Drug - Brand Name (Generic Name) PA Status Class Drug Notes Simulect (basiliximab) MB BIOLOGICAL MB Simbrinza (brinzolamide / brimonidine) OPHTHALMIC PREPARATIONS "Symbicort (budesonide / formoterol) BP, A90" BRONCHODILATORS "BP, A90" Sensorcaine (bupivacaine) MB ANESTHETICS MB "Suboxone (buprenorphine / naloxone film ≤ 24 mg/day) BP, PD" ALCOHOL AND DRUG CESSATION AGENT "BP, PD" Sublocade (buprenorphine extended-release injection-Sublocade) PD ALCOHOL AND DRUG CESSATION AGENT PD Stalevo # (carbidopa / levodopa / entacapone) A90 ANTIPARKINSON "A90, #" Sinemet # (carbidopa / levodopa tablet) A90 ANTIPARKINSON "A90, #" Sensipar # (cinacalcet) A90 CALCIMIMETIC "A90, #" "Sevenfact (coagulation factor VIIa, recombinant)" ANTI-HEMOPHILIA AGENTS "Spikevax (COVID-19 Moderna vaccine, COVID EUA – September 11, 2023 for members ≥ 6 months of age)" COVID - 19 related Treatments and Vaccines Sandimmune # (cyclosporine capsule) A90 IMMUNOMODULATOR "A90, #" Sandimmune (cyclosporine injection) MB IMMUNOMODULATOR MB Symtuza (darunavir / cobicistat / emtricitabine / tenofovir alafenamide) PD ANTIVIRALS PD Sprycel (dasatinib) CHEMOTHERAPY Slynd (drospirenone) CONTRACEPTIVES Sustiva # (efavirenz) A90 ANTIVIRALS "A90, #" Stribild (elvitegravir / cobicistat / emtricitabine / tenofovir disoproxil fumarate) ANTIVIRALS Synjardy (empagliflozin / metformin) DIABETIC AGENTS Synjardy XR (empagliflozin / metformin extended-release) DIABETIC AGENTS Symjepi (epinephrine injection) ADRENERGICS Safyral # (ethinyl estradiol / drospirenone / levomefolate-Safyral) M90 CONTRACEPTIVES "M90, #" Synalar # (fluocinolone 0.025% cream) A90 GLUCOCORTICOIDS "A90, #" Synalar # (fluocinolone ointment) A90 GLUCOCORTICOIDS "A90, #" Synalar # (fluocinolone solution) A90 GLUCOCORTICOIDS "A90, #" Solu-Cortef (hydrocortisone injection) GLUCOCORTICOIDS Sporanox # (itraconazole 100 mg capsule) A90 FUNGICIDES "A90, #" "Sporanox (itraconazole solution) BP, A90" FUNGICIDES "BP, A90" Stromectol # (ivermectin tablet) ANTIPARASITICS # Somatuline (lanreotide) ENDOCRINE/METABOLIC AGENTS Seasonique # (levonorgestrel / ethinyl estradiol-Seasonique) M90 CONTRACEPTIVES "M90, #" Skyla (levonorgestrel-releasing intrauterine system 13.5 mg) CONTRACEPTIVES Synthroid # (levothyroxine-Synthroid) M90 THYROID PREPARATIONS "M90, #" Sulfamylon # (mafenide) A90 ANTIBIOTICS "A90, #" Solu-Medrol # (methylprednisolone sodium succinate) GLUCOCORTICOIDS # Savella (milnacipran) ANALGESICS "Solodyn (minocycline extended-release 55 mg, 65 mg, 80 mg, 105 mg, 115 mg tablet) BP, A90" ANTIBIOTICS "BP, A90" "Singulair # (montelukast tablet, chewable tablet) M90" BRONCHODILATORS "M90, #" Sandostatin LAR (octreotide injectable suspension) ENDOCRINE/METABOLIC AGENTS Sandostatin # (octreotide injection) ENDOCRINE/METABOLIC AGENTS # Stimufend (pegfilgrastim-fpgk) HEMATINICS & BLOOD CELL STIMULATORS Sezaby (phenobarbital 100 mg vial) MB BARBITURATES MB Symlinpen (pramlintide) DIABETIC AGENTS Susvimo (ranibizumab) MB OPHTHALMIC PREPARATIONS MB "salicylic acid o, A90" DERMATOLOGICAL "o, A90" saliva substitute * ELECTROLYTES AND NUTRIENTS * salmeterol BRONCHODILATORS Serevent (salmeterol) BRONCHODILATORS samarium Sm 153 lexidronam MB CHEMOTHERAPY MB saquinavir ANTIVIRALS sargramostim HEMATINIC AGENT "saxagliptin BP, M90" DIABETIC AGENTS "BP, M90" "saxagliptin / metformin extended-release BP, M90" DIABETIC AGENTS "BP, M90" scopolamine A90 "ANTISPASMODICS,ANTICHOLINERGIC" A90 "scopolamine transdermal patch BP, A90" ANTIEMETICS "BP, A90" segesterone / ethinyl estradiol CONTRACEPTIVES "selegiline capsule, tablet A90" ANTIPARKINSON A90 "selenium sulfide *, A90" DERMATOLOGICAL "*, A90" "sennosides syrup *, A90" CONSTIPATION AGENTS "*, A90" "sennosides tablet *, M90" CONSTIPATION AGENTS "*, M90" sertaconazole FUNGICIDES sevelamer carbonate A90 ELECTROLYTES AND NUTRIENTS "A90, #" sevelamer hydrochloride A90 ELECTROLYTES AND NUTRIENTS "A90, #" silver sulfadiazine A90 ANTIBIOTICS A90 silver sulfadiazine-Silvadene A90 ANTIBIOTICS "A90, #" Silvadene # (silver sulfadiazine-Silvadene) A90 ANTIBIOTICS "A90, #" "simethicone *, A90" GASTROINTESTINAL AGENT "*, A90" simple syrup * COMPOUNDING AGENT * "sirolimus solution BP, A90" IMMUNOMODULATOR "BP, A90" sirolimus tablet A90 IMMUNOMODULATOR "A90, #" sitagliptin DIABETIC AGENTS sitagliptin / metformin DIABETIC AGENTS sitagliptin / metformin extended-release DIABETIC AGENTS sodium bicarbonate * ELECTROLYTES AND NUTRIENTS * "sodium chloride 3.5%, 7% for inhalation - Non-Drug Product" NON-DRUG PRODUCT sodium chloride 6% for inhalation - Non-Drug Product NON-DRUG PRODUCT sodium chloride 7% for inhalation - Non-Drug Product NON-DRUG PRODUCT sodium chloride for inhalation * - Non-Drug Product ELECTROLYTES AND NUTRIENTS * sodium chloride solution ELECTROLYTES AND NUTRIENTS sodium chloride tablet * ELECTROLYTES AND NUTRIENTS * sodium citrate / citric acid A90 ELECTROLYTES AND NUTRIENTS A90 sodium ferric gluconate complex HEMATINIC AGENT # "sodium fluoride *, M90" ELECTROLYTES AND NUTRIENTS "*, M90" sodium fluoride oral rinse A90 ELECTROLYTES AND NUTRIENTS A90 sodium phenylacetate / sodium benzoate ELECTROLYTES AND NUTRIENTS # "sodium phenylbutyrate powder, tablet BP, A90" ENZYMES "BP, A90" sodium phosphate LAXATIVES "sodium phosphate *, A90" GASTROINTESTINAL AGENT "*, A90" sodium polystyrene sulfonate CHELATING AGENT "sodium sulfate / potassium sulfate / magnesium sulfate BP, A90" LAXATIVES "BP, A90" "Suprep (sodium sulfate / potassium sulfate / magnesium sulfate) BP, A90" LAXATIVES "BP, A90" solifenacin tablet A90 URINARY ANTISPASMODICS "A90, #" sotalol tablet M90 CARDIOVASCULAR "M90, #" spironolactone / hydrochlorothiazide M90 CARDIOVASCULAR M90 spironolactone tablet M90 ALDOSTERONE ANTAGONISTS "M90, #" stavudine A90 ANTIVIRALS A90 streptomycin ANTIBIOTICS streptozocin MB CHEMOTHERAPY MB succimer CHELATING AGENT "sucralfate suspension BP, A90" ANTACIDS "BP, A90" sucralfate tablet A90 ANTACIDS "A90, #" sucroferric oxyhydroxide ELECTROLYTES AND NUTRIENTS sufentanil injection OPIOID ANALGESICS sulfacetamide / prednisolone sodium phosphate ophthalmic solution A90 OPHTHALMIC PREPARATIONS A90 "sulfacetamide ophthalmic ointment, solution A90" OPHTHALMIC PREPARATIONS A90 sulfadiazine A90 ANTIBIOTICS A90 sulfamethoxazole / trimethoprim injection ANTIBIOTICS sulfamethoxazole / trimethoprim suspension A90 ANTIBIOTICS "A90, #" Sulfatrim # (sulfamethoxazole / trimethoprim suspension) A90 ANTIBIOTICS "A90, #" sulfamethoxazole / trimethoprim tablet ANTIBIOTICS # sulfasalazine A90 GI ANTI-INFLAMMATORY "A90, #" sulfasalazine delayed-release A90 GI ANTI-INFLAMMATORY "A90, #" sulindac A90 NONSTEROIDAL ANTI-INFLAMMATORY A90 Soltamox (tamoxifen solution) CHEMOTHERAPY "Spiriva Handihaler (tiotropium inhalation powder) BP, A90" BRONCHODILATORS "BP, A90" Spiriva Respimat (tiotropium inhalation solution) BRONCHODILATORS "Syprine (trientine capsule) BP, A90" CHELATING AGENT "BP, A90" "Stamaril (yellow fever vaccine, live)" BIOLOGICAL Sympazan (clobazam film) - PA PA ANTICONVULSANTS Spritam (levetiracetam tablet for oral suspension) - PA PA ANTICONVULSANTS stiripentol - PA PA ANTICONVULSANTS "Sabril (vigabatrin) BP, A90 - PA" PA ANTICONVULSANTS "BP, A90" "simvastatin 5 mg, 10 mg, 20 mg, 40 mg M90 - PA > 1.5 units/day" PA > 1.5 units/day LIPID LOWERING AGENTS "M90, #" simvastatin 80 mg M90 - PA > 1 unit/day PA > 1 unit/day LIPID LOWERING AGENTS "M90, #" Synera (lidocaine / tetracaine) - PA > 4 patches/30 days PA > 4 patches/30 days ANESTHETICS Seglentis (celecoxib / tramadol) - PA PA ANALGESICS Sprix (ketorolac nasal spray) - PA PA NONSTEROIDAL ANTI-INFLAMMATORY salsalate A90 - PA PA NONSTEROIDAL ANTI-INFLAMMATORY A90 Sancuso (granisetron transdermal system) - PA PA ANTIEMETICS Sustol (granisetron extended-release injection) - PA > 2 units/28 days PA > 2 units/28 days ANTIEMETICS sinecatechins - PA PA ANTIVIRALS spinosad A90 - PA PA ANTIPARASITICS A90 Suprax (cefixime) A90 - PA PA ANTIBIOTICS A90 secnidazole - PA PA ANTIBIOTICS Solosec (secnidazole) - PA PA ANTIBIOTICS Sivextro (tedizolid tablet) - PA PA ANTIBIOTICS sofosbuvir - PA PA ANTIVIRALS Sovaldi (sofosbuvir) - PA PA ANTIVIRALS sofosbuvir / velpatasvir PD - PA PA ANTIVIRALS PD sofosbuvir / velpatasvir / voxilaprevir - PA PA ANTIVIRALS serdexmethylphenidate / dexmethylphenidate - PA; See Table 31; See Table 71 PA CEREBRAL STIMULANTS silodosin M90 - PA PA BENIGN PROSTATIC HYPERPLASIA AGENTS M90 "Suboxone (buprenorphine / naloxone film) BP, PD - PA > 32 mg/day" PA > 32 mg/day ALCOHOL AND DRUG CESSATION AGENT "BP, PD" "Suboxone (buprenorphine / naloxone film) BP, PD - PA > 90 days (> 24 mg/day and ≤ 32 mg/day)" PA > 90 days (> 24 mg/day and ≤ 32 mg/day) ALCOHOL AND DRUG CESSATION AGENT "BP, PD" sumatriptan / naproxen A90 - PA PA TRIPTAN/NON STEROIDAL ANTI-INFLAMMATORY A90 sumatriptan 10 mg nasal spray - PA PA TRIPTAN sumatriptan injection-Imitrex - PA PA TRIPTAN sumatriptan injection-Zembrace - PA PA TRIPTAN "sumatriptan 5 mg, 20 mg nasal spray A90 - PA > 18 units/30 days" PA > 18 units/30 days TRIPTAN "A90, #" sumatriptan tablet A90 - PA > 18 units/30 days PA > 18 units/30 days TRIPTAN "A90, #" Savaysa (edoxaban) - PA PA ANTICOAGULANTS Sinuva (mometasone sinus implant) - PA PA NASAL PREPARATIONS Symfi Lo (efavirenz 400 mg / lamivudine 300 mg / tenofovir disoproxil fumarate 300 mg) A90 - PA PA ANTIVIRALS A90 Symfi (efavirenz 600 mg / lamivudine 300 mg / tenofovir disoproxil fumarate 300 mg) A90 - PA PA ANTIVIRALS A90 Sunlenca (lenacapavir) - PA PA ANTIVIRALS Selzentry (maraviroc solution) - PA PA ANTIVIRALS "Selzentry (maraviroc tablet) BP, A90 - PA" PA ANTIVIRALS "BP, A90" Supartz (hyaluronate-Supartz) MB - PA PA HYALURONAN MB Synojoynt (hyaluronate-Synojoynt) MB - PA PA HYALURONAN MB Synvisc (hylan G-F20-Synvisc) MB - PA PA HYALURONAN MB Synvisc-One (hylan G-F20-Synvisc-One) MB - PA PA HYALURONAN MB selexipag - PA PA CARDIOVASCULAR sildenafil 20 mg tablet A90 - PA PA CARDIOVASCULAR A90 sildenafil oral suspension-Liqrev - PA PA CARDIOVASCULAR "sildenafil oral suspension-Revatio BP, A90 - PA" PA CARDIOVASCULAR "BP, A90" Siliq (brodalumab) - PA PA IMMUNOMODULATOR Sotyktu (deucravacitinib) - PA PA IMMUNOMODULATOR Simponi (golimumab) - PA PA IMMUNOMODULATOR Simponi Aria (golimumab for infusion) - PA PA IMMUNOMODULATOR Skyrizi (risankizumab-rzaa) - PA PA IMMUNOMODULATOR sarilumab - PA PA IMMUNOMODULATOR secukinumab - PA PA IMMUNOMODULATOR spesolimab-sbzo - PA PA IMMUNOMODULATOR Spevigo (spesolimab-sbzo) - PA PA IMMUNOMODULATOR Stelara (ustekinumab 130 mg/26 mL vial) MB - PA PA IMMUNOMODULATOR MB "Stelara (ustekinumab 45 mg/0.5 mL prefilled syringe, 90 mg/mL prefilled syringe, 45 mg/0.5 mL vial) PD - PA" PA IMMUNOMODULATOR PD Spravato (esketamine) - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS Symbyax (olanzapine / fluoxetine) A90 - PA; See Table 17; See Table 24; See Table 71 PA ANTIDEPRESSANTS A90 selegiline transdermal patch - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS sertraline capsule A90 - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS A90 "sertraline oral concentrate, tablet A90 - PA < 6 years; See Table 17; See Table 71" PA ANTIDEPRESSANTS "A90, #" sodium picosulfate / magnesium oxide / anhydrous citric acid-Clenpiq - PA PA LAXATIVES sodium sulfate / magnesium sulfate / potassium chloride - PA PA LAXATIVES Sutab (sodium sulfate / magnesium sulfate / potassium chloride) - PA PA LAXATIVES siponimod - PA PA SPHINGOSINE 1-PHOSPHATE RECEPTOR MODULATOR Sitavig (acyclovir buccal tablet) - PA PA ANTIVIRALS Scenesse (afamelanotide) MB - PA PA DERMATOLOGICAL MB Saphnelo (anifrolumab-fnia) MB - PA PA BIOLOGICAL MB Strensiq (asfotase alfa) - PA PA ENZYMES Sirturo (bedaquiline) - PA PA TB PREPARATIONS Soma (carisoprodol) - PA PA MUSCLE RELAXANT Santyl (collagenase) - PA PA DERMATOLOGICAL Sandimmune (cyclosporine solution) - PA PA IMMUNOMODULATOR Soliris (eculizumab) MB - PA PA BIOLOGICAL MB Skelaxin (metaxalone) A90 - PA PA MUSCLE RELAXANT A90 Sular (nisoldipine) M90 - PA PA CARDIOVASCULAR M90 Skyclarys (omaveloxolone) - PA PA UNCLASSIFIED DRUG PRODUCTS Synagis (palivizumab) - PA PA ANTIVIRALS Signifor (pasireotide) - PA PA ENDOCRINE/METABOLIC AGENTS Signifor LAR (pasireotide injectable suspension) MB - PA PA ENDOCRINE/METABOLIC AGENTS MB Syfovre (pegcetacoplan 150 mg/mL vial) MB - PA PA BIOLOGICAL MB Somavert (pegvisomant) - PA PA HORMONE AGENTS sacrosidase - PA PA UNCLASSIFIED DRUG PRODUCTS Sucraid (sacrosidase) - PA PA UNCLASSIFIED DRUG PRODUCTS safinamide - PA PA ANTIPARKINSON sapropterin - PA PA ENZYMES satralizumab-mwge - PA PA BIOLOGICAL sebelipase alfa MB - PA PA ENZYMES MB selegiline orally disintegrating tablet - PA PA ANTIPARKINSON short ragweed pollen allergen extract - PA PA ALLERGENS siltuximab MB - PA PA BIOLOGICAL MB Sylvant (siltuximab) MB - PA PA BIOLOGICAL MB sodium phenylbutyrate / sodium taurursodiol - PA PA AMYOTROPHIC LATERAL SCLEROSIS AGENTS sodium phenylbutyrate granules - PA PA ENZYMES sodium phenylbutyrate pellets for suspension - PA PA ENZYMES sodium thiosulfate MB - PA PA ANTIDOTES MB solifenacin suspension - PA PA ANTISPASMODIC AND ANTICHOLINERGIC AGENTS sotalol solution - PA PA CARDIOVASCULAR Sotylize (sotalol solution) - PA PA CARDIOVASCULAR sparsentan - PA PA OTHER ANTIHYPERTENSIVES spironolactone suspension M90 - PA PA ALDOSTERONE ANTAGONISTS M90 sutimlimab-jome MB - PA PA BIOLOGICAL MB Sotradecol (tetradecyl sulfate injection) MB - PA PA CARDIOVASCULAR MB "Samsca (tolvaptan-Samsca) BP, A90 - PA" PA VASOPRESSIN ANTAGONISTS "BP, A90" saccharomyces boulardii - PA ≥ 22 years PA ≥ 22 years GASTROINTESTINAL AGENT sulfacetamide 10% lotion A90 - PA ≥ 22 years PA ≥ 22 years DERMATOLOGICAL "A90, #" "Shingrix (zoster vaccine recombinant, adjuvanted) - PA < 50 years" PA BIOLOGICAL SSKI (potassium iodide) - PA > 1 mL/day PA > 1 mL/day IODINE THERAPY sodium zirconium cyclosilicate - PA > 1 unit/day PA > 1 unit/day CHELATING AGENT Steglatro (ertugliflozin) - PA PA DIABETIC AGENTS Segluromet (ertugliflozin / metformin) - PA PA DIABETIC AGENTS Steglujan (ertugliflozin / sitagliptin) - PA PA DIABETIC AGENTS Soliqua (insulin glargine / lixisenatide) - PA PA DIABETIC AGENTS Semglee (insulin glargine-yfgn) - PA PA DIABETIC AGENTS semaglutide injection-Ozempic - PA PA DIABETIC AGENTS semaglutide tablet - PA PA DIABETIC AGENTS sotagliflozin - PA PA DIABETIC AGENTS "Sorilux (calcipotriene foam) BP, A90 - PA" PA DERMATOLOGICAL "BP, A90" Symproic (naldemedine) - PA PA CONSTIPATION AGENTS sodium oxybate BP - PA PA SEDATIVES BP solriamfetol - PA PA NARCOLEPSY AGENTS Sunosi (solriamfetol) - PA PA NARCOLEPSY AGENTS Strattera # (atomoxetine) A90 - PA < 6 years; See Table 31; See Table 71 PA NONSTIMULANT ADHD AGENTS "A90, #" Sernivo (betamethasone dipropionate spray) - PA PA GLUCOCORTICOIDS Synalar (fluocinolone cream kit) - PA PA GLUCOCORTICOIDS Synalar (fluocinolone ointment kit) - PA PA GLUCOCORTICOIDS Synalar (fluocinolone solution kit) - PA PA GLUCOCORTICOIDS Saphris (asenapine sublingual tablet) A90 - PA; See Table 24; See Table 71 PA ANTIPSYCHOTIC A90 Secuado (asenapine transdermal) - PA; See Table 24; See Table 71 PA ANTIPSYCHOTIC Seroquel XR # (quetiapine extended-release) A90 - PA 2 units/day; See Table 24; See Table 71 PA 2 units/day ANTIPSYCHOTIC "A90, #" Seroquel # (quetiapine) A90 - PA 3 units/day; See Table 24; See Table 71 PA 3 units/day ANTIPSYCHOTIC "A90, #" sacubitril / valsartan - PA PA CARDIOVASCULAR Symdeko (tezacaftor / ivacaftor) PD - PA PA CYSTIC FIBROSIS AGENTS PD Spinraza (nusinersen) MB - PA PA BIOLOGICAL MB Scemblix (asciminib) - PA PA CHEMOTHERAPY Synribo (omacetaxine mepesuccinate) - PA PA CHEMOTHERAPY Stivarga (regorafenib) - PA PA CHEMOTHERAPY selpercatinib - PA PA CHEMOTHERAPY selumetinib - PA PA CHEMOTHERAPY sirolimus gel - PA PA IMMUNOMODULATOR sirolimus injection - PA PA IMMUNOMODULATOR sonidegib - PA PA CHEMOTHERAPY "sorafenib BP, A90 - PA" PA CHEMOTHERAPY "BP, A90" "sunitinib BP, A90 - PA" PA CHEMOTHERAPY "BP, A90" "Sutent (sunitinib) BP, A90 - PA" PA CHEMOTHERAPY "BP, A90" Siklos (hydroxyurea tablet) - PA PA HEMATOLOGIC setmelanotide - PA PA BIOLOGICAL sacituzumab govitecan-hziy MB - PA PA CHEMOTHERAPY MB Sarclisa (isatuximab-irfc) MB - PA PA CHEMOTHERAPY MB selinexor - PA PA CHEMOTHERAPY sotorasib - PA PA CHEMOTHERAPY "Skysona (elivaldogene autotemcel) CO, MB - PA" PA GENE THERAPY "CO, MB" Saxenda (liraglutide-Saxenda) - PA PA ANTI-OBESITY AGENTS semaglutide injection-Wegovy PD - PA PA ANTI-OBESITY AGENTS PD Skytrofa (lonapegsomatropin-tcgd) PD - PA PA HORMONE AGENTS PD somapacitan-beco - PA PA HORMONE AGENTS Sogroya (somapacitan-beco) - PA PA HORMONE AGENTS somatrogon-ghla - PA PA HORMONE AGENTS somatropin-Genotropin PD - PA PA HORMONE AGENTS PD somatropin-Humatrope - PA PA HORMONE AGENTS somatropin-Norditropin - PA PA HORMONE AGENTS somatropin-Nutropin AQ - PA PA HORMONE AGENTS somatropin-Omnitrope - PA PA HORMONE AGENTS somatropin-Saizen - PA PA HORMONE AGENTS Saizen (somatropin-Saizen) - PA PA HORMONE AGENTS somatropin-Serostim - PA PA HORMONE AGENTS Serostim (somatropin-Serostim) - PA PA HORMONE AGENTS somatropin-Zomacton - PA PA HORMONE AGENTS suvorexant - PA; See Table 15; See Table 71 PA "SEDATIVE, NON-BARBITURATE" Supprelin LA (histrelin) - PA PA HORMONE AGENTS Synarel (nafarelin) - PA PA HORMONE AGENTS Synercid (dalfopristin / quinupristin) - PA PA ANTIBIOTICS Sivextro (tedizolid injection) - PA PA ANTIBIOTICS Striverdi (olodaterol) - PA PA BRONCHODILATORS Stiolto (tiotropium / olodaterol) - PA PA BRONCHODILATORS Singulair (montelukast granules) M90 - PA PA BRONCHODILATORS M90 sipuleucel-T MB - PA PA CHEMOTHERAPY MB