndc>
    <ndc_label_name>Nicorette 4 mg buccal lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784750</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784760</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784911</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784914</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784931</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784934</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784950</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766784955</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766785840</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766785870</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766785922</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766785940</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766786750</ndc>
    <ndc_label_name>Nicorette 2 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766786760</ndc>
    <ndc_label_name>Nicorette 4 mg gum</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766788000</ndc>
    <ndc_label_name>Nicorette 2 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766788040</ndc>
    <ndc_label_name>Nicorette 2 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766788050</ndc>
    <ndc_label_name>Nicorette 4 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766788070</ndc>
    <ndc_label_name>Nicorette 4 mg buccal mini lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766796025</ndc>
    <ndc_label_name>Tums Dual Action (famotidine) 10 mg-800 mg-165 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00766796050</ndc>
    <ndc_label_name>Tums Dual Action (famotidine) 10 mg-800 mg-165 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00766798000</ndc>
    <ndc_label_name>Tums 300 mg (as calcium carbonate 750 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00774031773</ndc>
    <ndc_label_name>Bullfrog Mosquito Coast 20 %-SPF 30 topical spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00777310402</ndc>
    <ndc_label_name>Prozac 10 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00777310502</ndc>
    <ndc_label_name>Prozac 20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00777310530</ndc>
    <ndc_label_name>Prozac 20 mg capsule</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00777310730</ndc>
    <ndc_label_name>PROZAC 40 MG PULVULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781106101</ndc>
    <ndc_label_name>ALPRAZOLAM 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781106105</ndc>
    <ndc_label_name>ALPRAZOLAM 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781106110</ndc>
    <ndc_label_name>ALPRAZOLAM 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781107701</ndc>
    <ndc_label_name>ALPRAZOLAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781107705</ndc>
    <ndc_label_name>ALPRAZOLAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781107710</ndc>
    <ndc_label_name>ALPRAZOLAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781107901</ndc>
    <ndc_label_name>ALPRAZOLAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781107905</ndc>
    <ndc_label_name>ALPRAZOLAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781107910</ndc>
    <ndc_label_name>ALPRAZOLAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781108901</ndc>
    <ndc_label_name>ALPRAZOLAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781108905</ndc>
    <ndc_label_name>ALPRAZOLAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781148601</ndc>
    <ndc_label_name>AMITRIPTYLINE HCL 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781148610</ndc>
    <ndc_label_name>AMITRIPTYLINE HCL 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781148701</ndc>
    <ndc_label_name>AMITRIPTYLINE HCL 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781148710</ndc>
    <ndc_label_name>AMITRIPTYLINE HCL 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781148801</ndc>
    <ndc_label_name>AMITRIPTYLINE HCL 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781148810</ndc>
    <ndc_label_name>AMITRIPTYLINE HCL 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781148901</ndc>
    <ndc_label_name>AMITRIPTYLINE HCL 75 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781149001</ndc>
    <ndc_label_name>AMITRIPTYLINE HCL 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781149101</ndc>
    <ndc_label_name>AMITRIPTYLINE HCL 150 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781155601</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781155610</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781163501</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781163510</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781169501</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781169510</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781183101</ndc>
    <ndc_label_name>AMOX-CLAV 500-125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781183120</ndc>
    <ndc_label_name>AMOX-CLAV 500-125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781185201</ndc>
    <ndc_label_name>AMOX-CLAV 875-125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781185220</ndc>
    <ndc_label_name>AMOX-CLAV 875-125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781187431</ndc>
    <ndc_label_name>AMOX-CLAV 250-125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781194339</ndc>
    <ndc_label_name>AMOX-CLAV ER 1,000-62.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781194382</ndc>
    <ndc_label_name>AMOX-CLAV ER 1,000-62.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781196160</ndc>
    <ndc_label_name>CLARITHROMYCIN 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781196260</ndc>
    <ndc_label_name>CLARITHROMYCIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781202001</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781202005</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781202701</ndc>
    <ndc_label_name>CLOMIPRAMINE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781203701</ndc>
    <ndc_label_name>CLOMIPRAMINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781206701</ndc>
    <ndc_label_name>MYCOPHENOLATE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781206705</ndc>
    <ndc_label_name>MYCOPHENOLATE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781206789</ndc>
    <ndc_label_name>MYCOPHENOLATE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781207401</ndc>
    <ndc_label_name>TRIAMTERENE-HCTZ 37.5-25 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781207410</ndc>
    <ndc_label_name>TRIAMTERENE-HCTZ 37.5-25 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781207601</ndc>
    <ndc_label_name>TAMSULOSIN HCL 0.4 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781208102</ndc>
    <ndc_label_name>CALCIUM ACETATE 667 MG GELCAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781210201</ndc>
    <ndc_label_name>TACROLIMUS 0.5 MG CAPSULE (IR)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781210301</ndc>
    <ndc_label_name>TACROLIMUS 1 MG CAPSULE (IR)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781210401</ndc>
    <ndc_label_name>TACROLIMUS 5 MG CAPSULE (IR)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781214501</ndc>
    <ndc_label_name>AMPICILLIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781214505</ndc>
    <ndc_label_name>AMPICILLIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781215832</ndc>
    <ndc_label_name>PIRFENIDONE 267 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781216460</ndc>
    <ndc_label_name>ZIPRASIDONE HCL 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781216660</ndc>
    <ndc_label_name>ZIPRASIDONE HCL 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781216760</ndc>
    <ndc_label_name>ZIPRASIDONE HCL 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781216860</ndc>
    <ndc_label_name>ZIPRASIDONE HCL 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781223401</ndc>
    <ndc_label_name>OMEPRAZOLE DR 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781223410</ndc>
    <ndc_label_name>OMEPRAZOLE DR 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781223431</ndc>
    <ndc_label_name>OMEPRAZOLE DR 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781227001</ndc>
    <ndc_label_name>BUTALBITAL-ASPIRIN-CAFFEINE CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781229901</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781232106</ndc>
    <ndc_label_name>APREPITANT 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781232151</ndc>
    <ndc_label_name>APREPITANT 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781232206</ndc>
    <ndc_label_name>APREPITANT 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781232246</ndc>
    <ndc_label_name>APREPITANT 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781232268</ndc>
    <ndc_label_name>APREPITANT 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781232306</ndc>
    <ndc_label_name>APREPITANT 125 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781232368</ndc>
    <ndc_label_name>APREPITANT 125 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781236101</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(LA) 10MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781236201</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(LA) 20MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781236301</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(LA) 30MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781236401</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(LA) 40MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781238301</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(LA) 10MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781238401</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(LA) 20MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781238501</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(LA) 30MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781238601</ndc>
    <ndc_label_name>METHYLPHENIDATE ER(LA) 40MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781247601</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781247701</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781247801</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781247901</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781248001</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781248101</ndc>
    <ndc_label_name>LISDEXAMFETAMINE 70 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781249260</ndc>
    <ndc_label_name>NINTEDANIB ESYLATE 100 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781249560</ndc>
    <ndc_label_name>NINTEDANIB ESYLATE 150 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781261301</ndc>
    <ndc_label_name>AMOXICILLIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781261305</ndc>
    <ndc_label_name>AMOXICILLIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781285901</ndc>
    <ndc_label_name>OMEPRAZOLE DR 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781285910</ndc>
    <ndc_label_name>OMEPRAZOLE DR 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781285931</ndc>
    <ndc_label_name>OMEPRAZOLE DR 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781286801</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781286810</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781286831</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781286892</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781300095</ndc>
    <ndc_label_name>MEROPENEM IV 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781300107</ndc>
    <ndc_label_name>Omnitrope 5 mg/1.5 mL (3.3 mg/mL) subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781300407</ndc>
    <ndc_label_name>Omnitrope 10 mg/1.5 mL (6.7 mg/mL) subcutaneous cartridge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781300642</ndc>
    <ndc_label_name>LEUPROLIDE 2WK 14 MG/2.8 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781304072</ndc>
    <ndc_label_name>Regonol 5 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781304095</ndc>
    <ndc_label_name>Regonol 5 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781305670</ndc>
    <ndc_label_name>ISONIAZID 100 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781305972</ndc>
    <ndc_label_name>DIGOXIN 500 MCG/2 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781305995</ndc>
    <ndc_label_name>DIGOXIN 500 MCG/2 ML AMPULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781309894</ndc>
    <ndc_label_name>MEROPENEM IV 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781309895</ndc>
    <ndc_label_name>MEROPENEM IV 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781311090</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 2.25 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781311095</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 2.25 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781311390</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 3.375 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781311395</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 3.375 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781311491</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 4.5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781311495</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 4.5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781315075</ndc>
    <ndc_label_name>CISATRACURIUM 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781315095</ndc>
    <ndc_label_name>CISATRACURIUM 10 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781315270</ndc>
    <ndc_label_name>CISATRACURIUM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781315295</ndc>
    <ndc_label_name>CISATRACURIUM 20 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781315380</ndc>
    <ndc_label_name>CISATRACURIUM 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781315395</ndc>
    <ndc_label_name>CISATRACURIUM 200 MG/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781315401</ndc>
    <ndc_label_name>FERUMOXYTOL 510 MG/17 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781315606</ndc>
    <ndc_label_name>ACETAMINOPHEN 1,000MG/100ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781315695</ndc>
    <ndc_label_name>ACETAMINOPHEN 1,000MG/100ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781315894</ndc>
    <ndc_label_name>BIVALIRUDIN 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781315895</ndc>
    <ndc_label_name>BIVALIRUDIN 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781315972</ndc>
    <ndc_label_name>OLANZAPINE 10 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781318094</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 40.5 GRAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781320685</ndc>
    <ndc_label_name>CEFTRIAXONE 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781320695</ndc>
    <ndc_label_name>CEFTRIAXONE 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781320785</ndc>
    <ndc_label_name>CEFTRIAXONE 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781320795</ndc>
    <ndc_label_name>CEFTRIAXONE 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781320885</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781320895</ndc>
    <ndc_label_name>CEFTRIAXONE 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781320990</ndc>
    <ndc_label_name>CEFTRIAXONE 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781320995</ndc>
    <ndc_label_name>CEFTRIAXONE 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781321046</ndc>
    <ndc_label_name>CEFTRIAXONE 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781322075</ndc>
    <ndc_label_name>ROCURONIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781322092</ndc>
    <ndc_label_name>ROCURONIUM 100 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781322095</ndc>
    <ndc_label_name>ROCURONIUM 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781323295</ndc>
    <ndc_label_name>PANTOPRAZOLE SODIUM 40 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781323394</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781323434</ndc>
    <ndc_label_name>Glatopa 20 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781323471</ndc>
    <ndc_label_name>Glatopa 20 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781323801</ndc>
    <ndc_label_name>ENOXAPARIN 30 MG/0.3 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781323863</ndc>
    <ndc_label_name>ENOXAPARIN 30 MG/0.3 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781324494</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781324602</ndc>
    <ndc_label_name>ENOXAPARIN 40 MG/0.4 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781324664</ndc>
    <ndc_label_name>ENOXAPARIN 40 MG/0.4 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781325071</ndc>
    <ndc_label_name>Glatopa 40 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781325089</ndc>
    <ndc_label_name>Glatopa 40 mg/mL subcutaneous syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781325594</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781325603</ndc>
    <ndc_label_name>ENOXAPARIN 60 MG/0.6 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781325666</ndc>
    <ndc_label_name>ENOXAPARIN 60 MG/0.6 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781326204</ndc>
    <ndc_label_name>ENOXAPARIN 80 MG/0.8 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781326268</ndc>
    <ndc_label_name>ENOXAPARIN 80 MG/0.8 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781326805</ndc>
    <ndc_label_name>ENOXAPARIN 100 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781326869</ndc>
    <ndc_label_name>ENOXAPARIN 100 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781326971</ndc>
    <ndc_label_name>EPHEDRINE SULFATE 50 MG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781326995</ndc>
    <ndc_label_name>EPHEDRINE SULFATE 50 MG/ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781328809</ndc>
    <ndc_label_name>CLINDAMYCIN 300 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781328891</ndc>
    <ndc_label_name>CLINDAMYCIN 300 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781328909</ndc>
    <ndc_label_name>CLINDAMYCIN 600 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781328991</ndc>
    <ndc_label_name>CLINDAMYCIN 600 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781329009</ndc>
    <ndc_label_name>CLINDAMYCIN 900 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781329091</ndc>
    <ndc_label_name>CLINDAMYCIN 900 MG/50 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781329804</ndc>
    <ndc_label_name>ENOXAPARIN 120 MG/0.8 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781329868</ndc>
    <ndc_label_name>ENOXAPARIN 120 MG/0.8 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781329905</ndc>
    <ndc_label_name>ENOXAPARIN 150 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781329969</ndc>
    <ndc_label_name>ENOXAPARIN 150 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781331275</ndc>
    <ndc_label_name>PALONOSETRON 0.25 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781331295</ndc>
    <ndc_label_name>PALONOSETRON 0.25 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781331570</ndc>
    <ndc_label_name>OXALIPLATIN 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781331780</ndc>
    <ndc_label_name>OXALIPLATIN 100 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781339194</ndc>
    <ndc_label_name>ERIBULIN MESYLATE 1 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781340278</ndc>
    <ndc_label_name>AMPICILLIN 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781340295</ndc>
    <ndc_label_name>AMPICILLIN 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781340485</ndc>
    <ndc_label_name>AMPICILLIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781340495</ndc>
    <ndc_label_name>AMPICILLIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781340778</ndc>
    <ndc_label_name>AMPICILLIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781340795</ndc>
    <ndc_label_name>AMPICILLIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781340880</ndc>
    <ndc_label_name>AMPICILLIN 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781340895</ndc>
    <ndc_label_name>AMPICILLIN 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781340946</ndc>
    <ndc_label_name>AMPICILLIN 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781340995</ndc>
    <ndc_label_name>AMPICILLIN 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781341170</ndc>
    <ndc_label_name>Anectine 20 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781341195</ndc>
    <ndc_label_name>Anectine 20 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781341292</ndc>
    <ndc_label_name>AMPICILLIN 1 GM ADD-VANTAGE VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781341315</ndc>
    <ndc_label_name>AMPICILLIN 2 GM ADD-VANTAGE VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781341392</ndc>
    <ndc_label_name>AMPICILLIN 2 GM ADD-VANTAGE VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781341575</ndc>
    <ndc_label_name>PALONOSETRON 0.25 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781341694</ndc>
    <ndc_label_name>VORICONAZOLE 200 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781342080</ndc>
    <ndc_label_name>TREPROSTINIL 20 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781342101</ndc>
    <ndc_label_name>CASPOFUNGIN ACETATE 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781342194</ndc>
    <ndc_label_name>CASPOFUNGIN ACETATE 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781342271</ndc>
    <ndc_label_name>PHENYLEPHRINE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781342292</ndc>
    <ndc_label_name>PHENYLEPHRINE 10 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781342301</ndc>
    <ndc_label_name>CASPOFUNGIN ACETATE 70 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781342394</ndc>
    <ndc_label_name>CASPOFUNGIN ACETATE 70 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781342580</ndc>
    <ndc_label_name>TREPROSTINIL 50 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781342780</ndc>
    <ndc_label_name>TREPROSTINIL 100 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781343080</ndc>
    <ndc_label_name>TREPROSTINIL 200 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781343346</ndc>
    <ndc_label_name>LINEZOLID 600 MG/300 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781343395</ndc>
    <ndc_label_name>LINEZOLID 600 MG/300 ML-D5W</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781344071</ndc>
    <ndc_label_name>COSYNTROPIN 0.25 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781344095</ndc>
    <ndc_label_name>COSYNTROPIN 0.25 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781344395</ndc>
    <ndc_label_name>FONDAPARINUX 2.5 MG/0.5 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781345170</ndc>
    <ndc_label_name>CEFAZOLIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781345195</ndc>
    <ndc_label_name>CEFAZOLIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781345196</ndc>
    <ndc_label_name>CEFAZOLIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781345246</ndc>
    <ndc_label_name>CEFAZOLIN 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781345295</ndc>
    <ndc_label_name>CEFAZOLIN 10 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781345495</ndc>
    <ndc_label_name>FONDAPARINUX 5 MG/0.4 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781345875</ndc>
    <ndc_label_name>PHENYLEPHRINE 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781345895</ndc>
    <ndc_label_name>PHENYLEPHRINE 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781346595</ndc>
    <ndc_label_name>FONDAPARINUX 7.5 MG/0.6 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781346670</ndc>
    <ndc_label_name>PHENYLEPHRINE 100 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781347090</ndc>
    <ndc_label_name>CARMUSTINE 100 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781347393</ndc>
    <ndc_label_name>DILUENT FOR CARMUSTINE 3 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781347432</ndc>
    <ndc_label_name>CARMUSTINE 100 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781347695</ndc>
    <ndc_label_name>FONDAPARINUX 10 MG/0.8 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348094</ndc>
    <ndc_label_name>PANTOPRAZOLE SODIUM 40 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348095</ndc>
    <ndc_label_name>PANTOPRAZOLE SODIUM 40 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348170</ndc>
    <ndc_label_name>TIGECYCLINE 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348192</ndc>
    <ndc_label_name>TIGECYCLINE 50 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348556</ndc>
    <ndc_label_name>IRON SUCROSE 50 MG/2.5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348595</ndc>
    <ndc_label_name>IRON SUCROSE 50 MG/2.5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348596</ndc>
    <ndc_label_name>IRON SUCROSE 50 MG/2.5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348675</ndc>
    <ndc_label_name>IRON SUCROSE 100 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348695</ndc>
    <ndc_label_name>IRON SUCROSE 100 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348696</ndc>
    <ndc_label_name>IRON SUCROSE 100 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348714</ndc>
    <ndc_label_name>IRON SUCROSE 200 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348770</ndc>
    <ndc_label_name>IRON SUCROSE 200 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781348794</ndc>
    <ndc_label_name>IRON SUCROSE 200 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781349194</ndc>
    <ndc_label_name>AZACITIDINE 100 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781349380</ndc>
    <ndc_label_name>DEXMEDETOMIDINE 80 MCG/20ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781349395</ndc>
    <ndc_label_name>DEXMEDETOMIDINE 80 MCG/20ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781349491</ndc>
    <ndc_label_name>DEXMEDETOMIDINE 200MCG/50ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781349495</ndc>
    <ndc_label_name>DEXMEDETOMIDINE 200MCG/50ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781349546</ndc>
    <ndc_label_name>DEXMEDETOMIDIN 400MCG/100ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781349595</ndc>
    <ndc_label_name>DEXMEDETOMIDIN 400MCG/100ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781349806</ndc>
    <ndc_label_name>ARSENIC TRIOXIDE 12 MG/6 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781349894</ndc>
    <ndc_label_name>ARSENIC TRIOXIDE 12 MG/6 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781349895</ndc>
    <ndc_label_name>ARSENIC TRIOXIDE 12 MG/6 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781351675</ndc>
    <ndc_label_name>METHYLPREDNISOLONE 400 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781351876</ndc>
    <ndc_label_name>PEMETREXED DISODIUM 100 MG/4ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781351990</ndc>
    <ndc_label_name>PEMETREXED DISODIUM 500MG/20ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781352091</ndc>
    <ndc_label_name>PEMETREXED DISODIUM 1 GM/40 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781352270</ndc>
    <ndc_label_name>METHYLPREDNISOLONE 400 MG/10ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781352275</ndc>
    <ndc_label_name>METHYLPREDNISOLONE 200 MG/5 ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781352720</ndc>
    <ndc_label_name>EDARAVONE 30 MG/100 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781352794</ndc>
    <ndc_label_name>EDARAVONE 30 MG/100 ML BAG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781352810</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 500 MG/5ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781352875</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 500 MG/5ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781352910</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 1 GM/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781352970</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 1 GM/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781353010</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 2 GM/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781353080</ndc>
    <ndc_label_name>CYCLOPHOSPHAMIDE 2 GM/20 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781353191</ndc>
    <ndc_label_name>PACLITAXEL PROTEIN-BOUND 100MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781353201</ndc>
    <ndc_label_name>FULVESTRANT 250 MG/5 ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781353212</ndc>
    <ndc_label_name>FULVESTRANT 250 MG/5 ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781353810</ndc>
    <ndc_label_name>HEPARIN SOD 1,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781353825</ndc>
    <ndc_label_name>HEPARIN SOD 1,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781354010</ndc>
    <ndc_label_name>HEPARIN 10,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781354025</ndc>
    <ndc_label_name>HEPARIN 10,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781354310</ndc>
    <ndc_label_name>HEPARIN 30,000 UNIT/30 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781354325</ndc>
    <ndc_label_name>HEPARIN 30,000 UNIT/30 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781354510</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781354525</ndc>
    <ndc_label_name>HEPARIN SOD 5,000 UNIT/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781355010</ndc>
    <ndc_label_name>HEPARIN 50,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781355025</ndc>
    <ndc_label_name>HEPARIN 50,000 UNIT/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781355510</ndc>
    <ndc_label_name>HEPARIN 2,000 UNIT/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781355525</ndc>
    <ndc_label_name>HEPARIN 2,000 UNIT/2 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781375575</ndc>
    <ndc_label_name>NOREPINEPHRINE 4 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781375595</ndc>
    <ndc_label_name>NOREPINEPHRINE 4 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781382571</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781382596</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.2 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781382772</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.4 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781382796</ndc>
    <ndc_label_name>GLYCOPYRROLATE 0.4 MG/2 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781382975</ndc>
    <ndc_label_name>GLYCOPYRROLATE 1 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781382996</ndc>
    <ndc_label_name>GLYCOPYRROLATE 1 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781383180</ndc>
    <ndc_label_name>GLYCOPYRROLATE 4 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781383195</ndc>
    <ndc_label_name>GLYCOPYRROLATE 4 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781400332</ndc>
    <ndc_label_name>LEUPROLIDE 2WK 14 MG/2.8 ML KT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781400436</ndc>
    <ndc_label_name>Omnitrope 5.8 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781401471</ndc>
    <ndc_label_name>Omnitrope 5.8 mg subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781402472</ndc>
    <ndc_label_name>Bacteriostatic Water-Omnitrope injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781402753</ndc>
    <ndc_label_name>CHLORPROMAZINE 30 MG/ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781402822</ndc>
    <ndc_label_name>CHLORPROMAZINE 100 MG/ML CONC</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781406336</ndc>
    <ndc_label_name>APREPITANT 125-80-80 MG PACK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781407515</ndc>
    <ndc_label_name>DROSP-EE-LEVOMEF 3-0.02-0.451</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781407552</ndc>
    <ndc_label_name>DROSP-EE-LEVOMEF 3-0.02-0.451</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781410315</ndc>
    <ndc_label_name>DROSP-EE-LEVOMEF 3-0.03-0.451</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781410352</ndc>
    <ndc_label_name>DROSP-EE-LEVOMEF 3-0.03-0.451</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781506101</ndc>
    <ndc_label_name>AMOXICILLIN 875 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781506120</ndc>
    <ndc_label_name>AMOXICILLIN 875 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781517501</ndc>
    <ndc_label_name>MYCOPHENOLATE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781517505</ndc>
    <ndc_label_name>MYCOPHENOLATE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781522101</ndc>
    <ndc_label_name>CARVEDILOL 3.125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781522201</ndc>
    <ndc_label_name>CARVEDILOL 6.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781522301</ndc>
    <ndc_label_name>CARVEDILOL 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781522401</ndc>
    <ndc_label_name>CARVEDILOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781528364</ndc>
    <ndc_label_name>CETIRIZINE HCL 5 MG CHEW TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781528464</ndc>
    <ndc_label_name>CETIRIZINE HCL 10 MG CHEW TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781531701</ndc>
    <ndc_label_name>ZOLPIDEM TARTRATE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781531710</ndc>
    <ndc_label_name>ZOLPIDEM TARTRATE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781531801</ndc>
    <ndc_label_name>ZOLPIDEM TARTRATE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781531810</ndc>
    <ndc_label_name>ZOLPIDEM TARTRATE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781532501</ndc>
    <ndc_label_name>BROMOCRIPTINE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781532531</ndc>
    <ndc_label_name>BROMOCRIPTINE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781543820</ndc>
    <ndc_label_name>CEFPODOXIME 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781543901</ndc>
    <ndc_label_name>CEFPODOXIME 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781543920</ndc>
    <ndc_label_name>CEFPODOXIME 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781551501</ndc>
    <ndc_label_name>GRISEOFULVIN MICRO 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781557801</ndc>
    <ndc_label_name>ENTACAPONE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781561301</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 50 MG-ENTA</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781562501</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 75 MG-ENTA</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781563701</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 100 MG-ENTA</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781564101</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 125 MG-ENTA</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781565401</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 150 MG-ENTA</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781566731</ndc>
    <ndc_label_name>VORICONAZOLE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781566831</ndc>
    <ndc_label_name>VORICONAZOLE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781566901</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 200 MG-ENTA</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781574731</ndc>
    <ndc_label_name>TERIFLUNOMIDE 7 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781575531</ndc>
    <ndc_label_name>TERIFLUNOMIDE 14 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781580160</ndc>
    <ndc_label_name>SITAGLIPTIN-METFORMIN 50-500MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781580260</ndc>
    <ndc_label_name>SITAGLIPTIN-METFORMIN 50-1000</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781582701</ndc>
    <ndc_label_name>GRISEOFULVIN ULTRA 125 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781582801</ndc>
    <ndc_label_name>GRISEOFULVIN ULTRA 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781598531</ndc>
    <ndc_label_name>DAPAGLIFLOZIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781599031</ndc>
    <ndc_label_name>DAPAGLIFLOZIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781600078</ndc>
    <ndc_label_name>DIFLUPREDNATE 0.05% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781601470</ndc>
    <ndc_label_name>BRINZOLAMIDE 1% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781601485</ndc>
    <ndc_label_name>BRINZOLAMIDE 1% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781602194</ndc>
    <ndc_label_name>STERILE DILUENT-TREPROSTINIL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781602246</ndc>
    <ndc_label_name>CLARITHROMYCIN 125 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781602252</ndc>
    <ndc_label_name>CLARITHROMYCIN 125 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781602346</ndc>
    <ndc_label_name>CLARITHROMYCIN 250 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781602352</ndc>
    <ndc_label_name>CLARITHROMYCIN 250 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781603946</ndc>
    <ndc_label_name>AMOXICILLIN 125 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781603955</ndc>
    <ndc_label_name>AMOXICILLIN 125 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781603958</ndc>
    <ndc_label_name>AMOXICILLIN 125 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781604146</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781604155</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781604158</ndc>
    <ndc_label_name>AMOXICILLIN 250 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781610246</ndc>
    <ndc_label_name>AMOX-CLAV 200-28.5 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781610252</ndc>
    <ndc_label_name>AMOX-CLAV 200-28.5 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781610257</ndc>
    <ndc_label_name>AMOX-CLAV 200-28.5 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781610446</ndc>
    <ndc_label_name>AMOX-CLAV 400-57 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781610452</ndc>
    <ndc_label_name>AMOX-CLAV 400-57 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781610457</ndc>
    <ndc_label_name>AMOX-CLAV 400-57 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781613595</ndc>
    <ndc_label_name>PENICILLIN GK 5 MILLION UNIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781613694</ndc>
    <ndc_label_name>PENICILLIN GK 20 MILLION UNIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781613948</ndc>
    <ndc_label_name>AMOX-CLAV 600-42.9 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781613954</ndc>
    <ndc_label_name>AMOX-CLAV 600-42.9 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781613957</ndc>
    <ndc_label_name>AMOX-CLAV 600-42.9 MG/5 ML SUS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781615394</ndc>
    <ndc_label_name>PENICILLIN G NA 5 MILLION UNIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781615395</ndc>
    <ndc_label_name>PENICILLIN G NA 5 MILLION UNIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781615646</ndc>
    <ndc_label_name>AMOXICILLIN 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781615652</ndc>
    <ndc_label_name>AMOXICILLIN 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781615657</ndc>
    <ndc_label_name>AMOXICILLIN 200 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781615746</ndc>
    <ndc_label_name>AMOXICILLIN 400 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781615752</ndc>
    <ndc_label_name>AMOXICILLIN 400 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781615757</ndc>
    <ndc_label_name>AMOXICILLIN 400 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781616043</ndc>
    <ndc_label_name>SEVOFLURANE INHALATION LIQUID</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781616086</ndc>
    <ndc_label_name>SEVOFLURANE INHALATION LIQUID</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781617222</ndc>
    <ndc_label_name>DESFLURANE INHALATION LIQUID</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781617286</ndc>
    <ndc_label_name>DESFLURANE INHALATION LIQUID</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781618414</ndc>
    <ndc_label_name>TAFLUPROST 0.0015% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781618487</ndc>
    <ndc_label_name>TAFLUPROST 0.0015% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781618556</ndc>
    <ndc_label_name>TRAVOPROST 0.004% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781618575</ndc>
    <ndc_label_name>TRAVOPROST 0.004% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781618667</ndc>
    <ndc_label_name>CIPROFLOX-DEXAMETH OTIC SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781620675</ndc>
    <ndc_label_name>BIMATOPROST 0.03% EYELASH SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781620693</ndc>
    <ndc_label_name>BIMATOPROST 0.03% EYELASH SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781710454</ndc>
    <ndc_label_name>ESTRADIOL 0.1 MG PATCH (1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781710458</ndc>
    <ndc_label_name>ESTRADIOL 0.1 MG PATCH (1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781711954</ndc>
    <ndc_label_name>ESTRADIOL 0.025 MG PATCH(1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781711958</ndc>
    <ndc_label_name>ESTRADIOL 0.025 MG PATCH(1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781712254</ndc>
    <ndc_label_name>ESTRADIOL 0.0375MG PATCH(1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781712258</ndc>
    <ndc_label_name>ESTRADIOL 0.0375MG PATCH(1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781712958</ndc>
    <ndc_label_name>ESTRADIOL 0.025 MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781712983</ndc>
    <ndc_label_name>ESTRADIOL 0.025 MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781713354</ndc>
    <ndc_label_name>ESTRADIOL 0.05 MG PATCH (1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781713358</ndc>
    <ndc_label_name>ESTRADIOL 0.05 MG PATCH (1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781713454</ndc>
    <ndc_label_name>ESTRADIOL 0.06 MG PATCH (1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781713458</ndc>
    <ndc_label_name>ESTRADIOL 0.06 MG PATCH (1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781713593</ndc>
    <ndc_label_name>MOXIFLOXACIN 0.5% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781713654</ndc>
    <ndc_label_name>ESTRADIOL 0.075 MG PATCH(1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781713658</ndc>
    <ndc_label_name>ESTRADIOL 0.075 MG PATCH(1/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781713858</ndc>
    <ndc_label_name>ESTRADIOL 0.0375MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781713883</ndc>
    <ndc_label_name>ESTRADIOL 0.0375MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781714458</ndc>
    <ndc_label_name>ESTRADIOL 0.05 MG PATCH (2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781714483</ndc>
    <ndc_label_name>ESTRADIOL 0.05 MG PATCH (2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781715658</ndc>
    <ndc_label_name>ESTRADIOL 0.075 MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781715683</ndc>
    <ndc_label_name>ESTRADIOL 0.075 MG PATCH(2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781716758</ndc>
    <ndc_label_name>ESTRADIOL 0.1 MG PATCH (2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781716783</ndc>
    <ndc_label_name>ESTRADIOL 0.1 MG PATCH (2/WK)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781717250</ndc>
    <ndc_label_name>AZELAIC ACID 15% GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781717770</ndc>
    <ndc_label_name>BRIMONIDINE TARTRATE 0.1% DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781717775</ndc>
    <ndc_label_name>BRIMONIDINE TARTRATE 0.1% DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781717785</ndc>
    <ndc_label_name>BRIMONIDINE TARTRATE 0.1% DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781718670</ndc>
    <ndc_label_name>BRIMONIDINE-TIMOLOL 0.2%-0.5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781718675</ndc>
    <ndc_label_name>BRIMONIDINE-TIMOLOL 0.2%-0.5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781718685</ndc>
    <ndc_label_name>BRIMONIDINE-TIMOLOL 0.2%-0.5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781729685</ndc>
    <ndc_label_name>ALBUTEROL HFA 90 MCG INHALER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781730431</ndc>
    <ndc_label_name>RIVASTIGMINE 4.6 MG/24HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781730458</ndc>
    <ndc_label_name>RIVASTIGMINE 4.6 MG/24HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781730931</ndc>
    <ndc_label_name>RIVASTIGMINE 9.5 MG/24HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781730958</ndc>
    <ndc_label_name>RIVASTIGMINE 9.5 MG/24HR PATCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781731331</ndc>
    <ndc_label_name>RIVASTIGMINE 13.3 MG/24HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781731358</ndc>
    <ndc_label_name>RIVASTIGMINE 13.3 MG/24HR PTCH</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781751514</ndc>
    <ndc_label_name>BUDESONIDE 0.25 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781751587</ndc>
    <ndc_label_name>BUDESONIDE 0.25 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781751614</ndc>
    <ndc_label_name>BUDESONIDE 0.5 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781751687</ndc>
    <ndc_label_name>BUDESONIDE 0.5 MG/2 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781751714</ndc>
    <ndc_label_name>BUDESONIDE 1 MG/2 ML INH SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781751787</ndc>
    <ndc_label_name>BUDESONIDE 1 MG/2 ML INH SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781801701</ndc>
    <ndc_label_name>FLUVASTATIN ER 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781801731</ndc>
    <ndc_label_name>FLUVASTATIN ER 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781802801</ndc>
    <ndc_label_name>TRIFLUOPERAZINE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781802931</ndc>
    <ndc_label_name>ARMODAFINIL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781803201</ndc>
    <ndc_label_name>TRIFLUOPERAZINE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781803401</ndc>
    <ndc_label_name>TRIFLUOPERAZINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781803601</ndc>
    <ndc_label_name>TRIFLUOPERAZINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781803731</ndc>
    <ndc_label_name>ARMODAFINIL 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781804531</ndc>
    <ndc_label_name>ARMODAFINIL 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781804601</ndc>
    <ndc_label_name>PERPHENAZINE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781804701</ndc>
    <ndc_label_name>PERPHENAZINE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781804801</ndc>
    <ndc_label_name>PERPHENAZINE 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781804901</ndc>
    <ndc_label_name>PERPHENAZINE 16 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781805331</ndc>
    <ndc_label_name>ARMODAFINIL 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781808532</ndc>
    <ndc_label_name>PIRFENIDONE 267 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781808692</ndc>
    <ndc_label_name>PIRFENIDONE 801 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781808926</ndc>
    <ndc_label_name>AZITHROMYCIN 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781808931</ndc>
    <ndc_label_name>AZITHROMYCIN 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781809003</ndc>
    <ndc_label_name>AZITHROMYCIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781809031</ndc>
    <ndc_label_name>AZITHROMYCIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781809131</ndc>
    <ndc_label_name>AZITHROMYCIN 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781815831</ndc>
    <ndc_label_name>PRUCALOPRIDE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781815931</ndc>
    <ndc_label_name>PRUCALOPRIDE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781820106</ndc>
    <ndc_label_name>CLADRIBINE 10 MG X 1 TB DAY PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781820137</ndc>
    <ndc_label_name>CLADRIBINE 10 MG X 9 TABLET PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781820146</ndc>
    <ndc_label_name>CLADRIBINE 10 MG X 2 TB DAY PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781820151</ndc>
    <ndc_label_name>CLADRIBINE 10 MG X 5 TABLET PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781820168</ndc>
    <ndc_label_name>CLADRIBINE 10 MG X 6 TABLET PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781820171</ndc>
    <ndc_label_name>CLADRIBINE 10 MG X 7 TABLET PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781820180</ndc>
    <ndc_label_name>CLADRIBINE 10 MG X 10 TAB PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781820185</ndc>
    <ndc_label_name>CLADRIBINE 10 MG X 8 TABLET PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781820194</ndc>
    <ndc_label_name>CLADRIBINE 10 MG X 4 TABLET PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781905370</ndc>
    <ndc_label_name>Anectine 20 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781905395</ndc>
    <ndc_label_name>Anectine 20 mg/mL injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781905501</ndc>
    <ndc_label_name>FULVESTRANT 250 MG/5 ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781905512</ndc>
    <ndc_label_name>FULVESTRANT 250 MG/5 ML SYRING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781910572</ndc>
    <ndc_label_name>OLANZAPINE 10 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781921090</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 2.25 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781921095</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 2.25 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781921390</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 3.375 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781921395</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 3.375 GM VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781921491</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 4.5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781921495</ndc>
    <ndc_label_name>PIPERACIL-TAZOBACT 4.5 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781922775</ndc>
    <ndc_label_name>PHENYLEPHRINE 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781922795</ndc>
    <ndc_label_name>PHENYLEPHRINE 50 MG/5 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781922870</ndc>
    <ndc_label_name>PHENYLEPHRINE 100 MG/10 ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781926185</ndc>
    <ndc_label_name>AMPICILLIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781926195</ndc>
    <ndc_label_name>AMPICILLIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781927380</ndc>
    <ndc_label_name>AMPICILLIN 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781927395</ndc>
    <ndc_label_name>AMPICILLIN 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781927406</ndc>
    <ndc_label_name>ACETAMINOPHEN 1,000MG/100ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781927495</ndc>
    <ndc_label_name>ACETAMINOPHEN 1,000MG/100ML VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781931570</ndc>
    <ndc_label_name>OXALIPLATIN 50 MG/10 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00781931780</ndc>
    <ndc_label_name>OXALIPLATIN 100 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781940178</ndc>
    <ndc_label_name>AMPICILLIN 125 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781940195</ndc>
    <ndc_label_name>AMPICILLIN 125 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781940278</ndc>
    <ndc_label_name>AMPICILLIN 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781940295</ndc>
    <ndc_label_name>AMPICILLIN 250 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781940485</ndc>
    <ndc_label_name>AMPICILLIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781940495</ndc>
    <ndc_label_name>AMPICILLIN 1 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781940778</ndc>
    <ndc_label_name>AMPICILLIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781940795</ndc>
    <ndc_label_name>AMPICILLIN 500 MG VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781940880</ndc>
    <ndc_label_name>AMPICILLIN 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781940895</ndc>
    <ndc_label_name>AMPICILLIN 2 GM VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781941292</ndc>
    <ndc_label_name>AMPICILLIN 1 GM ADD-VANTAGE VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00781941392</ndc>
    <ndc_label_name>AMPICILLIN 2 GM ADD-VANTAGE VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00799000102</ndc>
    <ndc_label_name>Calmoseptine 0.44 %-20.6 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00799000103</ndc>
    <ndc_label_name>Calmoseptine 0.44 %-20.6 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00799000104</ndc>
    <ndc_label_name>Calmoseptine 0.44 %-20.6 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00799000105</ndc>
    <ndc_label_name>Calmoseptine 0.44 %-20.6 % topical ointment in packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00802391316</ndc>
    <ndc_label_name>SORBITOL 70% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00802392016</ndc>
    <ndc_label_name>SyrPalta Vehicle oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00802392594</ndc>
    <ndc_label_name>SODIUM CHLORIDE-SOD BICARB PWD</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00802392716</ndc>
    <ndc_label_name>SyrPalta Vehicle oral syrup</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00802395928</ndc>
    <ndc_label_name>CHERRY SYRUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00810067013</ndc>
    <ndc_label_name>Sudafed 12 Hour 120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00810067020</ndc>
    <ndc_label_name>Sudafed 12 Hour 120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00810073087</ndc>
    <ndc_label_name>Neosporin (neo-bac-polym) 3.5 mg-400 unit-5,000 unit/gram top ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00810073088</ndc>
    <ndc_label_name>Neosporin (neo-bac-polym) 3.5 mg-400 unit-5,000 unit/gram top ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00810074687</ndc>
    <ndc_label_name>Neosporin PlusPain Relief(bacit)3.5 mg-500 unit-10,000 unit/g top oint</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00810074688</ndc>
    <ndc_label_name>Neosporin PlusPain Relief(bacit)3.5 mg-500 unit-10,000 unit/g top oint</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00810079887</ndc>
    <ndc_label_name>Polysporin 500 unit-10,000 unit/gram topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00810086548</ndc>
    <ndc_label_name>Sudafed 30 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00813001206</ndc>
    <ndc_label_name>Ferretts 325 mg (106 mg iron) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00813079955</ndc>
    <ndc_label_name>Fem pH 0.9 %-0.025 % vaginal gel</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00813200408</ndc>
    <ndc_label_name>Ferretts IPS 40 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00813202101</ndc>
    <ndc_label_name>Ferretts IPS 18 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832003800</ndc>
    <ndc_label_name>OXYBUTYNIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832003801</ndc>
    <ndc_label_name>OXYBUTYNIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832003810</ndc>
    <ndc_label_name>OXYBUTYNIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832003850</ndc>
    <ndc_label_name>OXYBUTYNIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832003889</ndc>
    <ndc_label_name>OXYBUTYNIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832011100</ndc>
    <ndc_label_name>AMANTADINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832011103</ndc>
    <ndc_label_name>AMANTADINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832011150</ndc>
    <ndc_label_name>AMANTADINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832011189</ndc>
    <ndc_label_name>AMANTADINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832022500</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 10 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832022600</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832022700</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832022800</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832022900</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 60 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832023000</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 80 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832023300</ndc>
    <ndc_label_name>MORPHINE SULFATE ER 100 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832027311</ndc>
    <ndc_label_name>MORPHINE SULFATE IR 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832027411</ndc>
    <ndc_label_name>MORPHINE SULFATE IR 30 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832028500</ndc>
    <ndc_label_name>BEXAROTENE 75 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832031011</ndc>
    <ndc_label_name>VALPROIC ACID 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832035611</ndc>
    <ndc_label_name>DOXAZOSIN MESYLATE 1 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832035711</ndc>
    <ndc_label_name>DOXAZOSIN MESYLATE 2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832040211</ndc>
    <ndc_label_name>FLUOXETINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832040230</ndc>
    <ndc_label_name>FLUOXETINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832040311</ndc>
    <ndc_label_name>FLUOXETINE HCL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832040330</ndc>
    <ndc_label_name>FLUOXETINE HCL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832046515</ndc>
    <ndc_label_name>Nyamyc 100,000 unit/gram topical powder</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832046530</ndc>
    <ndc_label_name>Nyamyc 100,000 unit/gram topical powder</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832046560</ndc>
    <ndc_label_name>Nyamyc 100,000 unit/gram topical powder</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832051000</ndc>
    <ndc_label_name>BETHANECHOL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832051100</ndc>
    <ndc_label_name>BETHANECHOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832051101</ndc>
    <ndc_label_name>BETHANECHOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832051189</ndc>
    <ndc_label_name>BETHANECHOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832051200</ndc>
    <ndc_label_name>BETHANECHOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832051201</ndc>
    <ndc_label_name>BETHANECHOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832051289</ndc>
    <ndc_label_name>BETHANECHOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832051300</ndc>
    <ndc_label_name>BETHANECHOL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832051301</ndc>
    <ndc_label_name>BETHANECHOL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832051389</ndc>
    <ndc_label_name>BETHANECHOL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832053209</ndc>
    <ndc_label_name>IMATINIB MESYLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832053303</ndc>
    <ndc_label_name>IMATINIB MESYLATE 400 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832054011</ndc>
    <ndc_label_name>BUMETANIDE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832054111</ndc>
    <ndc_label_name>BUMETANIDE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832054211</ndc>
    <ndc_label_name>BUMETANIDE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832058011</ndc>
    <ndc_label_name>CLOBAZAM 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832058111</ndc>
    <ndc_label_name>CLOBAZAM 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832059530</ndc>
    <ndc_label_name>EXEMESTANE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832064211</ndc>
    <ndc_label_name>BUMETANIDE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832074060</ndc>
    <ndc_label_name>PROPAFENONE HCL ER 225 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832074160</ndc>
    <ndc_label_name>PROPAFENONE HCL ER 325 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832074260</ndc>
    <ndc_label_name>PROPAFENONE HCL ER 425 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832081411</ndc>
    <ndc_label_name>DEFLAZACORT 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832081530</ndc>
    <ndc_label_name>DEFLAZACORT 18 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832081630</ndc>
    <ndc_label_name>DEFLAZACORT 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832081730</ndc>
    <ndc_label_name>DEFLAZACORT 36 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832101500</ndc>
    <ndc_label_name>AMANTADINE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832101550</ndc>
    <ndc_label_name>AMANTADINE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832105410</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832105411</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832105415</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832105511</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832105515</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832107130</ndc>
    <ndc_label_name>TOPIRAMATE ER 25MG SPRINKL CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832107230</ndc>
    <ndc_label_name>TOPIRAMATE ER 50MG SPRINKL CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832107330</ndc>
    <ndc_label_name>TOPIRAMATE ER 200MG SPRINK CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832107430</ndc>
    <ndc_label_name>TOPIRAMATE ER 100MG SPRINK CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832107530</ndc>
    <ndc_label_name>TOPIRAMATE ER 150MG SPRINK CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832111260</ndc>
    <ndc_label_name>MEMANTINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832111360</ndc>
    <ndc_label_name>MEMANTINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832112005</ndc>
    <ndc_label_name>TESTOSTERONE 50 MG/5 GRAM GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832112035</ndc>
    <ndc_label_name>TESTOSTERONE 50 MG/5 GRAM PKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832112065</ndc>
    <ndc_label_name>TESTOSTERONE 50 MG/5 GRAM GEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832112089</ndc>
    <ndc_label_name>TESTOSTERONE 50 MG/5 GRAM PKT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832112140</ndc>
    <ndc_label_name>TESTOSTERONE 12.5 MG/1.25 GRAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832112142</ndc>
    <ndc_label_name>TESTOSTERONE 12.5 MG/1.25 GRAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121100</ndc>
    <ndc_label_name>Jantoven 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121101</ndc>
    <ndc_label_name>Jantoven 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121110</ndc>
    <ndc_label_name>Jantoven 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121189</ndc>
    <ndc_label_name>Jantoven 1 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121200</ndc>
    <ndc_label_name>Jantoven 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121201</ndc>
    <ndc_label_name>Jantoven 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121210</ndc>
    <ndc_label_name>Jantoven 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121289</ndc>
    <ndc_label_name>Jantoven 2 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121300</ndc>
    <ndc_label_name>Jantoven 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121301</ndc>
    <ndc_label_name>Jantoven 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121310</ndc>
    <ndc_label_name>Jantoven 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121389</ndc>
    <ndc_label_name>Jantoven 2.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121400</ndc>
    <ndc_label_name>Jantoven 3 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121401</ndc>
    <ndc_label_name>Jantoven 3 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121410</ndc>
    <ndc_label_name>Jantoven 3 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121489</ndc>
    <ndc_label_name>Jantoven 3 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121500</ndc>
    <ndc_label_name>Jantoven 4 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121501</ndc>
    <ndc_label_name>Jantoven 4 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121510</ndc>
    <ndc_label_name>Jantoven 4 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121589</ndc>
    <ndc_label_name>Jantoven 4 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121600</ndc>
    <ndc_label_name>Jantoven 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121601</ndc>
    <ndc_label_name>Jantoven 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121610</ndc>
    <ndc_label_name>Jantoven 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121689</ndc>
    <ndc_label_name>Jantoven 5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121700</ndc>
    <ndc_label_name>Jantoven 6 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121701</ndc>
    <ndc_label_name>Jantoven 6 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121710</ndc>
    <ndc_label_name>Jantoven 6 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121789</ndc>
    <ndc_label_name>Jantoven 6 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121800</ndc>
    <ndc_label_name>Jantoven 7.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121801</ndc>
    <ndc_label_name>Jantoven 7.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121889</ndc>
    <ndc_label_name>Jantoven 7.5 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121900</ndc>
    <ndc_label_name>Jantoven 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121901</ndc>
    <ndc_label_name>Jantoven 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832121989</ndc>
    <ndc_label_name>Jantoven 10 mg tablet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832125011</ndc>
    <ndc_label_name>RAMELTEON 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832125030</ndc>
    <ndc_label_name>RAMELTEON 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832135811</ndc>
    <ndc_label_name>DOXAZOSIN MESYLATE 4 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832135911</ndc>
    <ndc_label_name>DOXAZOSIN MESYLATE 8 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832141003</ndc>
    <ndc_label_name>MOXIFLOXACIN 0.5% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832142505</ndc>
    <ndc_label_name>BRIMONIDINE-TIMOLOL 0.2%-0.5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832142510</ndc>
    <ndc_label_name>BRIMONIDINE-TIMOLOL 0.2%-0.5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832142515</ndc>
    <ndc_label_name>BRIMONIDINE-TIMOLOL 0.2%-0.5%</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832143075</ndc>
    <ndc_label_name>CIPROFLOX-DEXAMETH OTIC SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832151011</ndc>
    <ndc_label_name>HALOPERIDOL 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832152001</ndc>
    <ndc_label_name>HALOPERIDOL 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832152011</ndc>
    <ndc_label_name>HALOPERIDOL 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832152089</ndc>
    <ndc_label_name>HALOPERIDOL 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832153011</ndc>
    <ndc_label_name>HALOPERIDOL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832154001</ndc>
    <ndc_label_name>HALOPERIDOL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832154011</ndc>
    <ndc_label_name>HALOPERIDOL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832154089</ndc>
    <ndc_label_name>HALOPERIDOL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832155001</ndc>
    <ndc_label_name>HALOPERIDOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832155011</ndc>
    <ndc_label_name>HALOPERIDOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832155089</ndc>
    <ndc_label_name>HALOPERIDOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832156011</ndc>
    <ndc_label_name>HALOPERIDOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832167011</ndc>
    <ndc_label_name>FLUVOXAMINE MALEATE 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832167111</ndc>
    <ndc_label_name>FLUVOXAMINE MALEATE 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832167211</ndc>
    <ndc_label_name>FLUVOXAMINE MALEATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832169011</ndc>
    <ndc_label_name>ETHACRYNIC ACID 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832532210</ndc>
    <ndc_label_name>POTASSIUM CL ER 8 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832532211</ndc>
    <ndc_label_name>POTASSIUM CL ER 8 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832532310</ndc>
    <ndc_label_name>POTASSIUM CL ER 10 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832532311</ndc>
    <ndc_label_name>POTASSIUM CL ER 10 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832532410</ndc>
    <ndc_label_name>POTASSIUM CL ER 10 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832532411</ndc>
    <ndc_label_name>POTASSIUM CL ER 10 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832532510</ndc>
    <ndc_label_name>POTASSIUM CL ER 20 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832532511</ndc>
    <ndc_label_name>POTASSIUM CL ER 20 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832532515</ndc>
    <ndc_label_name>POTASSIUM CL ER 20 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832600311</ndc>
    <ndc_label_name>FLUPHENAZINE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832600411</ndc>
    <ndc_label_name>FLUPHENAZINE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832600511</ndc>
    <ndc_label_name>FLUPHENAZINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832600611</ndc>
    <ndc_label_name>FLUPHENAZINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832601700</ndc>
    <ndc_label_name>CHLORPROMAZINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832601800</ndc>
    <ndc_label_name>CHLORPROMAZINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832601810</ndc>
    <ndc_label_name>CHLORPROMAZINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832601900</ndc>
    <ndc_label_name>CHLORPROMAZINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832601901</ndc>
    <ndc_label_name>CHLORPROMAZINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832601910</ndc>
    <ndc_label_name>CHLORPROMAZINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832601989</ndc>
    <ndc_label_name>CHLORPROMAZINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832602000</ndc>
    <ndc_label_name>CHLORPROMAZINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832602001</ndc>
    <ndc_label_name>CHLORPROMAZINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832602010</ndc>
    <ndc_label_name>CHLORPROMAZINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832602089</ndc>
    <ndc_label_name>CHLORPROMAZINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832602100</ndc>
    <ndc_label_name>CHLORPROMAZINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832602101</ndc>
    <ndc_label_name>CHLORPROMAZINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832602110</ndc>
    <ndc_label_name>CHLORPROMAZINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832602189</ndc>
    <ndc_label_name>CHLORPROMAZINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832602211</ndc>
    <ndc_label_name>CARBAMAZEPINE ER 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832602311</ndc>
    <ndc_label_name>CARBAMAZEPINE ER 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832602411</ndc>
    <ndc_label_name>CARBAMAZEPINE ER 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832603212</ndc>
    <ndc_label_name>FLUOXETINE 20 MG/5 ML SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832604510</ndc>
    <ndc_label_name>FAMOTIDINE 40 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832604515</ndc>
    <ndc_label_name>FAMOTIDINE 40 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832604550</ndc>
    <ndc_label_name>FAMOTIDINE 40 MG/5 ML SUSP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832604890</ndc>
    <ndc_label_name>PITAVASTATIN 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832604990</ndc>
    <ndc_label_name>PITAVASTATIN 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832605090</ndc>
    <ndc_label_name>PITAVASTATIN 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832605210</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832605211</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832605310</ndc>
    <ndc_label_name>DICYCLOMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832605311</ndc>
    <ndc_label_name>DICYCLOMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832605405</ndc>
    <ndc_label_name>DIFLUPREDNATE 0.05% EYE DROP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832605612</ndc>
    <ndc_label_name>MESALAMINE ER 0.375 GRAM CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832607211</ndc>
    <ndc_label_name>METHIMAZOLE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832607311</ndc>
    <ndc_label_name>METHIMAZOLE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832607803</ndc>
    <ndc_label_name>OLANZAPINE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832607850</ndc>
    <ndc_label_name>OLANZAPINE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832607903</ndc>
    <ndc_label_name>OLANZAPINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832607950</ndc>
    <ndc_label_name>OLANZAPINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832608003</ndc>
    <ndc_label_name>OLANZAPINE 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832608050</ndc>
    <ndc_label_name>OLANZAPINE 7.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832608103</ndc>
    <ndc_label_name>OLANZAPINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832608150</ndc>
    <ndc_label_name>OLANZAPINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832608203</ndc>
    <ndc_label_name>OLANZAPINE 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832608250</ndc>
    <ndc_label_name>OLANZAPINE 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832608303</ndc>
    <ndc_label_name>OLANZAPINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832608350</ndc>
    <ndc_label_name>OLANZAPINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832608430</ndc>
    <ndc_label_name>GLATIRAMER 20 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832608489</ndc>
    <ndc_label_name>GLATIRAMER 20 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832608512</ndc>
    <ndc_label_name>GLATIRAMER 40 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00832608589</ndc>
    <ndc_label_name>GLATIRAMER 40 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832712211</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 125 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832712215</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 125 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832712301</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832712311</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832712315</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832712389</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832712401</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832712411</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832712415</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832712489</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832830130</ndc>
    <ndc_label_name>ISOTRETINOIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832830189</ndc>
    <ndc_label_name>ISOTRETINOIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832830230</ndc>
    <ndc_label_name>ISOTRETINOIN 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832830289</ndc>
    <ndc_label_name>ISOTRETINOIN 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832830330</ndc>
    <ndc_label_name>ISOTRETINOIN 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832830389</ndc>
    <ndc_label_name>ISOTRETINOIN 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832830430</ndc>
    <ndc_label_name>ISOTRETINOIN 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00832830489</ndc>
    <ndc_label_name>ISOTRETINOIN 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847001200</ndc>
    <ndc_label_name>L-ARGININE POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847001300</ndc>
    <ndc_label_name>GLYCINE POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847001500</ndc>
    <ndc_label_name>L-LEUCINE POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847001600</ndc>
    <ndc_label_name>L-TYROSINE POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847001700</ndc>
    <ndc_label_name>L-VALINE POWDER</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847059000</ndc>
    <ndc_label_name>Complex MSD Amino Acid Blend 10 gram-42 kcal/13 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847059102</ndc>
    <ndc_label_name>Complex Junior MSD 13 gram-496 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847059722</ndc>
    <ndc_label_name>Complex Essential 25 gram-380 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847075000</ndc>
    <ndc_label_name>GlutarAde Amino Acid Blend 81 gram-324 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847075102</ndc>
    <ndc_label_name>GlutarAde Junior 10 gram-410 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847075422</ndc>
    <ndc_label_name>GlutarAde GA-1 25 gram-385 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095000</ndc>
    <ndc_label_name>PhenylAde Amino Acids 10 gram-42 kcal/13 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095004</ndc>
    <ndc_label_name>PhenylAde Amino Acids 10 gram-42 kcal/13 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095012</ndc>
    <ndc_label_name>Phenylade Essential (flax) 25 gram-390 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095014</ndc>
    <ndc_label_name>Phenylade Essential (flax) 10 gram-156 kcal/40 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095022</ndc>
    <ndc_label_name>Phenylade Essential (flax) 25 gram-390 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095024</ndc>
    <ndc_label_name>Phenylade Essential (flax) 10 gram-156 kcal/40 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095032</ndc>
    <ndc_label_name>Phenylade Essential (flax) 25 gram-390 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095034</ndc>
    <ndc_label_name>Phenylade Essential (flax) 10 gram-156 kcal/40 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095042</ndc>
    <ndc_label_name>Phenylade Essential (flax) 25 gram-390 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095044</ndc>
    <ndc_label_name>Phenylade Essential (flax) 10 gram-156 kcal/40 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095082</ndc>
    <ndc_label_name>Phenylade Essential (flax) 25 gram-390 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095084</ndc>
    <ndc_label_name>Phenylade Essential (flax) 10 gram-156 kcal/40 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095404</ndc>
    <ndc_label_name>PhenylAde 40 10 gram-84 kcal/25 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095414</ndc>
    <ndc_label_name>PhenylAde 40 10 gram-84 kcal/25 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095501</ndc>
    <ndc_label_name>Phenylade Phebloc 750 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095504</ndc>
    <ndc_label_name>Phenylade Phebloc 2.2 gram-10 kcal/3 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095602</ndc>
    <ndc_label_name>PhenylAde 60  60 gram-295 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095604</ndc>
    <ndc_label_name>PhenylAde 60 10 gram-49 kcal/16.7 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095622</ndc>
    <ndc_label_name>PhenylAde 60  60 gram-327 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095624</ndc>
    <ndc_label_name>PhenylAde 60 10 gram-49 kcal/16.7 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095960</ndc>
    <ndc_label_name>Phenylade MTE Amino Acids 10 gram-42 kcal/13 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00847095964</ndc>
    <ndc_label_name>Phenylade MTE Amino Acids 10 gram-42 kcal/13 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851000001</ndc>
    <ndc_label_name>CeraLyte-70  70 mEq-60 mEq-20 mEq-30 mEq oral packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851000002</ndc>
    <ndc_label_name>CeraLyte 90  90 mEq-80 mEq-20 mEq-30 mEq oral packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851000005</ndc>
    <ndc_label_name>CeraLyte-70 2.3 g-1.5 g-2.9 g-160 kcal/50 oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851000009</ndc>
    <ndc_label_name>CeraLyte 50 240 mg-300 mg-32 kcal/10 g oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851000010</ndc>
    <ndc_label_name>CeraLyte-70  440 mg-300 mg-32 kcal/10 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851000012</ndc>
    <ndc_label_name>CeraLyte-70  440 mg-300 mg-32 kcal/10 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851000014</ndc>
    <ndc_label_name>CeraLyte-70  70 mEq-60 mEq-20 mEq-30 mEq oral packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851000019</ndc>
    <ndc_label_name>Ceralyte 50 Potassium Free 50 mEq-20 mEq-30 mEq oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851020001</ndc>
    <ndc_label_name>CeraSport 200 mg-75 mg-80 kcal/20 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851020003</ndc>
    <ndc_label_name>CeraSport 200 mg-75 mg-80 kcal/20 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851020009</ndc>
    <ndc_label_name>CeraSport EX1 400 mg-200 mg-40 kcal/12.5 g oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851020010</ndc>
    <ndc_label_name>CeraSport EX1 400 mg-200 mg-40 kcal/12.5 g oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851020012</ndc>
    <ndc_label_name>CeraSport EX1 400 mg-200 mg-40 kcal/12.5 g oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851020020</ndc>
    <ndc_label_name>Cerasport Plus 230 mg-85 mg-120 kcal/31 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851022003</ndc>
    <ndc_label_name>CeraSport 115 mg-40 mg-40 kcal/10.5 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851022005</ndc>
    <ndc_label_name>CeraSport EX1 200 mg-100 mg-20 kcal/6 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851022010</ndc>
    <ndc_label_name>CeraSport 115 mg-40 mg-40 kcal/10.5 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851023000</ndc>
    <ndc_label_name>Cerasport Endurance 400 mg-160 mg/42 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851023001</ndc>
    <ndc_label_name>Cerasport Endurance 400 mg-160 mg/42 gram oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851050012</ndc>
    <ndc_label_name>CERASPORT LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00851050013</ndc>
    <ndc_label_name>CERASPORT EX1 LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00851050030</ndc>
    <ndc_label_name>CERALYTE-70 ELECTROLYTE DRINK</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00856000309</ndc>
    <ndc_label_name>Rompe Pecho Max Multi Symptoms 10 mg-20 mg-650 mg/20 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869007816</ndc>
    <ndc_label_name>CASTOR OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869008810</ndc>
    <ndc_label_name>IODINE 2% TINCTURE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869016438</ndc>
    <ndc_label_name>Citroma oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869016638</ndc>
    <ndc_label_name>Citroma oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869060243</ndc>
    <ndc_label_name>Epsom Salt 100 % crystals</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869066738</ndc>
    <ndc_label_name>Citroma oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869068638</ndc>
    <ndc_label_name>Citroma oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869069338</ndc>
    <ndc_label_name>Citroma oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869081043</ndc>
    <ndc_label_name>ISOPROPYL ALCOHOL 70%</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869081045</ndc>
    <ndc_label_name>SWAN ISOPROPYL ALCOHOL 70%</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869083143</ndc>
    <ndc_label_name>MINERAL OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869087143</ndc>
    <ndc_label_name>HYDROGEN PEROXIDE 3% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869087145</ndc>
    <ndc_label_name>HYDROGEN PEROXIDE 3% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869385110</ndc>
    <ndc_label_name>IODINE 2% TINCTURE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00869420610</ndc>
    <ndc_label_name>MINERAL OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00869462910</ndc>
    <ndc_label_name>Petroleum Jelly topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00870020102</ndc>
    <ndc_label_name>Enfamil A.R. 2.5-5.1-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00870020142</ndc>
    <ndc_label_name>Enfamil A.R. 2.5-5.1-11.3 gram/100 kcal oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00875010110</ndc>
    <ndc_label_name>BCAD 2  24 gram-410 kcal/100 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00875010185</ndc>
    <ndc_label_name>BCAD 1 16.2 g-500 kcal/100 g oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00875012058</ndc>
    <ndc_label_name>Enfamil 24 2.1-5.3-11.2 gram/100 kcal oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00875012123</ndc>
    <ndc_label_name>Enfamil NeuroPro Gentlease Non-GMO 2.3 gram-5.3 gram/100 kcal oral pwd</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00875012886</ndc>
    <ndc_label_name>Enfamil DHA-in-Sol 110 mg (55 mg-55 mg)/mL oral drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00875012889</ndc>
    <ndc_label_name>Enfamil DHA-in-Sol 110 mg (55 mg-55 mg)/mL oral drops</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00884029301</ndc>
    <ndc_label_name>Fungoid Tincture 2 % topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00884044904</ndc>
    <ndc_label_name>Ureacin-20 20 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00884324908</ndc>
    <ndc_label_name>Ureacin-10 10 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00884489102</ndc>
    <ndc_label_name>Nail Scrub lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00884629730</ndc>
    <ndc_label_name>Phenol EZ 89 % topical swab</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904001224</ndc>
    <ndc_label_name>Allergy (chlorpheniramine) 4 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904001259</ndc>
    <ndc_label_name>Allergy (chlorpheniramine) 4 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904001261</ndc>
    <ndc_label_name>Allergy (chlorpheniramine) 4 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904001280</ndc>
    <ndc_label_name>Allergy (chlorpheniramine) 4 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904026252</ndc>
    <ndc_label_name>Stress Formula tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904027746</ndc>
    <ndc_label_name>VITAMIN E 450 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904027760</ndc>
    <ndc_label_name>VITAMIN E 450 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904042804</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904042806</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904043004</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904043006</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904043095</ndc>
    <ndc_label_name>DOXYCYCLINE HYCLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904052360</ndc>
    <ndc_label_name>Vitamin C 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904052361</ndc>
    <ndc_label_name>Vitamin C 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904052372</ndc>
    <ndc_label_name>Vitamin C 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904052380</ndc>
    <ndc_label_name>Vitamin C 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904053061</ndc>
    <ndc_label_name>Tab-A-Vite 400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904053961</ndc>
    <ndc_label_name>Thera 400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904073431</ndc>
    <ndc_label_name>Triple Antibiotic 3.5 mg-400 unit-5,000 unit/gram topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904078816</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904110309</ndc>
    <ndc_label_name>POVIDONE-IODINE 10% SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904188260</ndc>
    <ndc_label_name>CALCIUM 250 MG-VIT D3 3 MCG TB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904188361</ndc>
    <ndc_label_name>Oyster Shell Calcium-500  500 mg (as carbonate 1,250 mg) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904188372</ndc>
    <ndc_label_name>Oyster Shell Calcium-500  500 mg (as carbonate 1,250 mg) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904198760</ndc>
    <ndc_label_name>Mapap (acetaminophen) 500 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904201559</ndc>
    <ndc_label_name>Tri-Buffered Aspirin 325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904205112</ndc>
    <ndc_label_name>Driminate 50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904205159</ndc>
    <ndc_label_name>Driminate 50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904205661</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 50 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904208560</ndc>
    <ndc_label_name>VITAMIN A 3,000 MCG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904227260</ndc>
    <ndc_label_name>NIACIN 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904250091</ndc>
    <ndc_label_name>Fiber (calcium polycarbophil) 625 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904253321</ndc>
    <ndc_label_name>CALAMINE LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904264172</ndc>
    <ndc_label_name>Certavite-Antioxidant 18 mg-400 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904272561</ndc>
    <ndc_label_name>SULFAMETHOXAZOLE-TMP DS TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904385461</ndc>
    <ndc_label_name>CARBAMAZEPINE 100 MG TAB CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904386575</ndc>
    <ndc_label_name>Deep Sea Nasal 0.65 % spray aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904404073</ndc>
    <ndc_label_name>ASPIRIN 81 MG CHEWABLE TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904421551</ndc>
    <ndc_label_name>ARGININE 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904423960</ndc>
    <ndc_label_name>MAGNESIUM OXIDE 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904427451</ndc>
    <ndc_label_name>Sleep-Tabs 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904429909</ndc>
    <ndc_label_name>Thera-Derm lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904505359</ndc>
    <ndc_label_name>Sudogest 30 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904515460</ndc>
    <ndc_label_name>GUAIFENESIN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904522452</ndc>
    <ndc_label_name>Dairy-Aid 3,000 unit tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904525944</ndc>
    <ndc_label_name>Thera-Gel 0.5 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904530016</ndc>
    <ndc_label_name>Lubrisoft lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904530760</ndc>
    <ndc_label_name>BANOPHEN 50 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904530780</ndc>
    <ndc_label_name>BANOPHEN 50 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904530909</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904530920</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904531346</ndc>
    <ndc_label_name>Prenatal Vitamin 27 mg iron-0.8 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904531360</ndc>
    <ndc_label_name>Prenatal Vitamin 27 mg iron-0.8 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904535124</ndc>
    <ndc_label_name>SudoGest Cold and Allergy 4 mg-60 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904535431</ndc>
    <ndc_label_name>Banophen Anti-Itch 2 %-0.1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904536560</ndc>
    <ndc_label_name>Acid Gone Antacid Extra Strength 160 mg-105 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904539561</ndc>
    <ndc_label_name>Ferrex 150 mg iron capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904544861</ndc>
    <ndc_label_name>PENTOXIFYLLINE ER 400 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904546052</ndc>
    <ndc_label_name>Oyster Shell Calcium-Vitamin D3 500 mg-5 mcg (200 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904546072</ndc>
    <ndc_label_name>Oyster Shell Calcium-Vitamin D3 500 mg-5 mcg (200 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904546080</ndc>
    <ndc_label_name>Oyster Shell Calcium-Vitamin D3 500 mg-5 mcg (200 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904546092</ndc>
    <ndc_label_name>Oyster Shell Calcium-Vitamin D3 500 mg-5 mcg (200 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904546335</ndc>
    <ndc_label_name>Infant's Ibuprofen 50 mg/1.25 mL oral drops,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904548652</ndc>
    <ndc_label_name>CertaVite Senior 0.4 mg-300 mcg-250 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904552261</ndc>
    <ndc_label_name>DOXAZOSIN MESYLATE 1 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904552361</ndc>
    <ndc_label_name>DOXAZOSIN MESYLATE 2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904552461</ndc>
    <ndc_label_name>DOXAZOSIN MESYLATE 4 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904552952</ndc>
    <ndc_label_name>Heartburn Relief (famotidine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904552987</ndc>
    <ndc_label_name>Heartburn Relief (famotidine) 10 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904555124</ndc>
    <ndc_label_name>Banophen 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904555159</ndc>
    <ndc_label_name>Banophen 25 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904557720</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904561646</ndc>
    <ndc_label_name>COENZYME Q10 50 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904567516</ndc>
    <ndc_label_name>Fiber Therapy (methylcellulose-sugar) 2 gram/19 gram oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904567661</ndc>
    <ndc_label_name>PAROXETINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904567761</ndc>
    <ndc_label_name>PAROXETINE HCL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904572514</ndc>
    <ndc_label_name>Mintox Maximum Strength 400 mg-400 mg-40 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904573182</ndc>
    <ndc_label_name>WHITE PETROLEUM JELLY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904578017</ndc>
    <ndc_label_name>Heartburn Relief (famotidine) 20 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904578051</ndc>
    <ndc_label_name>Heartburn Relief (famotidine) 20 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904578624</ndc>
    <ndc_label_name>Mapap Cold Formula 5 mg-10 mg-325 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904578961</ndc>
    <ndc_label_name>ACYCLOVIR 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904579061</ndc>
    <ndc_label_name>ACYCLOVIR 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904579146</ndc>
    <ndc_label_name>Children's Mapap 80 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904582360</ndc>
    <ndc_label_name>Vitamin D3 10 mcg (400 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904583315</ndc>
    <ndc_label_name>Loratadine-D 10 mg-240 mg tablet,extended release 24 hr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904583348</ndc>
    <ndc_label_name>Loratadine-D 10 mg-240 mg tablet,extended release 24 hr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904584709</ndc>
    <ndc_label_name>MAPAP 500 MG/15 ML LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904585340</ndc>
    <ndc_label_name>IBUPROFEN 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904585360</ndc>
    <ndc_label_name>IBUPROFEN 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904585361</ndc>
    <ndc_label_name>IBUPROFEN 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904585440</ndc>
    <ndc_label_name>IBUPROFEN 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904585460</ndc>
    <ndc_label_name>IBUPROFEN 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904585461</ndc>
    <ndc_label_name>IBUPROFEN 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904585540</ndc>
    <ndc_label_name>IBUPROFEN 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904585560</ndc>
    <ndc_label_name>IBUPROFEN 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904585561</ndc>
    <ndc_label_name>IBUPROFEN 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904589161</ndc>
    <ndc_label_name>PRAVASTATIN SODIUM 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904589261</ndc>
    <ndc_label_name>PRAVASTATIN SODIUM 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904589361</ndc>
    <ndc_label_name>PRAVASTATIN SODIUM 40 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904590887</ndc>
    <ndc_label_name>Lactase Fast Acting 9,000 unit tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904592161</ndc>
    <ndc_label_name>DIGOXIN 125 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904592261</ndc>
    <ndc_label_name>DIGOXIN 250 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904595961</ndc>
    <ndc_label_name>CLINDAMYCIN HCL 150 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904598348</ndc>
    <ndc_label_name>AMMONIUM LACTATE 12% CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904598426</ndc>
    <ndc_label_name>AMMONIUM LACTATE 12% LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904598463</ndc>
    <ndc_label_name>AMMONIUM LACTATE 12% LOTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904600760</ndc>
    <ndc_label_name>LORAZEPAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904600761</ndc>
    <ndc_label_name>LORAZEPAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904600860</ndc>
    <ndc_label_name>LORAZEPAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904600861</ndc>
    <ndc_label_name>LORAZEPAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904600960</ndc>
    <ndc_label_name>LORAZEPAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904600961</ndc>
    <ndc_label_name>LORAZEPAM 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904608261</ndc>
    <ndc_label_name>ZOLPIDEM TARTRATE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904608461</ndc>
    <ndc_label_name>CITALOPRAM HBR 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904608561</ndc>
    <ndc_label_name>CITALOPRAM HBR 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904617250</ndc>
    <ndc_label_name>CARBAMAZEPINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904617261</ndc>
    <ndc_label_name>CARBAMAZEPINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904622106</ndc>
    <ndc_label_name>URSODIOL 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904622161</ndc>
    <ndc_label_name>URSODIOL 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904625549</ndc>
    <ndc_label_name>Sore Throat (benzocaine with menthol) 15 mg-3.6 mg lozenges</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904626908</ndc>
    <ndc_label_name>ZIPRASIDONE HCL 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904626945</ndc>
    <ndc_label_name>ZIPRASIDONE HCL 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904627008</ndc>
    <ndc_label_name>ZIPRASIDONE HCL 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904627045</ndc>
    <ndc_label_name>ZIPRASIDONE HCL 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904627108</ndc>
    <ndc_label_name>ZIPRASIDONE HCL 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904627145</ndc>
    <ndc_label_name>ZIPRASIDONE HCL 60 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904627208</ndc>
    <ndc_label_name>ZIPRASIDONE HCL 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904627245</ndc>
    <ndc_label_name>ZIPRASIDONE HCL 80 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904628361</ndc>
    <ndc_label_name>OLANZAPINE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904628606</ndc>
    <ndc_label_name>OLANZAPINE 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904628661</ndc>
    <ndc_label_name>OLANZAPINE 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904628706</ndc>
    <ndc_label_name>OLANZAPINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904628761</ndc>
    <ndc_label_name>OLANZAPINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904629006</ndc>
    <ndc_label_name>ATORVASTATIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904629061</ndc>
    <ndc_label_name>ATORVASTATIN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904629106</ndc>
    <ndc_label_name>ATORVASTATIN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904629161</ndc>
    <ndc_label_name>ATORVASTATIN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904629206</ndc>
    <ndc_label_name>ATORVASTATIN 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904629261</ndc>
    <ndc_label_name>ATORVASTATIN 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904629304</ndc>
    <ndc_label_name>ATORVASTATIN 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904629461</ndc>
    <ndc_label_name>CLOPIDOGREL 75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904630061</ndc>
    <ndc_label_name>CARVEDILOL 3.125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904630161</ndc>
    <ndc_label_name>CARVEDILOL 6.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904630261</ndc>
    <ndc_label_name>CARVEDILOL 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904630361</ndc>
    <ndc_label_name>CARVEDILOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904630521</ndc>
    <ndc_label_name>Sore Throat (phenol) 1.4 % aerosol spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904631256</ndc>
    <ndc_label_name>Cough DM ER 30 mg/5 mL oral suspension,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904632078</ndc>
    <ndc_label_name>Enema 19 gram-7 gram/118 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904632206</ndc>
    <ndc_label_name>METOPROLOL SUCC ER 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904632261</ndc>
    <ndc_label_name>METOPROLOL SUCC ER 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904632361</ndc>
    <ndc_label_name>METOPROLOL SUCC ER 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904632461</ndc>
    <ndc_label_name>METOPROLOL SUCC ER 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904633724</ndc>
    <ndc_label_name>Sudogest 30 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904635161</ndc>
    <ndc_label_name>LEVOFLOXACIN 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904635261</ndc>
    <ndc_label_name>LEVOFLOXACIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904635361</ndc>
    <ndc_label_name>LEVOFLOXACIN 750 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904636345</ndc>
    <ndc_label_name>DIVALPROEX SOD ER 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904636361</ndc>
    <ndc_label_name>DIVALPROEX SOD ER 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904636961</ndc>
    <ndc_label_name>AMLODIPINE BESYLATE 2.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904637061</ndc>
    <ndc_label_name>AMLODIPINE BESYLATE 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904637161</ndc>
    <ndc_label_name>AMLODIPINE BESYLATE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904637361</ndc>
    <ndc_label_name>ROPINIROLE HCL 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904637461</ndc>
    <ndc_label_name>ROPINIROLE HCL 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904637661</ndc>
    <ndc_label_name>OLANZAPINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904637761</ndc>
    <ndc_label_name>OLANZAPINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904640360</ndc>
    <ndc_label_name>Ferate 240 mg (27 mg iron) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904640761</ndc>
    <ndc_label_name>BISACODYL EC 5 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904641292</ndc>
    <ndc_label_name>Calcium Antacid 200 mg (as calcium carbonate 500 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904641861</ndc>
    <ndc_label_name>TIZANIDINE HCL 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904642661</ndc>
    <ndc_label_name>ESCITALOPRAM 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904642761</ndc>
    <ndc_label_name>ESCITALOPRAM 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904643604</ndc>
    <ndc_label_name>TEMAZEPAM 7.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904644961</ndc>
    <ndc_label_name>ISOSORBIDE MONONIT ER 30 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904645061</ndc>
    <ndc_label_name>ISOSORBIDE MONONIT ER 60 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904646320</ndc>
    <ndc_label_name>DIMAPHEN DM ELIXIR</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904646509</ndc>
    <ndc_label_name>All-Nite Cold-Flu 6.25 mg-15 mg-325 mg/15 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904646707</ndc>
    <ndc_label_name>CLOPIDOGREL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904646710</ndc>
    <ndc_label_name>CLOPIDOGREL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904647461</ndc>
    <ndc_label_name>PANTOPRAZOLE SOD DR 40 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904647561</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904647661</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904647761</ndc>
    <ndc_label_name>DONEPEZIL HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904647861</ndc>
    <ndc_label_name>DONEPEZIL HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904648838</ndc>
    <ndc_label_name>Lubrifresh PM 83 %-15 % eye ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904650006</ndc>
    <ndc_label_name>FLUCONAZOLE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904650061</ndc>
    <ndc_label_name>FLUCONAZOLE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904650106</ndc>
    <ndc_label_name>FLUCONAZOLE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904650161</ndc>
    <ndc_label_name>FLUCONAZOLE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904650261</ndc>
    <ndc_label_name>CELECOXIB 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904650361</ndc>
    <ndc_label_name>CELECOXIB 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904650506</ndc>
    <ndc_label_name>MEMANTINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904650561</ndc>
    <ndc_label_name>MEMANTINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904650606</ndc>
    <ndc_label_name>MEMANTINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904650661</ndc>
    <ndc_label_name>MEMANTINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904651061</ndc>
    <ndc_label_name>ARIPIPRAZOLE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904651106</ndc>
    <ndc_label_name>ARIPIPRAZOLE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904651961</ndc>
    <ndc_label_name>MIRTAZAPINE 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904653720</ndc>
    <ndc_label_name>Robafen CF (phenylephrine) 5 mg-10 mg-100 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904655161</ndc>
    <ndc_label_name>ONDANSETRON HCL 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904655261</ndc>
    <ndc_label_name>ONDANSETRON HCL 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904655304</ndc>
    <ndc_label_name>LINEZOLID 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904655761</ndc>
    <ndc_label_name>MORPHINE SULF ER 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904655861</ndc>
    <ndc_label_name>MORPHINE SULF ER 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904655961</ndc>
    <ndc_label_name>MORPHINE SULF ER 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904656061</ndc>
    <ndc_label_name>MORPHINE SULF ER 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904656460</ndc>
    <ndc_label_name>BENZONATATE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904656507</ndc>
    <ndc_label_name>VALACYCLOVIR HCL 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904656561</ndc>
    <ndc_label_name>VALACYCLOVIR HCL 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904657004</ndc>
    <ndc_label_name>OXYBUTYNIN CL ER 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904657006</ndc>
    <ndc_label_name>OXYBUTYNIN CL ER 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904657061</ndc>
    <ndc_label_name>OXYBUTYNIN CL ER 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904657261</ndc>
    <ndc_label_name>ALLOPURINOL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904657561</ndc>
    <ndc_label_name>PHENOBARBITAL 32.4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904657580</ndc>
    <ndc_label_name>PHENOBARBITAL 32.4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904658168</ndc>
    <ndc_label_name>ESOMEPRAZOLE MAG DR 40 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904658304</ndc>
    <ndc_label_name>LAMIVUDINE 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904659204</ndc>
    <ndc_label_name>TOLTERODINE TART ER 2 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904659304</ndc>
    <ndc_label_name>TOLTERODINE TART ER 4 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904659604</ndc>
    <ndc_label_name>VORICONAZOLE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904659961</ndc>
    <ndc_label_name>PERPHENAZINE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904660061</ndc>
    <ndc_label_name>PERPHENAZINE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904660161</ndc>
    <ndc_label_name>PERPHENAZINE 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904661561</ndc>
    <ndc_label_name>DIVALPROEX DR 125 MG CAP SPRNK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904661761</ndc>
    <ndc_label_name>HYDROXYZINE HCL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904661861</ndc>
    <ndc_label_name>HYDROXYZINE HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904661961</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904662061</ndc>
    <ndc_label_name>ISOSORBIDE DINITRATE 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904662104</ndc>
    <ndc_label_name>IMATINIB MESYLATE 400 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904662261</ndc>
    <ndc_label_name>PYRIDOSTIGMINE BR 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904662361</ndc>
    <ndc_label_name>TACROLIMUS 0.5 MG CAPSULE (IR)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904662461</ndc>
    <ndc_label_name>TACROLIMUS 5 MG CAPSULE (IR)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904662735</ndc>
    <ndc_label_name>Ear Drops (carbamide peroxide) 6.5 %</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904663444</ndc>
    <ndc_label_name>Cough and Cold (chlorpheniramine-DM) 4 mg-30 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904663561</ndc>
    <ndc_label_name>BUPROPION HCL 75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904663661</ndc>
    <ndc_label_name>BUPROPION HCL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904663761</ndc>
    <ndc_label_name>GLIPIZIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904663861</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904663961</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904664061</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904664161</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 200 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904664261</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 300 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904664361</ndc>
    <ndc_label_name>QUETIAPINE FUMARATE 400 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904664524</ndc>
    <ndc_label_name>Children's Mapap 160 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904665640</ndc>
    <ndc_label_name>ARIPIPRAZOLE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904666104</ndc>
    <ndc_label_name>HALOPERIDOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904666245</ndc>
    <ndc_label_name>LANSOPRAZOLE DR 30 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904666361</ndc>
    <ndc_label_name>ACETAZOLAMIDE 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904666561</ndc>
    <ndc_label_name>GABAPENTIN 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904666661</ndc>
    <ndc_label_name>GABAPENTIN 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904666761</ndc>
    <ndc_label_name>GABAPENTIN 400 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904667104</ndc>
    <ndc_label_name>SILDENAFIL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904667106</ndc>
    <ndc_label_name>SILDENAFIL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904667840</ndc>
    <ndc_label_name>OXYCODONE HCL 5 MG/5 ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904668108</ndc>
    <ndc_label_name>DOFETILIDE 125 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904668208</ndc>
    <ndc_label_name>DOFETILIDE 250 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904668308</ndc>
    <ndc_label_name>DOFETILIDE 500 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904670060</ndc>
    <ndc_label_name>Mintox Plus 200 mg-200 mg-25 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904670310</ndc>
    <ndc_label_name>LEUCOVORIN CALCIUM 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904670461</ndc>
    <ndc_label_name>PRAMIPEXOLE 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904670606</ndc>
    <ndc_label_name>OMEGA-3 ETHYL ESTERS 1 GM CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904670706</ndc>
    <ndc_label_name>SEVELAMER CARBONATE 800 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904670782</ndc>
    <ndc_label_name>SEVELAMER CARBONATE 800 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904670961</ndc>
    <ndc_label_name>GLYCOPYRROLATE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904671146</ndc>
    <ndc_label_name>FEXOFENADINE HCL 180 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904671740</ndc>
    <ndc_label_name>CETIRIZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904671741</ndc>
    <ndc_label_name>CETIRIZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904671743</ndc>
    <ndc_label_name>CETIRIZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904671746</ndc>
    <ndc_label_name>CETIRIZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904671760</ndc>
    <ndc_label_name>CETIRIZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904671761</ndc>
    <ndc_label_name>CETIRIZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904671772</ndc>
    <ndc_label_name>CETIRIZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904671786</ndc>
    <ndc_label_name>CETIRIZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904671839</ndc>
    <ndc_label_name>Mucus Relief ER 600 mg tablet, extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904672024</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904672040</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904672051</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904672059</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904672060</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904672080</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904672559</ndc>
    <ndc_label_name>senna 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904672760</ndc>
    <ndc_label_name>Sudogest 30 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904672846</ndc>
    <ndc_label_name>Sudogest 60 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904672852</ndc>
    <ndc_label_name>Sudogest 60 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904673059</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904673060</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904673061</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904673080</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904673151</ndc>
    <ndc_label_name>Acetaminophen PM 25 mg-500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904673204</ndc>
    <ndc_label_name>COLCHICINE 0.6 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904673361</ndc>
    <ndc_label_name>HALOPERIDOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904673461</ndc>
    <ndc_label_name>MEMANTINE HCL ER 7 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904673561</ndc>
    <ndc_label_name>MEMANTINE HCL ER 28 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904674724</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904674740</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904674751</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904674759</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904674770</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904674780</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904674817</ndc>
    <ndc_label_name>BISACODYL EC 5 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904674860</ndc>
    <ndc_label_name>BISACODYL EC 5 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904674880</ndc>
    <ndc_label_name>BISACODYL EC 5 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904675060</ndc>
    <ndc_label_name>DOK 100 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904675180</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904675415</ndc>
    <ndc_label_name>Sudogest 12-hour 120 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904676130</ndc>
    <ndc_label_name>Nasal Decongestant (oxymetazoline) 0.05 % spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904676520</ndc>
    <ndc_label_name>Children's Cetirizine 1 mg/mL oral solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904676720</ndc>
    <ndc_label_name>CHILD LORATADINE 5 MG/5 ML SOL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904677212</ndc>
    <ndc_label_name>Driminate 50 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904677361</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904677861</ndc>
    <ndc_label_name>ROSUVASTATIN CALCIUM 5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904677961</ndc>
    <ndc_label_name>ROSUVASTATIN CALCIUM 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904678061</ndc>
    <ndc_label_name>ROSUVASTATIN CALCIUM 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904678161</ndc>
    <ndc_label_name>ROSUVASTATIN CALCIUM 40 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904678261</ndc>
    <ndc_label_name>HALOPERIDOL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904678370</ndc>
    <ndc_label_name>ASPIRIN EC 81 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904678504</ndc>
    <ndc_label_name>MYCOPHENOLIC ACID DR 180 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904678561</ndc>
    <ndc_label_name>MYCOPHENOLIC ACID DR 180 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904678604</ndc>
    <ndc_label_name>MYCOPHENOLIC ACID DR 360 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904678661</ndc>
    <ndc_label_name>MYCOPHENOLIC ACID DR 360 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904679104</ndc>
    <ndc_label_name>MODAFINIL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904679204</ndc>
    <ndc_label_name>MODAFINIL 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>True</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904679430</ndc>
    <ndc_label_name>ASPIRIN 81 MG CHEWABLE TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904679480</ndc>
    <ndc_label_name>ASPIRIN 81 MG CHEWABLE TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904679489</ndc>
    <ndc_label_name>ASPIRIN 81 MG CHEWABLE TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904679604</ndc>
    <ndc_label_name>VALGANCICLOVIR 450 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904679610</ndc>
    <ndc_label_name>VALGANCICLOVIR 450 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904679761</ndc>
    <ndc_label_name>LISINOPRIL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904679861</ndc>
    <ndc_label_name>LISINOPRIL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904679961</ndc>
    <ndc_label_name>LISINOPRIL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904680161</ndc>
    <ndc_label_name>QUETIAPINE ER 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904680261</ndc>
    <ndc_label_name>QUETIAPINE ER 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904680361</ndc>
    <ndc_label_name>QUETIAPINE ER 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904680461</ndc>
    <ndc_label_name>QUETIAPINE ER 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904680561</ndc>
    <ndc_label_name>QUETIAPINE ER 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904680806</ndc>
    <ndc_label_name>MONTELUKAST SOD 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904680861</ndc>
    <ndc_label_name>MONTELUKAST SOD 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904681706</ndc>
    <ndc_label_name>MIDODRINE HCL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904681761</ndc>
    <ndc_label_name>MIDODRINE HCL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904681806</ndc>
    <ndc_label_name>MIDODRINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904681861</ndc>
    <ndc_label_name>MIDODRINE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904681907</ndc>
    <ndc_label_name>MIDODRINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904682104</ndc>
    <ndc_label_name>TENOFOVIR DISOP FUM 300 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904682207</ndc>
    <ndc_label_name>ENTACAPONE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904682361</ndc>
    <ndc_label_name>GABAPENTIN 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904682805</ndc>
    <ndc_label_name>OXYCODONE HCL 5 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904682892</ndc>
    <ndc_label_name>OXYCODONE HCL 5 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904682894</ndc>
    <ndc_label_name>OXYCODONE HCL 5 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904682960</ndc>
    <ndc_label_name>Medi-Pads 50 % topical pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904683006</ndc>
    <ndc_label_name>FINASTERIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904683061</ndc>
    <ndc_label_name>FINASTERIDE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904683104</ndc>
    <ndc_label_name>METAXALONE 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904683106</ndc>
    <ndc_label_name>METAXALONE 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904683204</ndc>
    <ndc_label_name>MESALAMINE DR 1.2 GM TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904683407</ndc>
    <ndc_label_name>FLUCYTOSINE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904683507</ndc>
    <ndc_label_name>FLUCYTOSINE 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904683620</ndc>
    <ndc_label_name>LOPERAMIDE 1 MG/7.5 ML SOLN</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904685261</ndc>
    <ndc_label_name>LORATADINE 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904685272</ndc>
    <ndc_label_name>LORATADINE 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904685289</ndc>
    <ndc_label_name>LORATADINE 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904686061</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904686161</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904686190</ndc>
    <ndc_label_name>DIVALPROEX SOD DR 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904686704</ndc>
    <ndc_label_name>TRETINOIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904686861</ndc>
    <ndc_label_name>TRAZODONE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904686961</ndc>
    <ndc_label_name>TRAZODONE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904687045</ndc>
    <ndc_label_name>PANTOPRAZOLE SOD DR 40 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904687204</ndc>
    <ndc_label_name>CLARITHROMYCIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904687404</ndc>
    <ndc_label_name>ABACAVIR 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904687406</ndc>
    <ndc_label_name>ABACAVIR 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904688210</ndc>
    <ndc_label_name>PHYTONADIONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904688365</ndc>
    <ndc_label_name>ACETAMINOPHEN ER 650 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904688504</ndc>
    <ndc_label_name>CARBAMAZEPINE ER 200 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904688806</ndc>
    <ndc_label_name>MINOCYCLINE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904689004</ndc>
    <ndc_label_name>URSODIOL 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904689961</ndc>
    <ndc_label_name>BUSPIRONE HCL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904690004</ndc>
    <ndc_label_name>CHLORTHALIDONE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904690061</ndc>
    <ndc_label_name>CHLORTHALIDONE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904690104</ndc>
    <ndc_label_name>IMATINIB MESYLATE 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904690204</ndc>
    <ndc_label_name>RALOXIFENE HCL 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904690706</ndc>
    <ndc_label_name>PSEUDOEPHEDRINE 60 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904690804</ndc>
    <ndc_label_name>ATOMOXETINE HCL 40 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904691461</ndc>
    <ndc_label_name>METHYLPREDNISOLONE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904691761</ndc>
    <ndc_label_name>OMEPRAZOLE DR 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904692093</ndc>
    <ndc_label_name>DOCUSATE SODIUM MINI ENEMA</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904692361</ndc>
    <ndc_label_name>PREDNISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904692461</ndc>
    <ndc_label_name>SERTRALINE HCL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904692561</ndc>
    <ndc_label_name>SERTRALINE HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904692661</ndc>
    <ndc_label_name>SERTRALINE HCL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904692761</ndc>
    <ndc_label_name>SPIRONOLACTONE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904692861</ndc>
    <ndc_label_name>TOPIRAMATE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904692961</ndc>
    <ndc_label_name>TOPIRAMATE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904693126</ndc>
    <ndc_label_name>POLYETHYLENE GLYCOL 3350 POWD</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904693176</ndc>
    <ndc_label_name>POLYETHYLENE GLYCOL 3350 POWD</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904693181</ndc>
    <ndc_label_name>POLYETHYLENE GLYCOL 3350 POWD</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904693186</ndc>
    <ndc_label_name>POLYETHYLENE GLYCOL 3350 POWD</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904693561</ndc>
    <ndc_label_name>PALIPERIDONE ER 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904693661</ndc>
    <ndc_label_name>PALIPERIDONE ER 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904693761</ndc>
    <ndc_label_name>PALIPERIDONE ER 9 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904693806</ndc>
    <ndc_label_name>BUTALB-ACETAMIN-CAFF 50-325-40</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904693961</ndc>
    <ndc_label_name>HYDROXYUREA 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904694804</ndc>
    <ndc_label_name>ABIRATERONE ACETATE 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904694961</ndc>
    <ndc_label_name>LEVOTHYROXINE 25 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904695061</ndc>
    <ndc_label_name>LEVOTHYROXINE 50 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904695161</ndc>
    <ndc_label_name>LEVOTHYROXINE 75 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904695261</ndc>
    <ndc_label_name>LEVOTHYROXINE 88 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904695361</ndc>
    <ndc_label_name>LEVOTHYROXINE 100 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904695461</ndc>
    <ndc_label_name>LEVOTHYROXINE 112 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904695561</ndc>
    <ndc_label_name>LEVOTHYROXINE 125 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904695661</ndc>
    <ndc_label_name>LEVOTHYROXINE 150 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904695761</ndc>
    <ndc_label_name>LEVOTHYROXINE 175 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904696661</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904697712</ndc>
    <ndc_label_name>HEMORRHOIDAL SUPPOSITORY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904698516</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 12.5 MG/5 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904698520</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 12.5 MG/5 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904698640</ndc>
    <ndc_label_name>Mucus Relief ER 600 mg tablet, extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904698761</ndc>
    <ndc_label_name>DICYCLOMINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904698861</ndc>
    <ndc_label_name>DICYCLOMINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904699061</ndc>
    <ndc_label_name>PSEUDOEPHEDRINE 30 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904699104</ndc>
    <ndc_label_name>PREGABALIN 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904699161</ndc>
    <ndc_label_name>PREGABALIN 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904699261</ndc>
    <ndc_label_name>PREGABALIN 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904699361</ndc>
    <ndc_label_name>AMIODARONE HCL 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904699446</ndc>
    <ndc_label_name>Gas Relief Extra Strength 125 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904699544</ndc>
    <ndc_label_name>Daytime Cold and Flu Relief (phenylephrine) 5 mg-10 mg-325 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904699644</ndc>
    <ndc_label_name>Nighttime Cold-Flu 6.25 mg-15 mg-325 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904699740</ndc>
    <ndc_label_name>DOCUSATE CAL 240 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904699760</ndc>
    <ndc_label_name>DOCUSATE CAL 240 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904699780</ndc>
    <ndc_label_name>DOCUSATE CAL 240 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904700061</ndc>
    <ndc_label_name>PREGABALIN 75 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904700161</ndc>
    <ndc_label_name>PREGABALIN 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904700261</ndc>
    <ndc_label_name>PREGABALIN 150 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904700304</ndc>
    <ndc_label_name>PREGABALIN 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904700404</ndc>
    <ndc_label_name>PREGABALIN 225 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904700504</ndc>
    <ndc_label_name>PREGABALIN 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904700635</ndc>
    <ndc_label_name>Nasal Decongestant (oxymetazoline) 0.05 % spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904700761</ndc>
    <ndc_label_name>LAMOTRIGINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904700861</ndc>
    <ndc_label_name>LAMOTRIGINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904700906</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 2-0.5MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904701006</ndc>
    <ndc_label_name>BUPRENORPHINE-NALOX 8-2 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904701416</ndc>
    <ndc_label_name>Children's Acetaminophen 160 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904701420</ndc>
    <ndc_label_name>Children's Acetaminophen 160 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904701604</ndc>
    <ndc_label_name>BUMETANIDE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904701606</ndc>
    <ndc_label_name>BUMETANIDE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904701661</ndc>
    <ndc_label_name>BUMETANIDE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904702061</ndc>
    <ndc_label_name>PRAZOSIN 1 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904702161</ndc>
    <ndc_label_name>PRAZOSIN 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904702261</ndc>
    <ndc_label_name>PRAZOSIN 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904702367</ndc>
    <ndc_label_name>BACITRACIN ZN 500 UNIT/GM OINT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904702404</ndc>
    <ndc_label_name>VORICONAZOLE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904702661</ndc>
    <ndc_label_name>NITROFURANTOIN MCR 50 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904702761</ndc>
    <ndc_label_name>OXYBUTYNIN 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904703580</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12%  15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904703587</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12%  15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904703588</ndc>
    <ndc_label_name>CHLORHEXIDINE 0.12%  15 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904703604</ndc>
    <ndc_label_name>NALTREXONE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904703807</ndc>
    <ndc_label_name>CLOMIPRAMINE 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904703907</ndc>
    <ndc_label_name>CLOMIPRAMINE 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704161</ndc>
    <ndc_label_name>ALLOPURINOL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704206</ndc>
    <ndc_label_name>AMANTADINE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704240</ndc>
    <ndc_label_name>AMANTADINE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704259</ndc>
    <ndc_label_name>AMANTADINE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704261</ndc>
    <ndc_label_name>AMANTADINE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704304</ndc>
    <ndc_label_name>DULOXETINE HCL DR 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704361</ndc>
    <ndc_label_name>DULOXETINE HCL DR 20 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704461</ndc>
    <ndc_label_name>DULOXETINE HCL DR 30 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704561</ndc>
    <ndc_label_name>DULOXETINE HCL DR 60 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704606</ndc>
    <ndc_label_name>HYDROXYCHLOROQUINE 200 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704661</ndc>
    <ndc_label_name>HYDROXYCHLOROQUINE 200 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704761</ndc>
    <ndc_label_name>LOSARTAN POTASSIUM 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704861</ndc>
    <ndc_label_name>LOSARTAN POTASSIUM 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904704961</ndc>
    <ndc_label_name>LOSARTAN POTASSIUM 100 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904705040</ndc>
    <ndc_label_name>FEXOFENADINE HCL 180 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904705060</ndc>
    <ndc_label_name>FEXOFENADINE HCL 180 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904705261</ndc>
    <ndc_label_name>DOXEPIN 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904705361</ndc>
    <ndc_label_name>DOXEPIN 25 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904705461</ndc>
    <ndc_label_name>DOXEPIN 50 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904705561</ndc>
    <ndc_label_name>DOXEPIN 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904705699</ndc>
    <ndc_label_name>ASPIRIN-DIPYRIDAM ER 25-200 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904705761</ndc>
    <ndc_label_name>METHOCARBAMOL 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904705861</ndc>
    <ndc_label_name>METHOCARBAMOL 750 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904705952</ndc>
    <ndc_label_name>TROSPIUM CHLORIDE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904706180</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904706187</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904706188</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904706243</ndc>
    <ndc_label_name>POTASSIUM CL10%(40MEQ/30ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904706260</ndc>
    <ndc_label_name>POTASSIUM CL10%(40MEQ/30ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904706273</ndc>
    <ndc_label_name>POTASSIUM CL10%(40MEQ/30ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904706561</ndc>
    <ndc_label_name>HYDROXYZINE PAM 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904707007</ndc>
    <ndc_label_name>NADOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904707061</ndc>
    <ndc_label_name>NADOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904707107</ndc>
    <ndc_label_name>NADOLOL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904707161</ndc>
    <ndc_label_name>NADOLOL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904707341</ndc>
    <ndc_label_name>ONDANSETRON 4 MG/5 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904707393</ndc>
    <ndc_label_name>ONDANSETRON 4 MG/5 ML SOLN CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904707661</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 150 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904707761</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904707861</ndc>
    <ndc_label_name>MYCOPHENOLATE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904708106</ndc>
    <ndc_label_name>NIFEDIPINE ER 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904708161</ndc>
    <ndc_label_name>NIFEDIPINE ER 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904708204</ndc>
    <ndc_label_name>NIFEDIPINE ER 90 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904708206</ndc>
    <ndc_label_name>NIFEDIPINE ER 90 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904708361</ndc>
    <ndc_label_name>CIPROFLOXACIN HCL 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904708395</ndc>
    <ndc_label_name>CIPROFLOXACIN HCL 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904708404</ndc>
    <ndc_label_name>BUPROPION HCL XL 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904708461</ndc>
    <ndc_label_name>BUPROPION HCL XL 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904708761</ndc>
    <ndc_label_name>CLOZAPINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904708861</ndc>
    <ndc_label_name>CLOZAPINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904708961</ndc>
    <ndc_label_name>CLOZAPINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904709061</ndc>
    <ndc_label_name>PIOGLITAZONE HCL 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904709361</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHEN 5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904709461</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHN 7.5-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904709561</ndc>
    <ndc_label_name>OXYCODONE-ACETAMINOPHEN 10-325</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904709661</ndc>
    <ndc_label_name>PIOGLITAZONE HCL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904709761</ndc>
    <ndc_label_name>TACROLIMUS 1 MG CAPSULE (IR)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904709961</ndc>
    <ndc_label_name>BUPROPION HCL SR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904710304</ndc>
    <ndc_label_name>EZETIMIBE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904710310</ndc>
    <ndc_label_name>EZETIMIBE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904710561</ndc>
    <ndc_label_name>CAPTOPRIL 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904710661</ndc>
    <ndc_label_name>CAPTOPRIL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904710761</ndc>
    <ndc_label_name>RIVASTIGMINE 1.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904710861</ndc>
    <ndc_label_name>GABAPENTIN 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904711241</ndc>
    <ndc_label_name>HALOPERIDOL LAC 10 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904711270</ndc>
    <ndc_label_name>HALOPERIDOL LAC 10 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904711341</ndc>
    <ndc_label_name>MIDAZOLAM HCL 10 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904711393</ndc>
    <ndc_label_name>MIDAZOLAM HCL 10 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904711741</ndc>
    <ndc_label_name>DIAZEPAM 5 MG/5 ML ORAL CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904711793</ndc>
    <ndc_label_name>DIAZEPAM 5 MG/5 ML ORAL CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904711906</ndc>
    <ndc_label_name>CALCIUM ACETATE 667 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904711961</ndc>
    <ndc_label_name>CALCIUM ACETATE 667 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904712004</ndc>
    <ndc_label_name>COLCHICINE 0.6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904712161</ndc>
    <ndc_label_name>BUSPIRONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904712261</ndc>
    <ndc_label_name>BUSPIRONE HCL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904712361</ndc>
    <ndc_label_name>LEVETIRACETAM 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904712461</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904712561</ndc>
    <ndc_label_name>LEVETIRACETAM 750 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904712661</ndc>
    <ndc_label_name>METRONIDAZOLE 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904712761</ndc>
    <ndc_label_name>PREDNISONE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904712804</ndc>
    <ndc_label_name>FENOFIBRATE 160 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904712961</ndc>
    <ndc_label_name>CHLORPROMAZINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904713006</ndc>
    <ndc_label_name>CHLORPROMAZINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904713061</ndc>
    <ndc_label_name>CHLORPROMAZINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904713161</ndc>
    <ndc_label_name>CHLORPROMAZINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904713261</ndc>
    <ndc_label_name>CHLORPROMAZINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904713361</ndc>
    <ndc_label_name>CHLORPROMAZINE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904713470</ndc>
    <ndc_label_name>GUAIFENESIN-DM 100-10 MG/5 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904713572</ndc>
    <ndc_label_name>GUAIFENESIN-DM 200-20 MG/10 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904713761</ndc>
    <ndc_label_name>NITROFURANTOIN MONO-MCR 100 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904714004</ndc>
    <ndc_label_name>GUANFACINE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904714110</ndc>
    <ndc_label_name>METHOTREXATE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904714212</ndc>
    <ndc_label_name>BISACODYL 10 MG SUPPOSITORY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904714361</ndc>
    <ndc_label_name>SOTALOL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904714461</ndc>
    <ndc_label_name>DRONABINOL 2.5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904714504</ndc>
    <ndc_label_name>DRONABINOL 5 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904714904</ndc>
    <ndc_label_name>POSACONAZOLE DR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904714910</ndc>
    <ndc_label_name>POSACONAZOLE DR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904715361</ndc>
    <ndc_label_name>BENZONATATE 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904715404</ndc>
    <ndc_label_name>BUPRENORPHINE 2 MG TABLET SL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904715504</ndc>
    <ndc_label_name>BUPRENORPHINE 8 MG TABLET SL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904715661</ndc>
    <ndc_label_name>METRONIDAZOLE 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904715761</ndc>
    <ndc_label_name>FLUPHENAZINE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904715861</ndc>
    <ndc_label_name>FLUPHENAZINE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904715961</ndc>
    <ndc_label_name>FLUPHENAZINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904716061</ndc>
    <ndc_label_name>FLUPHENAZINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904716104</ndc>
    <ndc_label_name>FENOFIBRATE 145 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904716161</ndc>
    <ndc_label_name>FENOFIBRATE 145 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904716261</ndc>
    <ndc_label_name>METFORMIN HCL 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904716361</ndc>
    <ndc_label_name>METFORMIN HCL 850 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904716461</ndc>
    <ndc_label_name>METFORMIN HCL 1,000 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904716507</ndc>
    <ndc_label_name>AMINOCAPROIC ACID 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904716723</ndc>
    <ndc_label_name>UREA 40% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904716783</ndc>
    <ndc_label_name>UREA 40% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904716799</ndc>
    <ndc_label_name>UREA 40% CREAM</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904716806</ndc>
    <ndc_label_name>URSODIOL 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904716861</ndc>
    <ndc_label_name>URSODIOL 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904717207</ndc>
    <ndc_label_name>EMTRICITABINE-TENOFV 200-300MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904717761</ndc>
    <ndc_label_name>FUROSEMIDE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904717861</ndc>
    <ndc_label_name>FUROSEMIDE 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904717961</ndc>
    <ndc_label_name>TRAMADOL HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904718061</ndc>
    <ndc_label_name>OXYCODONE HCL (IR) 15 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904718245</ndc>
    <ndc_label_name>DIVALPROEX SOD ER 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904718261</ndc>
    <ndc_label_name>DIVALPROEX SOD ER 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904718361</ndc>
    <ndc_label_name>DOCUSATE SODIUM 100 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904718761</ndc>
    <ndc_label_name>ATENOLOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904718861</ndc>
    <ndc_label_name>HYDROCORTISONE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904718904</ndc>
    <ndc_label_name>NEBIVOLOL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904719004</ndc>
    <ndc_label_name>NEBIVOLOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904719106</ndc>
    <ndc_label_name>VITAMIN B-1 100 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904719204</ndc>
    <ndc_label_name>FEXOFENADINE HCL 60 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904719240</ndc>
    <ndc_label_name>FEXOFENADINE HCL 60 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904719260</ndc>
    <ndc_label_name>FEXOFENADINE HCL 60 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904719306</ndc>
    <ndc_label_name>FAMOTIDINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904719361</ndc>
    <ndc_label_name>FAMOTIDINE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904719461</ndc>
    <ndc_label_name>CLINDAMYCIN HCL 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904719907</ndc>
    <ndc_label_name>PHENYTOIN 50 MG TABLET CHEW</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904720061</ndc>
    <ndc_label_name>LISINOPRIL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904720546</ndc>
    <ndc_label_name>BISMUTH 262 MG TABLET CHEW</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904720660</ndc>
    <ndc_label_name>SIMETHICONE 80 MG TAB CHEW</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904720806</ndc>
    <ndc_label_name>NIFEDIPINE ER 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904720861</ndc>
    <ndc_label_name>NIFEDIPINE ER 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904720906</ndc>
    <ndc_label_name>SEVELAMER HCL 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904721104</ndc>
    <ndc_label_name>DANTROLENE SODIUM 25 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904721261</ndc>
    <ndc_label_name>TRAZODONE 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904721304</ndc>
    <ndc_label_name>ACAMPROSATE CALC DR 333 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904721661</ndc>
    <ndc_label_name>POTASSIUM CL ER 10 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904721761</ndc>
    <ndc_label_name>DILTIAZEM 24H ER(CD) 120 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904721861</ndc>
    <ndc_label_name>DILTIAZEM 24H ER(CD) 180 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904721961</ndc>
    <ndc_label_name>DILTIAZEM 24H ER(CD) 240 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904722061</ndc>
    <ndc_label_name>DILTIAZEM 24H ER(CD) 300 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904722320</ndc>
    <ndc_label_name>Robafen DM 5 mg-50 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904722359</ndc>
    <ndc_label_name>Robafen DM 5 mg-50 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904722461</ndc>
    <ndc_label_name>FOLIC ACID 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904722504</ndc>
    <ndc_label_name>NEBIVOLOL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904722604</ndc>
    <ndc_label_name>NEBIVOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904722761</ndc>
    <ndc_label_name>CLONAZEPAM 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904722961</ndc>
    <ndc_label_name>NIFEDIPINE 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904723006</ndc>
    <ndc_label_name>SACCH-BOULARDII 250 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904723661</ndc>
    <ndc_label_name>MEGESTROL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904723724</ndc>
    <ndc_label_name>BANOPHEN 25 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904723760</ndc>
    <ndc_label_name>BANOPHEN 25 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904723761</ndc>
    <ndc_label_name>BANOPHEN 25 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904723780</ndc>
    <ndc_label_name>BANOPHEN 25 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904723860</ndc>
    <ndc_label_name>FISH OIL 1,000 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904723961</ndc>
    <ndc_label_name>SODIUM CHLORIDE 1 GM TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904724361</ndc>
    <ndc_label_name>CIPROFLOXACIN HCL 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904724395</ndc>
    <ndc_label_name>CIPROFLOXACIN HCL 500 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904724468</ndc>
    <ndc_label_name>LACOSAMIDE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904724568</ndc>
    <ndc_label_name>LACOSAMIDE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904724668</ndc>
    <ndc_label_name>LACOSAMIDE 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904724768</ndc>
    <ndc_label_name>LACOSAMIDE 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904724804</ndc>
    <ndc_label_name>SIROLIMUS 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904725260</ndc>
    <ndc_label_name>senna 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904725261</ndc>
    <ndc_label_name>Senna Lax 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904725280</ndc>
    <ndc_label_name>senna 8.6 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904725304</ndc>
    <ndc_label_name>DABIGATRAN ETEXILATE 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904725335</ndc>
    <ndc_label_name>DABIGATRAN ETEXILATE 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904725368</ndc>
    <ndc_label_name>DABIGATRAN ETEXILATE 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904725435</ndc>
    <ndc_label_name>DABIGATRAN ETEXILATE 110 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904725468</ndc>
    <ndc_label_name>DABIGATRAN ETEXILATE 110 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904725510</ndc>
    <ndc_label_name>DABIGATRAN ETEXILATE 150 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904725535</ndc>
    <ndc_label_name>DABIGATRAN ETEXILATE 150 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904725568</ndc>
    <ndc_label_name>DABIGATRAN ETEXILATE 150 MG CP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904726006</ndc>
    <ndc_label_name>ACIDOPHILUS LACTBACLLI 500 MIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904726161</ndc>
    <ndc_label_name>SODIUM BICARB 650 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904726261</ndc>
    <ndc_label_name>OXCARBAZEPINE 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904726361</ndc>
    <ndc_label_name>OXCARBAZEPINE 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904726461</ndc>
    <ndc_label_name>OXCARBAZEPINE 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904726541</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904726592</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904726593</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904726594</ndc>
    <ndc_label_name>LEVETIRACETAM 500 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904726661</ndc>
    <ndc_label_name>DEXAMETHASONE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904726761</ndc>
    <ndc_label_name>DEXAMETHASONE 6 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904726918</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904726966</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904727061</ndc>
    <ndc_label_name>BUPROPION HCL SR 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904727641</ndc>
    <ndc_label_name>NYSTATIN 500,000 UNIT/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904727670</ndc>
    <ndc_label_name>NYSTATIN 500,000 UNIT/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904727692</ndc>
    <ndc_label_name>NYSTATIN 500,000 UNIT/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904727741</ndc>
    <ndc_label_name>FERROUS SULF 300 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904727770</ndc>
    <ndc_label_name>FERROUS SULF 300 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904727841</ndc>
    <ndc_label_name>Children's Acetaminophen 160 mg/5 mL (5 mL) oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904727870</ndc>
    <ndc_label_name>Children's Acetaminophen 160 mg/5 mL (5 mL) oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904727966</ndc>
    <ndc_label_name>DOCUSATE SOD 100 MG/10 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904727972</ndc>
    <ndc_label_name>DOCUSATE SOD 100 MG/10 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904728060</ndc>
    <ndc_label_name>DOCUSATE SODIUM 100 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904728080</ndc>
    <ndc_label_name>DOCUSATE SODIUM 100 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904728160</ndc>
    <ndc_label_name>DOCUSATE SODIUM 250 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904728180</ndc>
    <ndc_label_name>DOCUSATE SODIUM 250 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904728210</ndc>
    <ndc_label_name>METHYLERGONOVINE 0.2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904728306</ndc>
    <ndc_label_name>TORSEMIDE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904728361</ndc>
    <ndc_label_name>TORSEMIDE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904728454</ndc>
    <ndc_label_name>MUPIROCIN 2% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904728469</ndc>
    <ndc_label_name>MUPIROCIN 2% OINTMENT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904728861</ndc>
    <ndc_label_name>BENZTROPINE MES 0.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904728961</ndc>
    <ndc_label_name>BENZTROPINE MES 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904729061</ndc>
    <ndc_label_name>BENZTROPINE MES 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904729261</ndc>
    <ndc_label_name>POTASSIUM CL ER 10 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904729361</ndc>
    <ndc_label_name>POTASSIUM CL ER 20 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904730165</ndc>
    <ndc_label_name>BENZOCAINE 20% SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904730186</ndc>
    <ndc_label_name>BENZOCAINE 20% SPRAY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904730224</ndc>
    <ndc_label_name>Aprodine 2.5 mg-60 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904730260</ndc>
    <ndc_label_name>Aprodine 2.5 mg-60 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904730304</ndc>
    <ndc_label_name>KETOROLAC 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904730461</ndc>
    <ndc_label_name>PROMETHAZINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904730561</ndc>
    <ndc_label_name>CARVEDILOL 3.125 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904730661</ndc>
    <ndc_label_name>CARVEDILOL 6.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904730761</ndc>
    <ndc_label_name>CARVEDILOL 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904730861</ndc>
    <ndc_label_name>CARVEDILOL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904730961</ndc>
    <ndc_label_name>ENALAPRIL MALEATE 2.5 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904731061</ndc>
    <ndc_label_name>ENALAPRIL MALEATE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904731161</ndc>
    <ndc_label_name>ENALAPRIL MALEATE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904731261</ndc>
    <ndc_label_name>ENALAPRIL MALEATE 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904731310</ndc>
    <ndc_label_name>BUDESONIDE DR 3 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904731427</ndc>
    <ndc_label_name>ACETAMINOPHEN ER 650 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904731460</ndc>
    <ndc_label_name>ACETAMINOPHEN ER 650 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904731561</ndc>
    <ndc_label_name>RIFAMPIN 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904731662</ndc>
    <ndc_label_name>SOD CITRATE-CITRIC ACID CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904731673</ndc>
    <ndc_label_name>SOD CITRATE-CITRIC ACID CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904731680</ndc>
    <ndc_label_name>SOD CITRATE-CITRIC ACID CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904731688</ndc>
    <ndc_label_name>SOD CITRATE-CITRIC ACID CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904731706</ndc>
    <ndc_label_name>FLUDROCORTISONE 0.1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904731761</ndc>
    <ndc_label_name>FLUDROCORTISONE 0.1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904731813</ndc>
    <ndc_label_name>FISH OIL 500 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904731941</ndc>
    <ndc_label_name>ACETAMINOPHEN 160 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904731970</ndc>
    <ndc_label_name>ACETAMINOPHEN 160 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732002</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG/10.15 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732071</ndc>
    <ndc_label_name>ACETAMINOPHEN 325 MG/10.15 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732103</ndc>
    <ndc_label_name>ACETAMINOPHEN 650MG/20.3ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732176</ndc>
    <ndc_label_name>ACETAMINOPHEN 650MG/20.3ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732341</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 12.5MG/5ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732370</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 12.5MG/5ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732466</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 25 MG/10ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732472</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 25 MG/10ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732562</ndc>
    <ndc_label_name>ALUM-MAG HYDROXIDE-SIMETH CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732573</ndc>
    <ndc_label_name>ALUM-MAG HYDROXIDE-SIMETH CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732762</ndc>
    <ndc_label_name>MILK OF MAGNESIA SUSP 30ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732773</ndc>
    <ndc_label_name>MILK OF MAGNESIA SUSP 30ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732861</ndc>
    <ndc_label_name>METOLAZONE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904732961</ndc>
    <ndc_label_name>METOLAZONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904733301</ndc>
    <ndc_label_name>GLYCERIN ADULT SUPPOSITORY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904733317</ndc>
    <ndc_label_name>GLYCERIN ADULT SUPPOSITORY</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904733460</ndc>
    <ndc_label_name>SULINDAC 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904733560</ndc>
    <ndc_label_name>SULINDAC 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904733661</ndc>
    <ndc_label_name>CEPHALEXIN 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904733706</ndc>
    <ndc_label_name>CEPHALEXIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904733735</ndc>
    <ndc_label_name>CEPHALEXIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904733761</ndc>
    <ndc_label_name>CEPHALEXIN 500 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904734001</ndc>
    <ndc_label_name>HYDROCORTISONE AC 25 MG SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904734012</ndc>
    <ndc_label_name>HYDROCORTISONE AC 25 MG SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904734024</ndc>
    <ndc_label_name>HYDROCORTISONE AC 25 MG SUPP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904734201</ndc>
    <ndc_label_name>ARTHRITIS PAIN RLF 3-10% PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904734233</ndc>
    <ndc_label_name>ARTHRITIS PAIN RLF 3-10% PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904734561</ndc>
    <ndc_label_name>FLUOXETINE HCL 10 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904734661</ndc>
    <ndc_label_name>FLUOXETINE HCL 20 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904734920</ndc>
    <ndc_label_name>Lice Killing 0.33 %-4 % shampoo</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904735006</ndc>
    <ndc_label_name>AZITHROMYCIN 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904735061</ndc>
    <ndc_label_name>AZITHROMYCIN 250 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904735104</ndc>
    <ndc_label_name>AZITHROMYCIN 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904735504</ndc>
    <ndc_label_name>LURASIDONE HCL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904735661</ndc>
    <ndc_label_name>LURASIDONE HCL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904735761</ndc>
    <ndc_label_name>LURASIDONE HCL 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904735861</ndc>
    <ndc_label_name>LURASIDONE HCL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904735904</ndc>
    <ndc_label_name>LURASIDONE HCL 120 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904736061</ndc>
    <ndc_label_name>RISPERIDONE 0.25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904736161</ndc>
    <ndc_label_name>RISPERIDONE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904736261</ndc>
    <ndc_label_name>RISPERIDONE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904736361</ndc>
    <ndc_label_name>RISPERIDONE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904736461</ndc>
    <ndc_label_name>RISPERIDONE 3 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904736561</ndc>
    <ndc_label_name>RISPERIDONE 4 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904736604</ndc>
    <ndc_label_name>ARIPIPRAZOLE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904736706</ndc>
    <ndc_label_name>ARIPIPRAZOLE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904736761</ndc>
    <ndc_label_name>ARIPIPRAZOLE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904736806</ndc>
    <ndc_label_name>ARIPIPRAZOLE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904736861</ndc>
    <ndc_label_name>ARIPIPRAZOLE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904736904</ndc>
    <ndc_label_name>ARIPIPRAZOLE 15 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904737004</ndc>
    <ndc_label_name>ARIPIPRAZOLE 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904737104</ndc>
    <ndc_label_name>ARIPIPRAZOLE 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904737261</ndc>
    <ndc_label_name>MYCOPHENOLIC ACID DR 360 MG TB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904737561</ndc>
    <ndc_label_name>MECLIZINE 12.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904737661</ndc>
    <ndc_label_name>MECLIZINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904737740</ndc>
    <ndc_label_name>HYDROXYZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904737780</ndc>
    <ndc_label_name>HYDROXYZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904737840</ndc>
    <ndc_label_name>HYDROXYZINE HCL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904737880</ndc>
    <ndc_label_name>HYDROXYZINE HCL 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904737940</ndc>
    <ndc_label_name>HYDROXYZINE HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904737980</ndc>
    <ndc_label_name>HYDROXYZINE HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904738106</ndc>
    <ndc_label_name>PROCHLORPERAZINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904738206</ndc>
    <ndc_label_name>PROCHLORPERAZINE 10 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904738361</ndc>
    <ndc_label_name>TAMSULOSIN HCL 0.4 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904738961</ndc>
    <ndc_label_name>HALOPERIDOL 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904739061</ndc>
    <ndc_label_name>HALOPERIDOL 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904739161</ndc>
    <ndc_label_name>HALOPERIDOL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904739289</ndc>
    <ndc_label_name>DROXIDOPA 100 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904739389</ndc>
    <ndc_label_name>DROXIDOPA 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904739489</ndc>
    <ndc_label_name>DROXIDOPA 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904739546</ndc>
    <ndc_label_name>FEBUXOSTAT 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904739646</ndc>
    <ndc_label_name>FEBUXOSTAT 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904739753</ndc>
    <ndc_label_name>PIRFENIDONE 267 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904739789</ndc>
    <ndc_label_name>PIRFENIDONE 267 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904739889</ndc>
    <ndc_label_name>PIRFENIDONE 801 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904739946</ndc>
    <ndc_label_name>ROFLUMILAST 500 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904740004</ndc>
    <ndc_label_name>CYCLOBENZAPRINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904740006</ndc>
    <ndc_label_name>CYCLOBENZAPRINE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904740161</ndc>
    <ndc_label_name>CYCLOBENZAPRINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904740267</ndc>
    <ndc_label_name>BACITRACIN 500 UNIT/GM OINTMNT</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904740361</ndc>
    <ndc_label_name>VITAMIN B-12 1,000 MCG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904740661</ndc>
    <ndc_label_name>CLOZAPINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904740704</ndc>
    <ndc_label_name>MOXIFLOXACIN HCL 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904740706</ndc>
    <ndc_label_name>MOXIFLOXACIN HCL 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904740861</ndc>
    <ndc_label_name>MELATONIN 10 MG QUICK DISSOLVE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904740915</ndc>
    <ndc_label_name>PSEUDOEPHEDRINE ER 120 MG TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904741061</ndc>
    <ndc_label_name>AMITRIPTYLINE HCL 25 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904741161</ndc>
    <ndc_label_name>AMITRIPTYLINE HCL 50 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904741335</ndc>
    <ndc_label_name>VARENICLINE 0.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904741435</ndc>
    <ndc_label_name>VARENICLINE 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904741516</ndc>
    <ndc_label_name>VARENICLINE STARTING MONTH BOX</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904741661</ndc>
    <ndc_label_name>PHENYTOIN SOD EXT 100 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904741761</ndc>
    <ndc_label_name>METHADONE HCL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904741844</ndc>
    <ndc_label_name>MAGNESIUM CITRATE SOLUTION</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904741904</ndc>
    <ndc_label_name>VALGANCICLOVIR HCL 50 MG/ML</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904742016</ndc>
    <ndc_label_name>LEVETIRACETAM 100 MG/ML SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904742146</ndc>
    <ndc_label_name>LURASIDONE HCL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904742246</ndc>
    <ndc_label_name>LURASIDONE HCL 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904742346</ndc>
    <ndc_label_name>LURASIDONE HCL 60 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904742446</ndc>
    <ndc_label_name>LURASIDONE HCL 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904742546</ndc>
    <ndc_label_name>LURASIDONE HCL 120 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904742646</ndc>
    <ndc_label_name>LORATADINE 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904742659</ndc>
    <ndc_label_name>LORATADINE 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904742730</ndc>
    <ndc_label_name>Nasal Decongestant (oxymetazoline) 0.05 % spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904743368</ndc>
    <ndc_label_name>BALSAM PERU-CASTOR OIL OINT PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904743391</ndc>
    <ndc_label_name>BALSAM PERU-CASTOR OIL OINT PK</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904743405</ndc>
    <ndc_label_name>OFLOXACIN 0.3% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904743410</ndc>
    <ndc_label_name>OFLOXACIN 0.3% EYE DROPS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904743535</ndc>
    <ndc_label_name>Nasal Decongestant (oxymetazoline) 0.05 % spray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904744061</ndc>
    <ndc_label_name>SENNOSIDES-DOCUSATE SODIUM TAB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904744120</ndc>
    <ndc_label_name>Robafen DM 5 mg-50 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904744261</ndc>
    <ndc_label_name>CLONIDINE HCL 0.1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904744361</ndc>
    <ndc_label_name>CLONIDINE HCL 0.2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904744461</ndc>
    <ndc_label_name>DEXAMETHASONE 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904744520</ndc>
    <ndc_label_name>Children's Acetaminophen 160 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904744761</ndc>
    <ndc_label_name>HYDRALAZINE 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904744861</ndc>
    <ndc_label_name>HYDRALAZINE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904744961</ndc>
    <ndc_label_name>HYDRALAZINE 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904745061</ndc>
    <ndc_label_name>HYDRALAZINE 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904745161</ndc>
    <ndc_label_name>LABETALOL HCL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904745261</ndc>
    <ndc_label_name>LABETALOL HCL 200 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904745361</ndc>
    <ndc_label_name>LABETALOL HCL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904745411</ndc>
    <ndc_label_name>FORMOTEROL 20 MCG/2 ML NEB VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904745414</ndc>
    <ndc_label_name>FORMOTEROL 20 MCG/2 ML NEB VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904745455</ndc>
    <ndc_label_name>FORMOTEROL 20 MCG/2 ML NEB VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904745498</ndc>
    <ndc_label_name>FORMOTEROL 20 MCG/2 ML NEB VL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904745861</ndc>
    <ndc_label_name>PANTOPRAZOLE SOD DR 20 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904745925</ndc>
    <ndc_label_name>ATOVAQUONE 750 MG/5ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904745941</ndc>
    <ndc_label_name>ATOVAQUONE 750 MG/5ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904745953</ndc>
    <ndc_label_name>ATOVAQUONE 750 MG/5ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746146</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746147</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746151</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746180</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746187</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746188</ndc>
    <ndc_label_name>POTASSIUM CL10%(20MEQ/15ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746243</ndc>
    <ndc_label_name>POTASSIUM CL10%(40MEQ/30ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746260</ndc>
    <ndc_label_name>POTASSIUM CL10%(40MEQ/30ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746262</ndc>
    <ndc_label_name>POTASSIUM CL10%(40MEQ/30ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746273</ndc>
    <ndc_label_name>POTASSIUM CL10%(40MEQ/30ML)CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746341</ndc>
    <ndc_label_name>LACOSAMIDE 50 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746368</ndc>
    <ndc_label_name>LACOSAMIDE 50 MG/5 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746464</ndc>
    <ndc_label_name>LACOSAMIDE 100 MG/10 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746466</ndc>
    <ndc_label_name>LACOSAMIDE 100 MG/10 ML CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746561</ndc>
    <ndc_label_name>BUPROPION HCL SR 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746661</ndc>
    <ndc_label_name>MYCOPHENOLATE 250 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746761</ndc>
    <ndc_label_name>PROPRANOLOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746806</ndc>
    <ndc_label_name>PROPRANOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746861</ndc>
    <ndc_label_name>PROPRANOLOL 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904746904</ndc>
    <ndc_label_name>BUPROPION HCL XL 300 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904747001</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904747018</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904747056</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904747066</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904747072</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904747095</ndc>
    <ndc_label_name>SUCRALFATE 1 GM/10 ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904747261</ndc>
    <ndc_label_name>LOPERAMIDE 2 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904747546</ndc>
    <ndc_label_name>COENZYME Q-10 50 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904747761</ndc>
    <ndc_label_name>Thera-M (with Vitamin K) 9 mg iron-400 mcg-28 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904747835</ndc>
    <ndc_label_name>Ear Wax Removal Drops 6.5 %</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904748004</ndc>
    <ndc_label_name>FENOFIBRATE 145 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904748061</ndc>
    <ndc_label_name>FENOFIBRATE 145 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904748159</ndc>
    <ndc_label_name>ACETAMINOPHEN 1,000 MG/30 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904748303</ndc>
    <ndc_label_name>ROFLUMILAST 500 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904748389</ndc>
    <ndc_label_name>ROFLUMILAST 500 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904748403</ndc>
    <ndc_label_name>FEBUXOSTAT 40 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904748503</ndc>
    <ndc_label_name>FEBUXOSTAT 80 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904748602</ndc>
    <ndc_label_name>FEXOFENADINE HCL 180 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904748640</ndc>
    <ndc_label_name>FEXOFENADINE HCL 180 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904748660</ndc>
    <ndc_label_name>FEXOFENADINE HCL 180 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904748761</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 37.5 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904748861</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 75 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904748961</ndc>
    <ndc_label_name>VENLAFAXINE HCL ER 150 MG CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904749371</ndc>
    <ndc_label_name>ROFLUMILAST 250 MCG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904749406</ndc>
    <ndc_label_name>RAMELTEON 8 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904749506</ndc>
    <ndc_label_name>OMEGA-3 ETHYL ESTERS 1 GM CAP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904749661</ndc>
    <ndc_label_name>TRAMADOL HCL 50 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904749704</ndc>
    <ndc_label_name>NEBIVOLOL 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904749804</ndc>
    <ndc_label_name>NEBIVOLOL 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904749904</ndc>
    <ndc_label_name>NEBIVOLOL 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904750161</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 25-100 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904750204</ndc>
    <ndc_label_name>CINACALCET HCL 30 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904750313</ndc>
    <ndc_label_name>FISH OIL 500 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904750461</ndc>
    <ndc_label_name>HALOPERIDOL 2 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904750504</ndc>
    <ndc_label_name>BUPROPION HCL XL 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904750561</ndc>
    <ndc_label_name>BUPROPION HCL XL 150 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904750604</ndc>
    <ndc_label_name>RANOLAZINE ER 500 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904750761</ndc>
    <ndc_label_name>ACYCLOVIR 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904750852</ndc>
    <ndc_label_name>Dairy Relief 3,000 unit tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904750887</ndc>
    <ndc_label_name>Dairy Relief 9,000 unit tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904750930</ndc>
    <ndc_label_name>ASPIRIN 81 MG CHEWABLE TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904751061</ndc>
    <ndc_label_name>CETIRIZINE HCL 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904751161</ndc>
    <ndc_label_name>LORATADINE 10 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904751241</ndc>
    <ndc_label_name>GUAIFENESIN-DM 100-10 MG/5 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904751270</ndc>
    <ndc_label_name>GUAIFENESIN-DM 100-10 MG/5 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904751366</ndc>
    <ndc_label_name>GUAIFENESIN-DM 200-20 MG/10 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904751372</ndc>
    <ndc_label_name>GUAIFENESIN-DM 200-20 MG/10 ML</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904751961</ndc>
    <ndc_label_name>ACYCLOVIR 200 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904752061</ndc>
    <ndc_label_name>METOLAZONE 2.5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904752161</ndc>
    <ndc_label_name>METOLAZONE 5 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904752208</ndc>
    <ndc_label_name>DOFETILIDE 125 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904752308</ndc>
    <ndc_label_name>DOFETILIDE 250 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904752408</ndc>
    <ndc_label_name>DOFETILIDE 500 MCG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904752713</ndc>
    <ndc_label_name>Thera-M (with Vitamin K) 9 mg iron-400 mcg-28 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904752780</ndc>
    <ndc_label_name>Thera-M (with Vitamin K) 9 mg iron-400 mcg-28 mcg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904752841</ndc>
    <ndc_label_name>SENNA 8.8 MG/5 ML SYRUP CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904752894</ndc>
    <ndc_label_name>SENNA 8.8 MG/5 ML SYRUP CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904752960</ndc>
    <ndc_label_name>BUPROPION HCL 75 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904753060</ndc>
    <ndc_label_name>BUPROPION HCL 100 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904753120</ndc>
    <ndc_label_name>Child Cough-Cold (bromphen-DM) 2 mg-10 mg/10 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904753259</ndc>
    <ndc_label_name>ACETAMINOPHEN 500 MG/15 ML LIQ</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904753315</ndc>
    <ndc_label_name>Children's Allergy (diphenhydramine) 12.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904753320</ndc>
    <ndc_label_name>Children's Allergy (diphenhydramine) 12.5 mg/5 mL oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904753904</ndc>
    <ndc_label_name>FENOFIBRATE 160 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904754012</ndc>
    <ndc_label_name>Lubrifresh PM 83 %-15 % eye ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904754210</ndc>
    <ndc_label_name>CEFUROXIME AXETIL 250 MG TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904754361</ndc>
    <ndc_label_name>POTASSIUM CL ER 10 MEQ CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904754761</ndc>
    <ndc_label_name>POTASSIUM CL ER 10 MEQ TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904754961</ndc>
    <ndc_label_name>CARBIDOPA-LEVODOPA 25-250 TAB</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904755261</ndc>
    <ndc_label_name>BACLOFEN 10 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904755361</ndc>
    <ndc_label_name>BACLOFEN 20 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904755762</ndc>
    <ndc_label_name>ALUM-MAG HYDROXIDE-SIMETH CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904755773</ndc>
    <ndc_label_name>ALUM-MAG HYDROXIDE-SIMETH CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904755966</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 25 MG/10ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904755972</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 25 MG/10ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904756041</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 12.5MG/5ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904756070</ndc>
    <ndc_label_name>DIPHENHYDRAMINE 12.5MG/5ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904756160</ndc>
    <ndc_label_name>8 Hour Pain Reliever 650 mg tablet,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904756304</ndc>
    <ndc_label_name>CEFDINIR 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904756462</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904756473</ndc>
    <ndc_label_name>Milk of Magnesia 400 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904756541</ndc>
    <ndc_label_name>FERROUS SULF 300 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904756570</ndc>
    <ndc_label_name>FERROUS SULF 300 MG/5 ML CUP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904757718</ndc>
    <ndc_label_name>MEGESTROL 400 MG/10ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904757766</ndc>
    <ndc_label_name>MEGESTROL 400 MG/10ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904757772</ndc>
    <ndc_label_name>MEGESTROL 400 MG/10ML SUSP CUP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904758004</ndc>
    <ndc_label_name>SACUBITRIL-VALSARTAN 24-26 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904758104</ndc>
    <ndc_label_name>SACUBITRIL-VALSARTAN 97-103 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904758204</ndc>
    <ndc_label_name>SACUBITRIL-VALSARTAN 49-51 MG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904758361</ndc>
    <ndc_label_name>CHLORTHALIDONE 25 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904758740</ndc>
    <ndc_label_name>IBUPROFEN 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904758759</ndc>
    <ndc_label_name>IBUPROFEN 400 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904758840</ndc>
    <ndc_label_name>IBUPROFEN 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904758859</ndc>
    <ndc_label_name>IBUPROFEN 600 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904759060</ndc>
    <ndc_label_name>FeroSul 325 mg (65 mg iron) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904759080</ndc>
    <ndc_label_name>FeroSul 325 mg (65 mg iron) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904759160</ndc>
    <ndc_label_name>FeroSul 325 mg (65 mg iron) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904759161</ndc>
    <ndc_label_name>FERROUS SULFATE 325 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904759180</ndc>
    <ndc_label_name>FeroSul 325 mg (65 mg iron) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904759182</ndc>
    <ndc_label_name>FeroSul 325 mg (65 mg iron) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904759240</ndc>
    <ndc_label_name>IBUPROFEN 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904759259</ndc>
    <ndc_label_name>IBUPROFEN 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904760961</ndc>
    <ndc_label_name>DOCUSATE SODIUM 100 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904761461</ndc>
    <ndc_label_name>GABAPENTIN 300 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904761561</ndc>
    <ndc_label_name>GABAPENTIN 400 MG CAPSULE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00904764751</ndc>
    <ndc_label_name>SACCH-BOULARDII 250 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904772512</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904772524</ndc>
    <ndc_label_name>Anti-Diarrheal (loperamide) 2 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904772714</ndc>
    <ndc_label_name>Acid Gone Antacid 95 mg-358 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904772861</ndc>
    <ndc_label_name>CLONAZEPAM 1 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904773445</ndc>
    <ndc_label_name>Miconazole-7  2 % vaginal cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904773518</ndc>
    <ndc_label_name>Prosight 1,500 mcg-60 mg-13.5 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904773552</ndc>
    <ndc_label_name>Prosight 1,500 mcg-60 mg-13.5 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904775127</ndc>
    <ndc_label_name>Minerin Creme topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904775216</ndc>
    <ndc_label_name>Minerin lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904791251</ndc>
    <ndc_label_name>IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904791259</ndc>
    <ndc_label_name>IBUPROFEN 200 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904791459</ndc>
    <ndc_label_name>IBU-200 200 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904791461</ndc>
    <ndc_label_name>IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904880531</ndc>
    <ndc_label_name>Triple Antibiotic 3.5 mg-400 unit-5,000 unit/gram topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00904880567</ndc>
    <ndc_label_name>Triple Antibiotic 3.5 mg-400 unit-5,000 unit topical ointment packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941040901</ndc>
    <ndc_label_name>Dianeal Low Calcium with 1.5% Dextrose calcium 2.5 mEq/L-mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941040905</ndc>
    <ndc_label_name>Dianeal Low Calcium with 1.5% Dextrose calcium 2.5 mEq/L-mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941040906</ndc>
    <ndc_label_name>Dianeal Low Calcium with 1.5% Dextrose calcium 2.5 mEq/L-mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941040907</ndc>
    <ndc_label_name>Dianeal Low Calcium with 1.5% Dextrose calcium 2.5 mEq/L-mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041104</ndc>
    <ndc_label_name>Dianeal PD-2 with 1.5 % Dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041105</ndc>
    <ndc_label_name>Dianeal PD-2 with 1.5 % Dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041106</ndc>
    <ndc_label_name>Dianeal PD-2 with 1.5 % Dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041107</ndc>
    <ndc_label_name>Dianeal PD-2 with 1.5 % Dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041111</ndc>
    <ndc_label_name>Dianeal PD-2 with 1.5 % Dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041301</ndc>
    <ndc_label_name>Dianeal PD-2 with 2.5 % dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041304</ndc>
    <ndc_label_name>Dianeal PD-2 with 2.5 % dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041305</ndc>
    <ndc_label_name>Dianeal PD-2 with 2.5 % dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041306</ndc>
    <ndc_label_name>Dianeal PD-2 with 2.5 % dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041307</ndc>
    <ndc_label_name>Dianeal PD-2 with 2.5 % dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041501</ndc>
    <ndc_label_name>Dianeal PD-2 with 4.25% dextrose calcium 3.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041504</ndc>
    <ndc_label_name>Dianeal PD-2 with 4.25% dextrose calcium 3.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041505</ndc>
    <ndc_label_name>Dianeal PD-2 with 4.25% dextrose calcium 3.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041506</ndc>
    <ndc_label_name>Dianeal PD-2 with 4.25% dextrose calcium 3.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941041507</ndc>
    <ndc_label_name>Dianeal PD-2 with 4.25% dextrose calcium 3.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042451</ndc>
    <ndc_label_name>Dianeal with 1.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042452</ndc>
    <ndc_label_name>Dianeal with 1.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042453</ndc>
    <ndc_label_name>Dianeal with 1.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042455</ndc>
    <ndc_label_name>Dianeal with 1.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042652</ndc>
    <ndc_label_name>UltraBag/Dianeal PD-2/1.5% Dextros calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042653</ndc>
    <ndc_label_name>Dianeal PD-2 with 1.5 % Dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042655</ndc>
    <ndc_label_name>Dianeal PD-2 with 1.5 % Dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042752</ndc>
    <ndc_label_name>UltraBag/Dianeal PD-2 with 2.5% dextrose Ca 3.5 mEq/L-mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042753</ndc>
    <ndc_label_name>Dianeal PD-2 with 2.5 % dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042755</ndc>
    <ndc_label_name>Dianeal PD-2 with 2.5 % dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042952</ndc>
    <ndc_label_name>UltraBag/Dianeal PD-2 with 4.25 % dextrose Ca 3.5 mEq/L-mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042953</ndc>
    <ndc_label_name>Dianeal PD-2 with 4.25% dextrose calcium 3.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941042955</ndc>
    <ndc_label_name>Dianeal PD-2 with 4.25% dextrose calcium 3.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941043051</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941043052</ndc>
    <ndc_label_name>UltraBag/Dianeal Dextrose 2.5 %-low calcium 2.5 mEq-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941043053</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941043055</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941043351</ndc>
    <ndc_label_name>Dianeal with 4.25 % dextrose calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941043352</ndc>
    <ndc_label_name>Dianeal with 4.25 % dextrose calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941043353</ndc>
    <ndc_label_name>Dianeal with 4.25 % dextrose calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941043355</ndc>
    <ndc_label_name>Dianeal with 4.25 % dextrose calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941045701</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941045702</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941045705</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941045708</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941045901</ndc>
    <ndc_label_name>Dianeal Low Calcium with 4.25% dextrose calcium 2.5 mEq/L-mag 0.5mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941045902</ndc>
    <ndc_label_name>Dianeal Low Calcium with 4.25% dextrose calcium 2.5 mEq/L-mag 0.5mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941045905</ndc>
    <ndc_label_name>Dianeal Low Calcium with 4.25% dextrose calcium 2.5 mEq/L-mag 0.5mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941045908</ndc>
    <ndc_label_name>Dianeal Low Calcium with 4.25% dextrose calcium 2.5 mEq/L-mag 0.5mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941067905</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941067906</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941067952</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941067953</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941068101</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941068102</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941068104</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941068108</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941068401</ndc>
    <ndc_label_name>Dianeal with 1.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941068404</ndc>
    <ndc_label_name>Dianeal with 1.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941068601</ndc>
    <ndc_label_name>Dianeal with 1.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941068608</ndc>
    <ndc_label_name>Dianeal with 1.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941068801</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941068804</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941069001</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941069008</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941069201</ndc>
    <ndc_label_name>Dianeal with 4.25 % dextrose calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941069204</ndc>
    <ndc_label_name>Dianeal with 4.25 % dextrose calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941069401</ndc>
    <ndc_label_name>Dianeal with 4.25 % dextrose calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941069408</ndc>
    <ndc_label_name>Dianeal with 4.25 % dextrose calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941069601</ndc>
    <ndc_label_name>Dianeal Low Calcium with 4.25% dextrose calcium 2.5 mEq/L-mag 0.5mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941069606</ndc>
    <ndc_label_name>Dianeal Low Calcium with 4.25% dextrose calcium 2.5 mEq/L-mag 0.5mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941069801</ndc>
    <ndc_label_name>Dianeal PD-2 with 2.5 % dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941069806</ndc>
    <ndc_label_name>Dianeal PD-2 with 2.5 % dextrose calcium 3.5 mEq/L-low mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941070101</ndc>
    <ndc_label_name>Dianeal Low Calcium with 1.5% Dextrose calcium 2.5 mEq/L-mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941070102</ndc>
    <ndc_label_name>Dianeal Low Calcium with 1.5% Dextrose calcium 2.5 mEq/L-mag 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941070301</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941070302</ndc>
    <ndc_label_name>Dianeal with 2.5% Dextrose low calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941070501</ndc>
    <ndc_label_name>Dianeal Low Calcium with 4.25% dextrose calcium 2.5 mEq/L-mag 0.5mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941070502</ndc>
    <ndc_label_name>Dianeal Low Calcium with 4.25% dextrose calcium 2.5 mEq/L-mag 0.5mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941070701</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941070703</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941070706</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941070708</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941070901</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941070905</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941071101</ndc>
    <ndc_label_name>Dianeal PD4 CAPD with 1.5 % dextrose Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941071106</ndc>
    <ndc_label_name>Dianeal PD4 CAPD with 1.5 % dextrose Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941071301</ndc>
    <ndc_label_name>Dianeal PD4 with 2.5 % dextrose calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941071306</ndc>
    <ndc_label_name>Dianeal PD4 with 2.5 % dextrose calcium 2.5 mEq/L-magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941071501</ndc>
    <ndc_label_name>Dianeal PD4-3.86 % Glucose (4.25 % Dextrose) Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941071506</ndc>
    <ndc_label_name>Dianeal PD4-3.86 % Glucose (4.25 % Dextrose) Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941071701</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941071705</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941071901</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941071905</ndc>
    <ndc_label_name>Extraneal 7.5 % with calcium 3.5 mEq/L-low magnesium 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941072701</ndc>
    <ndc_label_name>Dianeal PD4-1.36 % Glucose (1.5 % Dextrose) Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941072702</ndc>
    <ndc_label_name>Dianeal PD4-1.36 % Glucose (1.5 % Dextrose) Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941072901</ndc>
    <ndc_label_name>Dianeal PD4-2.27 % Glucose (2.5 % Dextrose) Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941072902</ndc>
    <ndc_label_name>Dianeal PD4-2.27 % Glucose (2.5 % Dextrose) Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941073101</ndc>
    <ndc_label_name>Dianeal PD4-3.86 % Glucose (4.25 % Dextrose) Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941073102</ndc>
    <ndc_label_name>Dianeal PD4-3.86 % Glucose (4.25 % Dextrose) Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941073301</ndc>
    <ndc_label_name>Dianeal PD4-1.36 % Glucose (1.5 % Dextrose) Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941073304</ndc>
    <ndc_label_name>Dianeal PD4-1.36 % Glucose (1.5 % Dextrose) Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941073501</ndc>
    <ndc_label_name>Dianeal PD4-2.27 % Glucose (2.5 % Dextrose) Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00941073504</ndc>
    <ndc_label_name>Dianeal PD4-2.27 % Glucose (2.5 % Dextrose) Ca 2.5 mEq/L-Mg 0.5 mEq/L</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00942064103</ndc>
    <ndc_label_name>ACD-A 2.45-2.2 gram-730 mg/100 mL solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00942064104</ndc>
    <ndc_label_name>ACD-A 2.45-2.2 gram-730 mg/100 mL solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00942950410</ndc>
    <ndc_label_name>SODIUM CITRATE 4% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00942950510</ndc>
    <ndc_label_name>SODIUM CITRATE 4% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00942950625</ndc>
    <ndc_label_name>ANTICOAG SODIUM CITRATE 4% SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944049301</ndc>
    <ndc_label_name>Flexbumin 25 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944049302</ndc>
    <ndc_label_name>Flexbumin 25 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944049303</ndc>
    <ndc_label_name>Flexbumin 25 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944049304</ndc>
    <ndc_label_name>Flexbumin 25 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944049505</ndc>
    <ndc_label_name>Flexbumin 5 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944049506</ndc>
    <ndc_label_name>Flexbumin 5 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944251002</ndc>
    <ndc_label_name>HyQvia 2.5 gram/25 mL (10 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944251102</ndc>
    <ndc_label_name>HyQvia 5 gram/50 mL (10 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944251202</ndc>
    <ndc_label_name>HyQvia 10 gram/100 mL (10 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944251302</ndc>
    <ndc_label_name>HyQvia 20 gram/200 mL (10 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944251402</ndc>
    <ndc_label_name>HyQvia 30 gram/300 mL (10 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944265603</ndc>
    <ndc_label_name>Gammagard S-D (IgA &lt; 1 mcg/mL) 5 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944265707</ndc>
    <ndc_label_name>Gammagard S-D (IgA &lt; 1 mcg/mL) 5 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944265804</ndc>
    <ndc_label_name>Gammagard S-D (IgA &lt; 1 mcg/mL) 10 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944265908</ndc>
    <ndc_label_name>Gammagard S-D (IgA &lt; 1 mcg/mL) 10 gram intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270002</ndc>
    <ndc_label_name>Gammagard Liquid 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270003</ndc>
    <ndc_label_name>Gammagard Liquid 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270004</ndc>
    <ndc_label_name>Gammagard Liquid 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270005</ndc>
    <ndc_label_name>Gammagard Liquid 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270006</ndc>
    <ndc_label_name>Gammagard Liquid 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270007</ndc>
    <ndc_label_name>Gammagard Liquid 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270008</ndc>
    <ndc_label_name>Gammagard Liquid 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270009</ndc>
    <ndc_label_name>Gammagard Liquid 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270010</ndc>
    <ndc_label_name>Gammagard Liquid 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270011</ndc>
    <ndc_label_name>Gammagard Liquid 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270012</ndc>
    <ndc_label_name>Gammagard Liquid 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270013</ndc>
    <ndc_label_name>Gammagard Liquid 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270501</ndc>
    <ndc_label_name>Gammagard Liquid ERC 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270505</ndc>
    <ndc_label_name>Gammagard Liquid ERC 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270510</ndc>
    <ndc_label_name>Gammagard Liquid ERC 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944270550</ndc>
    <ndc_label_name>Gammagard Liquid ERC 10 % injection solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944271525</ndc>
    <ndc_label_name>HyQvia IG Component 2.5 gram/25 mL (10 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944271605</ndc>
    <ndc_label_name>HyQvia IG Component 5 gram/50 mL (10 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944271710</ndc>
    <ndc_label_name>HyQvia IG Component 10 gram/100 mL (10 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944271820</ndc>
    <ndc_label_name>HyQvia IG Component 20 gram/200 mL (10 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944271930</ndc>
    <ndc_label_name>HyQvia IG Component 30 gram/300 mL (10 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944272003</ndc>
    <ndc_label_name>HyQvia HY Component 200 unit/1.25 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944272103</ndc>
    <ndc_label_name>HyQvia HY Component 400 unit/2.5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944272203</ndc>
    <ndc_label_name>HyQvia HY Component 800 unit/5 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944272303</ndc>
    <ndc_label_name>HyQvia HY Component 1,600 unit/10 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944272403</ndc>
    <ndc_label_name>HyQvia HY Component 2,400 unit/15 mL subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944280303</ndc>
    <ndc_label_name>Aralast NP 500 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944280404</ndc>
    <ndc_label_name>Aralast NP 1,000 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944281401</ndc>
    <ndc_label_name>Aralast NP 500 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944281501</ndc>
    <ndc_label_name>Aralast NP 1,000 mg intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944283101</ndc>
    <ndc_label_name>Recombinate 250 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944283201</ndc>
    <ndc_label_name>Recombinate 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944283301</ndc>
    <ndc_label_name>Recombinate 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944284110</ndc>
    <ndc_label_name>Recombinate 250 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944284210</ndc>
    <ndc_label_name>Recombinate 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944284310</ndc>
    <ndc_label_name>Recombinate 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944284410</ndc>
    <ndc_label_name>Recombinate 1,500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944284510</ndc>
    <ndc_label_name>Recombinate 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944285001</ndc>
    <ndc_label_name>Cuvitru 1 gram/5 mL (20 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944285002</ndc>
    <ndc_label_name>Cuvitru 1 gram/5 mL (20 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944285003</ndc>
    <ndc_label_name>Cuvitru 2 gram/10 mL (20 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944285004</ndc>
    <ndc_label_name>Cuvitru 2 gram/10 mL (20 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944285005</ndc>
    <ndc_label_name>Cuvitru 4 gram/20 mL (20 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944285006</ndc>
    <ndc_label_name>Cuvitru 4 gram/20 mL (20 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944285007</ndc>
    <ndc_label_name>Cuvitru 8 gram/40 mL (20 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944285008</ndc>
    <ndc_label_name>Cuvitru 8 gram/40 mL (20 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944285009</ndc>
    <ndc_label_name>Cuvitru 10 gram/50 mL (20 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944285010</ndc>
    <ndc_label_name>Cuvitru 10 gram/50 mL (20 %) subcutaneous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944288401</ndc>
    <ndc_label_name>Glassia 20 mg/mL (2 %) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944288402</ndc>
    <ndc_label_name>Glassia 20 mg/mL (2 %) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944288403</ndc>
    <ndc_label_name>Glassia 20 mg/mL (2 %) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944288404</ndc>
    <ndc_label_name>Glassia 20 mg/mL (2 %) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944288405</ndc>
    <ndc_label_name>Glassia 20 mg/mL (2 %) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944288406</ndc>
    <ndc_label_name>Glassia 20 mg/mL (2 %) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944302501</ndc>
    <ndc_label_name>Rixubis 250 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944302602</ndc>
    <ndc_label_name>Rixubis 250 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944302701</ndc>
    <ndc_label_name>Rixubis 500 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944302802</ndc>
    <ndc_label_name>Rixubis 500 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944302901</ndc>
    <ndc_label_name>Rixubis 1,000 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944303002</ndc>
    <ndc_label_name>Rixubis 1,000 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944303101</ndc>
    <ndc_label_name>Rixubis 2,000 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944303202</ndc>
    <ndc_label_name>Rixubis 2,000 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944303301</ndc>
    <ndc_label_name>Rixubis 3,000 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944303402</ndc>
    <ndc_label_name>Rixubis 3,000 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944304510</ndc>
    <ndc_label_name>Advate 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944304511</ndc>
    <ndc_label_name>Advate 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944304512</ndc>
    <ndc_label_name>Advate 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944304610</ndc>
    <ndc_label_name>Advate 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944304611</ndc>
    <ndc_label_name>Advate 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944304710</ndc>
    <ndc_label_name>Advate 4,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944305102</ndc>
    <ndc_label_name>Advate 250 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944305103</ndc>
    <ndc_label_name>Advate 250 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944305104</ndc>
    <ndc_label_name>Advate 250 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944305202</ndc>
    <ndc_label_name>Advate 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944305203</ndc>
    <ndc_label_name>Advate 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944305204</ndc>
    <ndc_label_name>Advate 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944305302</ndc>
    <ndc_label_name>Advate 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944305303</ndc>
    <ndc_label_name>Advate 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944305304</ndc>
    <ndc_label_name>Advate 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944305402</ndc>
    <ndc_label_name>Advate 1,500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944305403</ndc>
    <ndc_label_name>Advate 1,500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944305404</ndc>
    <ndc_label_name>Advate 1,500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944394002</ndc>
    <ndc_label_name>Hemofil M Low 220 unit-400 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944394101</ndc>
    <ndc_label_name>Hemofil M Low 220 unit-400 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944394202</ndc>
    <ndc_label_name>Hemofil M Mid 401 unit-800 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944394301</ndc>
    <ndc_label_name>Hemofil M Mid 401 unit-800 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944394402</ndc>
    <ndc_label_name>Hemofil M High 801 unit-1,500 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944394501</ndc>
    <ndc_label_name>Hemofil M High 801 unit-1,500 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944394602</ndc>
    <ndc_label_name>Hemofil M Super High 1,501 unit-2,000 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944394701</ndc>
    <ndc_label_name>Hemofil M Super High 1,501 unit-2,000 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944417601</ndc>
    <ndc_label_name>Ceprotin (Blue Bar) 500 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944417705</ndc>
    <ndc_label_name>Ceprotin (Blue Bar) 500 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944417802</ndc>
    <ndc_label_name>Ceprotin (Green Bar) 1,000 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944417910</ndc>
    <ndc_label_name>Ceprotin (Green Bar) 1,000 unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462201</ndc>
    <ndc_label_name>Adynovate 250 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462202</ndc>
    <ndc_label_name>Adynovate 250 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462301</ndc>
    <ndc_label_name>Adynovate 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462302</ndc>
    <ndc_label_name>Adynovate 500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462401</ndc>
    <ndc_label_name>Adynovate 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462402</ndc>
    <ndc_label_name>Adynovate 1,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462501</ndc>
    <ndc_label_name>Adynovate 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462502</ndc>
    <ndc_label_name>Adynovate 2,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462601</ndc>
    <ndc_label_name>Adynovate 750 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462602</ndc>
    <ndc_label_name>Adynovate 750 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462701</ndc>
    <ndc_label_name>Adynovate 1,500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462702</ndc>
    <ndc_label_name>Adynovate 1,500 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462801</ndc>
    <ndc_label_name>Adynovate 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944462802</ndc>
    <ndc_label_name>Adynovate 3,000 (+/-) unit intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944500101</ndc>
    <ndc_label_name>Obizur 500 (+/-) unit range intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944755001</ndc>
    <ndc_label_name>Vonvendi 650 (+/-) unit range intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944755102</ndc>
    <ndc_label_name>Vonvendi 650 (+/-) unit range intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944755201</ndc>
    <ndc_label_name>Vonvendi 1,300 (+/-) unit range intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00944755302</ndc>
    <ndc_label_name>Vonvendi 1,300 (+/-) unit range intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955100301</ndc>
    <ndc_label_name>ENOXAPARIN 30 MG/0.3 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955100310</ndc>
    <ndc_label_name>ENOXAPARIN 30 MG/0.3 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955100401</ndc>
    <ndc_label_name>ENOXAPARIN 40 MG/0.4 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955100410</ndc>
    <ndc_label_name>ENOXAPARIN 40 MG/0.4 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955100601</ndc>
    <ndc_label_name>ENOXAPARIN 60 MG/0.6 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955100610</ndc>
    <ndc_label_name>ENOXAPARIN 60 MG/0.6 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955100801</ndc>
    <ndc_label_name>ENOXAPARIN 80 MG/0.8 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955100810</ndc>
    <ndc_label_name>ENOXAPARIN 80 MG/0.8 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955101001</ndc>
    <ndc_label_name>ENOXAPARIN 100 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955101010</ndc>
    <ndc_label_name>ENOXAPARIN 100 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955101201</ndc>
    <ndc_label_name>ENOXAPARIN 120 MG/0.8 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955101210</ndc>
    <ndc_label_name>ENOXAPARIN 120 MG/0.8 ML SYR</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955101501</ndc>
    <ndc_label_name>ENOXAPARIN 150 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955101510</ndc>
    <ndc_label_name>ENOXAPARIN 150 MG/ML SYRINGE</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00955101601</ndc>
    <ndc_label_name>ENOXAPARIN 300 MG/3 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00955102001</ndc>
    <ndc_label_name>DOCETAXEL 20 MG/ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00955102104</ndc>
    <ndc_label_name>DOCETAXEL 80 MG/4 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00955102208</ndc>
    <ndc_label_name>DOCETAXEL 160 MG/8 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00955104818</ndc>
    <ndc_label_name>SEVELAMER HCL 800 MG TABLET</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00955174601</ndc>
    <ndc_label_name>CLOFARABINE 20 MG/20 ML VIAL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00955290001</ndc>
    <ndc_label_name>INSULIN GLARGINE MAX SOLO U300</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00955290002</ndc>
    <ndc_label_name>INSULIN GLARGINE MAX SOLO U300</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00955390001</ndc>
    <ndc_label_name>INSULIN GLARGINE SOLOSTAR U300</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00955390003</ndc>
    <ndc_label_name>INSULIN GLARGINE SOLOSTAR U300</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990417803</ndc>
    <ndc_label_name>Aminosyn-PF 7 % (sulfite-free) intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990417905</ndc>
    <ndc_label_name>Aminosyn-PF 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990613803</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990613822</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990613903</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990613922</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990614109</ndc>
    <ndc_label_name>Physiosol Irrigation 140 mEq-5 mEq-3 mEq-98 mEq/L solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990614309</ndc>
    <ndc_label_name>ACETIC ACID 0.25% IRRIG SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990614322</ndc>
    <ndc_label_name>ACETIC ACID 0.25% IRRIG SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990707426</ndc>
    <ndc_label_name>POTASSIUM CL 10 MEQ/100 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990707514</ndc>
    <ndc_label_name>POTASSIUM CL 10 MEQ/50 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990707526</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ/100 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990707714</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ/50 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990707726</ndc>
    <ndc_label_name>POTASSIUM CL 40 MEQ/100 ML SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990710709</ndc>
    <ndc_label_name>KCL 20 MEQ/L-D5W-0.9% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990710909</ndc>
    <ndc_label_name>KCL 40 MEQ/L-D5W-0.9% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990711109</ndc>
    <ndc_label_name>KCL 20 MEQ IN D5W-LACT RINGER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990711509</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ/1,000ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990711609</ndc>
    <ndc_label_name>POTASSIUM CL 40 MEQ/1,000ML-NS</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990711807</ndc>
    <ndc_label_name>STERILE WATER FOR INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990712007</ndc>
    <ndc_label_name>DEXTROSE 70%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990713809</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990713836</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990713909</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990713936</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990717117</ndc>
    <ndc_label_name>Aminosyn II 15 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990717217</ndc>
    <ndc_label_name>Aminosyn II 10 % intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990737203</ndc>
    <ndc_label_name>Ionosol-MB in D5W intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990737262</ndc>
    <ndc_label_name>Ionosol-MB in D5W intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990767003</ndc>
    <ndc_label_name>Normosol-R pH 7.4 intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990767009</ndc>
    <ndc_label_name>Normosol-R pH 7.4 intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990771502</ndc>
    <ndc_label_name>MANNITOL 20% (50 GM/250 ML)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990771503</ndc>
    <ndc_label_name>MANNITOL 20% (100 GM/500 ML)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990771512</ndc>
    <ndc_label_name>MANNITOL 20% (50 GM/250 ML)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990771513</ndc>
    <ndc_label_name>MANNITOL 20% (100 GM/500 ML)</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990773036</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.45% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990773037</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.45% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990782808</ndc>
    <ndc_label_name>LACTATED RINGERS IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990790109</ndc>
    <ndc_label_name>KCL 20 MEQ/L-D5W-0.225% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990790203</ndc>
    <ndc_label_name>KCL 10 MEQ/500ML-D5W-0.45%NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990790209</ndc>
    <ndc_label_name>KCL 20 MEQ/L-D5W-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990790309</ndc>
    <ndc_label_name>KCL 30 MEQ/L-D5W-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990790409</ndc>
    <ndc_label_name>KCL 40 MEQ/L-D5W-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990790509</ndc>
    <ndc_label_name>KCL 20 MEQ/L IN D5W SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990791819</ndc>
    <ndc_label_name>DEXTROSE 70%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792202</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792203</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792209</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792253</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792255</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792261</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792313</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792320</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792323</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792336</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792337</ndc>
    <ndc_label_name>DEXTROSE 5%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792402</ndc>
    <ndc_label_name>DEXTROSE 5%-0.225% NACL IV SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792403</ndc>
    <ndc_label_name>DEXTROSE 5%-0.225% NACL IV SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792409</ndc>
    <ndc_label_name>DEXTROSE 5%-0.225% NACL IV SOL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792503</ndc>
    <ndc_label_name>DEXTROSE 5%-0.3% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792509</ndc>
    <ndc_label_name>DEXTROSE 5%-0.3% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792602</ndc>
    <ndc_label_name>DEXTROSE 5%-0.45% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792603</ndc>
    <ndc_label_name>DEXTROSE 5%-0.45% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792609</ndc>
    <ndc_label_name>DEXTROSE 5%-0.45% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792903</ndc>
    <ndc_label_name>DEXTROSE 5%-LR IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990792909</ndc>
    <ndc_label_name>DEXTROSE 5%-LR IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990793002</ndc>
    <ndc_label_name>DEXTROSE 10%-WATER IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990793003</ndc>
    <ndc_label_name>DEXTROSE 10%-WATER IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990793009</ndc>
    <ndc_label_name>DEXTROSE 10%-WATER IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990793519</ndc>
    <ndc_label_name>DEXTROSE 20%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990793619</ndc>
    <ndc_label_name>DEXTROSE 50%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990793719</ndc>
    <ndc_label_name>DEXTROSE 40%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990793819</ndc>
    <ndc_label_name>DEXTROSE 10%-WATER IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990794103</ndc>
    <ndc_label_name>DEXTROSE 5%-0.9% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990794109</ndc>
    <ndc_label_name>DEXTROSE 5%-0.9% NACL IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990795302</ndc>
    <ndc_label_name>LACTATED RINGERS INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990795303</ndc>
    <ndc_label_name>LACTATED RINGERS INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990795309</ndc>
    <ndc_label_name>LACTATED RINGERS INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990796509</ndc>
    <ndc_label_name>Normosol-M in 5 % dextrose intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990796709</ndc>
    <ndc_label_name>Normosol-R intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990796809</ndc>
    <ndc_label_name>Normosol-R in 5 % dextrose intravenous solution</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990797205</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990797207</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990797208</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% IRRIG.</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990797305</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990797307</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990797308</ndc>
    <ndc_label_name>STERILE WATER FOR IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990797408</ndc>
    <ndc_label_name>GLYCINE 1.5% IRRIGATION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798108</ndc>
    <ndc_label_name>SORBITOL-MANNITOL IRRIG</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>00990798209</ndc>
    <ndc_label_name>RINGER'S IV SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798302</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798303</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798309</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798355</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798361</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798413</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798420</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798423</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798436</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798437</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.9% SOLUTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798502</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.45% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798503</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.45% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798509</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.45% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990798525</ndc>
    <ndc_label_name>SODIUM CHLORIDE 0.45% SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990799009</ndc>
    <ndc_label_name>STERILE WATER FOR INJECTION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990799309</ndc>
    <ndc_label_name>KCL 10 MEQ/L-D5W-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990800415</ndc>
    <ndc_label_name>DEXTROSE 30%-WATER IV SOLN</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00990925739</ndc>
    <ndc_label_name>POTASSIUM CL 20 MEQ-0.45% NACL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00998001615</ndc>
    <ndc_label_name>Alcaine 0.5 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>00998035515</ndc>
    <ndc_label_name>Mydriacyl 1 % eye drops</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490000010</ndc>
    <ndc_label_name>Pepto-Bismol To-Go 262 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490000017</ndc>
    <ndc_label_name>Pepto-Bismol To-Go 262 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490000378</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003904</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003908</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003916</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003928</ndc>
    <ndc_label_name>Pepto-Bismol Max St 525 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003929</ndc>
    <ndc_label_name>Pepto-Bismol Max St 525 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003930</ndc>
    <ndc_label_name>Pepto-Bismol Max St 525 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003942</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003947</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003956</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003966</ndc>
    <ndc_label_name>Children's Pepto 160 mg (as calcium carbonate 400 mg) chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003977</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003978</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003990</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490003991</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490010048</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490032040</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490032047</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490032642</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490033690</ndc>
    <ndc_label_name>Pepto-Bismol 262 mg chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490085600</ndc>
    <ndc_label_name>Pepto-Bismol Max St 525 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490085601</ndc>
    <ndc_label_name>Pepto-Bismol Max St 525 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01490085602</ndc>
    <ndc_label_name>Pepto-Bismol Max St 525 mg/15 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741000038</ndc>
    <ndc_label_name>Avitene Flour topical powder</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741001688</ndc>
    <ndc_label_name>Bardex I.C. Foley Catheter 24 Fr</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741001782</ndc>
    <ndc_label_name>Bardex Lubricath Foley Cath 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741001835</ndc>
    <ndc_label_name>Bardia Red Rubber Catheter 14 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741001836</ndc>
    <ndc_label_name>Bardia Red Rubber Catheter 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741002008</ndc>
    <ndc_label_name>Silastic Foley Catheter 20 Fr</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741003877</ndc>
    <ndc_label_name>Bard Clean-Cath 8 Fr-10"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741003879</ndc>
    <ndc_label_name>Bard Clean-Cath 8 Fr-16"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741006807</ndc>
    <ndc_label_name>Magic3 Intermittent Catheter 12 Fr-16"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741006809</ndc>
    <ndc_label_name>Magic3 Intermittent Catheter 16 Fr-16"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741006855</ndc>
    <ndc_label_name>Magic3 Intermittent Catheter 10 Fr-16"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741006895</ndc>
    <ndc_label_name>Personal Catheter Intermittent 14 Fr-6"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741007049</ndc>
    <ndc_label_name>Pop-On Catheter 32 mm</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741007095</ndc>
    <ndc_label_name>Spirit Style-1 catheter 36 mm</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741007133</ndc>
    <ndc_label_name>Spirit Style-3 29 mm misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741007784</ndc>
    <ndc_label_name>Bard Lubricath Foley Catheter 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741008859</ndc>
    <ndc_label_name>Magic3 Intermittent Catheter 18 Fr-16"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01741013696</ndc>
    <ndc_label_name>Magic3 Go Intermittent Catheter 14 Fr-16"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01769099588</ndc>
    <ndc_label_name>diachrome 2 mg-600 mcg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>01875011045</ndc>
    <ndc_label_name>BIAFINE EMULSION</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01932080321</ndc>
    <ndc_label_name>Diastix strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01932080650</ndc>
    <ndc_label_name>Diastix strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>01932088121</ndc>
    <ndc_label_name>Ketostix strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>02340009000</ndc>
    <ndc_label_name>Durex Tropical Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>02340012900</ndc>
    <ndc_label_name>Durex Extra Sensitive Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>02340024100</ndc>
    <ndc_label_name>Durex Extra Sensitive Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>02340089455</ndc>
    <ndc_label_name>Durex Avanti Bare Real Feel Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>02340089456</ndc>
    <ndc_label_name>Durex Avanti Bare Real Feel Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>02340089457</ndc>
    <ndc_label_name>Durex Avanti Bare Real Feel Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>02359046005</ndc>
    <ndc_label_name>Biogaia 100 million cell chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>02359046010</ndc>
    <ndc_label_name>Replesta 1,250 mcg (50,000 unit) oral wafer</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>02359046013</ndc>
    <ndc_label_name>Replesta NX 350 mcg (14,000 unit) oral wafer</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>02359046015</ndc>
    <ndc_label_name>Biogaia Protectis-Vitamin D3 100 million cell-10 mcg/5 drops oral</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>02359046017</ndc>
    <ndc_label_name>BioGaia Gastrus 200 million cell chewable tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>02359046020</ndc>
    <ndc_label_name>Biogaia Protectis Baby 100 million cell/5 oral drops,suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>03215120107</ndc>
    <ndc_label_name>NICOTINE 7 MG/24HR PATCH</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>03999060069</ndc>
    <ndc_label_name>Dropsafe Insulin Syringe 0.3 mL 31 gauge x 5/16"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>03999060071</ndc>
    <ndc_label_name>Dropsafe Insulin Syringe 0.5 mL 31 gauge x 5/16"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>03999060072</ndc>
    <ndc_label_name>Dropsafe Insulin Syringe 1 mL 29 gauge x 1/2"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>03999060073</ndc>
    <ndc_label_name>Dropsafe Insulin Syringe 1 mL 31 gauge x 5/16"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>03999060077</ndc>
    <ndc_label_name>Dropsafe Insulin Syringe 0.5 mL 31 gauge x 15/64"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>03999060078</ndc>
    <ndc_label_name>Dropsafe Insulin Syringe 0.3 mL 31 gauge x 15/64"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>03999060079</ndc>
    <ndc_label_name>Dropsafe Insulin Syringe 1 mL 31 gauge x 15/64"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060189</ndc>
    <ndc_label_name>DropSafe Medlance Plus 25 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060190</ndc>
    <ndc_label_name>DropSafe Medlance Plus 21 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060191</ndc>
    <ndc_label_name>DropSafe Medlance Plus 21 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060192</ndc>
    <ndc_label_name>DropSafe Medlance Plus Blade 0.8 mm X 2 mm</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060195</ndc>
    <ndc_label_name>DropSafe MediSafe Solo Lancet 29 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060196</ndc>
    <ndc_label_name>DropSafe MediSafe Solo Lancet 23 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060197</ndc>
    <ndc_label_name>DropSafe Acti-Lance 28 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060198</ndc>
    <ndc_label_name>DropSafe Acti-Lance 23 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060199</ndc>
    <ndc_label_name>DropSafe Acti-Lance 17 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060200</ndc>
    <ndc_label_name>DropSafe Acti-Lance 28 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060201</ndc>
    <ndc_label_name>DropSafe Acti-Lance 23 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060202</ndc>
    <ndc_label_name>DropSafe Acti-Lance 17 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060207</ndc>
    <ndc_label_name>DropSafe Medlance Plus 30 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060208</ndc>
    <ndc_label_name>DropSafe Medlance Plus 30 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060209</ndc>
    <ndc_label_name>DropSafe Medlance Plus 25 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060210</ndc>
    <ndc_label_name>DropSafe Medlance Plus 21 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060211</ndc>
    <ndc_label_name>DropSafe Medlance Plus 21 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060212</ndc>
    <ndc_label_name>DropSafe Medlance Plus Blade 0.8 mm X 2 mm</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060228</ndc>
    <ndc_label_name>Droplet Medlance Plus 30 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060229</ndc>
    <ndc_label_name>DropSafe Haemolance Plus 28 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060230</ndc>
    <ndc_label_name>DropSafe Haemolance Plus 25 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060231</ndc>
    <ndc_label_name>DropSafe Haemolance Plus 21 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060232</ndc>
    <ndc_label_name>DropSafe Haemolance Plus 18 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060233</ndc>
    <ndc_label_name>DropSafe Haemolance Plus Blade 1.5 mm X 1.6 mm</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060234</ndc>
    <ndc_label_name>DropSafe Haemolance Plus Blade 1.5 mm X 1.2 mm</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060241</ndc>
    <ndc_label_name>DropSafe ergoLance 30 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060242</ndc>
    <ndc_label_name>DropSafe ergoLance 25 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>03999060243</ndc>
    <ndc_label_name>DropSafe ergoLance 21 gauge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000007</ndc>
    <ndc_label_name>Florastor 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000024</ndc>
    <ndc_label_name>Florastor 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000032</ndc>
    <ndc_label_name>Florastor 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000035</ndc>
    <ndc_label_name>Florastor 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000037</ndc>
    <ndc_label_name>FlorastorKids 250 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000040</ndc>
    <ndc_label_name>FlorastorKids 250 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000043</ndc>
    <ndc_label_name>FlorastorSelect Immunity Boost 250 mg-60 mg-10 mcg-10 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000047</ndc>
    <ndc_label_name>Florastor 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000048</ndc>
    <ndc_label_name>FlorastorSelect Gut Boost 250 mg-300 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000053</ndc>
    <ndc_label_name>Florastor 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000057</ndc>
    <ndc_label_name>FlorastorSelect Immunity Boost 250 mg-60 mg-10 mcg-10 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000060</ndc>
    <ndc_label_name>FlorastorBaby 250 mg oral powder packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000075</ndc>
    <ndc_label_name>Florastor 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142000081</ndc>
    <ndc_label_name>Florastor ADVANCED 250 mg-62.5 mg-30 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142010045</ndc>
    <ndc_label_name>Florastor 250 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142062340</ndc>
    <ndc_label_name>Florastor Woman's Probiotic 11 billion cell-200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142062440</ndc>
    <ndc_label_name>Florastor Digest-Skin Renew 4 billion cell-13.5 mg-300 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04142088130</ndc>
    <ndc_label_name>Florastor Digest-Metabolic 500 million cell-1 gram-125 mcg chew tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351024010</ndc>
    <ndc_label_name>ComfortSeal Medium Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351034010</ndc>
    <ndc_label_name>ComfortSeal Small Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351044010</ndc>
    <ndc_label_name>ComfortSeal Large Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351044050</ndc>
    <ndc_label_name>AeroEclipse II Nebulizer</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351050012</ndc>
    <ndc_label_name>Aerochamber Plus Flow-Vu</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351050112</ndc>
    <ndc_label_name>Aerochamber Plus Flow-Vu,Small Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351050212</ndc>
    <ndc_label_name>Aerochamber Plus Flow-Vu,Medium Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351050312</ndc>
    <ndc_label_name>Aerochamber Plus Flow-Vu,Large Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351050412</ndc>
    <ndc_label_name>Aerochamber Plus Flow-Vu,Medium Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351050612</ndc>
    <ndc_label_name>Aerochamber2go</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351052510</ndc>
    <ndc_label_name>AeroTrach Plus spacer</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351062510</ndc>
    <ndc_label_name>Aerobika Oscillating PEP System device</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351063506</ndc>
    <ndc_label_name>Ombra Compressor System</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351065055</ndc>
    <ndc_label_name>AeroEclipse II Nebulizer</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351066510</ndc>
    <ndc_label_name>EZ Twist Tubing misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351067150</ndc>
    <ndc_label_name>MC 300 Nebulizer with Mouthpiece</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351067750</ndc>
    <ndc_label_name>MC 300 Nebulizer with Universal Tubing misc</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351069010</ndc>
    <ndc_label_name>AeroEclipse XL Nebulizer</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351069350</ndc>
    <ndc_label_name>AeroEclipse II Nebulizer</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351078710</ndc>
    <ndc_label_name>AeroChamber Plus Z Stat Medium Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351078810</ndc>
    <ndc_label_name>Aerochamber Plus Flow-Vu,Medium Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351079710</ndc>
    <ndc_label_name>AeroChamber Z-Stat Plus-Flow Signal</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351079750</ndc>
    <ndc_label_name>Aerochamber Plus Z Stat spacer</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351079810</ndc>
    <ndc_label_name>Aerochamber Plus Flow-Vu</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351079850</ndc>
    <ndc_label_name>Aerochamber Plus Flow-Vu</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351080710</ndc>
    <ndc_label_name>Aerochamber Plus Z Stat Large Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351080810</ndc>
    <ndc_label_name>Aerochamber Plus Flow-Vu,Large Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351085810</ndc>
    <ndc_label_name>Aerovent Plus spacer</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351088710</ndc>
    <ndc_label_name>AeroChamber Plus Z Stat Small Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351088810</ndc>
    <ndc_label_name>Aerochamber Plus Flow-Vu,Small Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351088910</ndc>
    <ndc_label_name>Aerochamber Plus Flow-Vu,Medium Mask</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351089510</ndc>
    <ndc_label_name>AEROGEAR ASTHMA ACTION KIT</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351096510</ndc>
    <ndc_label_name>Truzone Peak Flow Meter</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351096610</ndc>
    <ndc_label_name>STRIVE PEAK FLOW METER</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351098510</ndc>
    <ndc_label_name>Aerochamber MV spacer</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04351098550</ndc>
    <ndc_label_name>Aerochamber Mechanical Vent</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>04351098810</ndc>
    <ndc_label_name>Aerochamber Mini</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>04960058014</ndc>
    <ndc_label_name>DERMEND BRUISE FORMULA CREAM</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05105010320</ndc>
    <ndc_label_name>FOLIC ACID 5 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001734</ndc>
    <ndc_label_name>MiniMed Quick Set 18"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001746</ndc>
    <ndc_label_name>MiniMed Quick Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001758</ndc>
    <ndc_label_name>MiniMed Quick Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001770</ndc>
    <ndc_label_name>MiniMed Quick Set 32"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001782</ndc>
    <ndc_label_name>MiniMed Quick Set 32"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001794</ndc>
    <ndc_label_name>MiniMed Quick Set 43"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001809</ndc>
    <ndc_label_name>MiniMed Quick Set 43"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001887</ndc>
    <ndc_label_name>MiniMed Mio Advance Infusion Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001890</ndc>
    <ndc_label_name>MiniMed Mio Advance Infusion Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001893</ndc>
    <ndc_label_name>MiniMed Mio Advance Infusion Set 43"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001908</ndc>
    <ndc_label_name>MiniMed Mio Advance Infusion Set 43"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001926</ndc>
    <ndc_label_name>MiniMed Sure T 18" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001929</ndc>
    <ndc_label_name>MiniMed Sure T 23" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001932</ndc>
    <ndc_label_name>MiniMed Sure T 32" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001935</ndc>
    <ndc_label_name>MiniMed Sure T 23" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001938</ndc>
    <ndc_label_name>MiniMed Sure T 32" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001944</ndc>
    <ndc_label_name>MiniMed Sure T 32" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001947</ndc>
    <ndc_label_name>MiniMed Silhouette 18" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001950</ndc>
    <ndc_label_name>MiniMed Silhouette 43" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001953</ndc>
    <ndc_label_name>MiniMed Silhouette 23" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001956</ndc>
    <ndc_label_name>MiniMed Silhouette 23" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001959</ndc>
    <ndc_label_name>MiniMed Silhouette 43" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001962</ndc>
    <ndc_label_name>MiniMed Silhouette 32" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244001965</ndc>
    <ndc_label_name>MiniMed Silhouette 32" infusion set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002268</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002280</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002283</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 32"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002292</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002295</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 32"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002298</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 43"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002304</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002307</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 32"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002310</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 43"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002316</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002328</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002331</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 32"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002340</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002343</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 32"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002346</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 43"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002352</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002355</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 32"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002358</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 43"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002535</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002538</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 32"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002541</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 43"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002547</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 23"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002550</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 32"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05244002553</ndc>
    <ndc_label_name>Medtronic Extended Infusion Set 43"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05388000251</ndc>
    <ndc_label_name>Restore PM 57.3 %-42.5 % eye ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05388000924</ndc>
    <ndc_label_name>Vitamin D3 25 mcg (1,000 unit) capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05388000926</ndc>
    <ndc_label_name>B12 5,000 mcg-100 mcg sublingual lozenge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05388000927</ndc>
    <ndc_label_name>SV VITAMIN D3 5,000 UNIT SFTGL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388002292</ndc>
    <ndc_label_name>ReliOn Prime Meter</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388002293</ndc>
    <ndc_label_name>ReliOn Prime Meter</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388004386</ndc>
    <ndc_label_name>RELION BP100 MONITOR</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388018382</ndc>
    <ndc_label_name>Instant Ear Thermometer</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388019332</ndc>
    <ndc_label_name>Glucose Gel 40 % oral gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388032554</ndc>
    <ndc_label_name>SV SELENIUM 200 MCG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388032556</ndc>
    <ndc_label_name>SV ECHINACEA 380 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388043611</ndc>
    <ndc_label_name>SV ECHINACEA 380 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388043617</ndc>
    <ndc_label_name>SV ALOE VERA 25 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388049228</ndc>
    <ndc_label_name>ReliOn Micro Glucose Monitor</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388056447</ndc>
    <ndc_label_name>Relion Confirm-Micro strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388062772</ndc>
    <ndc_label_name>SV ST. JOHN'S WORT 300 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388062777</ndc>
    <ndc_label_name>SV ALPHA LIPOIC ACID 200 MG CP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388062780</ndc>
    <ndc_label_name>Q-Sorb Co Q-10 100 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388062808</ndc>
    <ndc_label_name>SV MELATONIN 3 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388062809</ndc>
    <ndc_label_name>SV MELATONIN 5 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05388062842</ndc>
    <ndc_label_name>SV VITAMIN D3 25MCG(1000 UNIT)</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388066113</ndc>
    <ndc_label_name>Nasal Spray (sodium chloride) 0.65 % aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388066186</ndc>
    <ndc_label_name>Nasal Spray 12 Hour (oxymetazoline) 0.05 % mist</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388081745</ndc>
    <ndc_label_name>SV TEA TREE OIL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388081765</ndc>
    <ndc_label_name>SV VITAMIN E 450 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388086015</ndc>
    <ndc_label_name>Relion Confirm kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388086016</ndc>
    <ndc_label_name>Relion Confirm kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388086017</ndc>
    <ndc_label_name>Relion Confirm-Micro strips</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05388086024</ndc>
    <ndc_label_name>RELION GLUCOSE LIQUID</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05388098775</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05388098776</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05388098777</ndc>
    <ndc_label_name>Children's Ibuprofen 100 mg/5 mL oral suspension</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05388098778</ndc>
    <ndc_label_name>ClearLax 17 gram/dose oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>True</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05388099945</ndc>
    <ndc_label_name>Vitamin D3 10 mcg (400 unit) capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083005</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083010</ndc>
    <ndc_label_name>Trustex-RIA Lubricated/Spermicide Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083015</ndc>
    <ndc_label_name>Trustex-RIA Lubricated/Spermicide Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083020</ndc>
    <ndc_label_name>Trustex-RIA Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083025</ndc>
    <ndc_label_name>Trustex-RIA Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083027</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083030</ndc>
    <ndc_label_name>Trustex-RIA Lubricated/Spermicide Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083035</ndc>
    <ndc_label_name>Trustex-RIA Lubricated/Spermicide Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083040</ndc>
    <ndc_label_name>Trustex-RIA Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083045</ndc>
    <ndc_label_name>Trustex-RIA Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083047</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083050</ndc>
    <ndc_label_name>Trustex-RIA Non-Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083055</ndc>
    <ndc_label_name>Trustex-RIA Non-Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083065</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083067</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083087</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083137</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083157</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083177</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632083197</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084010</ndc>
    <ndc_label_name>Trustex Latex Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084015</ndc>
    <ndc_label_name>Trustex Latex Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084020</ndc>
    <ndc_label_name>Trustex Latex Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084025</ndc>
    <ndc_label_name>Trustex Latex Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084030</ndc>
    <ndc_label_name>Trustex Latex Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084035</ndc>
    <ndc_label_name>Trustex Latex Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084040</ndc>
    <ndc_label_name>Trustex Latex Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084140</ndc>
    <ndc_label_name>Trustex Non-Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084150</ndc>
    <ndc_label_name>Trustex Non-Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084152</ndc>
    <ndc_label_name>Trustex Non-Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084154</ndc>
    <ndc_label_name>Trustex Non-Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084156</ndc>
    <ndc_label_name>Trustex Non-Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084158</ndc>
    <ndc_label_name>Trustex Non-Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632084240</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632086805</ndc>
    <ndc_label_name>Fantasy Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632086815</ndc>
    <ndc_label_name>Fantasy Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632086825</ndc>
    <ndc_label_name>Fantasy Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632086835</ndc>
    <ndc_label_name>Fantasy Condom</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632088080</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>05632088082</ndc>
    <ndc_label_name>Trustex Lubricated Condoms</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928000099</ndc>
    <ndc_label_name>Nasogel 0.9 % nasal gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928000100</ndc>
    <ndc_label_name>Neilmed Sinus Rinse Complete with packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928000200</ndc>
    <ndc_label_name>Neilmed Sinus Rinse Refill packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928000204</ndc>
    <ndc_label_name>Neilmed Pediatric Sinus Rinse Refill packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928000300</ndc>
    <ndc_label_name>Sinus Rinse Pediatric with packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928000308</ndc>
    <ndc_label_name>Sinus Rinse Starter with packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928000400</ndc>
    <ndc_label_name>Sinus Rinse packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928000816</ndc>
    <ndc_label_name>NeilMed NasaFlo packet with sinus rinse device</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928000901</ndc>
    <ndc_label_name>Nasaflo Porcelain Kit with sinus rinse device and packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928001400</ndc>
    <ndc_label_name>Sinus Rinse Pediatric Starter Kit with packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928004530</ndc>
    <ndc_label_name>Nasogel 0.9 % nasal spray gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928005075</ndc>
    <ndc_label_name>NasaMist 0.9 % nasal spray aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928005177</ndc>
    <ndc_label_name>NasaMist 0.9 % nasal spray aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928005200</ndc>
    <ndc_label_name>Sinus Rinse packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928007125</ndc>
    <ndc_label_name>NasaMist Extra Strength 2.7 % nasal spray aerosol</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928010008</ndc>
    <ndc_label_name>Sinuflo ReadyRinse nasal kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928011001</ndc>
    <ndc_label_name>NasaDrops 0.9 % nasal solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928060311</ndc>
    <ndc_label_name>Clearcanal Ear Wax 6.5 %-0.9 % ear pack</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928088801</ndc>
    <ndc_label_name>Sinugator Nasal Wash Kit with packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>05928091901</ndc>
    <ndc_label_name>Nasadock Plus Kit with packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000051223</ndc>
    <ndc_label_name>CeraVe Acne 4 % topical cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000052755</ndc>
    <ndc_label_name>Effaclar Adapalene 0.1 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053479</ndc>
    <ndc_label_name>CeraVe Daily Moisturizing lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053717</ndc>
    <ndc_label_name>CeraVe SA (with niacinamide) topical cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053721</ndc>
    <ndc_label_name>CeraVe Healing 46.5 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053743</ndc>
    <ndc_label_name>CeraVe topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053745</ndc>
    <ndc_label_name>CeraVe PM lotion,extended release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053746</ndc>
    <ndc_label_name>CeraVe AM SPF 30 lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053748</ndc>
    <ndc_label_name>CeraVe Healing 46.5 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053751</ndc>
    <ndc_label_name>CeraVe Daily Moisturizing lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053754</ndc>
    <ndc_label_name>CeraVe Psoriasis 2 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053758</ndc>
    <ndc_label_name>CeraVe SA (with niacinamide) topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053762</ndc>
    <ndc_label_name>CeraVe Itch Relief 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053763</ndc>
    <ndc_label_name>CeraVe Itch Relief 1 % lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053764</ndc>
    <ndc_label_name>CeraVe Healing 46.5 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053766</ndc>
    <ndc_label_name>CeraVe topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053769</ndc>
    <ndc_label_name>CeraVe topical cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053771</ndc>
    <ndc_label_name>CeraVe SA lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053773</ndc>
    <ndc_label_name>CeraVe Daily Moisturizing lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053774</ndc>
    <ndc_label_name>CeraVe Daily Moisturizing lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053775</ndc>
    <ndc_label_name>CeraVe Foaming Facial topical cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>06000053784</ndc>
    <ndc_label_name>Cerave Baby Healing 46.5 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000053797</ndc>
    <ndc_label_name>CeraVe topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000055471</ndc>
    <ndc_label_name>CeraVe Healing 46.5 % topical ointment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000057517</ndc>
    <ndc_label_name>CeraVe Acne Control 2 % topical gel</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06000063753</ndc>
    <ndc_label_name>CeraVe Baby Eczema Relief 1 % topical cream</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06028009083</ndc>
    <ndc_label_name>TRYPAN BLUE 0.6 MG/ML VIAL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06121076304</ndc>
    <ndc_label_name>CELLTRION DIATRUST COV-19 HOME</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>06121076323</ndc>
    <ndc_label_name>CELLTRION DIATRUST COV-19 HOME</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>06424003030</ndc>
    <ndc_label_name>Stuart One 27 mg iron-800 mcg-200 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07249022224</ndc>
    <ndc_label_name>Thik and Clear oral packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07249022225</ndc>
    <ndc_label_name>Thik and Clear oral packet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07249022227</ndc>
    <ndc_label_name>Thik and Clear oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07249022228</ndc>
    <ndc_label_name>Thik and Clear oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07249091101</ndc>
    <ndc_label_name>Egg-Pro oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07249091104</ndc>
    <ndc_label_name>Nutra Pro High Protein oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07249091105</ndc>
    <ndc_label_name>Nutra Pro High Protein oral powder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07249404010</ndc>
    <ndc_label_name>Re-Gen oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07249404011</ndc>
    <ndc_label_name>Re-Gen oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07249404012</ndc>
    <ndc_label_name>Re-Gen oral liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07415024805</ndc>
    <ndc_label_name>MB IBUPROFEN 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07415082468</ndc>
    <ndc_label_name>Non-Aspirin Extra Strength 500 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610003220</ndc>
    <ndc_label_name>Vitamin B-2  100 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610003920</ndc>
    <ndc_label_name>Probiotic Gold Acidophilus 1 billion cell capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610004012</ndc>
    <ndc_label_name>CRANBERRY 250 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07610005820</ndc>
    <ndc_label_name>VITAMIN D3 400 UNIT TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07610009840</ndc>
    <ndc_label_name>VITAMIN D3 1,000 UNIT TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07610010418</ndc>
    <ndc_label_name>Prenatal Vitamin 27 mg iron-0.8 mg tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610011907</ndc>
    <ndc_label_name>L-Carnitine (tartrate) 500 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610012012</ndc>
    <ndc_label_name>ALPHA LIPOIC ACID 100 MG CAP</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610015224</ndc>
    <ndc_label_name>MELATONIN VIT B6 QUICK DISSOLV</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07610015832</ndc>
    <ndc_label_name>Calcium Citrate + D 315 mg-5 mcg (200 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07610016840</ndc>
    <ndc_label_name>Vitamin D3 50 mcg (2,000 unit) tablet</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610017120</ndc>
    <ndc_label_name>Fish Oil 300 mg-1,000 mg capsule,delayed release</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07610017840</ndc>
    <ndc_label_name>VITAMIN D3 5,000 UNIT TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07610020912</ndc>
    <ndc_label_name>Niacin Flush Free 400 mg niacin (500 mg) capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610021510</ndc>
    <ndc_label_name>DHEA 25 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610022312</ndc>
    <ndc_label_name>B-6 TR 200 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610022640</ndc>
    <ndc_label_name>MELATONIN 3 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07610028320</ndc>
    <ndc_label_name>MAGNESIUM OXIDE 250 MG CAPLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610030020</ndc>
    <ndc_label_name>VITAMIN E 45 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610031924</ndc>
    <ndc_label_name>GLUCOSAMINE-CHONDROITIN-MSM TB</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07610032024</ndc>
    <ndc_label_name>MAGNESIUM OXIDE 400 MG TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07610051612</ndc>
    <ndc_label_name>VITAMIN B-12 2,500 MCG TAB SL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610054112</ndc>
    <ndc_label_name>TURMERIC 450-50 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610060512</ndc>
    <ndc_label_name>5-HTP 100 mg capsule</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610071602</ndc>
    <ndc_label_name>B-12 5,000 MCG/ML SUBLING LIQ</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610081007</ndc>
    <ndc_label_name>COENZYME Q-10 100 MG CAPSULE</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07610081232</ndc>
    <ndc_label_name>CALCIUM 600-VIT D3 200 TABLET</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>07610091010</ndc>
    <ndc_label_name>COENZYME Q-10 200 MG SOFTGEL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>07996009885</ndc>
    <ndc_label_name>Droplet Micron Pen Needle 34 gauge x 9/64"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011000538</ndc>
    <ndc_label_name>Bard Plastic Tubing/Adapter 8 1/2"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011004052</ndc>
    <ndc_label_name>Bard Cunningham Incontin Clamp</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011004053</ndc>
    <ndc_label_name>Bard Cunningham Incontin Clamp</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011004054</ndc>
    <ndc_label_name>Bard Cunningham Incontin Clamp</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011010112</ndc>
    <ndc_label_name>Bard Coude Tip Catheter 12 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011015914</ndc>
    <ndc_label_name>Bard Female Intermittent Cath 14 Fr-6"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011016524</ndc>
    <ndc_label_name>Bardex Lubricath Foley Cath 24 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011041170</ndc>
    <ndc_label_name>Toomey Syringe 70 mL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011094140</ndc>
    <ndc_label_name>Urethral Catheter 14 Fr-16"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011120608</ndc>
    <ndc_label_name>Bard Coude Tip Catheter 8 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011120610</ndc>
    <ndc_label_name>Bard Coude Tip Catheter 10 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011120612</ndc>
    <ndc_label_name>Bard Coude Tip Catheter 12 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011120614</ndc>
    <ndc_label_name>Bard Coude Tip Catheter 14 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011120616</ndc>
    <ndc_label_name>Bard Coude Tip Catheter 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011120618</ndc>
    <ndc_label_name>Bard Coude Tip Catheter 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011120620</ndc>
    <ndc_label_name>Bard Coude Tip Catheter 20 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011120622</ndc>
    <ndc_label_name>Bard Coude Tip Catheter 22 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150101</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Small</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150102</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Medium</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150103</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Large</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150111</ndc>
    <ndc_label_name>Bard Leg Bag Holder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150121</ndc>
    <ndc_label_name>Bard Leg Bag Holder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150131</ndc>
    <ndc_label_name>Bard Leg Bag Holder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150319</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Medium</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150332</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Large</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150419</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Medium</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150432</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Large</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150507</ndc>
    <ndc_label_name>Bard Deluxe Fabric Leg Straps</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150520</ndc>
    <ndc_label_name>Bard Catheter Strap</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150615</ndc>
    <ndc_label_name>Bard Extension Tubing/Connect misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150619</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Medium</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150632</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Large</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150707</ndc>
    <ndc_label_name>Bard Latex Leg Straps</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150719</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Medium</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150732</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Large</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150819</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Medium</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150832</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Large</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150919</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Medium</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011150932</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Large</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011151919</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Medium</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011151932</ndc>
    <ndc_label_name>Dispoz-A-Bag Leg Bag Large</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011153504</ndc>
    <ndc_label_name>Bard Center Entry Close System</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011153509</ndc>
    <ndc_label_name>Bard Urinary Drainage System</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011154002</ndc>
    <ndc_label_name>Bard Center Entry Close System</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011154004</ndc>
    <ndc_label_name>Bard Infection Control Bag</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011162110</ndc>
    <ndc_label_name>Bard Leg Bag Straps/Fabric</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011162210</ndc>
    <ndc_label_name>Bard Leg Bag Straps/Fabric</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011162310</ndc>
    <ndc_label_name>Bard Leg Bag Straps/Fabric</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011165814</ndc>
    <ndc_label_name>Bardex All-Silicone Foley Catheter 14 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011165816</ndc>
    <ndc_label_name>Bardex All-Silicone Foley Catheter 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011165818</ndc>
    <ndc_label_name>Bardex All-Silicone Foley Catheter 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011165820</ndc>
    <ndc_label_name>Bardex All-Silicone Foley Catheter 20 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011165822</ndc>
    <ndc_label_name>Bardex All-Silicone Foley Catheter 22 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011165824</ndc>
    <ndc_label_name>Bardex All-Silicone Foley Catheter 24 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011166816</ndc>
    <ndc_label_name>Bardex All-Silicone Foley Catheter 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011166818</ndc>
    <ndc_label_name>Bardex All-Silicone Foley Catheter 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011166820</ndc>
    <ndc_label_name>Bardex All-Silicone Foley Catheter 20 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011166822</ndc>
    <ndc_label_name>Bardex All-Silicone Foley Catheter 22 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011166824</ndc>
    <ndc_label_name>Bardex All-Silicone Foley Catheter 24 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011277708</ndc>
    <ndc_label_name>Bard Rubber Utility Catheter 8 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011277710</ndc>
    <ndc_label_name>Bard Rubber Utility Catheter 10 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011277712</ndc>
    <ndc_label_name>Bard Rubber Utility Catheter 12 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011277714</ndc>
    <ndc_label_name>Bard Rubber Utility Catheter 14 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011277716</ndc>
    <ndc_label_name>Bard Rubber Utility Catheter 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011277718</ndc>
    <ndc_label_name>Bard Rubber Utility Catheter 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011277720</ndc>
    <ndc_label_name>Bard Rubber Utility Catheter 20 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011420614</ndc>
    <ndc_label_name>Vinyl Catheter 14 Fr-6"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011421010</ndc>
    <ndc_label_name>Bard Clean-Cath</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011421614</ndc>
    <ndc_label_name>Vinyl Catheter 14 Fr-16"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011740013</ndc>
    <ndc_label_name>Protective Barrier Film Wipes</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011740020</ndc>
    <ndc_label_name>Bard Adhesive Remover Wipes</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011740041</ndc>
    <ndc_label_name>Vigilon Primary Wound Dressing 4" X 4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011740042</ndc>
    <ndc_label_name>Vigilon Primary Wound Dressing 3" X 8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011740043</ndc>
    <ndc_label_name>Vigilon Primary Wound Dressing 6" X 8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011740047</ndc>
    <ndc_label_name>Vigilon Primary Wound Dressing 13" X 24"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011770715</ndc>
    <ndc_label_name>Bard Urethral Catheter Tray 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011771114</ndc>
    <ndc_label_name>Bard Urethral Catheter Tray 14 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011771215</ndc>
    <ndc_label_name>Bard Urethral Catheter Tray 15 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011772414</ndc>
    <ndc_label_name>Bard Urethral Catheter Tray 15 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011772415</ndc>
    <ndc_label_name>Bard Urethral Catheter Tray 15 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011772416</ndc>
    <ndc_label_name>Bard Urethral Catheter Tray 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011772514</ndc>
    <ndc_label_name>Bard Urethral Catheter Tray 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011775516</ndc>
    <ndc_label_name>Bardex Urethral CatheterTray 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011782100</ndc>
    <ndc_label_name>Bard Universal Foley Cath Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011782102</ndc>
    <ndc_label_name>Bard Universal Foley Cath Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011800316</ndc>
    <ndc_label_name>Davol Complete Foley kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011800318</ndc>
    <ndc_label_name>Davol Complete Foley kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011800516</ndc>
    <ndc_label_name>Davol Complete Foley kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011800518</ndc>
    <ndc_label_name>Davol Complete Foley kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802001</ndc>
    <ndc_label_name>Davol Urinary Drainage Bag</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802002</ndc>
    <ndc_label_name>Bardia Urinary Drainage Bag</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802010</ndc>
    <ndc_label_name>Davol Foley Cath Insert Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802011</ndc>
    <ndc_label_name>Davol Foley Cath Insert Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802015</ndc>
    <ndc_label_name>Davol Universal Cath Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802016</ndc>
    <ndc_label_name>Davol Closed System Foley Catheter Tray 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802018</ndc>
    <ndc_label_name>Davol Closed System Foley Catheter Tray 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802030</ndc>
    <ndc_label_name>Davol Foley Cath Insert Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802031</ndc>
    <ndc_label_name>Davol Foley Cath Insert Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802035</ndc>
    <ndc_label_name>Davol Universal Cath Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802055</ndc>
    <ndc_label_name>Davol Irrigation Syringe</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802065</ndc>
    <ndc_label_name>Davol Piston Irrigation Syringe</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802100</ndc>
    <ndc_label_name>Davol Urethral Cath Tray (without cathether)</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802110</ndc>
    <ndc_label_name>Davol Foley Cath Insert Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802115</ndc>
    <ndc_label_name>Davol Urethral Catheter Tray 15 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011802130</ndc>
    <ndc_label_name>Davol Foley Cath Insert Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011806316</ndc>
    <ndc_label_name>Davol Silicone Foley Catheter 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011806318</ndc>
    <ndc_label_name>Davol Silicone Foley Catheter 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011806320</ndc>
    <ndc_label_name>Davol Silicone Foley Catheter 20 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011806322</ndc>
    <ndc_label_name>Davol Silicone Foley Catheter 22 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011806324</ndc>
    <ndc_label_name>Davol Silicone Foley Catheter 24 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011806514</ndc>
    <ndc_label_name>Davol Silicone Foley Catheter 14 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011806516</ndc>
    <ndc_label_name>Davol Silicone Foley Catheter 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011806518</ndc>
    <ndc_label_name>Davol Silicone Foley Catheter 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011806520</ndc>
    <ndc_label_name>Davol Silicone Foley Catheter 20 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011806522</ndc>
    <ndc_label_name>Davol Silicone Foley Catheter 22 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011806524</ndc>
    <ndc_label_name>Davol Silicone Foley Catheter 24 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011896300</ndc>
    <ndc_label_name>Bardex Closed System Cath Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011899100</ndc>
    <ndc_label_name>Bard Infect Cont Tray-no Cath</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011899616</ndc>
    <ndc_label_name>Bard Lubricath Foley Tray 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011899618</ndc>
    <ndc_label_name>Bard Lubricath Foley Tray 18Fr 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011968602</ndc>
    <ndc_label_name>Scanpor Tape 1" X 11 yard</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011968622</ndc>
    <ndc_label_name>Scanpor Tape 1" X 11 yard</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08011968624</ndc>
    <ndc_label_name>Scanpor Tape 2" X 11 yard</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08021354221</ndc>
    <ndc_label_name>Filtered Extension Set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08021375153</ndc>
    <ndc_label_name>Rate Flow Regulator IV Set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08021470117</ndc>
    <ndc_label_name>Filtered Extension Set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026000040</ndc>
    <ndc_label_name>Opsite Flexifix 2" X 11 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026000041</ndc>
    <ndc_label_name>Opsite Flexifix 4" X 11 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026118377</ndc>
    <ndc_label_name>EXU-DRY Wound Dressing 3" X 4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026118414</ndc>
    <ndc_label_name>EXU-DRY Wound Dressing 6" X 9"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026118438</ndc>
    <ndc_label_name>EXU-DRY Wound Dressing 9" X 15"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026118452</ndc>
    <ndc_label_name>EXU-DRY Wound Dressing 15" X 18"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026118483</ndc>
    <ndc_label_name>EXU-DRY Wound Dressing 15" X 24"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026118513</ndc>
    <ndc_label_name>EXU-DRY Wound Dressing 20" X 28"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026118544</ndc>
    <ndc_label_name>EXU-DRY Wound Dressing 2" X 3"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026118551</ndc>
    <ndc_label_name>EXU-DRY Wound Dressing 3" X 4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026118582</ndc>
    <ndc_label_name>EXU-DRY Wound Dressing 3"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026402500</ndc>
    <ndc_label_name>Uni-Solve Adhesive Remover liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026403100</ndc>
    <ndc_label_name>Remove misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026405000</ndc>
    <ndc_label_name>Uri-Clean liquid</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026420900</ndc>
    <ndc_label_name>Hypafix 2" X 10 yard tape</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026421000</ndc>
    <ndc_label_name>Hypafix 4" X 10 yard tape</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026421100</ndc>
    <ndc_label_name>Hypafix 6" X 360" tape</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026421500</ndc>
    <ndc_label_name>Hypafix 2" X 72" tape</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026421600</ndc>
    <ndc_label_name>Hypafix 4" X 2 yard tape</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026421700</ndc>
    <ndc_label_name>Hypafix 6" X 2 yard tape</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026443500</ndc>
    <ndc_label_name>Uniderm Moisturizer lotion</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026449000</ndc>
    <ndc_label_name>Dermal Wound Cleanser</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026462800</ndc>
    <ndc_label_name>Opsite Flexigrid Dressing 2 3/8" X 2 3/4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026462900</ndc>
    <ndc_label_name>Opsite Flexigrid Dressing 4" X 4 3/4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026463000</ndc>
    <ndc_label_name>Opsite Flexigrid Dressing 4" X 4 3/4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026463100</ndc>
    <ndc_label_name>Opsite Flexigrid Dressing 6" X 8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026463200</ndc>
    <ndc_label_name>Opsite Flexigrid Dressing 4 3/4" X 10"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026480400</ndc>
    <ndc_label_name>Algisite M 3/4" X 12" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026482300</ndc>
    <ndc_label_name>Solosite 2" X 2" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026482340</ndc>
    <ndc_label_name>Solosite 2" X 2" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026482400</ndc>
    <ndc_label_name>Solosite 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026482440</ndc>
    <ndc_label_name>Solosite 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026495600</ndc>
    <ndc_label_name>Viscopaste PB7 3" X 10 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026496300</ndc>
    <ndc_label_name>Opsite Adhesive Dressing 4" X 5 1/2"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026498600</ndc>
    <ndc_label_name>Opsite Adhesive Dressing 6" X 11"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026498700</ndc>
    <ndc_label_name>Opsite Adhesive Dressing 11" X 11 3/4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026498900</ndc>
    <ndc_label_name>Opsite Adhesive Dressing 17 3/4" X 22"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026714000</ndc>
    <ndc_label_name>Covrsite 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026714100</ndc>
    <ndc_label_name>Covrsite 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026714300</ndc>
    <ndc_label_name>Covrsite 6" X 6" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026714400</ndc>
    <ndc_label_name>Covrsite 6" X 6" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026715000</ndc>
    <ndc_label_name>Covrsite Plus 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026715100</ndc>
    <ndc_label_name>Covrsite Plus 6" X 6" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026730800</ndc>
    <ndc_label_name>Intrasite Gel Dressing topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026731100</ndc>
    <ndc_label_name>Intrasite Gel Dressing topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08026731300</ndc>
    <ndc_label_name>Intrasite Gel Dressing topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08065100002</ndc>
    <ndc_label_name>Microsponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08065100003</ndc>
    <ndc_label_name>Microsponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08065183004</ndc>
    <ndc_label_name>Provisc 10 mg/mL intraocular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08065183055</ndc>
    <ndc_label_name>Provisc 10 mg/mL intraocular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08065183085</ndc>
    <ndc_label_name>Provisc 10 mg/mL intraocular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08065183135</ndc>
    <ndc_label_name>DuoVisc Visco Elastic 3 %-4 %(0.35 mL) 1 %(0.4 mL) intraocular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08065183150</ndc>
    <ndc_label_name>DuoVisc Visco Elastic 3 %-4 %(0.5 mL) 1 %(0.55 mL) intraocular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08065183710</ndc>
    <ndc_label_name>DisCoVisc 40 mg-17 mg/mL intraocular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08065183810</ndc>
    <ndc_label_name>CELLUGEL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08065183905</ndc>
    <ndc_label_name>Viscoat 4 %-3 % (40 mg-30 mg/mL) intraocular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08065183975</ndc>
    <ndc_label_name>Viscoat 4 %-3 % (40 mg-30 mg/mL) intraocular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08065199907</ndc>
    <ndc_label_name>DuoVisc Visco Elastic 4 %-3 %(0.5 mL) 1 %(0.85 mL) intraocular syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080015220</ndc>
    <ndc_label_name>SharpSafety Container</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080032010</ndc>
    <ndc_label_name>Monoject Syringe 3 mL 20 gauge x 1"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080072030</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080100000</ndc>
    <ndc_label_name>Curity Sterile Water irrigation solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080100555</ndc>
    <ndc_label_name>Monoject Tuberculin Syringe 1 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080100777</ndc>
    <ndc_label_name>Monoject TB Luer Lok 1 mL syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080102000</ndc>
    <ndc_label_name>Sterile Saline 0.9 % irrigation solution</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080103800</ndc>
    <ndc_label_name>Durasorb Underpad 23" X 24"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080104000</ndc>
    <ndc_label_name>Simplicity Contoured Liner pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080104400</ndc>
    <ndc_label_name>Simplicity Contoured Liner pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080104600</ndc>
    <ndc_label_name>Simplicity Pad</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080105000</ndc>
    <ndc_label_name>Telfa Ouchless Non-Adherent Dressing 4" X 3"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080105800</ndc>
    <ndc_label_name>Maxicare Belted Undergarment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080109300</ndc>
    <ndc_label_name>Durasorb Underpad 23" X 36"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080110900</ndc>
    <ndc_label_name>Telfa Clear Wound Dressing 3" X 3"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080111100</ndc>
    <ndc_label_name>Telfa Clear Wound Dressing 4" X 5"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080111300</ndc>
    <ndc_label_name>Telfa Clear Wound Dressing 12" X 12"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080111400</ndc>
    <ndc_label_name>Telfa Clear Wound Dressing 12" X 24"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080111500</ndc>
    <ndc_label_name>Telfa Clear Wound Dressing 39" X 25 yard</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080114063</ndc>
    <ndc_label_name>Monoject Syringe 140 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080114300</ndc>
    <ndc_label_name>Curity Gauze 1" X 10 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080116700</ndc>
    <ndc_label_name>Kerlix sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080116900</ndc>
    <ndc_label_name>Telfa Ouchless Non-Adherent Dressing 6" X 3"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080120500</ndc>
    <ndc_label_name>Sure Care Protective Underwear</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080121500</ndc>
    <ndc_label_name>Sure Care Protective Underwear</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080123800</ndc>
    <ndc_label_name>Telfa 3" X 8" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080125058</ndc>
    <ndc_label_name>Monoject Tuberculin Syringe 1 mL 25 gauge x 5/8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080125158</ndc>
    <ndc_label_name>Monoject Tuberculin Syringe 1 mL 25 gauge x 5/8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080126038</ndc>
    <ndc_label_name>Monoject Tuberculin Syringe 1 mL 26 gauge x 3/8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080127012</ndc>
    <ndc_label_name>Monoject Tuberculin Syringe 1 mL 27 x 1/2"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080127200</ndc>
    <ndc_label_name>Kerlix sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080128012</ndc>
    <ndc_label_name>Monoject TB 1 mL 28 gauge x 1/2" syringe</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080133400</ndc>
    <ndc_label_name>Curity Gauze 2" X 360" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080141600</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080141800</ndc>
    <ndc_label_name>Webril 2" X 4 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080141900</ndc>
    <ndc_label_name>TOUCH-TROL 10 Fr misc</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080141901</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080142000</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter 20 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080142200</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter 22 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080142400</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter 24 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080142600</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter 26 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080142700</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter 28 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080143100</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter 30 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080143699</ndc>
    <ndc_label_name>Sharps-A-Gator Disposal System</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080145540</ndc>
    <ndc_label_name>SEAMLESS ENEMA BAG</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080147300</ndc>
    <ndc_label_name>Curity Gauze 36" X 3600" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080152200</ndc>
    <ndc_label_name>Curity Gauze 3" X 360" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080153000</ndc>
    <ndc_label_name>Handicare Garment Liner pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080159610</ndc>
    <ndc_label_name>Kendall Paper Tape 1/2" X 10 yard</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080160500</ndc>
    <ndc_label_name>Sure Care Protective Undergmnt misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080161200</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter 12 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080161400</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter 14 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080161500</ndc>
    <ndc_label_name>Sure Care Protective Undergmnt misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080161600</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter, Latex/Teflon 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080161900</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter, Latex/Teflon 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080162100</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter, Latex/Teflon 20 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080162200</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter 22 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080162400</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter, Latex/Teflon 24 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080162500</ndc>
    <ndc_label_name>Sure Care Protective Underwear</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080162600</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter, Latex/Teflon 26 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080162800</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter Teflon 28 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080163100</ndc>
    <ndc_label_name>Curity Ultramer 2-Way Catheter, Latex/Teflon 30 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080170000</ndc>
    <ndc_label_name>Curity Cover 3" X 3" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080171300</ndc>
    <ndc_label_name>Curity Cover 4" X 3" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080179200</ndc>
    <ndc_label_name>Curity Cover 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080180100</ndc>
    <ndc_label_name>Kerlix 2 1/4" X 3 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080180600</ndc>
    <ndc_label_name>Curity Gauze 2" X 2" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080181030</ndc>
    <ndc_label_name>Maxicare Beltless Undergarment</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080181400</ndc>
    <ndc_label_name>Curity Foley Catheter Kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080181700</ndc>
    <ndc_label_name>Curity Foley Catheter Kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080181800</ndc>
    <ndc_label_name>Curity Foley Catheter Kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080182400</ndc>
    <ndc_label_name>Curity Gauze 4" X 360" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080189200</ndc>
    <ndc_label_name>Kerlix 4 1/2" X 147" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080190300</ndc>
    <ndc_label_name>Curity Gauze 3" X 3" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080196100</ndc>
    <ndc_label_name>Telfa 2" X 3" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080196700</ndc>
    <ndc_label_name>Curity Multi-Trauma Dressing 10" X 30"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080200055</ndc>
    <ndc_label_name>Monoject Disposable Syringe 20 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080200077</ndc>
    <ndc_label_name>Monoject Disposable Syringe 20 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080200777</ndc>
    <ndc_label_name>Monoject Luer-Lock Tip 12 mL syringe</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080205900</ndc>
    <ndc_label_name>Webril 3" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080210100</ndc>
    <ndc_label_name>Curity Universal - No Drainage 16 Fr tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080213200</ndc>
    <ndc_label_name>Telfa 3" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080214600</ndc>
    <ndc_label_name>Curity Gauze 2" X 2" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080216017</ndc>
    <ndc_label_name>Monoject Blood Collection 20 gauge x 1" needle</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080216025</ndc>
    <ndc_label_name>Monoject Blood Collection 20 x 1 1/2" needle</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080216033</ndc>
    <ndc_label_name>Monoject Blood Collection 21 gauge x 1" needle</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080216066</ndc>
    <ndc_label_name>Monoject Blood Collection 22 gauge x 1" needle</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080218100</ndc>
    <ndc_label_name>Monoject Syringe 12 mL 18 gauge x 1"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080218700</ndc>
    <ndc_label_name>Curity Gauze 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080220112</ndc>
    <ndc_label_name>Monoject Syringe 12 mL 20 x 1 1/2"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080221100</ndc>
    <ndc_label_name>Monoject Syringe 12 mL 21 gauge x 1"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080221112</ndc>
    <ndc_label_name>Monoject Syringe 12 mL 21 gauge x 1 1/2"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080223000</ndc>
    <ndc_label_name>Conform 1" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080223100</ndc>
    <ndc_label_name>Conform 2" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080223200</ndc>
    <ndc_label_name>Conform 3" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080223600</ndc>
    <ndc_label_name>Conform 4" X 75" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080223800</ndc>
    <ndc_label_name>Conform 6" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080223900</ndc>
    <ndc_label_name>Conform 1" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080224200</ndc>
    <ndc_label_name>Conform 2" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080224400</ndc>
    <ndc_label_name>Conform 3" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080224700</ndc>
    <ndc_label_name>Conform 4" X 75" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080224900</ndc>
    <ndc_label_name>Conform 6" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080225200</ndc>
    <ndc_label_name>Curity Gauze 2" X 2" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080225257</ndc>
    <ndc_label_name>Monoject Luer Adapter intravenous admix accessory</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080225900</ndc>
    <ndc_label_name>Curity Gauze 8" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080228300</ndc>
    <ndc_label_name>Webril 2" X 4 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080234600</ndc>
    <ndc_label_name>Curity Gauze 3" X 3" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080239400</ndc>
    <ndc_label_name>Webril 3" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080243800</ndc>
    <ndc_label_name>Curity Gauze 4" X 3 1/2" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080248000</ndc>
    <ndc_label_name>Curity Ureth Cath Closed Systm tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080250200</ndc>
    <ndc_label_name>Webril 4" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080250600</ndc>
    <ndc_label_name>Curity AMD (with polyhexamethylene) 0.2 %-2" X 2" sponge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080254000</ndc>
    <ndc_label_name>Curity Urethral Catheter 14 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080255600</ndc>
    <ndc_label_name>Curity Gauze 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080256200</ndc>
    <ndc_label_name>Telfa Island Dressing 4" X 6"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080256300</ndc>
    <ndc_label_name>Telfa Island Dressing 6" X 7"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080258500</ndc>
    <ndc_label_name>Kerlix sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080260000</ndc>
    <ndc_label_name>Curity Cotton Prep Balls misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080260100</ndc>
    <ndc_label_name>Curity Cotton Prep Balls misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080260200</ndc>
    <ndc_label_name>Curity Cotton Prep Balls misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080263400</ndc>
    <ndc_label_name>Curity Gauze 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080266600</ndc>
    <ndc_label_name>Webril II 2" X 4 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080267100</ndc>
    <ndc_label_name>Kerlix 9" X 100 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080271800</ndc>
    <ndc_label_name>Curity Ultramer Irrgation 3 way Catheter 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080272000</ndc>
    <ndc_label_name>Curity Ultramer Irrgation 3 way Catheter 20 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080272200</ndc>
    <ndc_label_name>Curity Ultramer Irrgation 3 way Catheter 22 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080272300</ndc>
    <ndc_label_name>Curity Ultramer Irrgation 3 way Catheter 24 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080273300</ndc>
    <ndc_label_name>Curity Gauze 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080275400</ndc>
    <ndc_label_name>Webril II 3" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080279800</ndc>
    <ndc_label_name>Curity Ready-Cut Gauze 36" X 36" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080281900</ndc>
    <ndc_label_name>Curity Ultramer Irrgation 3 way Catheter 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080282100</ndc>
    <ndc_label_name>Curity Ultramer Irrgation 3 way Catheter 20 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080282200</ndc>
    <ndc_label_name>Curity Ultramer Irrgation 3 way Catheter 22 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080282400</ndc>
    <ndc_label_name>Curity Ultramer Irrgation 3 way Catheter 24 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080282600</ndc>
    <ndc_label_name>Curity Ultramer Irrgation 3 way Catheter 26 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080283500</ndc>
    <ndc_label_name>Curity Gauze 8" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080284100</ndc>
    <ndc_label_name>Curity Eye pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080284700</ndc>
    <ndc_label_name>Webril II 4" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080289100</ndc>
    <ndc_label_name>Telfa 3" X 8" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080291300</ndc>
    <ndc_label_name>Curity Cover 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080294900</ndc>
    <ndc_label_name>Kerlix sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080300555</ndc>
    <ndc_label_name>Monoject Syringe 3 mL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080300777</ndc>
    <ndc_label_name>Monoject Syringe 3 mL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080301515</ndc>
    <ndc_label_name>Argyle Connecting Tubes</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080303300</ndc>
    <ndc_label_name>Curity Gauze 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080303900</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080304100</ndc>
    <ndc_label_name>Lisco 2" X 2" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080304400</ndc>
    <ndc_label_name>Curity Universal - No Drainage 18 Fr tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080305700</ndc>
    <ndc_label_name>Curity Bedside Drainage Set tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080308500</ndc>
    <ndc_label_name>Kerlix sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080311440</ndc>
    <ndc_label_name>Sharps-A-Gator Disposal System</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080314100</ndc>
    <ndc_label_name>Curity Ureth Cath Open System tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080314400</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080315700</ndc>
    <ndc_label_name>Curity Cover 4" X 3" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080317000</ndc>
    <ndc_label_name>Curity Ureth Cath Closed Systm tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080317500</ndc>
    <ndc_label_name>Webril 4" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080319500</ndc>
    <ndc_label_name>Curity Ready-Cut Gauze 18" X 18" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080320112</ndc>
    <ndc_label_name>Monoject Syringe 3 mL 20 gauge x 1 1/2"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080320800</ndc>
    <ndc_label_name>Lisco 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080321100</ndc>
    <ndc_label_name>Monoject Syringe 3 mL 21 gauge x 1"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080321112</ndc>
    <ndc_label_name>Monoject Syringe 3 mL 21 gauge x 1 1/2"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080321700</ndc>
    <ndc_label_name>Curity Ureth Cath Open System tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080322100</ndc>
    <ndc_label_name>Monoject Syringe 3 mL 22 gauge x 1"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080322110</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080322112</ndc>
    <ndc_label_name>Monoject Syringe 3 mL 22 x 1 1/2"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080322200</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080322210</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080323100</ndc>
    <ndc_label_name>Monoject Syringe 3 mL 23 x 1"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080325000</ndc>
    <ndc_label_name>Curity Gauze 3" X 360" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080325058</ndc>
    <ndc_label_name>Monoject Syringe 3 mL 25 x 5/8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080325100</ndc>
    <ndc_label_name>Monoject 3cc Syringe 3 mL 25 gauge x 1"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080325114</ndc>
    <ndc_label_name>Monoject Syringe 3 mL 25 x 1 1/4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080327114</ndc>
    <ndc_label_name>Monoject Syringe 3 mL 27 gauge x 1 1/4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080327900</ndc>
    <ndc_label_name>Telfa 8" X 10" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080330200</ndc>
    <ndc_label_name>Tensor 2" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080330500</ndc>
    <ndc_label_name>Curity Ureth Cath Open System tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080330600</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080332000</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080332400</ndc>
    <ndc_label_name>Kerlix 4 1/2" X 147" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080333100</ndc>
    <ndc_label_name>Kerlix AMD 0.2 %-4.5" X 4.1 yard bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080333200</ndc>
    <ndc_label_name>Kerlix AMD 0.2 %-4.5" X 4.1 yard bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080333700</ndc>
    <ndc_label_name>Curity Wet Dressing 4" X 8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080333900</ndc>
    <ndc_label_name>Curity Dressing 6" X 6 3/4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080336400</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080338100</ndc>
    <ndc_label_name>Curity Gauze 2" X 2" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080341000</ndc>
    <ndc_label_name>Curity Ureth Cath Closed Systm tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080341610</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080343300</ndc>
    <ndc_label_name>Urinary Leg Medium Bag</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080344900</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080345000</ndc>
    <ndc_label_name>Curity Ureth Cath Closed Systm tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080348900</ndc>
    <ndc_label_name>Webril 6" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080351200</ndc>
    <ndc_label_name>Kenguard Urinary Drain Bag 2,000 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080351220</ndc>
    <ndc_label_name>Kenguard Urinary Drain Bag 2,000 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080351500</ndc>
    <ndc_label_name>Add-A-Foley Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080352300</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080353100</ndc>
    <ndc_label_name>Add-A-Foley Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080354900</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080355000</ndc>
    <ndc_label_name>Tensor 3" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080355800</ndc>
    <ndc_label_name>Foley Catheter 14 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080356000</ndc>
    <ndc_label_name>Foley Catheter 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080356300</ndc>
    <ndc_label_name>Foley Catheter 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080356500</ndc>
    <ndc_label_name>Foley Catheter 20 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080356700</ndc>
    <ndc_label_name>Foley Catheter 22 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080357000</ndc>
    <ndc_label_name>Foley Catheter 24 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080357300</ndc>
    <ndc_label_name>Foley Catheter 26 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080357500</ndc>
    <ndc_label_name>Foley Catheter 28 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080357700</ndc>
    <ndc_label_name>Foley Catheter 30 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080360100</ndc>
    <ndc_label_name>Foley Catheter 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080360700</ndc>
    <ndc_label_name>Foley Catheter 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080361100</ndc>
    <ndc_label_name>Foley Catheter 20 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080361400</ndc>
    <ndc_label_name>Foley Catheter 22 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080361600</ndc>
    <ndc_label_name>Tensor 4" X 4.5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080361800</ndc>
    <ndc_label_name>Foley Catheter 24 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080361900</ndc>
    <ndc_label_name>Foley Catheter 26 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080362300</ndc>
    <ndc_label_name>Foley Catheter 28 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080363100</ndc>
    <ndc_label_name>Foley Catheter 30 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080391300</ndc>
    <ndc_label_name>Heavy Drainage Dressing Steril package</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080392200</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080393000</ndc>
    <ndc_label_name>Tensor 6" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080396700</ndc>
    <ndc_label_name>Curity Gauze 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080396800</ndc>
    <ndc_label_name>Curity Gauze 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080399500</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080400616</ndc>
    <ndc_label_name>Robinson Clear Vinyl Catheter 16 Fr</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080401400</ndc>
    <ndc_label_name>Specipan Collection Unit misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080402718</ndc>
    <ndc_label_name>Kenguard Foley Catheter 18 Fr-16"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080403100</ndc>
    <ndc_label_name>Kerlix 26" X 17" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080403200</ndc>
    <ndc_label_name>Kerlix 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080403400</ndc>
    <ndc_label_name>Kerlix 14" X 14" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080403700</ndc>
    <ndc_label_name>Kerlix 30" X 7" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080403728</ndc>
    <ndc_label_name>Dover Latex Foley Catheter 28 Fr</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080404800</ndc>
    <ndc_label_name>Kerlix 14" X 3" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080406900</ndc>
    <ndc_label_name>Kerlix 9" X 9" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080409500</ndc>
    <ndc_label_name>Webril II 2" X 4 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080412600</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze 1" X 36" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080413605</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080414600</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze 3" X 18" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080415200</ndc>
    <ndc_label_name>Webril II 3" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080415600</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze 3" X 36" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080416600</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze 6" X 36" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080417601</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze 1" X 8" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080420200</ndc>
    <ndc_label_name>Curity Bandage 2" X 4.1 yard</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080421600</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze 1/2" X 72" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080422100</ndc>
    <ndc_label_name>Webril II 4" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080422600</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze 1" X 36" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080423600</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080424600</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze 3" X 18" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080425600</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze 3" X 36" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080426500</ndc>
    <ndc_label_name>T.E.D. Knee Length-S-Regular misc</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080426600</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze 6" X 36" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080427100</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080427601</ndc>
    <ndc_label_name>Vaseline Petrolatum Gauze 1" X 8" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080427800</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080427900</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080428000</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080428100</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080428200</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080428300</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080428400</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080428500</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080428900</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080429600</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080429700</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080429800</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080429900</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080430000</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080430100</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080430101</ndc>
    <ndc_label_name>Vaseline jelly, topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080430200</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080430201</ndc>
    <ndc_label_name>Vaseline jelly, topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080430300</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080430301</ndc>
    <ndc_label_name>Vaseline jelly, topical</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080430400</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080430500</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080430800</ndc>
    <ndc_label_name>Kerlix sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080431302</ndc>
    <ndc_label_name>Xeroform Petrolatum Overwrap 1" X 8" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080431605</ndc>
    <ndc_label_name>Xeroform Petrolatum Overwrap 5" X 9" bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080431700</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080432000</ndc>
    <ndc_label_name>Xeroform Petrolatum Dressing 4" X 3 yard</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080432300</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080433200</ndc>
    <ndc_label_name>Vaseline White Petroleum topical ointment in packet</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080433301</ndc>
    <ndc_label_name>Xeroform Petrolatum Dressing 1" X 8"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080433401</ndc>
    <ndc_label_name>Xeroform Petrolatum Dressing 2" X 2"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080433500</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080433501</ndc>
    <ndc_label_name>Xeroform Petrolatum Dressing 4" X 4"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080433605</ndc>
    <ndc_label_name>Xeroform Petrolatum Dressing 5" X 9"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080434400</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080437100</ndc>
    <ndc_label_name>XEROFORM 5"X9" GAUZE STRIP</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441102</ndc>
    <ndc_label_name>Dermacea 3.4" X 3.6 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441106</ndc>
    <ndc_label_name>Dermacea 4" X 4.1 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441201</ndc>
    <ndc_label_name>Dermacea sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441202</ndc>
    <ndc_label_name>Dermacea sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441203</ndc>
    <ndc_label_name>Dermacea 2" X 2" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441204</ndc>
    <ndc_label_name>Dermacea 2" X 2" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441205</ndc>
    <ndc_label_name>Dermacea 2" X 2" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441206</ndc>
    <ndc_label_name>Dermacea 3" X 3" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441208</ndc>
    <ndc_label_name>Dermacea 3" X 3" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441209</ndc>
    <ndc_label_name>Dermacea 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441210</ndc>
    <ndc_label_name>Dermacea 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441214</ndc>
    <ndc_label_name>Dermacea 3" X 3" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441215</ndc>
    <ndc_label_name>Dermacea 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441216</ndc>
    <ndc_label_name>Dermacea 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441217</ndc>
    <ndc_label_name>Dermacea 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441218</ndc>
    <ndc_label_name>Dermacea 2" X 2" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441219</ndc>
    <ndc_label_name>Dermacea 3" X 3" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441250</ndc>
    <ndc_label_name>Dermacea 2 1/4" X 3 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441251</ndc>
    <ndc_label_name>Dermacea 4.5" X 4.1 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441401</ndc>
    <ndc_label_name>Dermacea Non-Woven 3" X 3" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441402</ndc>
    <ndc_label_name>Dermacea Non-Woven 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441403</ndc>
    <ndc_label_name>Dermacea Non-Woven 2" X 2" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441404</ndc>
    <ndc_label_name>Dermacea Non-Woven 3" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441405</ndc>
    <ndc_label_name>Dermacea Non-Woven 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441406</ndc>
    <ndc_label_name>Dermacea Non-Woven 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441410</ndc>
    <ndc_label_name>Dermacea Non-Woven 3" X 3" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441411</ndc>
    <ndc_label_name>Dermacea Non-Woven 3" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441412</ndc>
    <ndc_label_name>Dermacea Non-Woven 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441504</ndc>
    <ndc_label_name>Dermacea Stretch 2" X 4 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441505</ndc>
    <ndc_label_name>Dermacea Stretch 3" X 4.1 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441506</ndc>
    <ndc_label_name>Dermacea Stretch 4" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080441507</ndc>
    <ndc_label_name>Dermacea Stretch 6" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080442212</ndc>
    <ndc_label_name>Dermacea 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080442213</ndc>
    <ndc_label_name>Dermacea 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080442214</ndc>
    <ndc_label_name>Dermacea 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080442215</ndc>
    <ndc_label_name>Dermacea 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080442308</ndc>
    <ndc_label_name>Dermacea 2" X 2" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080443400</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080443500</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080443600</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080443700</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080451900</ndc>
    <ndc_label_name>Webril II 6" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080457200</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080457300</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080457400</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080457500</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080458800</ndc>
    <ndc_label_name>Kerlix 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080476154</ndc>
    <ndc_label_name>Aquaflo 4.75 " bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080478910</ndc>
    <ndc_label_name>Argyle Tracheostomy Care Tray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080490000</ndc>
    <ndc_label_name>Argyle Tracheostom Tube Holder</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080493500</ndc>
    <ndc_label_name>Kerlix sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080500555</ndc>
    <ndc_label_name>Monoject Regular Luer 35 mL syringe</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080500777</ndc>
    <ndc_label_name>Monoject Regular Luer 35 mL syringe</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080500888</ndc>
    <ndc_label_name>Monoject 35cc Syringe Cath Tip 35 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080501459</ndc>
    <ndc_label_name>Monoject Pharmacy Tray Regular Tip 1 mL syringe</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080502700</ndc>
    <ndc_label_name>Kenline Add-A-Foley Tray 30cc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080502900</ndc>
    <ndc_label_name>Add-A-Foley Cath-Pre-Fill Syrn tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080503300</ndc>
    <ndc_label_name>Webcol topical pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080504200</ndc>
    <ndc_label_name>Kerlix 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080507200</ndc>
    <ndc_label_name>Kerlix 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080511000</ndc>
    <ndc_label_name>Webcol topical pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080536000</ndc>
    <ndc_label_name>Kerlix Packing Sponge 4 1/2" X 22"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080541400</ndc>
    <ndc_label_name>Curity Cotton Tip Applicator</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080555230</ndc>
    <ndc_label_name>Kendall Foam Border 1 3/4" X 3 1/4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080555440</ndc>
    <ndc_label_name>Copa Hydrophilic Foam 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080560805</ndc>
    <ndc_label_name>Argyle Trocar 8 Fr misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080561019</ndc>
    <ndc_label_name>Argyle Trocar 10 Fr misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080561027</ndc>
    <ndc_label_name>Argyle Trocar 12 Fr misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080561035</ndc>
    <ndc_label_name>Argyle Trocar 16 Fr misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080561043</ndc>
    <ndc_label_name>Argyle Trocar 20 Fr misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080561050</ndc>
    <ndc_label_name>Argyle Trocar 24 Fr misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080575000</ndc>
    <ndc_label_name>Curity Alcohol Swabs</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080600310</ndc>
    <ndc_label_name>Wings Choice Plus Youth Briefs</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080600320</ndc>
    <ndc_label_name>Wings Choice Plus Adult Briefs</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080600330</ndc>
    <ndc_label_name>Wings Choice Plus Adult Briefs</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080600340</ndc>
    <ndc_label_name>Wings Choice Plus Adult Briefs</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080600350</ndc>
    <ndc_label_name>Wings Choice Plus Adult Briefs</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080600430</ndc>
    <ndc_label_name>Wings Choice Adult Brief</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080600440</ndc>
    <ndc_label_name>Wings Choice Adult Brief</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080600555</ndc>
    <ndc_label_name>Monoject Syringe 6 mL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080600777</ndc>
    <ndc_label_name>Monoject Syringe 6 mL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080601400</ndc>
    <ndc_label_name>Foley Catheter Tray 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080601700</ndc>
    <ndc_label_name>Telfa 2" X 3" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080602100</ndc>
    <ndc_label_name>Curity Gauze 4" X 360" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080602200</ndc>
    <ndc_label_name>Curity Disp Lap Sponge Tray 18" X 18"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080603101</ndc>
    <ndc_label_name>Dover Foley Catheter 10 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080603400</ndc>
    <ndc_label_name>Curity Disp Lap Sponge Tray 12" X 12"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080603500</ndc>
    <ndc_label_name>Kerlix sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080604500</ndc>
    <ndc_label_name>Curity Disp Lap Sponge Tray 18" X 4"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080605600</ndc>
    <ndc_label_name>Curity Disp Lap Sponge Tray 36" X 8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080607000</ndc>
    <ndc_label_name>Curity Strmlin Cath - Mono-Flo 14 Fr tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080608000</ndc>
    <ndc_label_name>Foley Catheter Tray 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080611100</ndc>
    <ndc_label_name>Curity Non-Adherent Strip 1/2" X 144" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080611200</ndc>
    <ndc_label_name>Curity Non-Adhering Dressing 3" X 3"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080611300</ndc>
    <ndc_label_name>Curity Non-Adherent Strip 3" X 8" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080612000</ndc>
    <ndc_label_name>Kerlix 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080612100</ndc>
    <ndc_label_name>Curity Non-Adherent Strip 9" X 16" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080612200</ndc>
    <ndc_label_name>Curity Ready-Cut Gauze 12" X 12" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080613200</ndc>
    <ndc_label_name>Curity Gauze 3" X 3" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080614000</ndc>
    <ndc_label_name>Foley Catheter Tray 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080615300</ndc>
    <ndc_label_name>Curity Premium Catheter Tray 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080615400</ndc>
    <ndc_label_name>Curity Premium Catheter Tray 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080615500</ndc>
    <ndc_label_name>Curity Premium Catheter Tray 16 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080615600</ndc>
    <ndc_label_name>Curity Premium Catheter Tray 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080617500</ndc>
    <ndc_label_name>Add-A-Foley Cath-Mono-Flo Drng tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080620112</ndc>
    <ndc_label_name>Monoject Syringe 6 mL 20 x 1 1/2"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080620600</ndc>
    <ndc_label_name>Curity Drainage Bag 2,000 mL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080620800</ndc>
    <ndc_label_name>Curity Bedside-Mono-Flo Drange tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080620900</ndc>
    <ndc_label_name>Mono-Flo Drainage Bag 2,000 mL</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080621000</ndc>
    <ndc_label_name>Foley Catheter Tray 18 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080621100</ndc>
    <ndc_label_name>Monoject Syringe 6 mL 21 x 1"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080621112</ndc>
    <ndc_label_name>Monoject Syringe 6 mL 21 x 1 1/2"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080622112</ndc>
    <ndc_label_name>Monoject Syringe 6 mL 22 x 1 1/2"</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080624100</ndc>
    <ndc_label_name>Dermacea I.V. 2" X 2" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080624300</ndc>
    <ndc_label_name>Tenderol kit</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080625100</ndc>
    <ndc_label_name>Curity Ureteral Drain Set</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080625500</ndc>
    <ndc_label_name>Foley Catheter Tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080626100</ndc>
    <ndc_label_name>Curity Bedside Drainage Bag</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080628600</ndc>
    <ndc_label_name>Curity Triangular Bandage misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080630000</ndc>
    <ndc_label_name>Curity Bedside Drainage Bag</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080630103</ndc>
    <ndc_label_name>Simplicity Adult Poly Medium misc</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080630900</ndc>
    <ndc_label_name>Curity Gauze 4" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080631000</ndc>
    <ndc_label_name>Curity Bedside Drainage Bag</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080631800</ndc>
    <ndc_label_name>Curity Gauze 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080635000</ndc>
    <ndc_label_name>Handicare Garment Liner pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080647400</ndc>
    <ndc_label_name>Curity Dressing 4 1/2" X 3600"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080660085</ndc>
    <ndc_label_name>Dover Red Rubber Robinson Cath 8 Fr</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080660101</ndc>
    <ndc_label_name>Dover Catheter 10 Fr</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080664000</ndc>
    <ndc_label_name>Kendall 2" X 2 3/4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080664100</ndc>
    <ndc_label_name>Polyskin II 4" X 4 3/4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080664200</ndc>
    <ndc_label_name>Polyskin II 6" X 8" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080664600</ndc>
    <ndc_label_name>Curity Dressing 9" X 100 yard</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080666000</ndc>
    <ndc_label_name>Kerlix AMD 0.2 %-6" X 6.75" sponge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080666200</ndc>
    <ndc_label_name>Kerlix AMD 0.2 %-6" X 6.75" sponge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080666500</ndc>
    <ndc_label_name>Kerlix AMD 0.2 %-6" X 6.75" sponge</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080670000</ndc>
    <ndc_label_name>Dover Bulb Syringe 60 mL</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080670930</ndc>
    <ndc_label_name>Wings XXL Adult Brief</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080671500</ndc>
    <ndc_label_name>Kerlix 4 1/2" X 147" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080672000</ndc>
    <ndc_label_name>Kerlix 2 1/4" X 3 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080673000</ndc>
    <ndc_label_name>Kerlix 4 1/2" X 147" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080673500</ndc>
    <ndc_label_name>Kerlix 3.4" X 3.6 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080676000</ndc>
    <ndc_label_name>Kerlix Burn Pack 4 1/2" X 148" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>1</drug_tier>
    <ndc>08080681800</ndc>
    <ndc_label_name>Webcol topical pads</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080682010</ndc>
    <ndc_label_name>Monoject Safety Syringe Tip Cap</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080689167</ndc>
    <ndc_label_name>Dover Latex Foley Catheter 16 Fr</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080693900</ndc>
    <ndc_label_name>Curity Gauze 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080702520</ndc>
    <ndc_label_name>Kangaroo Gravity Set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080707100</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080708300</ndc>
    <ndc_label_name>Excilon 4" X 3" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080708400</ndc>
    <ndc_label_name>Excilon 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080708401</ndc>
    <ndc_label_name>Excilon AMD (with polyhexamethylene) 0.2 %-4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080708500</ndc>
    <ndc_label_name>Excilon 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080708600</ndc>
    <ndc_label_name>Excilon Drain 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080708700</ndc>
    <ndc_label_name>Excilon I.V. 2" X 2" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080708800</ndc>
    <ndc_label_name>Excilon AMD (with polyhexamethylene) 0.2 %-4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080710000</ndc>
    <ndc_label_name>Add-A-Foley Cath-Pre-Fill Syrn tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080710500</ndc>
    <ndc_label_name>Tendersorb Underpad</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080711006</ndc>
    <ndc_label_name>Kangaroo Feeding Tube 10 Fr-43"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712080</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712100</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712120</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712150</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712170</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712200</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712230</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712250</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712270</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712300</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712350</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712400</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712450</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080712500</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080713400</ndc>
    <ndc_label_name>Tendersorb Underpad 23" X 24"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080714080</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080714120</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080714150</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080714170</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080714230</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080714250</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080714270</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080714300</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080714350</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080714450</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080714500</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080716080</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080716100</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080716120</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080716150</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080716170</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080716200</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080716230</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080716270</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080716350</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080716400</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080716450</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080716500</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080717400</ndc>
    <ndc_label_name>Tendersorb Underpad 23" X 36"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080717600</ndc>
    <ndc_label_name>Tendersorb Underpad 23" X 36"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718080</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718100</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718120</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718150</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718170</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718200</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718230</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718250</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718270</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718300</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718350</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718400</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718450</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080718500</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080719300</ndc>
    <ndc_label_name>Durasorb Underpad 23" X 36"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080719810</ndc>
    <ndc_label_name>Dermacea 8" X 10" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720080</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720100</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720120</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720150</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720170</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720200</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720230</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720250</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720270</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720300</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720350</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720400</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720450</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720500</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080720900</ndc>
    <ndc_label_name>Diapers-Disp-Polyethylene Back</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724080</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724100</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724120</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724150</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724170</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724200</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724230</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724250</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724270</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724300</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724350</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724450</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080724500</ndc>
    <ndc_label_name>Nutriport Balloon kit</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080726700</ndc>
    <ndc_label_name>Curity Gauze 3" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080731000</ndc>
    <ndc_label_name>Kerlix sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080733200</ndc>
    <ndc_label_name>Dover Urinary Leg Bag</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080733900</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080740200</ndc>
    <ndc_label_name>Curity Skin Scrub tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080740500</ndc>
    <ndc_label_name>Curity Skin Scrub tray</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080748000</ndc>
    <ndc_label_name>T.E.D. ANTI-EMBOL STOCKING</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080753901</ndc>
    <ndc_label_name>Telfa 2" X 3 3/4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080754000</ndc>
    <ndc_label_name>Telfa Island Dressing 4" X 5"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080754100</ndc>
    <ndc_label_name>Telfa Island Dressing 4" X 8"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080754200</ndc>
    <ndc_label_name>Telfa Island Dressing 4" X 10"</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080759400</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080760000</ndc>
    <ndc_label_name>Kenguard Foley Catheter tray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080760100</ndc>
    <ndc_label_name>Dover Universal tray</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080760400</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080760500</ndc>
    <ndc_label_name>Curity Gauze 4" X 4" sponge</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080763100</ndc>
    <ndc_label_name>Curity Plain Packing Strip 1/4" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080763200</ndc>
    <ndc_label_name>Curity Plain Packing Strip 1/2" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080763300</ndc>
    <ndc_label_name>Curity Plain Packing Strip 1" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080763400</ndc>
    <ndc_label_name>Curity Plain Packing Strip 2" X 5 yard bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080764300</ndc>
    <ndc_label_name>Telfa 3" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080766200</ndc>
    <ndc_label_name>Telfa (with polyhexamethylene) 0.2 %-3" X 4" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080766300</ndc>
    <ndc_label_name>Telfa (with polyhexamethylene) 0.2 %-3" X 8" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080766500</ndc>
    <ndc_label_name>Telfa AMD 4" X 5" bandage</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080773656</ndc>
    <ndc_label_name>Kangaroo Epump Set</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080773662</ndc>
    <ndc_label_name>Kangaroo Epump Set</ndc_label_name>
    <otc>True</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080775759</ndc>
    <ndc_label_name>Kangaroo 924 Safety Screw</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080780200</ndc>
    <ndc_label_name>T.E.D. Anti-Embolism Stocking</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080783100</ndc>
    <ndc_label_name>Curity Iodoform Packing Strip 1/4" X 5 yard bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080783110</ndc>
    <ndc_label_name>Curity AMD 1/4 " X 36 " bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080783200</ndc>
    <ndc_label_name>Curity Iodoform Packing Strip 1/2" X 5 yard bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080783210</ndc>
    <ndc_label_name>Curity AMD (with polyhexamethylene) 0.2 %-1/2" X 3 feet topical strips</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080783300</ndc>
    <ndc_label_name>Curity Iodoform Packing Strip 1" X 5 yard bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</drug_tier>
    <ndc>08080783310</ndc>
    <ndc_label_name>Curity AMD 1" X 5 yard bandage</ndc_label_name>
    <otc>False</otc>
    <prior_authorization>False</prior_authorization>
    <quantity_limit>False</quantity_limit>
    <step_therapy>False</step_therapy>
  </Drug_Information>
  <Drug_Information>
    <drug_tier>0</d