05.03.01 |
Restricted Use
|
 |
Abacavir and Lamivudine and Zidovudine Trizivir® |
10.03.01 |
Formulary
|
 |
Collagenase clostridium histolyticum Xiapex® |
20.01 |
Restricted Use
|
 |
Idelalisib 100mg and 150mg tablets Zydelig® |
01.09.01 |
Formulary
|
 |
Obeticholic acid Ocaliva® |
24.16 |
Formulary
|
 |
Poractant alfa (Curosurf) Neonatal |
08.01.05 |
Restricted Use
|
 |
Trastuzumab emtansine Kadcyla® |