Drug - Brand Name (Generic Name) PA Status Class Drug Notes phenylephrine ophthalmic solution ADRENERGICS Palforzia (peanut allergen powder-dnfp) - PA PA ALLERGENS peanut allergen powder-dnfp - PA PA ALLERGENS pentosan ANALGESICS phenazopyridine A90 ANALGESICS A90 "penicillin G 0.6 million, 1.2 million, 2.4 million units" ANTIBIOTICS "penicillin G 5 million, 20 million units" ANTIBIOTICS # penicillin G benzathine / penicillin G procaine ANTIBIOTICS penicillin V A90 ANTIBIOTICS A90 "Pfizerpen # (penicillin G 5 million, 20 million units)" ANTIBIOTICS # piperacillin / tazobactam ANTIBIOTICS # plazomicin - PA PA ANTIBIOTICS Primaxin # (imipenem / cilastatin) ANTIBIOTICS # pyrazinamide A90 ANTIBIOTICS A90 "Pradaxa (dabigatran capsule) BP, M90" ANTICOAGULANTS "BP, M90" Pradaxa (dabigatran oral pellet) - PA PA ANTICOAGULANTS perampanel - PA PA ANTICONVULSANTS phenytoin chewable tablet A90 ANTICONVULSANTS "A90, #" phenytoin extended 200 mg and 300 mg capsule A90 ANTICONVULSANTS A90 phenytoin extended 30 mg and 100 mg capsule A90 ANTICONVULSANTS "A90, #" phenytoin injection MB ANTICONVULSANTS MB phenytoin suspension A90 ANTICONVULSANTS "A90, #" pregabalin - PA; See Table 20; See Table 71 PA ANTICONVULSANTS primidone A90 ANTICONVULSANTS "A90, #" Pamelor # (nortriptyline) A90 - PA < 6 years; See Table 17; See Table 71 PA ANTIDEPRESSANTS "A90, #" paroxetine controlled-release A90 - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS A90 paroxetine hydrochloride A90 - PA < 6 years; See Table 17; See Table 71 PA ANTIDEPRESSANTS "A90, #" paroxetine mesylate tablet - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS Paxil # (paroxetine hydrochloride) A90 - PA < 6 years; See Table 17; See Table 71 PA ANTIDEPRESSANTS "A90, #" Paxil CR (paroxetine controlled-release) A90 - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS A90 Pexeva (paroxetine mesylate tablet) - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS phenelzine A90 - PA < 6 years; See Table 17; See Table 71 PA ANTIDEPRESSANTS "A90, #" "Pristiq (desvenlafaxine succinate extended-release) BP, A90 - PA 1 unit/day; See Table 17; See Table 71" PA 1 unit/day ANTIDEPRESSANTS "BP, A90" protriptyline A90 - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS A90 "Prozac # (fluoxetine 10 mg, 20 mg, 40 mg capsule, solution) A90 - PA < 6 years; See Table 17; See Table 71" PA ANTIDEPRESSANTS "A90, #" palifermin MB ANTIDOTES MB Pedmark (sodium thiosulfate) MB - PA PA ANTIDOTES MB palonosetron 0.25 mg/2 mL injection A90 - PA > 2 units/28 days PA > 2 units/28 days ANTIEMETICS A90 palonosetron 0.25 mg/5 mL injection - PA > 2 units/28 days PA > 2 units/28 days ANTIEMETICS # prochlorperazine A90 ANTIEMETICS A90 posaconazole powder for oral suspension - PA PA ANTIFUNGALS Profilnine SD (factor IX complex human-Profilnine SD) ANTI-HEMOPHILIA AGENTS promethazine A90 ANTIHISTAMINES A90 primaquine A90 ANTIMALARIALS A90 "pyrimethamine BP, A90 - PA" PA ANTIMALARIALS "BP, A90" Panretin (alitretinoin) - PA PA ANTINEOPLASTICS Proleukin (aldesleukin) - PA PA ANTINEOPLASTICS phendimetrazine extended-release - PA PA ANTI-OBESITY AGENTS phendimetrazine - PA PA ANTI-OBESITY AGENTS "phentermine 15 mg, 30 mg capsule - PA" PA ANTI-OBESITY AGENTS "phentermine 37.5 mg capsule, tablet - PA" PA ANTI-OBESITY AGENTS phentermine 8 mg tablet - PA PA ANTI-OBESITY AGENTS paromomycin A90 ANTIPARASITICS A90 pentamidine A90 ANTIPARASITICS "A90, #" "permethrin *, A90" ANTIPARASITICS "*, A90" permethrin cream A90 ANTIPARASITICS A90 "piperonyl butoxide / pyrethrins *, A90" ANTIPARASITICS "*, A90" "praziquantel BP, A90" ANTIPARASITICS "BP, A90" pyrantel pamoate ANTIPARASITICS "Parlodel # (bromocriptine 2.5 mg, 5 mg) A90" ANTIPARKINSON "A90, #" pramipexole A90 ANTIPARKINSON "A90, #" pramipexole extended-release A90 - PA PA ANTIPARKINSON A90 Plavix # (clopidogrel) A90 ANTIPLATELET AGENT "A90, #" prasugrel A90 ANTIPLATELET AGENT "A90, #" paliperidone extended-release 1-month injection PD - PA 2 injections/28 days within the first 28 days of therapy and PA > 1 injection/28 days after 28 days of therapy; See Table 24; See Table 71 PA 2 injections/28 days within the first 28 days of therapy and PA > 1 injection/28 days after 28 days of therapy ANTIPSYCHOTIC PD paliperidone extended-release 3-month injection PD - PA 1 injection/84 days; See Table 24; See Table 71 PA 1 injection/84 days ANTIPSYCHOTIC PD paliperidone extended-release 6-month injection PD - PA 1 injection/168 days; See Table 24; See Table 71 PA 1 injection/168 days ANTIPSYCHOTIC PD paliperidone tablet A90 - PA; See Table 24; See Table 71 PA ANTIPSYCHOTIC A90 perphenazine A90 - PA < 6 years; See Table 24; See Table 71 PA ANTIPSYCHOTIC A90 "Perseris (risperidone 90 mg, 120 mg extended-release subcutaneous injection) PD - PA 1 injection/28 days; See Table 24; See Table 71" PA 1 injection/28 days ANTIPSYCHOTIC PD pimavanserin - PA PA ANTIPSYCHOTIC pimozide A90 - PA < 6 years; See Table 24; See Table 71 PA ANTIPSYCHOTIC "A90, #" "povidone *, A90" ANTISEPTICS "*, A90" palivizumab - PA PA ANTIVIRALS Pegasys (peginterferon alfa-2a) - PA PA ANTIVIRALS peginterferon alfa-2a - PA PA ANTIVIRALS peginterferon alfa-2b - PA PA ANTIVIRALS Pegintron (peginterferon alfa-2b) - PA PA ANTIVIRALS penciclovir A90 - PA PA ANTIVIRALS A90 Pifeltro (doravirine) PD ANTIVIRALS PD Prevymis (letermovir) - PA PA ANTIVIRALS Prezcobix (darunavir / cobicistat) PD ANTIVIRALS PD "Prezista (darunavir) BP, A90" ANTIVIRALS "BP, A90" phenobarbital 100 mg vial MB BARBITURATES MB "phenobarbital tablet, solution, injection" BARBITURATES Proscar # (finasteride) M90 BENIGN PROSTATIC HYPERPLASIA AGENTS "M90, #" "Panzyga (immune globulin IV, human-ifas) - PA" PA BIOLOGICAL "Pediarix (diphtheria / tetanus toxoids / acellular pertussis / hepatitis B, recombinant / poliovirus, inactivated vaccine) 1" BIOLOGICAL 1 Pedvaxhib (haemophilus B conjugate vaccine-Pedvaxhib) 1 BIOLOGICAL 1 "pegcetacoplan 1,080 mg/20 mL vial - PA" PA BIOLOGICAL pegcetacoplan 150 mg/mL vial MB - PA PA BIOLOGICAL MB Pentacel (diphtheria / tetanus / acellular pertussis / poliovirus inactivated / haemophilus B conjugate vaccine) 1 BIOLOGICAL 1 pneumococcal 13-valent conjugate vaccine 1 BIOLOGICAL 1 pneumococcal 15-valent conjugate vaccine BIOLOGICAL pneumococcal 23-valent polysaccharide vaccine 1 BIOLOGICAL 1 Pneumovax (pneumococcal 23-valent polysaccharide vaccine) 1 BIOLOGICAL 1 "poliovirus vaccine, inactivated 1" BIOLOGICAL 1 Prevnar 13 (pneumococcal 13-valent conjugate vaccine) 1 BIOLOGICAL 1 Priorix (measles / mumps / rubella vaccine) BIOLOGICAL "Privigen (immune globulin IV, human-Privigen) - PA" PA BIOLOGICAL Prolia (denosumab-Prolia) - PA PA BIOLOGICAL Proquad (measles / mumps / rubella / varicella virus vaccine) 1 BIOLOGICAL 1 pneumococcal 20-valent conjugate vaccine BIOLOGICALS Prehevbrio (hepatitis B recombinant vaccine) 1 BIOLOGICALS 1 Prevnar 20 (pneumococcal 20-valent conjugate vaccine) BIOLOGICALS Perforomist (formoterol) - PA PA BRONCHODILATORS Proair Digihaler (albuterol inhalation powder-Proair Digihaler) - PA PA BRONCHODILATORS "Proair HFA (albuterol inhaler-Proair HFA) BP, A90" BRONCHODILATORS "BP, A90" Proair Respiclick (albuterol inhalation powder-Proair Respiclick) BRONCHODILATORS "Proventil (albuterol inhaler-Proventil) BP, A90" BRONCHODILATORS "BP, A90" Pulmicort (budesonide inhalation powder) BRONCHODILATORS Pulmicort # (budesonide inhalation suspension) A90 - PA ≥ 13 years PA ≥ 13 years BRONCHODILATORS "A90, #" Parsabiv (etelcalcetide) MB CALCIMIMETIC MB pentoxifylline A90 CARDIOVASCULAR A90 perindopril M90 CARDIOVASCULAR M90 phenoxybenzamine M90 - PA PA CARDIOVASCULAR M90 pindolol M90 CARDIOVASCULAR M90 polidocanol MB - PA PA CARDIOVASCULAR MB prazosin M90; See Table 18; See Table 19 CARDIOVASCULAR "M90, #" Procardia XL # (nifedipine extended-release) M90 CARDIOVASCULAR "M90, #" propafenone extended-release M90 CARDIOVASCULAR "M90, #" propafenone immediate-release M90 CARDIOVASCULAR M90 propranolol / hydrochlorothiazide M90 CARDIOVASCULAR M90 propranolol extended-release M90 CARDIOVASCULAR "M90, #" propranolol immediate-release M90 CARDIOVASCULAR M90 propranolol long-acting capsule - PA PA CARDIOVASCULAR propranolol solution M90 - PA PA CARDIOVASCULAR M90 patiromer - PA > 1 unit/day PA > 1 unit/day CHELATING AGENT "penicillamine capsule BP, A90" CHELATING AGENT "BP, A90" penicillamine tablet A90 CHELATING AGENT "A90, #" paclitaxel injectable suspension MB CHEMOTHERAPY MB paclitaxel injection CHEMOTHERAPY pacritinib - PA PA CHEMOTHERAPY Padcev (enfortumab vedotin-ejfv) MB - PA PA CHEMOTHERAPY MB palbociclib PD - PA PA CHEMOTHERAPY PD panitumumab MB CHEMOTHERAPY MB "pazopanib BP, A90 - PA" PA CHEMOTHERAPY "BP, A90" pegaspargase MB CHEMOTHERAPY MB Pemazyre (pemigatinib) - PA PA CHEMOTHERAPY pembrolizumab MB - PA PA CHEMOTHERAPY MB pemetrexed disodium MB CHEMOTHERAPY MB pemetrexed MB CHEMOTHERAPY MB pemetrexed-Pemfexy MB - PA PA CHEMOTHERAPY MB Pemfexy (pemetrexed-Pemfexy) MB - PA PA CHEMOTHERAPY MB pemigatinib - PA PA CHEMOTHERAPY pentostatin MB CHEMOTHERAPY MB Perjeta (pertuzumab) MB - PA PA CHEMOTHERAPY MB pertuzumab / trastuzumab / hyaluronidase-zzxf MB - PA PA CHEMOTHERAPY MB pertuzumab MB - PA PA CHEMOTHERAPY MB pexidartinib - PA PA CHEMOTHERAPY Phesgo (pertuzumab / trastuzumab / hyaluronidase-zzxf) MB - PA PA CHEMOTHERAPY MB Piqray (alpelisib-Piqray) - PA PA CHEMOTHERAPY pirtobrutinib - PA PA CHEMOTHERAPY polatuzumab vedotin-piiq MB - PA PA CHEMOTHERAPY MB Polivy (polatuzumab vedotin-piiq) MB - PA PA CHEMOTHERAPY MB pomalidomide - PA PA CHEMOTHERAPY Pomalyst (pomalidomide) - PA PA CHEMOTHERAPY ponatinib - PA PA CHEMOTHERAPY Portrazza (necitumumab) - PA PA CHEMOTHERAPY Poteligeo (mogamulizumab-kpkc) MB - PA PA CHEMOTHERAPY MB pralatrexate MB CHEMOTHERAPY MB pralsetinib - PA PA CHEMOTHERAPY procarbazine CHEMOTHERAPY Provenge (sipuleucel-T) MB - PA PA CHEMOTHERAPY MB Purixan (mercaptopurine oral suspension) - PA PA CHEMOTHERAPY plecanatide - PA PA CONSTIPATION AGENTS prucalopride - PA PA CONSTIPATION AGENTS "psyllium capsule *, M90" CONSTIPATION AGENTS "*, M90" "psyllium powder *, A90" CONSTIPATION AGENTS "*, A90" Paragard (copper IUD) CONTRACEPTIVES Phexxi (lactic acid / citric acid / potassium bitartrate vaginal gel) CONTRACEPTIVES "Paxlovid (nirmatrelvir/ritonavir COVID EUA – December 22, 2021)" COVID - 19 related Treatments and Vaccines Paxlovid (nirmatrelvir / ritonavir for members ≥ 18 years of age) COVID - 19 related Treatments and Vaccines phenylephrine / promethazine A90 DECONGESTANT A90 pseudoephedrine* - PA > 240 mg/day PA > 240 mg/day DECONGESTANT * "petrolatum *, A90" DERMATOLOGICAL "*, A90" "pimecrolimus BP, A90" DERMATOLOGICAL "BP, A90" podofilox A90 DERMATOLOGICAL "A90, #" Protopic # (tacrolimus topical) A90 DERMATOLOGICAL "A90, #" Prudoxin (doxepin cream-Prudoxin) - PA PA DERMATOLOGICAL pioglitazone / metformin M90 DIABETIC AGENTS "M90, #" pioglitazone M90 DIABETIC AGENTS "M90, #" pramlintide DIABETIC AGENTS Precose # (acarbose) M90 DIABETIC AGENTS "M90, #" "Proglycem (diazoxide) BP, A90" DIABETIC AGENTS "BP, A90" pamidronate ELECTROLYTES AND NUTRIENTS paricalcitol capsule M90 - PA PA ELECTROLYTES AND NUTRIENTS M90 paricalcitol injection MB ELECTROLYTES AND NUTRIENTS MB "pediatric multivitamins *, M90" ELECTROLYTES AND NUTRIENTS "*, M90" Phos-Flur (sodium fluoride oral rinse) A90 ELECTROLYTES AND NUTRIENTS A90 Phoslyra (calcium acetate) ELECTROLYTES AND NUTRIENTS phytonadione A90 ELECTROLYTES AND NUTRIENTS "A90, #" potassium bicarbonate A90 ELECTROLYTES AND NUTRIENTS A90 potassium chloride injection ELECTROLYTES AND NUTRIENTS potassium chloride-Kaochlor A90 ELECTROLYTES AND NUTRIENTS A90 potassium chloride-Kaon-CL A90 ELECTROLYTES AND NUTRIENTS A90 potassium chloride-Klor-Con A90 ELECTROLYTES AND NUTRIENTS "A90, #" potassium chloride-K-Tab A90 ELECTROLYTES AND NUTRIENTS A90 potassium chloride-Micro-K A90 ELECTROLYTES AND NUTRIENTS "A90, #" potassium citrate / citric acid A90 ELECTROLYTES AND NUTRIENTS A90 potassium citrate / sodium citrate / citric acid A90 ELECTROLYTES AND NUTRIENTS A90 potassium citrate A90 ELECTROLYTES AND NUTRIENTS "A90, #" potassium phosphate / dibasic sodium phosphate / monobasic sodium phosphate A90 ELECTROLYTES AND NUTRIENTS A90 potassium phosphate / sodium phosphate / phosphorus ELECTROLYTES AND NUTRIENTS potassium phosphate * ELECTROLYTES AND NUTRIENTS * "prenatal vitamins *, M90" ELECTROLYTES AND NUTRIENTS "*, M90" "pyridoxine *, M90" ELECTROLYTES AND NUTRIENTS "*, M90" pasireotide injectable suspension MB - PA PA ENDOCRINE/METABOLIC AGENTS MB pasireotide - PA PA ENDOCRINE/METABOLIC AGENTS Palynziq (pegvaliase-pqpz) - PA PA ENZYMES pancrelipase-Creon DR ENZYMES pancrelipase-Pertzye DR ENZYMES pancrelipase-Viokace ENZYMES pancrelipase-Zenpep DR ENZYMES pegunigalsidase alfa-iwxj - PA PA ENZYMES pegvaliase-pqpz - PA PA ENZYMES Pertzye DR (pancrelipase-Pertzye DR) ENZYMES Pheburane (sodium phenylbutyrate granules) - PA PA ENZYMES Procysbi (cysteamine delayed-release capsule) - PA PA ENZYMES Procysbi (cysteamine delayed-release granule) - PA PA ENZYMES "Prolastin-C (alpha-1-proteinase inhibitor, human-Prolastin-C) MB" ENZYMES MB Pulmozyme (dornase alfa) ENZYMES "posaconazole injection, suspension BP, A90 - PA" PA FUNGICIDES "BP, A90" posaconazole tablet A90 FUNGICIDES "A90, #" pregabalin extended-release BP - PA; See Table 71; See Table 72 PA GABA ANALOGS BP "Pentasa (mesalamine controlled-release) BP, A90" GI ANTI-INFLAMMATORY "BP, A90" Pandel (hydrocortisone probutate cream) GLUCOCORTICOIDS Pediapred # (prednisolone 5 mg/5 mL oral solution) A90 GLUCOCORTICOIDS "A90, #" "prednicarbate cream, ointment A90" GLUCOCORTICOIDS A90 prednisolone 10 mg/5 mL oral solution A90 - PA PA GLUCOCORTICOIDS A90 "prednisolone 15 mg/5 mL, 25 mg/5 mL oral solution A90" GLUCOCORTICOIDS A90 prednisolone 20 mg/5 mL oral solution A90 - PA PA GLUCOCORTICOIDS A90 prednisolone 5 mg/5 mL oral solution A90 GLUCOCORTICOIDS "A90, #" prednisolone orally disintegrating tablet A90 - PA PA GLUCOCORTICOIDS A90 prednisolone tablet A90 - PA PA GLUCOCORTICOIDS A90 prednisone A90 GLUCOCORTICOIDS A90 prednisone delayed-release - PA PA GLUCOCORTICOIDS pegloticase MB - PA PA GOUT AGENTS MB probenecid / colchicine M90 GOUT AGENTS M90 probenecid M90 GOUT AGENTS M90 "Pylera (bismuth subcitrate / metronidazole / tetracycline) BP, A90" H. PYLORI AGENTS "BP, A90" "Pepcid # (famotidine tablet) *, M90" H2 ANTAGONISTS "*, M90, #" pegfilgrastim HEMATINIC AGENT pegfilgrastim-apgf HEMATINIC AGENT pegfilgrastim-bmez HEMATINIC AGENT pegfilgrastim-cbqv HEMATINIC AGENT pegfilgrastim-jmdb HEMATINIC AGENT plerixafor HEMATINIC AGENT # Procrit (epoetin alfa-Procrit) - PA PA HEMATINIC AGENT Promacta (eltrombopag) - PA PA HEMATINIC AGENT protein C concentrate MB - PA PA HEMATINIC AGENT MB pegfilgrastim-fpgk HEMATINICS & BLOOD CELL STIMULATORS pegfilgrastim-pbbk HEMATINICS & BLOOD CELL STIMULATORS "plasminogen, human-tvmh - PA" PA HEMOSTATICS "prothrombin complex concentrate, human" HEMOSTATICS parathyroid hormone - PA PA HORMONE AGENTS pegvisomant - PA PA HORMONE AGENTS Prefest (estradiol / norgestimate) HORMONE REPLACEMENT THERAPY "Premarin (estrogens, conjugated)" HORMONE REPLACEMENT THERAPY "Premphase (medroxyprogesterone / estrogens, conjugated-Premphase)" HORMONE REPLACEMENT THERAPY "Prempro (medroxyprogesterone / estrogens, conjugated-Prempro)" HORMONE REPLACEMENT THERAPY progesterone capsule A90 HORMONE REPLACEMENT THERAPY "A90, #" progesterone gel - PA PA HORMONE REPLACEMENT THERAPY Prometrium # (progesterone capsule) A90 HORMONE REPLACEMENT THERAPY "A90, #" Provera # (medroxyprogesterone tablet) A90 HORMONE REPLACEMENT THERAPY "A90, #" Prograf (tacrolimus granules) - PA PA IMMUNOMODULATOR Prograf (tacrolimus injection) MB IMMUNOMODULATOR MB Prograf # (tacrolimus immediate-release capsule) A90 IMMUNOMODULATOR "A90, #" potassium iodide - PA > 1 mL/day PA > 1 mL/day IODINE THERAPY Plenvu (polyethylene glycol-electrolyte solution-Plenvu) LAXATIVES "polyethylene glycol 3350 *, A90" LAXATIVES "*, A90" polyethylene glycol-electrolyte solution A90 LAXATIVES A90 polyethylene glycol-electrolyte solution-Golytely A90 LAXATIVES "A90, #" "polyethylene glycol-electrolyte solution-Moviprep BP, A90" LAXATIVES "BP, A90" polyethylene glycol-electrolyte solution-Plenvu LAXATIVES pitavastatin calcium M90 - PA PA LIPID LOWERING AGENTS M90 pitavastatin magnesium - PA PA LIPID LOWERING AGENTS Praluent (alirocumab) - PA PA LIPID LOWERING AGENTS "pravastatin 10 mg, 20 mg, 40 mg M90 - PA > 1.5 units/day" PA > 1.5 units/day LIPID LOWERING AGENTS M90 pravastatin 80 mg M90 - PA > 1 unit/day PA > 1 unit/day LIPID LOWERING AGENTS M90 peginterferon beta-1a - PA PA MULTIPLE SCLEROSIS AGENTS Plegridy (peginterferon beta-1a) - PA PA MULTIPLE SCLEROSIS AGENTS pitolisant - PA PA NARCOLEPSY AGENTS Provigil # (modafinil 100 mg) - PA 1.5 units/day; See Table 50; See Table 71 PA 1.5 units/day NARCOLEPSY AGENTS # Provigil # (modafinil 200 mg) - PA 2 units/day; See Table 50; See Table 71 PA 2 units/day NARCOLEPSY AGENTS # Patanase (olopatadine nasal spray) A90 - PA PA NASAL PREPARATIONS A90 Pulmosal (sodium chloride 7% for inhalation) - Non-Drug Product NON-DRUG PRODUCT "Pennsaid (diclofenac topical solution) BP, A90" NONSTEROIDAL ANTI-INFLAMMATORY "BP, A90" piroxicam A90 NONSTEROIDAL ANTI-INFLAMMATORY "A90, #" pegaptanib MB OPHTHALMIC PREPARATIONS MB perfluorohexyloctane - PA PA OPHTHALMIC PREPARATIONS phenylephrine / ketorolac MB OPHTHALMIC PREPARATIONS MB Phospholine Iodide (echothiophate iodide) OPHTHALMIC PREPARATIONS pilocarpine 1.2% ophthalmic solution - PA PA OPHTHALMIC PREPARATIONS "pilocarpine 1%, 2%, 4% ophthalmic solution M90" OPHTHALMIC PREPARATIONS "M90, #" Polytrim # (trimethoprim / polymyxin B ophthalmic solution) A90 OPHTHALMIC PREPARATIONS "A90, #" Pred Forte # (prednisolone acetate 1% ophthalmic suspension) A90 OPHTHALMIC PREPARATIONS "A90, #" Pred-G (gentamicin / prednisolone ophthalmic ointment) - PA PA OPHTHALMIC PREPARATIONS Pred-G (gentamicin / prednisolone ophthalmic suspension) OPHTHALMIC PREPARATIONS Pred Mild (prednisolone acetate 0.12% ophthalmic suspension) OPHTHALMIC PREPARATIONS prednisolone acetate 0.12% ophthalmic suspension OPHTHALMIC PREPARATIONS prednisolone acetate 1% ophthalmic suspension A90 OPHTHALMIC PREPARATIONS "A90, #" prednisolone sodium phosphate ophthalmic solution A90 OPHTHALMIC PREPARATIONS A90 "Prolensa (bromfenac 0.07%) BP, A90" OPHTHALMIC PREPARATIONS "BP, A90" proparacaine A90 OPHTHALMIC PREPARATIONS A90 pentazocine / naloxone - PA PA OPIOID ANALGESICS Percocet # (oxycodone / acetaminophen-Percocet) - PA > 80 mg/day oxycodone and PA > 4 g/day acetaminophen PA > 80 mg/day oxycodone and PA > 4 g/day acetaminophen OPIOID ANALGESICS # pilocarpine tablet A90 PARASYMPATHETIC AGENTS A90 pyridostigmine bromide 30 mg tablet A90 - PA PA PARASYMPATHETIC AGENTS A90 "pyridostigmine bromide 60 mg tablet, 180 mg extended-release tablet A90" PARASYMPATHETIC AGENTS "A90, #" "pyridostigmine bromide solution BP, A90" PARASYMPATHETIC AGENTS "BP, A90" progesterone injection PROGESTERONE progesterone vaginal insert - PA PA PROGESTERONE "pantoprazole 40 mg suspension BP, M90 - PA" PA PROTON PUMP INHIBITORS "BP, M90" pantoprazole IV PROTON PUMP INHIBITORS # pantoprazole tablet M90 - PA > 4 units/day PA > 4 units/day PROTON PUMP INHIBITORS "M90, #" Prevacid # (lansoprazole capsule) M90 - PA > 1 unit/day PA > 1 unit/day PROTON PUMP INHIBITORS "M90, #" "Prevacid Solutab (lansoprazole orally disintegrating tablet) BP, M90 - PA ≥ 2 years" PA ≥ 2 years PROTON PUMP INHIBITORS "BP, M90" Prilosec (omeprazole suspension) - PA PA PROTON PUMP INHIBITORS "Protonix (pantoprazole 40 mg suspension) BP, M90 - PA" PA PROTON PUMP INHIBITORS "BP, M90" Protonix # (pantoprazole tablet) M90 - PA > 4 units/day PA > 4 units/day PROTON PUMP INHIBITORS "M90, #" Protonix IV # (pantoprazole IV) PROTON PUMP INHIBITORS # pirfenidone A90 - PA PA PULMONARY FIBROSIS AGENTS A90 "patisiran PD, MB - PA" PA SMALL INTERFERING RNA AGENTS "PD, MB" ponesimod - PA PA SPHINGOSINE 1-PHOSPHATE RECEPTOR MODULATOR Ponvory (ponesimod) - PA PA SPHINGOSINE 1-PHOSPHATE RECEPTOR MODULATOR Paser (aminosalicylic acid) TB PREPARATIONS pretomanid A90 TB PREPARATIONS A90 Priftin (rifapentine) TB PREPARATIONS propylthiouracil M90 THYROID PREPARATIONS M90 paroxetine mesylate capsule A90 - PA PA UNCLASSIFIED DRUG PRODUCTS A90 Pyrukynd (mitapivat) - PA PA UNCLASSIFIED DRUG PRODUCTS