{"id":61,"date":"2014-12-23T22:37:05","date_gmt":"2014-12-23T22:37:05","guid":{"rendered":"http:\/\/fisher.arvixe.com\/~banikmp\/?page_id=61"},"modified":"2024-10-09T11:22:17","modified_gmt":"2024-10-09T17:22:17","slug":"pharmacy","status":"publish","type":"page","link":"https:\/\/dsiohn098w.mpqhf.org\/corporate\/montanans-with-medicaid\/pharmacy\/","title":{"rendered":"Pharmacy"},"content":{"rendered":"<div id=\"calloutboxright\">\n<p>\u201cIt is comforting to know [Mountain Pacific] staff \u2018get it\u2019 and are not just reciting from a manual. It is very evident [they have] extensive pharmacy knowledge and experience.\u201d<br \/>\n&#8211; Director of Pharmacy at a Montana Hospital<\/p>\n<p>\u201cQuick, logical responses make Mountain Pacific stand out as a prior authorization provider. As a taxpayer, I appreciate the state paying for a company that has customer service like that.\u201d<br \/>\n&#8211; Pharmacist in Montana<\/p>\n<p>\u201cWe interact on a regular basis with [Mountain Pacific] personnel, who have been extremely helpful in facilitating the best medical care for our Montana Medicaid patients.\u201d<br \/>\n&#8211; Medical Director at a Montana Health Care Facility<\/p>\n<\/div>\n<h1>Pharmacy<\/h1>\n<p>Medications can be expensive. And paired with other medications, they can also have significant side effects. Under contract with the <a href=\"http:\/\/dphhs.mt.gov\/\" target=\"_blank\" rel=\"noopener\">Montana Department of Public Health and Human Services<\/a>, Mountain Pacific employs pharmacists and certified pharmacy technicians to help make sure Montanans get the right medicines at the right time for the right reasons \u2014 and at the right price \u2014 to feel as healthy as possible.<\/p>\n<p>Our expert pharmacists also<\/p>\n<ul>\n<li>support the <a href=\"http:\/\/dphhs.mt.gov\/MontanaHealthcarePrograms\" target=\"_blank\" rel=\"noopener\">Department for Medicaid, Mental Health Services<\/a> Plan and the <a href=\"http:\/\/dphhs.mt.gov\/hmk\" target=\"_blank\" rel=\"noopener\">Healthy Montana Kids<\/a> prescription programs as a policy advisor;<\/li>\n<li>provide all technical and administrative management duties of the Montana Medicaid Drug Use Review Board (DURB)\/Formulary Committee, which comprises Montana physicians and pharmacists.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<div class=\"su-spoiler su-spoiler-style-simple su-spoiler-icon-plus spoilertitle23 su-spoiler-closed\" data-anchor=\"spoilertitle23\" data-scroll-offset=\"0\" data-anchor-in-url=\"no\"><div class=\"su-spoiler-title\" tabindex=\"0\" role=\"button\"><span class=\"su-spoiler-icon\"><\/span><strong>Drug Prior Authorization<\/strong><\/div><div class=\"su-spoiler-content su-u-clearfix su-u-trim\">\n<p>Many medications require prior authorization (PA) before<strong>\u00a0<\/strong>pharmacists can provide them to their patients. Our expert team of pharmacist reviewers check medications for medical necessity and cost effectiveness before providing authorization. Providers can view a list of medications and their coverage below and contact our drug PA team for approval at 1-800-395-7961.<\/p>\n<div class=\"supsystic-table-loader spinner\"style=\"background-color:#000000\"><\/div><div id=\"supsystic-table-9_31590\" class=\"supsystic-tables-wrap pagination-large\" style=\" width:75%; visibility: hidden; \" data-table-width-fixed=\"75%\" data-table-width-mobile=\"100%\" ><table id=\"supsystic-table-9\" class=\"supsystic-table compact border lightboxImg cell-border\" data-id=\"9\" data-view-id=\"9_31590\" data-title=\"Pharmacy Drug List\" data-currency-format=\"$1,000.00\" data-percent-format=\"10.00%\" data-date-format=\"DD.MM.YYYY\" data-time-format=\"HH:mm\" data-features=\"[&quot;paging&quot;,&quot;searching&quot;,&quot;after_table_loaded_script&quot;]\" data-search-value=\"\" data-lightbox-img=\"\" data-head-rows-count=\"1\" data-pagination-length=\"25,50,100,150,All\" data-pagination-scroll=\"on\" data-auto-index=\"off\" data-searching-settings=\"{&quot;columnSearchPosition&quot;:&quot;top&quot;,&quot;minChars&quot;:&quot;0&quot;}\" data-lang=\"default\" data-override=\"{&quot;emptyTable&quot;:&quot;&quot;,&quot;info&quot;:&quot;&quot;,&quot;infoEmpty&quot;:&quot;&quot;,&quot;infoFiltered&quot;:&quot;&quot;,&quot;lengthMenu&quot;:&quot;&quot;,&quot;search&quot;:&quot;&quot;,&quot;previous&quot;:&quot;&quot;,&quot;next&quot;:&quot;&quot;,&quot;zeroRecords&quot;:&quot;&quot;,&quot;exportLabel&quot;:&quot;&quot;,&quot;file&quot;:&quot;default&quot;}\" data-merged=\"[]\" data-responsive-mode=\"0\" data-from-history=\"0\" ><thead><tr><th class=\"\" style=\"width:; padding: 0 !important;\"><\/th><\/tr><\/thead><tbody><tr style=\"height:px\" ><td data-cell-id=\"A1\" data-x=\"0\" data-y=\"1\" data-db-index=\"1\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abilify-Maintena-aripiprazole-508.pdf&quot;&gt;Abilify Maintena (aripiprazole)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abilify-Maintena-aripiprazole-508.pdf&quot;&gt;Abilify Maintena (aripiprazole)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abilify-Maintena-aripiprazole-508.pdf\">Abilify Maintena (aripiprazole)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A2\" data-x=\"0\" data-y=\"2\" data-db-index=\"2\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abilify-Mycite-aripiprazole-drug-device-combination-508.pdf&quot;&gt;Abilify Mycite (aripiprazole drug-device combination)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abilify-Mycite-aripiprazole-drug-device-combination-508.pdf&quot;&gt;Abilify Mycite (aripiprazole drug-device combination)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abilify-Mycite-aripiprazole-drug-device-combination-508.pdf\">Abilify Mycite (aripiprazole drug-device combination)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A3\" data-x=\"0\" data-y=\"3\" data-db-index=\"3\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abstral-fentanyl-sublingual-tablets-508.pdf&quot;&gt;Abstral (fentanyl sublingual tablets)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abstral-fentanyl-sublingual-tablets-508.pdf&quot;&gt;Abstral (fentanyl sublingual tablets)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abstral-fentanyl-sublingual-tablets-508.pdf\">Abstral (fentanyl sublingual tablets)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A4\" data-x=\"0\" data-y=\"4\" data-db-index=\"4\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Actemra-tocilizumab-508.pdf&quot;&gt;Actemra (tocilizumab)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Actemra-tocilizumab-508.pdf&quot;&gt;Actemra (tocilizumab)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Actemra-tocilizumab-508.pdf\">Actemra (tocilizumab)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A5\" data-x=\"0\" data-y=\"5\" data-db-index=\"5\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Acthar-Gel-repository-corticotropin-508.pdf&quot;&gt;Acthar Gel (repository corticotropin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Acthar-Gel-repository-corticotropin-508.pdf&quot;&gt;Acthar Gel (repository corticotropin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Acthar-Gel-repository-corticotropin-508.pdf\">Acthar Gel (repository corticotropin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A6\" data-x=\"0\" data-y=\"6\" data-db-index=\"6\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Actiq-fentanyl-citrate-lozenges-508.pdf&quot;&gt;Actiq (fentanyl citrate lozenges)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Actiq-fentanyl-citrate-lozenges-508.pdf&quot;&gt;Actiq (fentanyl citrate lozenges)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Actiq-fentanyl-citrate-lozenges-508.pdf\">Actiq (fentanyl citrate lozenges)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A7\" data-x=\"0\" data-y=\"7\" data-db-index=\"7\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Adbry-tralokinumab-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Adbry (tralokinumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Adbry-tralokinumab-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Adbry (tralokinumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Adbry-tralokinumab-PA-Form.pdf\" target=\"_self\">Adbry (tralokinumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A8\" data-x=\"0\" data-y=\"8\" data-db-index=\"8\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Adcirca-tadalafil-508.pdf&quot;&gt;Adcirca (tadalafil)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Adcirca-tadalafil-508.pdf&quot;&gt;Adcirca (tadalafil)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Adcirca-tadalafil-508.pdf\">Adcirca (tadalafil)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A9\" data-x=\"0\" data-y=\"9\" data-db-index=\"9\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Adempas-riociguat-508.pdf&quot;&gt;Adempas (riociguat)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Adempas-riociguat-508.pdf&quot;&gt;Adempas (riociguat)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Adempas-riociguat-508.pdf\">Adempas (riociguat)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A10\" data-x=\"0\" data-y=\"10\" data-db-index=\"10\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Afrezza-insulin-regular-human-inhalationa-508.pdf&quot;&gt;Afrezza (insulin regular [human] inhalation)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Afrezza-insulin-regular-human-inhalationa-508.pdf&quot;&gt;Afrezza (insulin regular [human] inhalation)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Afrezza-insulin-regular-human-inhalationa-508.pdf\">Afrezza (insulin regular [human] inhalation)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A11\" data-x=\"0\" data-y=\"11\" data-db-index=\"11\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Agamree-vamorolone-Suspension-PA-form.pdf&quot; target=&quot;_self&quot;&gt;Agamree (vamorolone)&lt;\/a&gt; - Suspension PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Agamree-vamorolone-Suspension-PA-form.pdf&quot; target=&quot;_self&quot;&gt;Agamree (vamorolone)&lt;\/a&gt; - Suspension PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Agamree-vamorolone-Suspension-PA-form.pdf\" target=\"_self\">Agamree (vamorolone)<\/a> - Suspension PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A12\" data-x=\"0\" data-y=\"12\" data-db-index=\"12\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Aimovig-erenumab-PA-Form.pdf&quot;&gt;Aimovig (erenumab-aooe)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Aimovig-erenumab-PA-Form.pdf&quot;&gt;Aimovig (erenumab-aooe)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Aimovig-erenumab-PA-Form.pdf\">Aimovig (erenumab-aooe)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A13\" data-x=\"0\" data-y=\"13\" data-db-index=\"13\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Ajovy-fremanezumab-PA-Form.pdf&quot;&gt;Ajovy (fremanezumab-vfrm)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Ajovy-fremanezumab-PA-Form.pdf&quot;&gt;Ajovy (fremanezumab-vfrm)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Ajovy-fremanezumab-PA-Form.pdf\">Ajovy (fremanezumab-vfrm)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A14\" data-x=\"0\" data-y=\"14\" data-db-index=\"14\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aklief-trifarotene-508.pdf&quot;&gt;Aklief (trifaroten)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aklief-trifarotene-508.pdf&quot;&gt;Aklief (trifaroten)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aklief-trifarotene-508.pdf\">Aklief (trifaroten)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A15\" data-x=\"0\" data-y=\"15\" data-db-index=\"15\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Albenza-albendazole.pdf&quot;&gt;Albenza (albendazole)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Albenza-albendazole.pdf&quot;&gt;Albenza (albendazole)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Albenza-albendazole.pdf\">Albenza (albendazole)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A16\" data-x=\"0\" data-y=\"16\" data-db-index=\"16\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Altreno-tretinoin-508.pdf&quot;&gt;Altreno (tretinoin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Altreno-tretinoin-508.pdf&quot;&gt;Altreno (tretinoin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Altreno-tretinoin-508.pdf\">Altreno (tretinoin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A17\" data-x=\"0\" data-y=\"17\" data-db-index=\"17\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Alyq-tadalafil-508.pdf&quot;&gt;Alyq (tadalafil)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Alyq-tadalafil-508.pdf&quot;&gt;Alyq (tadalafil)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Alyq-tadalafil-508.pdf\">Alyq (tadalafil)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A18\" data-x=\"0\" data-y=\"18\" data-db-index=\"18\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Amerge-naratriptan-508.pdf&quot;&gt;Amerge (naratriptan)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Amerge-naratriptan-508.pdf&quot;&gt;Amerge (naratriptan)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Amerge-naratriptan-508.pdf\">Amerge (naratriptan)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A19\" data-x=\"0\" data-y=\"19\" data-db-index=\"19\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Amitiza-lubiprostone.pdf&quot;&gt;Amitiza (lubiprostone)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Amitiza-lubiprostone.pdf&quot;&gt;Amitiza (lubiprostone)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Amitiza-lubiprostone.pdf\">Amitiza (lubiprostone)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A20\" data-x=\"0\" data-y=\"20\" data-db-index=\"20\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Apokyn-apomorphine-PA-Form-508-Compliant.pdf&quot;&gt;Apokyn (apomorphine)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Apokyn-apomorphine-PA-Form-508-Compliant.pdf&quot;&gt;Apokyn (apomorphine)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Apokyn-apomorphine-PA-Form-508-Compliant.pdf\">Apokyn (apomorphine)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A21\" data-x=\"0\" data-y=\"21\" data-db-index=\"21\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aricept-23-donepezil-23-508.pdf&quot;&gt;Aricept 23 (donepezil 23)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aricept-23-donepezil-23-508.pdf&quot;&gt;Aricept 23 (donepezil 23)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aricept-23-donepezil-23-508.pdf\">Aricept 23 (donepezil 23)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A22\" data-x=\"0\" data-y=\"22\" data-db-index=\"22\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Arikayce-amikacin-508.pdf&quot;&gt;Arikayce (amikacin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Arikayce-amikacin-508.pdf&quot;&gt;Arikayce (amikacin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Arikayce-amikacin-508.pdf\">Arikayce (amikacin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A23\" data-x=\"0\" data-y=\"23\" data-db-index=\"23\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aristada-aripiprazole-508.pdf&quot;&gt;Aristada (aripiprazole)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aristada-aripiprazole-508.pdf&quot;&gt;Aristada (aripiprazole)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aristada-aripiprazole-508.pdf\">Aristada (aripiprazole)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A24\" data-x=\"0\" data-y=\"24\" data-db-index=\"24\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Atralin-tretinoin-508.pdf&quot;&gt;Atralin (tretinoin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Atralin-tretinoin-508.pdf&quot;&gt;Atralin (tretinoin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Atralin-tretinoin-508.pdf\">Atralin (tretinoin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A25\" data-x=\"0\" data-y=\"25\" data-db-index=\"25\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Atypical-Use-in-Children-Eight-and-Under-Initial-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Atypical Use in Children Eight and Under&lt;\/a&gt; - Initial PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Atypical-Use-in-Children-Eight-and-Under-Initial-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Atypical Use in Children Eight and Under&lt;\/a&gt; - Initial PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Atypical-Use-in-Children-Eight-and-Under-Initial-PA-Form.pdf\" target=\"_self\">Atypical Use in Children Eight and Under<\/a> - Initial PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A26\" data-x=\"0\" data-y=\"26\" data-db-index=\"26\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Atypical-Use-in-Children-Eight-and-Under-Renewal-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Atypical Use in Children Eight and Under&lt;\/a&gt; - Renewal PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Atypical-Use-in-Children-Eight-and-Under-Renewal-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Atypical Use in Children Eight and Under&lt;\/a&gt; - Renewal PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Atypical-Use-in-Children-Eight-and-Under-Renewal-PA-Form.pdf\" target=\"_self\">Atypical Use in Children Eight and Under<\/a> - Renewal PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A27\" data-x=\"0\" data-y=\"27\" data-db-index=\"27\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aubagio-teriflunomide-508.pdf&quot;&gt;Aubagio (teriflunomide)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aubagio-teriflunomide-508.pdf&quot;&gt;Aubagio (teriflunomide)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aubagio-teriflunomide-508.pdf\">Aubagio (teriflunomide)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A28\" data-x=\"0\" data-y=\"28\" data-db-index=\"28\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Austedo-deutetrabenazine-PA-Form.pdf&quot;&gt;Austedo (deutetrabenazine)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Austedo-deutetrabenazine-PA-Form.pdf&quot;&gt;Austedo (deutetrabenazine)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Austedo-deutetrabenazine-PA-Form.pdf\">Austedo (deutetrabenazine)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A29\" data-x=\"0\" data-y=\"29\" data-db-index=\"29\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Auvelity-dextromethorphan-bupropion-ER-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Auvelity (dextromethorphan-bupropion ER)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Auvelity-dextromethorphan-bupropion-ER-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Auvelity (dextromethorphan-bupropion ER)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Auvelity-dextromethorphan-bupropion-ER-PA-Form.pdf\" target=\"_self\">Auvelity (dextromethorphan-bupropion ER)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A30\" data-x=\"0\" data-y=\"30\" data-db-index=\"30\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Avita-tretinoin-508.pdf&quot;&gt;Avita (tretinoin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Avita-tretinoin-508.pdf&quot;&gt;Avita (tretinoin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Avita-tretinoin-508.pdf\">Avita (tretinoin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A31\" data-x=\"0\" data-y=\"31\" data-db-index=\"31\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Avonex-interferon-beta-1a-508.pdf&quot;&gt;Avonex (interferon beta-1a)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Avonex-interferon-beta-1a-508.pdf&quot;&gt;Avonex (interferon beta-1a)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Avonex-interferon-beta-1a-508.pdf\">Avonex (interferon beta-1a)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A32\" data-x=\"0\" data-y=\"32\" data-db-index=\"32\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Bafiertam-monomethyl-fumarate-508.pdf&quot;&gt;Bafiertam (monomethyl fumarate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Bafiertam-monomethyl-fumarate-508.pdf&quot;&gt;Bafiertam (monomethyl fumarate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Bafiertam-monomethyl-fumarate-508.pdf\">Bafiertam (monomethyl fumarate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A33\" data-x=\"0\" data-y=\"33\" data-db-index=\"33\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Banzel-rufinamide-508.pdf&quot;&gt;Banzel (rufinamide)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Banzel-rufinamide-508.pdf&quot;&gt;Banzel (rufinamide)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Banzel-rufinamide-508.pdf\">Banzel (rufinamide)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A34\" data-x=\"0\" data-y=\"34\" data-db-index=\"34\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Baqsimi-glucagon-508.pdf&quot;&gt;Baqsimi (glucagon)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Baqsimi-glucagon-508.pdf&quot;&gt;Baqsimi (glucagon)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Baqsimi-glucagon-508.pdf\">Baqsimi (glucagon)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A35\" data-x=\"0\" data-y=\"35\" data-db-index=\"35\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Belbuca-buprenorphine-hydrochloride.pdf&quot;&gt;Belbuca (buprenorphine hydrochloride)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Belbuca-buprenorphine-hydrochloride.pdf&quot;&gt;Belbuca (buprenorphine hydrochloride)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Belbuca-buprenorphine-hydrochloride.pdf\">Belbuca (buprenorphine hydrochloride)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A36\" data-x=\"0\" data-y=\"36\" data-db-index=\"36\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Belsomra-suvorexant-PA-Form508.pdf&quot;&gt;Belsomra (suvorexannt)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Belsomra-suvorexant-PA-Form508.pdf&quot;&gt;Belsomra (suvorexannt)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Belsomra-suvorexant-PA-Form508.pdf\">Belsomra (suvorexannt)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A37\" data-x=\"0\" data-y=\"37\" data-db-index=\"37\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Benlysta-belimumab-PA-Form-508.pdf&quot;&gt;Benlysta (belimumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Benlysta-belimumab-PA-Form-508.pdf&quot;&gt;Benlysta (belimumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Benlysta-belimumab-PA-Form-508.pdf\">Benlysta (belimumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A38\" data-x=\"0\" data-y=\"38\" data-db-index=\"38\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Betaseron-interferon-beta-1b-508.pdf&quot;&gt;Betaseron (interferon beta-1b)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Betaseron-interferon-beta-1b-508.pdf&quot;&gt;Betaseron (interferon beta-1b)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Betaseron-interferon-beta-1b-508.pdf\">Betaseron (interferon beta-1b)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A39\" data-x=\"0\" data-y=\"39\" data-db-index=\"39\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Bethkis-tobramycin-508.pdf&quot;&gt;Bethkis (tobramycin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Bethkis-tobramycin-508.pdf&quot;&gt;Bethkis (tobramycin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Bethkis-tobramycin-508.pdf\">Bethkis (tobramycin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A40\" data-x=\"0\" data-y=\"40\" data-db-index=\"40\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Bimzelx-bimekizumab-bkzx-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Bimzelx (bimekizumab-bkzx)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Bimzelx-bimekizumab-bkzx-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Bimzelx (bimekizumab-bkzx)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Bimzelx-bimekizumab-bkzx-PA-Form.pdf\" target=\"_self\">Bimzelx (bimekizumab-bkzx)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A41\" data-x=\"0\" data-y=\"41\" data-db-index=\"41\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Bonjesta-doxylamine-succinate-and-pyridoxine-hydrochloride-508.pdf&quot;&gt;Bonjesta (doxylamine succinate and pyridoxine hydrochloride)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Bonjesta-doxylamine-succinate-and-pyridoxine-hydrochloride-508.pdf&quot;&gt;Bonjesta (doxylamine succinate and pyridoxine hydrochloride)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Bonjesta-doxylamine-succinate-and-pyridoxine-hydrochloride-508.pdf\">Bonjesta (doxylamine succinate and pyridoxine hydrochloride)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A42\" data-x=\"0\" data-y=\"42\" data-db-index=\"42\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Brisdelle-paroxetine-508.pdf&quot;&gt;Brisdelle (paroxetine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Brisdelle-paroxetine-508.pdf&quot;&gt;Brisdelle (paroxetine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Brisdelle-paroxetine-508.pdf\">Brisdelle (paroxetine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A43\" data-x=\"0\" data-y=\"43\" data-db-index=\"43\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/06\/Brixadi-buprenorphine-extended-release-injection-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Brixadi (buprenorphine extended-release injection)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/06\/Brixadi-buprenorphine-extended-release-injection-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Brixadi (buprenorphine extended-release injection)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/06\/Brixadi-buprenorphine-extended-release-injection-PA-Form.pdf\" target=\"_self\">Brixadi (buprenorphine extended-release injection)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A44\" data-x=\"0\" data-y=\"44\" data-db-index=\"44\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Buprenorphine-containing-products-PA-Form-1.pdf&quot;&gt;Buprenorphine-containing Products&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Buprenorphine-containing-products-PA-Form-1.pdf&quot;&gt;Buprenorphine-containing Products&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Buprenorphine-containing-products-PA-Form-1.pdf\">Buprenorphine-containing Products<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A45\" data-x=\"0\" data-y=\"45\" data-db-index=\"45\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Buprenorphine-Induction-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Buprenorphine Induction&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Buprenorphine-Induction-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Buprenorphine Induction&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Buprenorphine-Induction-PA-Form.pdf\" target=\"_self\">Buprenorphine Induction<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A46\" data-x=\"0\" data-y=\"46\" data-db-index=\"46\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Butrans-buprenorphine-transdermal-508.pdf&quot;&gt;Butrans (buprenorphine transdermal)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Butrans-buprenorphine-transdermal-508.pdf&quot;&gt;Butrans (buprenorphine transdermal)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Butrans-buprenorphine-transdermal-508.pdf\">Butrans (buprenorphine transdermal)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A47\" data-x=\"0\" data-y=\"47\" data-db-index=\"47\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Byvalson-nebivolol-valsartan-508.pdf&quot;&gt;Byvalson (nebivolol-valsartan)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Byvalson-nebivolol-valsartan-508.pdf&quot;&gt;Byvalson (nebivolol-valsartan)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Byvalson-nebivolol-valsartan-508.pdf\">Byvalson (nebivolol-valsartan)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A48\" data-x=\"0\" data-y=\"48\" data-db-index=\"48\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Calcitrene-calcipotriol-508.pdf&quot;&gt;Calcitrene (calcipotriol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Calcitrene-calcipotriol-508.pdf&quot;&gt;Calcitrene (calcipotriol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Calcitrene-calcipotriol-508.pdf\">Calcitrene (calcipotriol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A49\" data-x=\"0\" data-y=\"49\" data-db-index=\"49\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cambia-diclofenac-508.pdf&quot;&gt;Cambia (diclofenac)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cambia-diclofenac-508.pdf&quot;&gt;Cambia (diclofenac)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cambia-diclofenac-508.pdf\">Cambia (diclofenac)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A50\" data-x=\"0\" data-y=\"50\" data-db-index=\"50\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Carac-fluorouracil-508.pdf&quot;&gt;Carac (fluorouracil)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Carac-fluorouracil-508.pdf&quot;&gt;Carac (fluorouracil)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Carac-fluorouracil-508.pdf\">Carac (fluorouracil)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A51\" data-x=\"0\" data-y=\"51\" data-db-index=\"51\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cayston-aztreonam-508.pdf&quot;&gt;Cayston (aztreonam)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cayston-aztreonam-508.pdf&quot;&gt;Cayston (aztreonam)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cayston-aztreonam-508.pdf\">Cayston (aztreonam)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A52\" data-x=\"0\" data-y=\"52\" data-db-index=\"52\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Celexa-citalopram-508.pdf&quot;&gt;Celexa (citalopram)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Celexa-citalopram-508.pdf&quot;&gt;Celexa (citalopram)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Celexa-citalopram-508.pdf\">Celexa (citalopram)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A53\" data-x=\"0\" data-y=\"53\" data-db-index=\"53\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Chenodal-chenodiol-508.pdf&quot;&gt;Chenodal (chenodiol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Chenodal-chenodiol-508.pdf&quot;&gt;Chenodal (chenodiol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Chenodal-chenodiol-508.pdf\">Chenodal (chenodiol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A54\" data-x=\"0\" data-y=\"54\" data-db-index=\"54\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cholbam-cholic-acid-508.pdf&quot;&gt;Cholbam (cholic acid)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cholbam-cholic-acid-508.pdf&quot;&gt;Cholbam (cholic acid)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cholbam-cholic-acid-508.pdf\">Cholbam (cholic acid)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A55\" data-x=\"0\" data-y=\"55\" data-db-index=\"55\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Cialis-tadalafil-1.pdf&quot;&gt;Cialis (tadalafil)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Cialis-tadalafil-1.pdf&quot;&gt;Cialis (tadalafil)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Cialis-tadalafil-1.pdf\">Cialis (tadalafil)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A56\" data-x=\"0\" data-y=\"56\" data-db-index=\"56\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Cibinqo-abrocitinib-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Cibinqo (abrocitinib)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Cibinqo-abrocitinib-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Cibinqo (abrocitinib)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Cibinqo-abrocitinib-PA-Form.pdf\" target=\"_self\">Cibinqo (abrocitinib)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A57\" data-x=\"0\" data-y=\"57\" data-db-index=\"57\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cimzia-certolizumab-pegol-508.pdf&quot;&gt;Cimzia (certolizumab pegol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cimzia-certolizumab-pegol-508.pdf&quot;&gt;Cimzia (certolizumab pegol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cimzia-certolizumab-pegol-508.pdf\">Cimzia (certolizumab pegol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A58\" data-x=\"0\" data-y=\"58\" data-db-index=\"58\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cinqair-reslizumab-PA-Form-508.pdf&quot;&gt;Cinqair (reslizumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cinqair-reslizumab-PA-Form-508.pdf&quot;&gt;Cinqair (reslizumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cinqair-reslizumab-PA-Form-508.pdf\">Cinqair (reslizumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A59\" data-x=\"0\" data-y=\"59\" data-db-index=\"59\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Clindareach-Kit-clindamycin-508.pdf&quot;&gt;Clindareach Kit (clindamycin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Clindareach-Kit-clindamycin-508.pdf&quot;&gt;Clindareach Kit (clindamycin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Clindareach-Kit-clindamycin-508.pdf\">Clindareach Kit (clindamycin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A60\" data-x=\"0\" data-y=\"60\" data-db-index=\"60\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Colcrys-colchicine-508.pdf&quot;&gt;Colcrys (colchicine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Colcrys-colchicine-508.pdf&quot;&gt;Colcrys (colchicine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Colcrys-colchicine-508.pdf\">Colcrys (colchicine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A61\" data-x=\"0\" data-y=\"61\" data-db-index=\"61\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Condylox-Gel-podofilox-508.pdf&quot;&gt;Condylox Gel (podofilox)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Condylox-Gel-podofilox-508.pdf&quot;&gt;Condylox Gel (podofilox)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Condylox-Gel-podofilox-508.pdf\">Condylox Gel (podofilox)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A62\" data-x=\"0\" data-y=\"62\" data-db-index=\"62\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Conzip-ER-tramadol-hydrochloride-508.pdf&quot;&gt;Conzip ER (tramadol hydrochloride)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Conzip-ER-tramadol-hydrochloride-508.pdf&quot;&gt;Conzip ER (tramadol hydrochloride)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Conzip-ER-tramadol-hydrochloride-508.pdf\">Conzip ER (tramadol hydrochloride)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A63\" data-x=\"0\" data-y=\"63\" data-db-index=\"63\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Copaxone-glatiramer-acetate-injection-508.pdf&quot;&gt;Copaxone (glatiramer acetate injection)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Copaxone-glatiramer-acetate-injection-508.pdf&quot;&gt;Copaxone (glatiramer acetate injection)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Copaxone-glatiramer-acetate-injection-508.pdf\">Copaxone (glatiramer acetate injection)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A64\" data-x=\"0\" data-y=\"64\" data-db-index=\"64\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cosentyx-secukinumab-508.pdf&quot;&gt;Cosentyx (secukinumab)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cosentyx-secukinumab-508.pdf&quot;&gt;Cosentyx (secukinumab)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cosentyx-secukinumab-508.pdf\">Cosentyx (secukinumab)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A65\" data-x=\"0\" data-y=\"65\" data-db-index=\"65\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Daliresp-roflumilast-PA-Form.pdf&quot;&gt;Daliresp (roflumilast)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Daliresp-roflumilast-PA-Form.pdf&quot;&gt;Daliresp (roflumilast)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Daliresp-roflumilast-PA-Form.pdf\">Daliresp (roflumilast)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A66\" data-x=\"0\" data-y=\"66\" data-db-index=\"66\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Dartisla-ODT-glycopyrrolate.pdf&quot; target=&quot;_self&quot;&gt;Dartisla ODT (glycopyrrolate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Dartisla-ODT-glycopyrrolate.pdf&quot; target=&quot;_self&quot;&gt;Dartisla ODT (glycopyrrolate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Dartisla-ODT-glycopyrrolate.pdf\" target=\"_self\">Dartisla ODT (glycopyrrolate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A67\" data-x=\"0\" data-y=\"67\" data-db-index=\"67\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Dayvigo-lemborexant-PA-Form508.pdf&quot;&gt;Dayvigo (lemborexant)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Dayvigo-lemborexant-PA-Form508.pdf&quot;&gt;Dayvigo (lemborexant)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Dayvigo-lemborexant-PA-Form508.pdf\">Dayvigo (lemborexant)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A68\" data-x=\"0\" data-y=\"68\" data-db-index=\"68\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Desoxyn-methamphetamine-508.pdf&quot;&gt;Desoxyn (mathamphetamine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Desoxyn-methamphetamine-508.pdf&quot;&gt;Desoxyn (mathamphetamine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Desoxyn-methamphetamine-508.pdf\">Desoxyn (mathamphetamine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A69\" data-x=\"0\" data-y=\"69\" data-db-index=\"69\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Diacomit-stiripentol-PA-Form.pdf&quot;&gt;Diacomit (stiripentol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Diacomit-stiripentol-PA-Form.pdf&quot;&gt;Diacomit (stiripentol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Diacomit-stiripentol-PA-Form.pdf\">Diacomit (stiripentol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A70\" data-x=\"0\" data-y=\"70\" data-db-index=\"70\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Diastat-Gel-diazepam-508.pdf&quot;&gt;Diastat Gel (diazepam)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Diastat-Gel-diazepam-508.pdf&quot;&gt;Diastat Gel (diazepam)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Diastat-Gel-diazepam-508.pdf\">Diastat Gel (diazepam)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A71\" data-x=\"0\" data-y=\"71\" data-db-index=\"71\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Diclegis-doxylamine-succinate-and-pyridoxine-hydrochloride-508.pdf&quot;&gt;Diclegis (doxylamine succinate and pyridoxine hydrocholoride)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Diclegis-doxylamine-succinate-and-pyridoxine-hydrochloride-508.pdf&quot;&gt;Diclegis (doxylamine succinate and pyridoxine hydrocholoride)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Diclegis-doxylamine-succinate-and-pyridoxine-hydrochloride-508.pdf\">Diclegis (doxylamine succinate and pyridoxine hydrocholoride)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A72\" data-x=\"0\" data-y=\"72\" data-db-index=\"72\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Differin-adapalene-508.pdf&quot;&gt;Differin (adapalene)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Differin-adapalene-508.pdf&quot;&gt;Differin (adapalene)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Differin-adapalene-508.pdf\">Differin (adapalene)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A73\" data-x=\"0\" data-y=\"73\" data-db-index=\"73\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Dificid-fidaxomicin-508.pdf&quot;&gt;Dificid (fidaxomicin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Dificid-fidaxomicin-508.pdf&quot;&gt;Dificid (fidaxomicin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Dificid-fidaxomicin-508.pdf\">Dificid (fidaxomicin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A74\" data-x=\"0\" data-y=\"74\" data-db-index=\"74\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Doptelet-avatrombopag-508.pdf&quot;&gt;Doptelet (avatrombopag)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Doptelet-avatrombopag-508.pdf&quot;&gt;Doptelet (avatrombopag)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Doptelet-avatrombopag-508.pdf\">Doptelet (avatrombopag)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A75\" data-x=\"0\" data-y=\"75\" data-db-index=\"75\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Dovonex-calcipotriene-508.pdf&quot;&gt;Dovonex (calcipotriene)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Dovonex-calcipotriene-508.pdf&quot;&gt;Dovonex (calcipotriene)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Dovonex-calcipotriene-508.pdf\">Dovonex (calcipotriene)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A76\" data-x=\"0\" data-y=\"76\" data-db-index=\"76\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Droxia-hydroxyurea-508.pdf&quot;&gt;Droxia (hydroxyurea)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Droxia-hydroxyurea-508.pdf&quot;&gt;Droxia (hydroxyurea)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Droxia-hydroxyurea-508.pdf\">Droxia (hydroxyurea)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A77\" data-x=\"0\" data-y=\"77\" data-db-index=\"77\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Dupixent-dupilumab-PA-Form-508-Compliant-1.pdf&quot;&gt;Dupixent (dupilumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Dupixent-dupilumab-PA-Form-508-Compliant-1.pdf&quot;&gt;Dupixent (dupilumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Dupixent-dupilumab-PA-Form-508-Compliant-1.pdf\">Dupixent (dupilumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A78\" data-x=\"0\" data-y=\"78\" data-db-index=\"78\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Durlaza-aspirin-508.pdf&quot;&gt;Durlaza (aspirin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Durlaza-aspirin-508.pdf&quot;&gt;Durlaza (aspirin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Durlaza-aspirin-508.pdf\">Durlaza (aspirin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A79\" data-x=\"0\" data-y=\"79\" data-db-index=\"79\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Duzallo-lesinurad-allopurinol-508.pdf&quot;&gt;Duzallo (lesinurad-allpurinol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Duzallo-lesinurad-allopurinol-508.pdf&quot;&gt;Duzallo (lesinurad-allpurinol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Duzallo-lesinurad-allopurinol-508.pdf\">Duzallo (lesinurad-allpurinol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A80\" data-x=\"0\" data-y=\"80\" data-db-index=\"80\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Edluar-zolpidem-tartrate-508.pdf&quot;&gt;Edluar (zolpidem tartrate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Edluar-zolpidem-tartrate-508.pdf&quot;&gt;Edluar (zolpidem tartrate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Edluar-zolpidem-tartrate-508.pdf\">Edluar (zolpidem tartrate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A81\" data-x=\"0\" data-y=\"81\" data-db-index=\"81\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Effient-prasugrel-508.pdf&quot;&gt;Effient (prasugrel)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Effient-prasugrel-508.pdf&quot;&gt;Effient (prasugrel)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Effient-prasugrel-508.pdf\">Effient (prasugrel)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A82\" data-x=\"0\" data-y=\"82\" data-db-index=\"82\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Efudex-fluorouracil-cream-508.pdf&quot;&gt;Efudex (fluorouracil cream)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Efudex-fluorouracil-cream-508.pdf&quot;&gt;Efudex (fluorouracil cream)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Efudex-fluorouracil-cream-508.pdf\">Efudex (fluorouracil cream)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A83\" data-x=\"0\" data-y=\"83\" data-db-index=\"83\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Elaprase-idursulfase-508.pdf&quot;&gt;Elaprase (idursulfase)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Elaprase-idursulfase-508.pdf&quot;&gt;Elaprase (idursulfase)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Elaprase-idursulfase-508.pdf\">Elaprase (idursulfase)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A84\" data-x=\"0\" data-y=\"84\" data-db-index=\"84\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Eliquis-apixaban-508.pdf&quot;&gt;Eliquis (apixaban)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Eliquis-apixaban-508.pdf&quot;&gt;Eliquis (apixaban)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Eliquis-apixaban-508.pdf\">Eliquis (apixaban)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A85\" data-x=\"0\" data-y=\"85\" data-db-index=\"85\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Emend-aprepitant-508.pdf&quot;&gt;Emend (aprepitant)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Emend-aprepitant-508.pdf&quot;&gt;Emend (aprepitant)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Emend-aprepitant-508.pdf\">Emend (aprepitant)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A86\" data-x=\"0\" data-y=\"86\" data-db-index=\"86\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Emflaza-deflazacort-PA-form-508.pdf&quot;&gt;Emflaza (deflazacort)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Emflaza-deflazacort-PA-form-508.pdf&quot;&gt;Emflaza (deflazacort)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Emflaza-deflazacort-PA-form-508.pdf\">Emflaza (deflazacort)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A87\" data-x=\"0\" data-y=\"87\" data-db-index=\"87\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Emgality-galcanezumab-PA-Form.pdf&quot;&gt;Emgality (galcanezumab-gnlm)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Emgality-galcanezumab-PA-Form.pdf&quot;&gt;Emgality (galcanezumab-gnlm)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Emgality-galcanezumab-PA-Form.pdf\">Emgality (galcanezumab-gnlm)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A88\" data-x=\"0\" data-y=\"88\" data-db-index=\"88\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Emverm-mebendazole.pdf&quot;&gt;Emverm (mebendazole)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Emverm-mebendazole.pdf&quot;&gt;Emverm (mebendazole)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Emverm-mebendazole.pdf\">Emverm (mebendazole)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A89\" data-x=\"0\" data-y=\"89\" data-db-index=\"89\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Enbrel-etanercept-508.pdf&quot;&gt;Enbrel (etanercept)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Enbrel-etanercept-508.pdf&quot;&gt;Enbrel (etanercept)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Enbrel-etanercept-508.pdf\">Enbrel (etanercept)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A90\" data-x=\"0\" data-y=\"90\" data-db-index=\"90\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Enspryng-satralizumab-mwge-508.pdf&quot;&gt;Enspryng (satralizumab-mwge)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Enspryng-satralizumab-mwge-508.pdf&quot;&gt;Enspryng (satralizumab-mwge)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Enspryng-satralizumab-mwge-508.pdf\">Enspryng (satralizumab-mwge)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A91\" data-x=\"0\" data-y=\"91\" data-db-index=\"91\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Enstilar-calcipotriene-betamethasone-dipropionate-508.pdf&quot;&gt;Enstilar (calcipotriene-betamethasone dipropionate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Enstilar-calcipotriene-betamethasone-dipropionate-508.pdf&quot;&gt;Enstilar (calcipotriene-betamethasone dipropionate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Enstilar-calcipotriene-betamethasone-dipropionate-508.pdf\">Enstilar (calcipotriene-betamethasone dipropionate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A92\" data-x=\"0\" data-y=\"92\" data-db-index=\"92\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Entadfi-tadalafil-5mg-and-finasteride-5mg.pdf&quot; target=&quot;_self&quot;&gt;Entadfi (tadalafil 5mg and finasteride 5mg&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Entadfi-tadalafil-5mg-and-finasteride-5mg.pdf&quot; target=&quot;_self&quot;&gt;Entadfi (tadalafil 5mg and finasteride 5mg&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Entadfi-tadalafil-5mg-and-finasteride-5mg.pdf\" target=\"_self\">Entadfi (tadalafil 5mg and finasteride 5mg<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A93\" data-x=\"0\" data-y=\"93\" data-db-index=\"93\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Entyvio-vedolizumab-PA-Form-508-Compliant.pdf&quot; target=&quot;_self&quot;&gt;Entyvio (vedolizumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Entyvio-vedolizumab-PA-Form-508-Compliant.pdf&quot; target=&quot;_self&quot;&gt;Entyvio (vedolizumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Entyvio-vedolizumab-PA-Form-508-Compliant.pdf\" target=\"_self\">Entyvio (vedolizumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A94\" data-x=\"0\" data-y=\"94\" data-db-index=\"94\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Epclusa-sofosbuvir-velpatasvir.pdf&quot;&gt;Epclusa (sofosbuvir-velpatasvir)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Epclusa-sofosbuvir-velpatasvir.pdf&quot;&gt;Epclusa (sofosbuvir-velpatasvir)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Epclusa-sofosbuvir-velpatasvir.pdf\">Epclusa (sofosbuvir-velpatasvir)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A95\" data-x=\"0\" data-y=\"95\" data-db-index=\"95\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Epidiolex-cannabidiol-508.pdf&quot;&gt;Epidiolex (cannabidiol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Epidiolex-cannabidiol-508.pdf&quot;&gt;Epidiolex (cannabidiol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Epidiolex-cannabidiol-508.pdf\">Epidiolex (cannabidiol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A96\" data-x=\"0\" data-y=\"96\" data-db-index=\"96\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Epiduo-adapalene-benzoyl-peroxide-508.pdf&quot;&gt;Epiduo (adapalene-benzoyl peroxide)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Epiduo-adapalene-benzoyl-peroxide-508.pdf&quot;&gt;Epiduo (adapalene-benzoyl peroxide)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Epiduo-adapalene-benzoyl-peroxide-508.pdf\">Epiduo (adapalene-benzoyl peroxide)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A97\" data-x=\"0\" data-y=\"97\" data-db-index=\"97\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Esbriet-pirfenidone-508.pdf&quot;&gt;Esbriet (pirfenidone)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Esbriet-pirfenidone-508.pdf&quot;&gt;Esbriet (pirfenidone)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Esbriet-pirfenidone-508.pdf\">Esbriet (pirfenidone)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A98\" data-x=\"0\" data-y=\"98\" data-db-index=\"98\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Etidronate-etidronic-acid-508.pdf&quot;&gt;Etidronate (etidronic acid)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Etidronate-etidronic-acid-508.pdf&quot;&gt;Etidronate (etidronic acid)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Etidronate-etidronic-acid-508.pdf\">Etidronate (etidronic acid)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A99\" data-x=\"0\" data-y=\"99\" data-db-index=\"99\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Eucrisa-crisaborole-PA-Form-508.pdf&quot;&gt;Eucrisa (crisaborole)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Eucrisa-crisaborole-PA-Form-508.pdf&quot;&gt;Eucrisa (crisaborole)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Eucrisa-crisaborole-PA-Form-508.pdf\">Eucrisa (crisaborole)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A100\" data-x=\"0\" data-y=\"100\" data-db-index=\"100\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Evrysdi-risdiplam-PA-Form.pdf&quot;&gt;Evrysdi (risdiplam)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Evrysdi-risdiplam-PA-Form.pdf&quot;&gt;Evrysdi (risdiplam)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Evrysdi-risdiplam-PA-Form.pdf\">Evrysdi (risdiplam)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A101\" data-x=\"0\" data-y=\"101\" data-db-index=\"101\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Extavia-interferon-beta-1b-508.pdf&quot;&gt;Extavia (interferon beta-1b)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Extavia-interferon-beta-1b-508.pdf&quot;&gt;Extavia (interferon beta-1b)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Extavia-interferon-beta-1b-508.pdf\">Extavia (interferon beta-1b)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A102\" data-x=\"0\" data-y=\"102\" data-db-index=\"102\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fabior-tazarotene-508.pdf&quot;&gt;Fabior (tazarotene)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fabior-tazarotene-508.pdf&quot;&gt;Fabior (tazarotene)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fabior-tazarotene-508.pdf\">Fabior (tazarotene)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A103\" data-x=\"0\" data-y=\"103\" data-db-index=\"103\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Fasenra-benralizumab-PA-Form-508-Compliant.pdf&quot;&gt;Fasenra (benralizumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Fasenra-benralizumab-PA-Form-508-Compliant.pdf&quot;&gt;Fasenra (benralizumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Fasenra-benralizumab-PA-Form-508-Compliant.pdf\">Fasenra (benralizumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A104\" data-x=\"0\" data-y=\"104\" data-db-index=\"104\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fentora-fentanyl-buccal-tablet-508.pdf&quot;&gt;Fentora (fentanyl buccal tablet)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fentora-fentanyl-buccal-tablet-508.pdf&quot;&gt;Fentora (fentanyl buccal tablet)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fentora-fentanyl-buccal-tablet-508.pdf\">Fentora (fentanyl buccal tablet)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A105\" data-x=\"0\" data-y=\"105\" data-db-index=\"105\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fintepla-fenfluramine-508.pdf&quot;&gt;Fintepla (fenfluramine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fintepla-fenfluramine-508.pdf&quot;&gt;Fintepla (fenfluramine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fintepla-fenfluramine-508.pdf\">Fintepla (fenfluramine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A106\" data-x=\"0\" data-y=\"106\" data-db-index=\"106\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fluorouracil-Solution-508.pdf&quot;&gt;Fluorouracil Solution&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fluorouracil-Solution-508.pdf&quot;&gt;Fluorouracil Solution&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fluorouracil-Solution-508.pdf\">Fluorouracil Solution<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A107\" data-x=\"0\" data-y=\"107\" data-db-index=\"107\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Forteo-teriparatide-injection-508.pdf&quot;&gt;Forteo (teriparatide injection)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Forteo-teriparatide-injection-508.pdf&quot;&gt;Forteo (teriparatide injection)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Forteo-teriparatide-injection-508.pdf\">Forteo (teriparatide injection)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A108\" data-x=\"0\" data-y=\"108\" data-db-index=\"108\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Frova-frovatriptan-508.pdf&quot;&gt;Frova (frovatriptan)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Frova-frovatriptan-508.pdf&quot;&gt;Frova (frovatriptan)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Frova-frovatriptan-508.pdf\">Frova (frovatriptan)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A109\" data-x=\"0\" data-y=\"109\" data-db-index=\"109\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gabitril-tiagabine-508.pdf&quot;&gt;Gabitril (tiagabine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gabitril-tiagabine-508.pdf&quot;&gt;Gabitril (tiagabine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gabitril-tiagabine-508.pdf\">Gabitril (tiagabine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A110\" data-x=\"0\" data-y=\"110\" data-db-index=\"110\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Galafold-migalastat-508.pdf&quot;&gt;Galafold (migalastat)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Galafold-migalastat-508.pdf&quot;&gt;Galafold (migalastat)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Galafold-migalastat-508.pdf\">Galafold (migalastat)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A111\" data-x=\"0\" data-y=\"111\" data-db-index=\"111\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gilenya-fingolimod-508.pdf&quot;&gt;Gilenya (fingolimod)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gilenya-fingolimod-508.pdf&quot;&gt;Gilenya (fingolimod)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gilenya-fingolimod-508.pdf\">Gilenya (fingolimod)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A112\" data-x=\"0\" data-y=\"112\" data-db-index=\"112\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glatopa-glatiramer-acetate-injection-508.pdf&quot;&gt;Glatopa (glatiramer acetate injection)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glatopa-glatiramer-acetate-injection-508.pdf&quot;&gt;Glatopa (glatiramer acetate injection)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glatopa-glatiramer-acetate-injection-508.pdf\">Glatopa (glatiramer acetate injection)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A113\" data-x=\"0\" data-y=\"113\" data-db-index=\"113\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gloperba-colchicine-508.pdf&quot;&gt;Gloperba (colchicine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gloperba-colchicine-508.pdf&quot;&gt;Gloperba (colchicine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gloperba-colchicine-508.pdf\">Gloperba (colchicine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A114\" data-x=\"0\" data-y=\"114\" data-db-index=\"114\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glucagon-Kit-508.pdf&quot;&gt;Glucagon Kit&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glucagon-Kit-508.pdf&quot;&gt;Glucagon Kit&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glucagon-Kit-508.pdf\">Glucagon Kit<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A115\" data-x=\"0\" data-y=\"115\" data-db-index=\"115\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glycate-glycopyrrolate-508.pdf&quot;&gt;Glycate (glycopyrrolate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glycate-glycopyrrolate-508.pdf&quot;&gt;Glycate (glycopyrrolate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glycate-glycopyrrolate-508.pdf\">Glycate (glycopyrrolate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A116\" data-x=\"0\" data-y=\"116\" data-db-index=\"116\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gralise-gabapentin-508.pdf&quot;&gt;Gralise (gabapentin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gralise-gabapentin-508.pdf&quot;&gt;Gralise (gabapentin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gralise-gabapentin-508.pdf\">Gralise (gabapentin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A117\" data-x=\"0\" data-y=\"117\" data-db-index=\"117\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Granisol-granisetron-508.pdf&quot;&gt;Granisol (granisetron)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Granisol-granisetron-508.pdf&quot;&gt;Granisol (granisetron)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Granisol-granisetron-508.pdf\">Granisol (granisetron)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A118\" data-x=\"0\" data-y=\"118\" data-db-index=\"118\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Grastek-grass-pollen-allergen-extract-timothy-grass-508.pdf&quot;&gt;Grastek (grass pollen allergen extract - timothy grass)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Grastek-grass-pollen-allergen-extract-timothy-grass-508.pdf&quot;&gt;Grastek (grass pollen allergen extract - timothy grass)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Grastek-grass-pollen-allergen-extract-timothy-grass-508.pdf\">Grastek (grass pollen allergen extract - timothy grass)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A119\" data-x=\"0\" data-y=\"119\" data-db-index=\"119\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Growth-Hormone-PA-Form-508-Compliant.pdf&quot;&gt;Growth Hormone&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Growth-Hormone-PA-Form-508-Compliant.pdf&quot;&gt;Growth Hormone&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Growth-Hormone-PA-Form-508-Compliant.pdf\">Growth Hormone<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A120\" data-x=\"0\" data-y=\"120\" data-db-index=\"120\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gvoke-glucagon-injectable-508.pdf&quot;&gt;Gvoke (glucagon injectable)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gvoke-glucagon-injectable-508.pdf&quot;&gt;Gvoke (glucagon injectable)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gvoke-glucagon-injectable-508.pdf\">Gvoke (glucagon injectable)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A121\" data-x=\"0\" data-y=\"121\" data-db-index=\"121\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Harvoni-ledipasvir-sofosbuvir.pdf&quot;&gt;Harvoni (ledipasvir-sofosbuvir)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Harvoni-ledipasvir-sofosbuvir.pdf&quot;&gt;Harvoni (ledipasvir-sofosbuvir)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Harvoni-ledipasvir-sofosbuvir.pdf\">Harvoni (ledipasvir-sofosbuvir)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A122\" data-x=\"0\" data-y=\"122\" data-db-index=\"122\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Hetlioz-tasimelteon-PA-Form.pdf&quot;&gt;Hetlioz (tasimelteon)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Hetlioz-tasimelteon-PA-Form.pdf&quot;&gt;Hetlioz (tasimelteon)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Hetlioz-tasimelteon-PA-Form.pdf\">Hetlioz (tasimelteon)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A123\" data-x=\"0\" data-y=\"123\" data-db-index=\"123\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Horizant-gabapentin-enacarbil-508.pdf&quot;&gt;Horizant (gabapentin enacarbil)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Horizant-gabapentin-enacarbil-508.pdf&quot;&gt;Horizant (gabapentin enacarbil)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Horizant-gabapentin-enacarbil-508.pdf\">Horizant (gabapentin enacarbil)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A124\" data-x=\"0\" data-y=\"124\" data-db-index=\"124\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Humira-adalimumab-508.pdf&quot;&gt;Humira (adalimumab)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Humira-adalimumab-508.pdf&quot;&gt;Humira (adalimumab)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Humira-adalimumab-508.pdf\">Humira (adalimumab)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A125\" data-x=\"0\" data-y=\"125\" data-db-index=\"125\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Hyftor-sirolimus-topical-gel-0.2-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Hyftor (sirolimus topical gel 0.2%)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Hyftor-sirolimus-topical-gel-0.2-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Hyftor (sirolimus topical gel 0.2%)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Hyftor-sirolimus-topical-gel-0.2-PA-Form.pdf\" target=\"_self\">Hyftor (sirolimus topical gel 0.2%)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A126\" data-x=\"0\" data-y=\"126\" data-db-index=\"126\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Hysingla-ER-hydrocodone-bitartrate-508.pdf&quot;&gt;Hysingla ER (hydrocodone bitartrate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Hysingla-ER-hydrocodone-bitartrate-508.pdf&quot;&gt;Hysingla ER (hydrocodone bitartrate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Hysingla-ER-hydrocodone-bitartrate-508.pdf\">Hysingla ER (hydrocodone bitartrate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A127\" data-x=\"0\" data-y=\"127\" data-db-index=\"127\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Ibsrela-tenapanor.pdf&quot; target=&quot;_self&quot;&gt;Ibsrela (tenapanor)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Ibsrela-tenapanor.pdf&quot; target=&quot;_self&quot;&gt;Ibsrela (tenapanor)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Ibsrela-tenapanor.pdf\" target=\"_self\">Ibsrela (tenapanor)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A128\" data-x=\"0\" data-y=\"128\" data-db-index=\"128\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ilaris-canakinumab-508.pdf&quot;&gt;Ilaris (canakinumab)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ilaris-canakinumab-508.pdf&quot;&gt;Ilaris (canakinumab)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ilaris-canakinumab-508.pdf\">Ilaris (canakinumab)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A129\" data-x=\"0\" data-y=\"129\" data-db-index=\"129\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Ilumya-tildrakizumab-asmn-PA-Form.pdf&quot;&gt;Ilumya (tildrakizumab-asmn)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Ilumya-tildrakizumab-asmn-PA-Form.pdf&quot;&gt;Ilumya (tildrakizumab-asmn)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Ilumya-tildrakizumab-asmn-PA-Form.pdf\">Ilumya (tildrakizumab-asmn)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A130\" data-x=\"0\" data-y=\"130\" data-db-index=\"130\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Imitrex-sumatriptan-508.pdf&quot;&gt;Imitrex (sumatriptan)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Imitrex-sumatriptan-508.pdf&quot;&gt;Imitrex (sumatriptan)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Imitrex-sumatriptan-508.pdf\">Imitrex (sumatriptan)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A131\" data-x=\"0\" data-y=\"131\" data-db-index=\"131\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Ingrezza-valbenazine-PA-Form.pdf&quot;&gt;Ingrezza (valbenazine)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Ingrezza-valbenazine-PA-Form.pdf&quot;&gt;Ingrezza (valbenazine)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Ingrezza-valbenazine-PA-Form.pdf\">Ingrezza (valbenazine)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A132\" data-x=\"0\" data-y=\"132\" data-db-index=\"132\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/Invega-Hafyera-paliperidone-palmitate.pdf&quot; target=&quot;_self&quot;&gt;Invega Hafyera (paliperidone palmitate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/Invega-Hafyera-paliperidone-palmitate.pdf&quot; target=&quot;_self&quot;&gt;Invega Hafyera (paliperidone palmitate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/Invega-Hafyera-paliperidone-palmitate.pdf\" target=\"_self\">Invega Hafyera (paliperidone palmitate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A133\" data-x=\"0\" data-y=\"133\" data-db-index=\"133\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Invega-Sustenna-paliperidone-508.pdf&quot;&gt;Invega Sustenna (paliperidone)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Invega-Sustenna-paliperidone-508.pdf&quot;&gt;Invega Sustenna (paliperidone)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Invega-Sustenna-paliperidone-508.pdf\">Invega Sustenna (paliperidone)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A134\" data-x=\"0\" data-y=\"134\" data-db-index=\"134\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Invega-Trinza-paliperidone.pdf&quot;&gt;Invega Trinza (paliperidone)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Invega-Trinza-paliperidone.pdf&quot;&gt;Invega Trinza (paliperidone)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Invega-Trinza-paliperidone.pdf\">Invega Trinza (paliperidone)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A135\" data-x=\"0\" data-y=\"135\" data-db-index=\"135\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Jublia-efinaconazole-508.pdf&quot;&gt;Jublia (efinaconazole)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Jublia-efinaconazole-508.pdf&quot;&gt;Jublia (efinaconazole)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Jublia-efinaconazole-508.pdf\">Jublia (efinaconazole)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A136\" data-x=\"0\" data-y=\"136\" data-db-index=\"136\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Juxtapid-lomitapide-PA-Form.pdf&quot;&gt;Juxtapid (lomitapide)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Juxtapid-lomitapide-PA-Form.pdf&quot;&gt;Juxtapid (lomitapide)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Juxtapid-lomitapide-PA-Form.pdf\">Juxtapid (lomitapide)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A137\" data-x=\"0\" data-y=\"137\" data-db-index=\"137\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Jynarque-tolvaptan-508.pdf&quot;&gt;Jynarque (tolvaptan)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Jynarque-tolvaptan-508.pdf&quot;&gt;Jynarque (tolvaptan)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Jynarque-tolvaptan-508.pdf\">Jynarque (tolvaptan)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A138\" data-x=\"0\" data-y=\"138\" data-db-index=\"138\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Kalydeco-ivacaftor.pdf&quot;&gt;Kalydeco (ivacaftor)&lt;\/a&gt;&lt;\/div&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Kalydeco-ivacaftor.pdf&quot;&gt;Kalydeco (ivacaftor)&lt;\/a&gt;&lt;\/div&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Kalydeco-ivacaftor.pdf\">Kalydeco (ivacaftor)<\/a><\/div><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A139\" data-x=\"0\" data-y=\"139\" data-db-index=\"139\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;div&gt;&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Kerendia-finerenone-PA-Form-508-Compliant.pdf&quot;&gt;Kerendia (finerenone)&lt;\/a&gt; - PA Form&lt;\/div&gt;\" data-order=\"&lt;div&gt;&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Kerendia-finerenone-PA-Form-508-Compliant.pdf&quot;&gt;Kerendia (finerenone)&lt;\/a&gt; - PA Form&lt;\/div&gt;\" style=\"min-width:100%; \" ><div><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Kerendia-finerenone-PA-Form-508-Compliant.pdf\">Kerendia (finerenone)<\/a> - PA Form<\/div><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A140\" data-x=\"0\" data-y=\"140\" data-db-index=\"140\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;div style=&quot;width: 50%;float: left&quot;&gt;&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kerydin-tavaborole-topical-solution-508.pdf&quot;&gt;Kerydin (tavaborole topical solution)&lt;\/a&gt;\" data-order=\"&lt;div style=&quot;width: 50%;float: left&quot;&gt;&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kerydin-tavaborole-topical-solution-508.pdf&quot;&gt;Kerydin (tavaborole topical solution)&lt;\/a&gt;\" style=\"min-width:100%; \" ><div style=\"width: 50%;float: left\"><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kerydin-tavaborole-topical-solution-508.pdf\">Kerydin (tavaborole topical solution)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A141\" data-x=\"0\" data-y=\"141\" data-db-index=\"141\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kesimpta-ofatumumab-508.pdf&quot;&gt;Kesimpta (ofatumumab)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kesimpta-ofatumumab-508.pdf&quot;&gt;Kesimpta (ofatumumab)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kesimpta-ofatumumab-508.pdf\">Kesimpta (ofatumumab)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A142\" data-x=\"0\" data-y=\"142\" data-db-index=\"142\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ketoconazole-Oral-508.pdf&quot;&gt;Ketoconazole Oral&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ketoconazole-Oral-508.pdf&quot;&gt;Ketoconazole Oral&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ketoconazole-Oral-508.pdf\">Ketoconazole Oral<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A143\" data-x=\"0\" data-y=\"143\" data-db-index=\"143\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Kevzara-sarilumab-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Kevzara (sarilumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Kevzara-sarilumab-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Kevzara (sarilumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Kevzara-sarilumab-PA-Form.pdf\" target=\"_self\">Kevzara (sarilumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A144\" data-x=\"0\" data-y=\"144\" data-db-index=\"144\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kineret-anakinra-508.pdf&quot;&gt;Kineret (anakinra)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kineret-anakinra-508.pdf&quot;&gt;Kineret (anakinra)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kineret-anakinra-508.pdf\">Kineret (anakinra)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A145\" data-x=\"0\" data-y=\"145\" data-db-index=\"145\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kitabis-tobramycin-508.pdf&quot;&gt;Kitabis (tobramycin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kitabis-tobramycin-508.pdf&quot;&gt;Kitabis (tobramycin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kitabis-tobramycin-508.pdf\">Kitabis (tobramycin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A146\" data-x=\"0\" data-y=\"146\" data-db-index=\"146\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Krystexxa-pegloticase-508.pdf&quot;&gt;Krystexxa (egloticase)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Krystexxa-pegloticase-508.pdf&quot;&gt;Krystexxa (egloticase)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Krystexxa-pegloticase-508.pdf\">Krystexxa (egloticase)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A147\" data-x=\"0\" data-y=\"147\" data-db-index=\"147\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kuvan-sapropterin-dihydrochloride-PA-Form-508.pdf&quot;&gt;Kuvan (sapropterin dihydrochloride)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kuvan-sapropterin-dihydrochloride-PA-Form-508.pdf&quot;&gt;Kuvan (sapropterin dihydrochloride)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kuvan-sapropterin-dihydrochloride-PA-Form-508.pdf\">Kuvan (sapropterin dihydrochloride)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A148\" data-x=\"0\" data-y=\"148\" data-db-index=\"148\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kynamro-mipomersen-sodium-508.pdf&quot;&gt;Kynamro (mipomersen sodium)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kynamro-mipomersen-sodium-508.pdf&quot;&gt;Kynamro (mipomersen sodium)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kynamro-mipomersen-sodium-508.pdf\">Kynamro (mipomersen sodium)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A149\" data-x=\"0\" data-y=\"149\" data-db-index=\"149\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Kynmobi-apomorphine-HCl-PA-Form-508-Compliant..pdf&quot;&gt;Kynmobi (apomorphine HCI)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Kynmobi-apomorphine-HCl-PA-Form-508-Compliant..pdf&quot;&gt;Kynmobi (apomorphine HCI)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Kynmobi-apomorphine-HCl-PA-Form-508-Compliant..pdf\">Kynmobi (apomorphine HCI)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A150\" data-x=\"0\" data-y=\"150\" data-db-index=\"150\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lamictal-ER-lamotrigine-ER-508.pdf&quot;&gt;Lamictal ER (lamotrigine ER)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lamictal-ER-lamotrigine-ER-508.pdf&quot;&gt;Lamictal ER (lamotrigine ER)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lamictal-ER-lamotrigine-ER-508.pdf\">Lamictal ER (lamotrigine ER)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A151\" data-x=\"0\" data-y=\"151\" data-db-index=\"151\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lamictal-ODT-lamotrigine-508.pdf&quot;&gt;Lamictal ODT (lamotrigine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lamictal-ODT-lamotrigine-508.pdf&quot;&gt;Lamictal ODT (lamotrigine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lamictal-ODT-lamotrigine-508.pdf\">Lamictal ODT (lamotrigine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A152\" data-x=\"0\" data-y=\"152\" data-db-index=\"152\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lazanda-fentanyl-nasal-spray-508.pdf&quot;&gt;Lazanda (fetanyl nasal spray)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lazanda-fentanyl-nasal-spray-508.pdf&quot;&gt;Lazanda (fetanyl nasal spray)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lazanda-fentanyl-nasal-spray-508.pdf\">Lazanda (fetanyl nasal spray)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A153\" data-x=\"0\" data-y=\"153\" data-db-index=\"153\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Leqvio-inclisiran-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Leqvio (inclisiran)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Leqvio-inclisiran-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Leqvio (inclisiran)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Leqvio-inclisiran-PA-Form.pdf\" target=\"_self\">Leqvio (inclisiran)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A154\" data-x=\"0\" data-y=\"154\" data-db-index=\"154\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Letairis-ambrisentan-508.pdf&quot;&gt;Letairis (ambrisentan)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Letairis-ambrisentan-508.pdf&quot;&gt;Letairis (ambrisentan)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Letairis-ambrisentan-508.pdf\">Letairis (ambrisentan)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A155\" data-x=\"0\" data-y=\"155\" data-db-index=\"155\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lexapro-escitalopram-508.pdf&quot;&gt;Lexapro (escitalopram)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lexapro-escitalopram-508.pdf&quot;&gt;Lexapro (escitalopram)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lexapro-escitalopram-508.pdf\">Lexapro (escitalopram)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A156\" data-x=\"0\" data-y=\"156\" data-db-index=\"156\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Linzess-linaclotide.pdf&quot;&gt;Linzess (linaclotide)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Linzess-linaclotide.pdf&quot;&gt;Linzess (linaclotide)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Linzess-linaclotide.pdf\">Linzess (linaclotide)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A157\" data-x=\"0\" data-y=\"157\" data-db-index=\"157\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/05\/Loreev-XR-lorazepam-ER.pdf&quot; target=&quot;_self&quot;&gt;Loreev XR (lorazepam ER)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/05\/Loreev-XR-lorazepam-ER.pdf&quot; target=&quot;_self&quot;&gt;Loreev XR (lorazepam ER)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/05\/Loreev-XR-lorazepam-ER.pdf\" target=\"_self\">Loreev XR (lorazepam ER)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A158\" data-x=\"0\" data-y=\"158\" data-db-index=\"158\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lotronex-alosetron-508.pdf&quot;&gt;Lotronex (alosetron)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lotronex-alosetron-508.pdf&quot;&gt;Lotronex (alosetron)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lotronex-alosetron-508.pdf\">Lotronex (alosetron)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A159\" data-x=\"0\" data-y=\"159\" data-db-index=\"159\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lovaza-omega-3-acid-ethyl-esters-508.pdf&quot;&gt;Lovaza (omega-3 acide ethyl esters)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lovaza-omega-3-acid-ethyl-esters-508.pdf&quot;&gt;Lovaza (omega-3 acide ethyl esters)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lovaza-omega-3-acid-ethyl-esters-508.pdf\">Lovaza (omega-3 acide ethyl esters)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A160\" data-x=\"0\" data-y=\"160\" data-db-index=\"160\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Lupkynis-voclosporin-PA-Form-508-Compliant.pdf&quot;&gt;Lupkynis (voclosporin)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Lupkynis-voclosporin-PA-Form-508-Compliant.pdf&quot;&gt;Lupkynis (voclosporin)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Lupkynis-voclosporin-PA-Form-508-Compliant.pdf\">Lupkynis (voclosporin)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A161\" data-x=\"0\" data-y=\"161\" data-db-index=\"161\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Luzu-luliconazole-cream-508.pdf&quot;&gt;Luzu (luliconazole cream)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Luzu-luliconazole-cream-508.pdf&quot;&gt;Luzu (luliconazole cream)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Luzu-luliconazole-cream-508.pdf\">Luzu (luliconazole cream)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A162\" data-x=\"0\" data-y=\"162\" data-db-index=\"162\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/Lybalvi-olanzapine-samidorphan-PA-Form-508-Compliant.pdf&quot; target=&quot;_self&quot;&gt;Lybalvi (olanzapine-samidorphan)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/Lybalvi-olanzapine-samidorphan-PA-Form-508-Compliant.pdf&quot; target=&quot;_self&quot;&gt;Lybalvi (olanzapine-samidorphan)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/Lybalvi-olanzapine-samidorphan-PA-Form-508-Compliant.pdf\" target=\"_self\">Lybalvi (olanzapine-samidorphan)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A163\" data-x=\"0\" data-y=\"163\" data-db-index=\"163\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Marinol-dronabinol-508.pdf&quot;&gt;Marinol (dronabinol)&lt;\/a&gt;&lt;\/div&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Marinol-dronabinol-508.pdf&quot;&gt;Marinol (dronabinol)&lt;\/a&gt;&lt;\/div&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Marinol-dronabinol-508.pdf\">Marinol (dronabinol)<\/a><\/div><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A164\" data-x=\"0\" data-y=\"164\" data-db-index=\"164\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;div style=&quot;width: 49%;float: left&quot;&gt;&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mavenclad-cladribine-508.pdf&quot;&gt;Mavenclad (cladribine)&lt;\/a&gt;\" data-order=\"&lt;div style=&quot;width: 49%;float: left&quot;&gt;&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mavenclad-cladribine-508.pdf&quot;&gt;Mavenclad (cladribine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><div style=\"width: 49%;float: left\"><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mavenclad-cladribine-508.pdf\">Mavenclad (cladribine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A165\" data-x=\"0\" data-y=\"165\" data-db-index=\"165\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Mavyret-glecaprevir-pibrentasvir-PA-Form.pdf&quot;&gt;Mavyret (glecaprevir-pibrentasvir)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Mavyret-glecaprevir-pibrentasvir-PA-Form.pdf&quot;&gt;Mavyret (glecaprevir-pibrentasvir)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Mavyret-glecaprevir-pibrentasvir-PA-Form.pdf\">Mavyret (glecaprevir-pibrentasvir)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A166\" data-x=\"0\" data-y=\"166\" data-db-index=\"166\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Maxalt-rizatriptan-508.pdf&quot;&gt;Maxalt (rizatriptan)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Maxalt-rizatriptan-508.pdf&quot;&gt;Maxalt (rizatriptan)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Maxalt-rizatriptan-508.pdf\">Maxalt (rizatriptan)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A167\" data-x=\"0\" data-y=\"167\" data-db-index=\"167\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mayzent-siponimod-508.pdf&quot;&gt;Mayzent (siponimod)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mayzent-siponimod-508.pdf&quot;&gt;Mayzent (siponimod)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mayzent-siponimod-508.pdf\">Mayzent (siponimod)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A168\" data-x=\"0\" data-y=\"168\" data-db-index=\"168\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Provider-Attestation-for-Suboxone-for-Opioid-Use-Disorder-3.7.24pdf.pdf&quot; target=&quot;_self&quot;&gt;Medication Assisted Therapy (MAT)&lt;\/a&gt; - Provider Notice and Attestation Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Provider-Attestation-for-Suboxone-for-Opioid-Use-Disorder-3.7.24pdf.pdf&quot; target=&quot;_self&quot;&gt;Medication Assisted Therapy (MAT)&lt;\/a&gt; - Provider Notice and Attestation Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Provider-Attestation-for-Suboxone-for-Opioid-Use-Disorder-3.7.24pdf.pdf\" target=\"_self\">Medication Assisted Therapy (MAT)<\/a> - Provider Notice and Attestation Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A169\" data-x=\"0\" data-y=\"169\" data-db-index=\"169\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Methadone-PA-Form-508.pdf&quot;&gt;Methadone&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Methadone-PA-Form-508.pdf&quot;&gt;Methadone&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Methadone-PA-Form-508.pdf\">Methadone<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A170\" data-x=\"0\" data-y=\"170\" data-db-index=\"170\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Metozolv-ODT-metoclopramide-508.pdf&quot;&gt;Metozolv ODT (metoclopramide)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Metozolv-ODT-metoclopramide-508.pdf&quot;&gt;Metozolv ODT (metoclopramide)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Metozolv-ODT-metoclopramide-508.pdf\">Metozolv ODT (metoclopramide)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A171\" data-x=\"0\" data-y=\"171\" data-db-index=\"171\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Miacalcin-calcitonin-intranasal-508.pdf&quot;&gt;Miacalcin (calcitonin intranasal)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Miacalcin-calcitonin-intranasal-508.pdf&quot;&gt;Miacalcin (calcitonin intranasal)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Miacalcin-calcitonin-intranasal-508.pdf\">Miacalcin (calcitonin intranasal)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A172\" data-x=\"0\" data-y=\"172\" data-db-index=\"172\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mirapex-ER-pramipexole-ER-508.pdf&quot;&gt;Mirapex ER (pramipexole ER)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mirapex-ER-pramipexole-ER-508.pdf&quot;&gt;Mirapex ER (pramipexole ER)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mirapex-ER-pramipexole-ER-508.pdf\">Mirapex ER (pramipexole ER)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A173\" data-x=\"0\" data-y=\"173\" data-db-index=\"173\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mitigare-colchicine-508.pdf&quot;&gt;Mitigare (colchicine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mitigare-colchicine-508.pdf&quot;&gt;Mitigare (colchicine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mitigare-colchicine-508.pdf\">Mitigare (colchicine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A174\" data-x=\"0\" data-y=\"174\" data-db-index=\"174\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Motegrity-prucalopride.pdf&quot;&gt;Motegrity (prucalopride)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Motegrity-prucalopride.pdf&quot;&gt;Motegrity (prucalopride)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Motegrity-prucalopride.pdf\">Motegrity (prucalopride)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A175\" data-x=\"0\" data-y=\"175\" data-db-index=\"175\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Motpoly-XR-lacosamide-PA-form.pdf&quot; target=&quot;_self&quot;&gt;Motpoly XR (lacosamide)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Motpoly-XR-lacosamide-PA-form.pdf&quot; target=&quot;_self&quot;&gt;Motpoly XR (lacosamide)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Motpoly-XR-lacosamide-PA-form.pdf\" target=\"_self\">Motpoly XR (lacosamide)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A176\" data-x=\"0\" data-y=\"176\" data-db-index=\"176\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Movantik-naloxegol.pdf&quot;&gt;Movantik (naloxegol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Movantik-naloxegol.pdf&quot;&gt;Movantik (naloxegol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Movantik-naloxegol.pdf\">Movantik (naloxegol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A177\" data-x=\"0\" data-y=\"177\" data-db-index=\"177\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Natpara-parathyroid-hormone-PA-Form-508.pdf&quot;&gt;Natpara (parathyroid hormone)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Natpara-parathyroid-hormone-PA-Form-508.pdf&quot;&gt;Natpara (parathyroid hormone)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Natpara-parathyroid-hormone-PA-Form-508.pdf\">Natpara (parathyroid hormone)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A178\" data-x=\"0\" data-y=\"178\" data-db-index=\"178\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nayzilam-midazolam-nasal-spray-508.pdf&quot;&gt;Nayzilam (midazolam nasal spray)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nayzilam-midazolam-nasal-spray-508.pdf&quot;&gt;Nayzilam (midazolam nasal spray)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nayzilam-midazolam-nasal-spray-508.pdf\">Nayzilam (midazolam nasal spray)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A179\" data-x=\"0\" data-y=\"179\" data-db-index=\"179\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nexiclon-XR-clonidine-508.pdf&quot;&gt;Nexiclon XR (clonidine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nexiclon-XR-clonidine-508.pdf&quot;&gt;Nexiclon XR (clonidine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nexiclon-XR-clonidine-508.pdf\">Nexiclon XR (clonidine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A180\" data-x=\"0\" data-y=\"180\" data-db-index=\"180\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Nexletol-bempedoic-acid-PA-Form.pdf&quot;&gt;Nexletol (bempedoic acid)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Nexletol-bempedoic-acid-PA-Form.pdf&quot;&gt;Nexletol (bempedoic acid)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Nexletol-bempedoic-acid-PA-Form.pdf\">Nexletol (bempedoic acid)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A181\" data-x=\"0\" data-y=\"181\" data-db-index=\"181\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Nexlizet-bempedoic-acid-and-ezetimibe-PA-Form.pdf&quot;&gt;Nexlizet (bempedoic acid and ezetimibe)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Nexlizet-bempedoic-acid-and-ezetimibe-PA-Form.pdf&quot;&gt;Nexlizet (bempedoic acid and ezetimibe)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Nexlizet-bempedoic-acid-and-ezetimibe-PA-Form.pdf\">Nexlizet (bempedoic acid and ezetimibe)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A182\" data-x=\"0\" data-y=\"182\" data-db-index=\"182\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nicotrol-nicotine-system-508.pdf&quot;&gt;Nicotrol (nicotine system)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nicotrol-nicotine-system-508.pdf&quot;&gt;Nicotrol (nicotine system)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nicotrol-nicotine-system-508.pdf\">Nicotrol (nicotine system)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A183\" data-x=\"0\" data-y=\"183\" data-db-index=\"183\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nocdurna-desmopressin-acetate-508.pdf&quot;&gt;Nocdurna (desmopressin acetate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nocdurna-desmopressin-acetate-508.pdf&quot;&gt;Nocdurna (desmopressin acetate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nocdurna-desmopressin-acetate-508.pdf\">Nocdurna (desmopressin acetate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A184\" data-x=\"0\" data-y=\"184\" data-db-index=\"184\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Noctiva-desmopressin-acetate-508.pdf&quot;&gt;Noctiva (desmopressin acetate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Noctiva-desmopressin-acetate-508.pdf&quot;&gt;Noctiva (desmopressin acetate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Noctiva-desmopressin-acetate-508.pdf\">Noctiva (desmopressin acetate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A185\" data-x=\"0\" data-y=\"185\" data-db-index=\"185\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nourianz-istradefylline-508.pdf&quot;&gt;Nourianz (istradefylline)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nourianz-istradefylline-508.pdf&quot;&gt;Nourianz (istradefylline)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nourianz-istradefylline-508.pdf\">Nourianz (istradefylline)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A186\" data-x=\"0\" data-y=\"186\" data-db-index=\"186\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Noxafil-posaconazole-508.pdf&quot;&gt;Noxafil (posaconzaole)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Noxafil-posaconazole-508.pdf&quot;&gt;Noxafil (posaconzaole)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Noxafil-posaconazole-508.pdf\">Noxafil (posaconzaole)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A187\" data-x=\"0\" data-y=\"187\" data-db-index=\"187\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Nucala-mepolizumab-PA-Form508.pdf&quot;&gt;Nucala (mepolizumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Nucala-mepolizumab-PA-Form508.pdf&quot;&gt;Nucala (mepolizumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Nucala-mepolizumab-PA-Form508.pdf\">Nucala (mepolizumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A188\" data-x=\"0\" data-y=\"188\" data-db-index=\"188\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nucynta-ER-tapentadol-hydrochloride-508.pdf&quot;&gt;Nucynta ER (tapentadol hydrochloride)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nucynta-ER-tapentadol-hydrochloride-508.pdf&quot;&gt;Nucynta ER (tapentadol hydrochloride)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nucynta-ER-tapentadol-hydrochloride-508.pdf\">Nucynta ER (tapentadol hydrochloride)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A189\" data-x=\"0\" data-y=\"189\" data-db-index=\"189\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nucynta-IR-tapentadol-508.pdf&quot;&gt;Nucynta IR (tapentadol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nucynta-IR-tapentadol-508.pdf&quot;&gt;Nucynta IR (tapentadol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nucynta-IR-tapentadol-508.pdf\">Nucynta IR (tapentadol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A190\" data-x=\"0\" data-y=\"190\" data-db-index=\"190\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Nuedexta-dextromethorphan-and-quinidine-PA-Form.pdf&quot;&gt;Nuedexta (destromethorphan hydrobromide-quinidine sulfate)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Nuedexta-dextromethorphan-and-quinidine-PA-Form.pdf&quot;&gt;Nuedexta (destromethorphan hydrobromide-quinidine sulfate)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Nuedexta-dextromethorphan-and-quinidine-PA-Form.pdf\">Nuedexta (destromethorphan hydrobromide-quinidine sulfate)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A191\" data-x=\"0\" data-y=\"191\" data-db-index=\"191\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/Nuplazid-pimavanserin.pdf&quot;&gt;Nuplazid (pimavanserin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/Nuplazid-pimavanserin.pdf&quot;&gt;Nuplazid (pimavanserin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/Nuplazid-pimavanserin.pdf\">Nuplazid (pimavanserin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A192\" data-x=\"0\" data-y=\"192\" data-db-index=\"192\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Nurtec-ODT-rimegepant-PA-Form.pdf&quot;&gt;Nurtec ODT (rimegepant)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Nurtec-ODT-rimegepant-PA-Form.pdf&quot;&gt;Nurtec ODT (rimegepant)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Nurtec-ODT-rimegepant-PA-Form.pdf\">Nurtec ODT (rimegepant)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A193\" data-x=\"0\" data-y=\"193\" data-db-index=\"193\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ocaliva-obeticholic-acid-508.pdf&quot;&gt;Ocaliva (obeticholic acid)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ocaliva-obeticholic-acid-508.pdf&quot;&gt;Ocaliva (obeticholic acid)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ocaliva-obeticholic-acid-508.pdf\">Ocaliva (obeticholic acid)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A194\" data-x=\"0\" data-y=\"194\" data-db-index=\"194\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ofev-nintedanib-508.pdf&quot;&gt;Ofev (nintedanib)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ofev-nintedanib-508.pdf&quot;&gt;Ofev (nintedanib)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ofev-nintedanib-508.pdf\">Ofev (nintedanib)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A195\" data-x=\"0\" data-y=\"195\" data-db-index=\"195\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Olumiant-baricitinib-508.pdf&quot;&gt;Olumiant (baricitinib)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Olumiant-baricitinib-508.pdf&quot;&gt;Olumiant (baricitinib)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Olumiant-baricitinib-508.pdf\">Olumiant (baricitinib)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A196\" data-x=\"0\" data-y=\"196\" data-db-index=\"196\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Omvoh-mirikizumab-mrkz-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Omvoh (mirikizumab-mrkz)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Omvoh-mirikizumab-mrkz-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Omvoh (mirikizumab-mrkz)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Omvoh-mirikizumab-mrkz-PA-Form.pdf\" target=\"_self\">Omvoh (mirikizumab-mrkz)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A197\" data-x=\"0\" data-y=\"197\" data-db-index=\"197\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Onfi-clobazam-508.pdf&quot;&gt;Onfi (clobazam)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Onfi-clobazam-508.pdf&quot;&gt;Onfi (clobazam)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Onfi-clobazam-508.pdf\">Onfi (clobazam)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A198\" data-x=\"0\" data-y=\"198\" data-db-index=\"198\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Onsolis-fentanyl-buccal-soluble-film-508.pdf&quot;&gt;Onsolis (fentanyl buccal soluble film)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Onsolis-fentanyl-buccal-soluble-film-508.pdf&quot;&gt;Onsolis (fentanyl buccal soluble film)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Onsolis-fentanyl-buccal-soluble-film-508.pdf\">Onsolis (fentanyl buccal soluble film)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A199\" data-x=\"0\" data-y=\"199\" data-db-index=\"199\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Opana-ER-oxymorphone-508.pdf&quot;&gt;Opana ER (oxymorphone)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Opana-ER-oxymorphone-508.pdf&quot;&gt;Opana ER (oxymorphone)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Opana-ER-oxymorphone-508.pdf\">Opana ER (oxymorphone)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A200\" data-x=\"0\" data-y=\"200\" data-db-index=\"200\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Opsumit-macitentan-508.pdf&quot;&gt;Opsumit (macitentan)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Opsumit-macitentan-508.pdf&quot;&gt;Opsumit (macitentan)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Opsumit-macitentan-508.pdf\">Opsumit (macitentan)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A201\" data-x=\"0\" data-y=\"201\" data-db-index=\"201\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/03\/Opzelura-ruxolitinib-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Opzelura (ruxolitinib)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/03\/Opzelura-ruxolitinib-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Opzelura (ruxolitinib)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/03\/Opzelura-ruxolitinib-PA-Form.pdf\" target=\"_self\">Opzelura (ruxolitinib)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A202\" data-x=\"0\" data-y=\"202\" data-db-index=\"202\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oralair-grass-pollen-allergen-extract-508.pdf&quot;&gt;Oralair (grass pollen allergen extract)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oralair-grass-pollen-allergen-extract-508.pdf&quot;&gt;Oralair (grass pollen allergen extract)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oralair-grass-pollen-allergen-extract-508.pdf\">Oralair (grass pollen allergen extract)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A203\" data-x=\"0\" data-y=\"203\" data-db-index=\"203\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Orencia-abatacept-508.pdf&quot;&gt;Orencia (abatacept)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Orencia-abatacept-508.pdf&quot;&gt;Orencia (abatacept)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Orencia-abatacept-508.pdf\">Orencia (abatacept)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A204\" data-x=\"0\" data-y=\"204\" data-db-index=\"204\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Orkambi-lumacaftor-ivacaftor-PA-Form.pdf&quot;&gt;Orkambi (lumacaftor-ivacaftor)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Orkambi-lumacaftor-ivacaftor-PA-Form.pdf&quot;&gt;Orkambi (lumacaftor-ivacaftor)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Orkambi-lumacaftor-ivacaftor-PA-Form.pdf\">Orkambi (lumacaftor-ivacaftor)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A205\" data-x=\"0\" data-y=\"205\" data-db-index=\"205\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oseni-pioglitazone-alogliptin-508.pdf&quot;&gt;Oseni (pioglitazone-alogliptin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oseni-pioglitazone-alogliptin-508.pdf&quot;&gt;Oseni (pioglitazone-alogliptin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oseni-pioglitazone-alogliptin-508.pdf\">Oseni (pioglitazone-alogliptin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A206\" data-x=\"0\" data-y=\"206\" data-db-index=\"206\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Otezla-apremilast-508.pdf&quot;&gt;Otezla (apremilast)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Otezla-apremilast-508.pdf&quot;&gt;Otezla (apremilast)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Otezla-apremilast-508.pdf\">Otezla (apremilast)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A207\" data-x=\"0\" data-y=\"207\" data-db-index=\"207\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxaydo-oxycodone-508.pdf&quot;&gt;Oxaydo (oxycodone)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxaydo-oxycodone-508.pdf&quot;&gt;Oxaydo (oxycodone)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxaydo-oxycodone-508.pdf\">Oxaydo (oxycodone)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A208\" data-x=\"0\" data-y=\"208\" data-db-index=\"208\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/01\/Oxbryta-voxelotor.pdf&quot;&gt;Oxbryta (voxelotor)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/01\/Oxbryta-voxelotor.pdf&quot;&gt;Oxbryta (voxelotor)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/01\/Oxbryta-voxelotor.pdf\">Oxbryta (voxelotor)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A209\" data-x=\"0\" data-y=\"209\" data-db-index=\"209\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxervate-cenegermin-bkbj-508.pdf&quot;&gt;Oxervate (cenegermin-bkbj)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxervate-cenegermin-bkbj-508.pdf&quot;&gt;Oxervate (cenegermin-bkbj)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxervate-cenegermin-bkbj-508.pdf\">Oxervate (cenegermin-bkbj)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A210\" data-x=\"0\" data-y=\"210\" data-db-index=\"210\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxycontin-oxycodone-508.pdf&quot;&gt;Oxycontin (oxycodone)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxycontin-oxycodone-508.pdf&quot;&gt;Oxycontin (oxycodone)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxycontin-oxycodone-508.pdf\">Oxycontin (oxycodone)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A211\" data-x=\"0\" data-y=\"211\" data-db-index=\"211\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Palforzia-peanut-allergen-powder-508.pdf&quot;&gt;Palforzia (peanut allergen powder)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Palforzia-peanut-allergen-powder-508.pdf&quot;&gt;Palforzia (peanut allergen powder)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Palforzia-peanut-allergen-powder-508.pdf\">Palforzia (peanut allergen powder)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A212\" data-x=\"0\" data-y=\"212\" data-db-index=\"212\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/01\/Palynziq-pegvaliase-pqpz-PA-Form.pdf&quot;&gt;Palynziq (pegvaliase)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/01\/Palynziq-pegvaliase-pqpz-PA-Form.pdf&quot;&gt;Palynziq (pegvaliase)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/01\/Palynziq-pegvaliase-pqpz-PA-Form.pdf\">Palynziq (pegvaliase)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A213\" data-x=\"0\" data-y=\"213\" data-db-index=\"213\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/PCSK-9-PA-Form-508.pdf&quot;&gt;PCSK-9&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/PCSK-9-PA-Form-508.pdf&quot;&gt;PCSK-9&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/PCSK-9-PA-Form-508.pdf\">PCSK-9<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A214\" data-x=\"0\" data-y=\"214\" data-db-index=\"214\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Picato-ingenol-mebutate-508.pdf&quot;&gt;Picato (ingenol mebutate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Picato-ingenol-mebutate-508.pdf&quot;&gt;Picato (ingenol mebutate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Picato-ingenol-mebutate-508.pdf\">Picato (ingenol mebutate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A215\" data-x=\"0\" data-y=\"215\" data-db-index=\"215\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Plegridy-peginterferon-beta-1a-508.pdf&quot;&gt;Plegridy (peginterferon beta-1a)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Plegridy-peginterferon-beta-1a-508.pdf&quot;&gt;Plegridy (peginterferon beta-1a)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Plegridy-peginterferon-beta-1a-508.pdf\">Plegridy (peginterferon beta-1a)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A216\" data-x=\"0\" data-y=\"216\" data-db-index=\"216\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Pradaxa-dabigatran-etexilate-mesylate-508.pdf&quot;&gt;Pradaxa (dabigatran etexilate mesylate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Pradaxa-dabigatran-etexilate-mesylate-508.pdf&quot;&gt;Pradaxa (dabigatran etexilate mesylate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Pradaxa-dabigatran-etexilate-mesylate-508.pdf\">Pradaxa (dabigatran etexilate mesylate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A217\" data-x=\"0\" data-y=\"217\" data-db-index=\"217\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Probenecid-Colchicine-Combination-508.pdf&quot;&gt;Probenecid-Colchicine Combination&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Probenecid-Colchicine-Combination-508.pdf&quot;&gt;Probenecid-Colchicine Combination&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Probenecid-Colchicine-Combination-508.pdf\">Probenecid-Colchicine Combination<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A218\" data-x=\"0\" data-y=\"218\" data-db-index=\"218\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Promacta-eltrombopag-olaminePA-form-508.pdf&quot;&gt;Promacta (eltrombopag olamine)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Promacta-eltrombopag-olaminePA-form-508.pdf&quot;&gt;Promacta (eltrombopag olamine)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Promacta-eltrombopag-olaminePA-form-508.pdf\">Promacta (eltrombopag olamine)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A219\" data-x=\"0\" data-y=\"219\" data-db-index=\"219\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Prozac-Weekly-fluoxetine-ER-508.pdf&quot;&gt;Prozac Weekly (fluoxetine ER)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Prozac-Weekly-fluoxetine-ER-508.pdf&quot;&gt;Prozac Weekly (fluoxetine ER)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Prozac-Weekly-fluoxetine-ER-508.pdf\">Prozac Weekly (fluoxetine ER)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A220\" data-x=\"0\" data-y=\"220\" data-db-index=\"220\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Pulmozyme-dornase-alfa-508.pdf&quot;&gt;Pulmozyme (dornase alfa)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Pulmozyme-dornase-alfa-508.pdf&quot;&gt;Pulmozyme (dornase alfa)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Pulmozyme-dornase-alfa-508.pdf\">Pulmozyme (dornase alfa)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A221\" data-x=\"0\" data-y=\"221\" data-db-index=\"221\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Qelbree-vioxazine.pdf&quot; target=&quot;_self&quot;&gt;Qelbree (vioxazine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Qelbree-vioxazine.pdf&quot; target=&quot;_self&quot;&gt;Qelbree (vioxazine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Qelbree-vioxazine.pdf\" target=\"_self\">Qelbree (vioxazine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A222\" data-x=\"0\" data-y=\"222\" data-db-index=\"222\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Qulipta-atogepant-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Qulipta (atogepant)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Qulipta-atogepant-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Qulipta (atogepant)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Qulipta-atogepant-PA-Form.pdf\" target=\"_self\">Qulipta (atogepant)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A223\" data-x=\"0\" data-y=\"223\" data-db-index=\"223\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Quviviq-daridorexant-PA-Form508.pdf&quot; target=&quot;_self&quot;&gt;Quviviq (daridorexant)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Quviviq-daridorexant-PA-Form508.pdf&quot; target=&quot;_self&quot;&gt;Quviviq (daridorexant)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Quviviq-daridorexant-PA-Form508.pdf\" target=\"_self\">Quviviq (daridorexant)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A224\" data-x=\"0\" data-y=\"224\" data-db-index=\"224\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ragwitek-short-ragweed-pollen-allergen-extract-508.pdf&quot;&gt;Ragwitek (short ragweed pollen allergen extract)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ragwitek-short-ragweed-pollen-allergen-extract-508.pdf&quot;&gt;Ragwitek (short ragweed pollen allergen extract)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ragwitek-short-ragweed-pollen-allergen-extract-508.pdf\">Ragwitek (short ragweed pollen allergen extract)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A225\" data-x=\"0\" data-y=\"225\" data-db-index=\"225\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rayos-prednisone-508.pdf&quot;&gt;Rayos (prednisone)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rayos-prednisone-508.pdf&quot;&gt;Rayos (prednisone)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rayos-prednisone-508.pdf\">Rayos (prednisone)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A226\" data-x=\"0\" data-y=\"226\" data-db-index=\"226\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rebif-interferon-beta-1a-508.pdf&quot;&gt;Rebif (interferon beta-1a)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rebif-interferon-beta-1a-508.pdf&quot;&gt;Rebif (interferon beta-1a)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rebif-interferon-beta-1a-508.pdf\">Rebif (interferon beta-1a)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A227\" data-x=\"0\" data-y=\"227\" data-db-index=\"227\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Relistor-methylnaltrexone-bromide-508.pdf&quot;&gt;Relistor (methylnaltrexone bromide)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Relistor-methylnaltrexone-bromide-508.pdf&quot;&gt;Relistor (methylnaltrexone bromide)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Relistor-methylnaltrexone-bromide-508.pdf\">Relistor (methylnaltrexone bromide)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A228\" data-x=\"0\" data-y=\"228\" data-db-index=\"228\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Relpax-eletriptan-508.pdf&quot;&gt;Relpax (eletriptan)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Relpax-eletriptan-508.pdf&quot;&gt;Relpax (eletriptan)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Relpax-eletriptan-508.pdf\">Relpax (eletriptan)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A229\" data-x=\"0\" data-y=\"229\" data-db-index=\"229\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Requip-ER-ropinirole-ER-508.pdf&quot;&gt;Requip ER (ropinirole ER)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Requip-ER-ropinirole-ER-508.pdf&quot;&gt;Requip ER (ropinirole ER)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Requip-ER-ropinirole-ER-508.pdf\">Requip ER (ropinirole ER)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A230\" data-x=\"0\" data-y=\"230\" data-db-index=\"230\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Retin-A-tretinoin-508.pdf&quot;&gt;Retin-A (tretinoin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Retin-A-tretinoin-508.pdf&quot;&gt;Retin-A (tretinoin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Retin-A-tretinoin-508.pdf\">Retin-A (tretinoin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A231\" data-x=\"0\" data-y=\"231\" data-db-index=\"231\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Revatio-sildenafil-citrate-508.pdf&quot;&gt;Revatio (sildenafil citrate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Revatio-sildenafil-citrate-508.pdf&quot;&gt;Revatio (sildenafil citrate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Revatio-sildenafil-citrate-508.pdf\">Revatio (sildenafil citrate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A232\" data-x=\"0\" data-y=\"232\" data-db-index=\"232\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Reyvow-lasmiditan-PA-Form.pdf&quot;&gt;Reyvow (lasmiditan)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Reyvow-lasmiditan-PA-Form.pdf&quot;&gt;Reyvow (lasmiditan)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Reyvow-lasmiditan-PA-Form.pdf\">Reyvow (lasmiditan)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A233\" data-x=\"0\" data-y=\"233\" data-db-index=\"233\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Rinvoq-upadacitinib-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Rinvoq (upadacitinib)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Rinvoq-upadacitinib-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Rinvoq (upadacitinib)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Rinvoq-upadacitinib-PA-Form.pdf\" target=\"_self\">Rinvoq (upadacitinib)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A234\" data-x=\"0\" data-y=\"234\" data-db-index=\"234\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Risperdal-Consta-risperidone-508.pdf&quot;&gt;Risperdal Consta (risperidone)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Risperdal-Consta-risperidone-508.pdf&quot;&gt;Risperdal Consta (risperidone)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Risperdal-Consta-risperidone-508.pdf\">Risperdal Consta (risperidone)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A235\" data-x=\"0\" data-y=\"235\" data-db-index=\"235\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rytary-carbidopa-levodopa-508.pdf&quot;&gt;Rytary (carbidopa-levodopa)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rytary-carbidopa-levodopa-508.pdf&quot;&gt;Rytary (carbidopa-levodopa)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rytary-carbidopa-levodopa-508.pdf\">Rytary (carbidopa-levodopa)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A236\" data-x=\"0\" data-y=\"236\" data-db-index=\"236\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sancuso-granisetron-patch-508.pdf&quot;&gt;Sancuso (granisetron patch)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sancuso-granisetron-patch-508.pdf&quot;&gt;Sancuso (granisetron patch)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sancuso-granisetron-patch-508.pdf\">Sancuso (granisetron patch)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A237\" data-x=\"0\" data-y=\"237\" data-db-index=\"237\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Savaysa-edoxaban-tosylate-508.pdf&quot;&gt;Savaysa (edoxaban tosylate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Savaysa-edoxaban-tosylate-508.pdf&quot;&gt;Savaysa (edoxaban tosylate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Savaysa-edoxaban-tosylate-508.pdf\">Savaysa (edoxaban tosylate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A238\" data-x=\"0\" data-y=\"238\" data-db-index=\"238\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Savella-milnacipran-PA-Form.pdf&quot;&gt;Savella (milnacipran)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Savella-milnacipran-PA-Form.pdf&quot;&gt;Savella (milnacipran)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Savella-milnacipran-PA-Form.pdf\">Savella (milnacipran)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A239\" data-x=\"0\" data-y=\"239\" data-db-index=\"239\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Seglentis-celecoxib-tramadol-hydrochloride.pdf&quot; target=&quot;_self&quot;&gt;Seglentis (celecoxib-tramadol hydrocholoride)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Seglentis-celecoxib-tramadol-hydrochloride.pdf&quot; target=&quot;_self&quot;&gt;Seglentis (celecoxib-tramadol hydrocholoride)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Seglentis-celecoxib-tramadol-hydrochloride.pdf\" target=\"_self\">Seglentis (celecoxib-tramadol hydrocholoride)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A240\" data-x=\"0\" data-y=\"240\" data-db-index=\"240\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Serzone-nefazodone-508.pdf&quot;&gt;Serzone (nefazodone)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Serzone-nefazodone-508.pdf&quot;&gt;Serzone (nefazodone)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Serzone-nefazodone-508.pdf\">Serzone (nefazodone)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A241\" data-x=\"0\" data-y=\"241\" data-db-index=\"241\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Silenor-doxepin-508.pdf&quot;&gt;Silenor (doxepin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Silenor-doxepin-508.pdf&quot;&gt;Silenor (doxepin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Silenor-doxepin-508.pdf\">Silenor (doxepin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A242\" data-x=\"0\" data-y=\"242\" data-db-index=\"242\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Siliq-brodalumab-508.pdf&quot;&gt;Siliq (brodalumab)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Siliq-brodalumab-508.pdf&quot;&gt;Siliq (brodalumab)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Siliq-brodalumab-508.pdf\">Siliq (brodalumab)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A243\" data-x=\"0\" data-y=\"243\" data-db-index=\"243\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Simponi-golimumab-508.pdf&quot;&gt;Simponi (golimumab)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Simponi-golimumab-508.pdf&quot;&gt;Simponi (golimumab)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Simponi-golimumab-508.pdf\">Simponi (golimumab)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A244\" data-x=\"0\" data-y=\"244\" data-db-index=\"244\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sivextro-tedizolid-phosphate-508.pdf&quot;&gt;Sivextro (tedizolid phosphate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sivextro-tedizolid-phosphate-508.pdf&quot;&gt;Sivextro (tedizolid phosphate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sivextro-tedizolid-phosphate-508.pdf\">Sivextro (tedizolid phosphate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A245\" data-x=\"0\" data-y=\"245\" data-db-index=\"245\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/02\/Skyrizi-risankizumab-rzaa-PA-Form.pdf&quot;&gt;Skyrizi (risankizumab-rzaa)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/02\/Skyrizi-risankizumab-rzaa-PA-Form.pdf&quot;&gt;Skyrizi (risankizumab-rzaa)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/02\/Skyrizi-risankizumab-rzaa-PA-Form.pdf\">Skyrizi (risankizumab-rzaa)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A246\" data-x=\"0\" data-y=\"246\" data-db-index=\"246\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Solaraze-diclofenac-topical-508.pdf&quot;&gt;Solaraze (diclofenac topical)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Solaraze-diclofenac-topical-508.pdf&quot;&gt;Solaraze (diclofenac topical)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Solaraze-diclofenac-topical-508.pdf\">Solaraze (diclofenac topical)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A247\" data-x=\"0\" data-y=\"247\" data-db-index=\"247\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Solodyn-minocycline-508.pdf&quot;&gt;Solodyn (minocycline)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Solodyn-minocycline-508.pdf&quot;&gt;Solodyn (minocycline)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Solodyn-minocycline-508.pdf\">Solodyn (minocycline)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A248\" data-x=\"0\" data-y=\"248\" data-db-index=\"248\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Soma-carisoprodol-508.pdf&quot;&gt;Soma (carisoprodol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Soma-carisoprodol-508.pdf&quot;&gt;Soma (carisoprodol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Soma-carisoprodol-508.pdf\">Soma (carisoprodol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A249\" data-x=\"0\" data-y=\"249\" data-db-index=\"249\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sorilux-calcipotriol-508.pdf&quot;&gt;Sorilux (calcipotriol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sorilux-calcipotriol-508.pdf&quot;&gt;Sorilux (calcipotriol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sorilux-calcipotriol-508.pdf\">Sorilux (calcipotriol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A250\" data-x=\"0\" data-y=\"250\" data-db-index=\"250\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Sotyktu-deucravacitinib-PA-Form508.pdf&quot; target=&quot;_self&quot;&gt;Sotyktu (deucravacitinib)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Sotyktu-deucravacitinib-PA-Form508.pdf&quot; target=&quot;_self&quot;&gt;Sotyktu (deucravacitinib)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Sotyktu-deucravacitinib-PA-Form508.pdf\" target=\"_self\">Sotyktu (deucravacitinib)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A251\" data-x=\"0\" data-y=\"251\" data-db-index=\"251\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Sovaldi-sofosbuvir-PA-Form.pdf&quot;&gt;Sovaldi (sofosbuvir)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Sovaldi-sofosbuvir-PA-Form.pdf&quot;&gt;Sovaldi (sofosbuvir)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Sovaldi-sofosbuvir-PA-Form.pdf\">Sovaldi (sofosbuvir)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A252\" data-x=\"0\" data-y=\"252\" data-db-index=\"252\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Spinraza-nusinersen-PA-Form-508.pdf&quot;&gt;Spinraza (nusinersen)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Spinraza-nusinersen-PA-Form-508.pdf&quot;&gt;Spinraza (nusinersen)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Spinraza-nusinersen-PA-Form-508.pdf\">Spinraza (nusinersen)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A253\" data-x=\"0\" data-y=\"253\" data-db-index=\"253\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Spiriva-Respimat-tiotropium-bromide.pdf&quot;&gt;Spiriva Respimat (tiotropium bromide)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Spiriva-Respimat-tiotropium-bromide.pdf&quot;&gt;Spiriva Respimat (tiotropium bromide)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Spiriva-Respimat-tiotropium-bromide.pdf\">Spiriva Respimat (tiotropium bromide)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A254\" data-x=\"0\" data-y=\"254\" data-db-index=\"254\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sprix-ketorolac-tromethamine-508.pdf&quot;&gt;Sprix (ketorolac tromethamine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sprix-ketorolac-tromethamine-508.pdf&quot;&gt;Sprix (ketorolac tromethamine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sprix-ketorolac-tromethamine-508.pdf\">Sprix (ketorolac tromethamine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A255\" data-x=\"0\" data-y=\"255\" data-db-index=\"255\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Stelara-ustekinumab-PA-Form.pdf&quot;&gt;Stelara (ustekinumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Stelara-ustekinumab-PA-Form.pdf&quot;&gt;Stelara (ustekinumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Stelara-ustekinumab-PA-Form.pdf\">Stelara (ustekinumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A256\" data-x=\"0\" data-y=\"256\" data-db-index=\"256\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Sublocade-buprenorphine-PA-Form-508-Compliant.pdf&quot;&gt;Sublocade (buprenorphine)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Sublocade-buprenorphine-PA-Form-508-Compliant.pdf&quot;&gt;Sublocade (buprenorphine)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Sublocade-buprenorphine-PA-Form-508-Compliant.pdf\">Sublocade (buprenorphine)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A257\" data-x=\"0\" data-y=\"257\" data-db-index=\"257\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Subsys-fentanyl-sublingual-spray-508.pdf&quot;&gt;Subsys (fentanyl sublingual spray)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Subsys-fentanyl-sublingual-spray-508.pdf&quot;&gt;Subsys (fentanyl sublingual spray)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Subsys-fentanyl-sublingual-spray-508.pdf\">Subsys (fentanyl sublingual spray)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A258\" data-x=\"0\" data-y=\"258\" data-db-index=\"258\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sumavel-sumatriptan-injection-508.pdf&quot;&gt;Sumavel (sumatriptan injection)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sumavel-sumatriptan-injection-508.pdf&quot;&gt;Sumavel (sumatriptan injection)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sumavel-sumatriptan-injection-508.pdf\">Sumavel (sumatriptan injection)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A259\" data-x=\"0\" data-y=\"259\" data-db-index=\"259\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sunosi-solriamfetol-508.pdf&quot;&gt;Sunosi (solriamfetol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sunosi-solriamfetol-508.pdf&quot;&gt;Sunosi (solriamfetol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sunosi-solriamfetol-508.pdf\">Sunosi (solriamfetol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A260\" data-x=\"0\" data-y=\"260\" data-db-index=\"260\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Symdeko-tezacaftor-ivacaftor-PA-Form.pdf&quot;&gt;Symdeko (tezacaftor-ivacaftor)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Symdeko-tezacaftor-ivacaftor-PA-Form.pdf&quot;&gt;Symdeko (tezacaftor-ivacaftor)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Symdeko-tezacaftor-ivacaftor-PA-Form.pdf\">Symdeko (tezacaftor-ivacaftor)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A261\" data-x=\"0\" data-y=\"261\" data-db-index=\"261\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sympazan-clobazam-film-508.pdf&quot;&gt;Sympazan (clobazam film)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sympazan-clobazam-film-508.pdf&quot;&gt;Sympazan (clobazam film)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sympazan-clobazam-film-508.pdf\">Sympazan (clobazam film)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A262\" data-x=\"0\" data-y=\"262\" data-db-index=\"262\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Symproic-naldemedine.pdf&quot;&gt;Symproic (naldemedine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Symproic-naldemedine.pdf&quot;&gt;Symproic (naldemedine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Symproic-naldemedine.pdf\">Symproic (naldemedine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A263\" data-x=\"0\" data-y=\"263\" data-db-index=\"263\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/10\/Synagis-palivizumab-PA-form-508-Compliant.pdf&quot;&gt;Synagis (palvizumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/10\/Synagis-palivizumab-PA-form-508-Compliant.pdf&quot;&gt;Synagis (palvizumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/10\/Synagis-palivizumab-PA-form-508-Compliant.pdf\">Synagis (palvizumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A264\" data-x=\"0\" data-y=\"264\" data-db-index=\"264\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Taclonex-calcipotriene-betamethasone-dipropionate-508.pdf&quot;&gt;Taclonex (calcipotriene-betamethasone dipropionate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Taclonex-calcipotriene-betamethasone-dipropionate-508.pdf&quot;&gt;Taclonex (calcipotriene-betamethasone dipropionate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Taclonex-calcipotriene-betamethasone-dipropionate-508.pdf\">Taclonex (calcipotriene-betamethasone dipropionate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A265\" data-x=\"0\" data-y=\"265\" data-db-index=\"265\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Taltz-ixekizumab-508.pdf&quot;&gt;Taltz (ix ekizumab)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Taltz-ixekizumab-508.pdf&quot;&gt;Taltz (ix ekizumab)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Taltz-ixekizumab-508.pdf\">Taltz (ix ekizumab)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A266\" data-x=\"0\" data-y=\"266\" data-db-index=\"266\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tavalisse-fostamatinib-PA-form-508.pdf&quot;&gt;Tavalisse (fostamatinib)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tavalisse-fostamatinib-PA-form-508.pdf&quot;&gt;Tavalisse (fostamatinib)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tavalisse-fostamatinib-PA-form-508.pdf\">Tavalisse (fostamatinib)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A267\" data-x=\"0\" data-y=\"267\" data-db-index=\"267\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tazorac-tazarotene-508.pdf&quot;&gt;Tazorac (tazarotene)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tazorac-tazarotene-508.pdf&quot;&gt;Tazorac (tazarotene)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tazorac-tazarotene-508.pdf\">Tazorac (tazarotene)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A268\" data-x=\"0\" data-y=\"268\" data-db-index=\"268\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tecfidera-dimethyl-fumarate-508.pdf&quot;&gt;Tecfidera (dimethyl fumarate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tecfidera-dimethyl-fumarate-508.pdf&quot;&gt;Tecfidera (dimethyl fumarate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tecfidera-dimethyl-fumarate-508.pdf\">Tecfidera (dimethyl fumarate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A269\" data-x=\"0\" data-y=\"269\" data-db-index=\"269\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tegsedi-inotersen-508.pdf&quot;&gt;Tegsedi (inotersen)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tegsedi-inotersen-508.pdf&quot;&gt;Tegsedi (inotersen)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tegsedi-inotersen-508.pdf\">Tegsedi (inotersen)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A270\" data-x=\"0\" data-y=\"270\" data-db-index=\"270\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tekturna-Tekturna-HCT-aliskiren-aliskiren-hydrochlorothiazide-508.pdf&quot;&gt;Tekturna\/Tekturna HCT (aliskiren, aliskiren-hydrochlorothiazide)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tekturna-Tekturna-HCT-aliskiren-aliskiren-hydrochlorothiazide-508.pdf&quot;&gt;Tekturna\/Tekturna HCT (aliskiren, aliskiren-hydrochlorothiazide)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tekturna-Tekturna-HCT-aliskiren-aliskiren-hydrochlorothiazide-508.pdf\">Tekturna\/Tekturna HCT (aliskiren, aliskiren-hydrochlorothiazide)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A271\" data-x=\"0\" data-y=\"271\" data-db-index=\"271\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Testosterone-Containing-Products-PA-Form-508-Compliant.pdf&quot;&gt;Testosterone-containing Products&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Testosterone-Containing-Products-PA-Form-508-Compliant.pdf&quot;&gt;Testosterone-containing Products&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Testosterone-Containing-Products-PA-Form-508-Compliant.pdf\">Testosterone-containing Products<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A272\" data-x=\"0\" data-y=\"272\" data-db-index=\"272\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Tezspire-tezepelumab-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Tezspire (tezepelumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Tezspire-tezepelumab-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Tezspire (tezepelumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Tezspire-tezepelumab-PA-Form.pdf\" target=\"_self\">Tezspire (tezepelumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A273\" data-x=\"0\" data-y=\"273\" data-db-index=\"273\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tiglutik-riluzole-508.pdf&quot;&gt;Tiglutik (riluzole)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tiglutik-riluzole-508.pdf&quot;&gt;Tiglutik (riluzole)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tiglutik-riluzole-508.pdf\">Tiglutik (riluzole)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A274\" data-x=\"0\" data-y=\"274\" data-db-index=\"274\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tivorbex-indomethacin-508.pdf&quot;&gt;Tivorbex (indomethacin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tivorbex-indomethacin-508.pdf&quot;&gt;Tivorbex (indomethacin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tivorbex-indomethacin-508.pdf\">Tivorbex (indomethacin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A275\" data-x=\"0\" data-y=\"275\" data-db-index=\"275\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tobi-tobramycin-508.pdf&quot;&gt;Tobi (tobramycin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tobi-tobramycin-508.pdf&quot;&gt;Tobi (tobramycin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tobi-tobramycin-508.pdf\">Tobi (tobramycin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A276\" data-x=\"0\" data-y=\"276\" data-db-index=\"276\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tobi-Podhaler-tobramycin-508.pdf&quot;&gt;Tobi Podhaler (tobramycin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tobi-Podhaler-tobramycin-508.pdf&quot;&gt;Tobi Podhaler (tobramycin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tobi-Podhaler-tobramycin-508.pdf\">Tobi Podhaler (tobramycin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A277\" data-x=\"0\" data-y=\"277\" data-db-index=\"277\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tolak-fluorouracil-cream-508.pdf&quot;&gt;Tolak (fluorouracil cream)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tolak-fluorouracil-cream-508.pdf&quot;&gt;Tolak (fluorouracil cream)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tolak-fluorouracil-cream-508.pdf\">Tolak (fluorouracil cream)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A278\" data-x=\"0\" data-y=\"278\" data-db-index=\"278\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Topamax-Sprinkles-topiramate-508.pdf&quot;&gt;Topamax Sprinkles (topiramate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Topamax-Sprinkles-topiramate-508.pdf&quot;&gt;Topamax Sprinkles (topiramate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Topamax-Sprinkles-topiramate-508.pdf\">Topamax Sprinkles (topiramate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A279\" data-x=\"0\" data-y=\"279\" data-db-index=\"279\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tracleer-bosentan-508.pdf&quot;&gt;Tracleer (bosentan)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tracleer-bosentan-508.pdf&quot;&gt;Tracleer (bosentan)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tracleer-bosentan-508.pdf\">Tracleer (bosentan)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A280\" data-x=\"0\" data-y=\"280\" data-db-index=\"280\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Trelegy-Ellipta-fluticasone-umeclidinium-vilanterol.pdf&quot;&gt;Trelegy Ellipta (fluticasone-umeclidinium-vilanterol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Trelegy-Ellipta-fluticasone-umeclidinium-vilanterol.pdf&quot;&gt;Trelegy Ellipta (fluticasone-umeclidinium-vilanterol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Trelegy-Ellipta-fluticasone-umeclidinium-vilanterol.pdf\">Trelegy Ellipta (fluticasone-umeclidinium-vilanterol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A281\" data-x=\"0\" data-y=\"281\" data-db-index=\"281\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Tremfya-guselkumab-PA-Form.pdf&quot;&gt;Tremfya (guselkumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Tremfya-guselkumab-PA-Form.pdf&quot;&gt;Tremfya (guselkumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Tremfya-guselkumab-PA-Form.pdf\">Tremfya (guselkumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A282\" data-x=\"0\" data-y=\"282\" data-db-index=\"282\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Treximet-sumatritpan-naproxen-508.pdf&quot;&gt;Treximet (sumatritpan-naproxen)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Treximet-sumatritpan-naproxen-508.pdf&quot;&gt;Treximet (sumatritpan-naproxen)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Treximet-sumatritpan-naproxen-508.pdf\">Treximet (sumatritpan-naproxen)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A283\" data-x=\"0\" data-y=\"283\" data-db-index=\"283\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Trikafta-tezacaftor-ivacaftor-elexacaftor-PA-Form.pdf&quot;&gt;Trikafta (elexacaftor-tezacaftor-ivacaftor)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Trikafta-tezacaftor-ivacaftor-elexacaftor-PA-Form.pdf&quot;&gt;Trikafta (elexacaftor-tezacaftor-ivacaftor)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/09\/Trikafta-tezacaftor-ivacaftor-elexacaftor-PA-Form.pdf\">Trikafta (elexacaftor-tezacaftor-ivacaftor)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A284\" data-x=\"0\" data-y=\"284\" data-db-index=\"284\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Trulance-plecanatide.pdf&quot;&gt;Trulance (plecanatide)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Trulance-plecanatide.pdf&quot;&gt;Trulance (plecanatide)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Trulance-plecanatide.pdf\">Trulance (plecanatide)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A285\" data-x=\"0\" data-y=\"285\" data-db-index=\"285\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tussionex-hydrocodone-chlorpheniramine-508.pdf&quot;&gt;Tussionex (hydrocodone-chlorpheniramine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tussionex-hydrocodone-chlorpheniramine-508.pdf&quot;&gt;Tussionex (hydrocodone-chlorpheniramine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tussionex-hydrocodone-chlorpheniramine-508.pdf\">Tussionex (hydrocodone-chlorpheniramine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A286\" data-x=\"0\" data-y=\"286\" data-db-index=\"286\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tyvaso-treprostinil-508.pdf&quot;&gt;Tyvaso (treprostinil)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tyvaso-treprostinil-508.pdf&quot;&gt;Tyvaso (treprostinil)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tyvaso-treprostinil-508.pdf\">Tyvaso (treprostinil)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A287\" data-x=\"0\" data-y=\"287\" data-db-index=\"287\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Ubrelvy-ubrogepant-PA-Form.pdf&quot;&gt;Ubrelvy (ubrogepant)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Ubrelvy-ubrogepant-PA-Form.pdf&quot;&gt;Ubrelvy (ubrogepant)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Ubrelvy-ubrogepant-PA-Form.pdf\">Ubrelvy (ubrogepant)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A288\" data-x=\"0\" data-y=\"288\" data-db-index=\"288\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Uloric-febuxostat-508.pdf&quot;&gt;Uloric (febuxostat)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Uloric-febuxostat-508.pdf&quot;&gt;Uloric (febuxostat)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Uloric-febuxostat-508.pdf\">Uloric (febuxostat)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A289\" data-x=\"0\" data-y=\"289\" data-db-index=\"289\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Uptravi-selexipag-508.pdf&quot;&gt;Uptravi (selexipag)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Uptravi-selexipag-508.pdf&quot;&gt;Uptravi (selexipag)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Uptravi-selexipag-508.pdf\">Uptravi (selexipag)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A290\" data-x=\"0\" data-y=\"290\" data-db-index=\"290\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Valtoco-diazepam-nasal-spray-508.pdf&quot;&gt;Valtoco (diazepam nasal spray)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Valtoco-diazepam-nasal-spray-508.pdf&quot;&gt;Valtoco (diazepam nasal spray)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Valtoco-diazepam-nasal-spray-508.pdf\">Valtoco (diazepam nasal spray)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A291\" data-x=\"0\" data-y=\"291\" data-db-index=\"291\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vascepa-icosapent-ethyl-508.pdf&quot;&gt;Vascepa (icosapent ethyl)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vascepa-icosapent-ethyl-508.pdf&quot;&gt;Vascepa (icosapent ethyl)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vascepa-icosapent-ethyl-508.pdf\">Vascepa (icosapent ethyl)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A292\" data-x=\"0\" data-y=\"292\" data-db-index=\"292\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vectical-calcitriol-508.pdf&quot;&gt;Vectical (calcitriol)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vectical-calcitriol-508.pdf&quot;&gt;Vectical (calcitriol)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vectical-calcitriol-508.pdf\">Vectical (calcitriol)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A293\" data-x=\"0\" data-y=\"293\" data-db-index=\"293\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Velsipity-etrasimod-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Velsipity (etrasimod)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Velsipity-etrasimod-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Velsipity (etrasimod)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Velsipity-etrasimod-PA-Form.pdf\" target=\"_self\">Velsipity (etrasimod)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A294\" data-x=\"0\" data-y=\"294\" data-db-index=\"294\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ventavis-iloprost-508.pdf&quot;&gt;Ventavis (iloprost)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ventavis-iloprost-508.pdf&quot;&gt;Ventavis (iloprost)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ventavis-iloprost-508.pdf\">Ventavis (iloprost)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A295\" data-x=\"0\" data-y=\"295\" data-db-index=\"295\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/Verquvo-vericiguat-PA-Form-508-Compliant-Dec-2021.pdf&quot;&gt;Verquvo (vericiquat)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/Verquvo-vericiguat-PA-Form-508-Compliant-Dec-2021.pdf&quot;&gt;Verquvo (vericiquat)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/12\/Verquvo-vericiguat-PA-Form-508-Compliant-Dec-2021.pdf\">Verquvo (vericiquat)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A296\" data-x=\"0\" data-y=\"296\" data-db-index=\"296\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Viberzi-eluxadoline-508.pdf&quot;&gt;Viberzi (eluxodoline)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Viberzi-eluxadoline-508.pdf&quot;&gt;Viberzi (eluxodoline)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Viberzi-eluxadoline-508.pdf\">Viberzi (eluxodoline)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A297\" data-x=\"0\" data-y=\"297\" data-db-index=\"297\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vimpat-lacosamide-508.pdf&quot;&gt;Vimpat (lacosamide)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vimpat-lacosamide-508.pdf&quot;&gt;Vimpat (lacosamide)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vimpat-lacosamide-508.pdf\">Vimpat (lacosamide)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A298\" data-x=\"0\" data-y=\"298\" data-db-index=\"298\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/06\/Vivitrol-naltrexone-for-extended-release-injectable-suspension-PA-Form.pdf&quot;&gt;Vivitrol (naltrexone)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/06\/Vivitrol-naltrexone-for-extended-release-injectable-suspension-PA-Form.pdf&quot;&gt;Vivitrol (naltrexone)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/06\/Vivitrol-naltrexone-for-extended-release-injectable-suspension-PA-Form.pdf\">Vivitrol (naltrexone)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A299\" data-x=\"0\" data-y=\"299\" data-db-index=\"299\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Vosevi-sofosbuvir-velpatasvir-PA-Form.pdf&quot;&gt;Vosevi (sofosbuvir-velpatasvir)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Vosevi-sofosbuvir-velpatasvir-PA-Form.pdf&quot;&gt;Vosevi (sofosbuvir-velpatasvir)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Vosevi-sofosbuvir-velpatasvir-PA-Form.pdf\">Vosevi (sofosbuvir-velpatasvir)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A300\" data-x=\"0\" data-y=\"300\" data-db-index=\"300\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Vowst-fecal-microbiota-spores-live-brpk-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Vowst&lt;\/a&gt; (fecal microbiota spores, live-brpk) - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Vowst-fecal-microbiota-spores-live-brpk-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Vowst&lt;\/a&gt; (fecal microbiota spores, live-brpk) - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Vowst-fecal-microbiota-spores-live-brpk-PA-Form.pdf\" target=\"_self\">Vowst<\/a> (fecal microbiota spores, live-brpk) - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A301\" data-x=\"0\" data-y=\"301\" data-db-index=\"301\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Vtama-tapinarof.pdf&quot; target=&quot;_self&quot;&gt;Vtama (tapinarof)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Vtama-tapinarof.pdf&quot; target=&quot;_self&quot;&gt;Vtama (tapinarof)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Vtama-tapinarof.pdf\" target=\"_self\">Vtama (tapinarof)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A302\" data-x=\"0\" data-y=\"302\" data-db-index=\"302\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vumerity-diroximel-fumarate-508.pdf&quot;&gt;Vumerity (diroximel fumarate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vumerity-diroximel-fumarate-508.pdf&quot;&gt;Vumerity (diroximel fumarate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vumerity-diroximel-fumarate-508.pdf\">Vumerity (diroximel fumarate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A303\" data-x=\"0\" data-y=\"303\" data-db-index=\"303\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vyndamax-tafamidis-508.pdf&quot;&gt;Vyndamax (tafamidis)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vyndamax-tafamidis-508.pdf&quot;&gt;Vyndamax (tafamidis)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vyndamax-tafamidis-508.pdf\">Vyndamax (tafamidis)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A304\" data-x=\"0\" data-y=\"304\" data-db-index=\"304\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vyndaqel-tafamidis-meglumine-508.pdf&quot;&gt;Vyndaqel (tafamidis meglumine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vyndaqel-tafamidis-meglumine-508.pdf&quot;&gt;Vyndaqel (tafamidis meglumine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vyndaqel-tafamidis-meglumine-508.pdf\">Vyndaqel (tafamidis meglumine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A305\" data-x=\"0\" data-y=\"305\" data-db-index=\"305\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Wakix-pitolisant-hydrochloride-PA-Form-508.pdf&quot;&gt;Wakix (pitolisant hydrocholoride)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Wakix-pitolisant-hydrochloride-PA-Form-508.pdf&quot;&gt;Wakix (pitolisant hydrocholoride)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Wakix-pitolisant-hydrochloride-PA-Form-508.pdf\">Wakix (pitolisant hydrocholoride)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A306\" data-x=\"0\" data-y=\"306\" data-db-index=\"306\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xanax-XR-alprazolam-508.pdf&quot;&gt;Xanax XR (alprazolam)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xanax-XR-alprazolam-508.pdf&quot;&gt;Xanax XR (alprazolam)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xanax-XR-alprazolam-508.pdf\">Xanax XR (alprazolam)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A307\" data-x=\"0\" data-y=\"307\" data-db-index=\"307\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/01\/Xarelto-rivaroxaban-1.pdf&quot;&gt;Xarelto (rivaroxaban)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/01\/Xarelto-rivaroxaban-1.pdf&quot;&gt;Xarelto (rivaroxaban)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/01\/Xarelto-rivaroxaban-1.pdf\">Xarelto (rivaroxaban)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A308\" data-x=\"0\" data-y=\"308\" data-db-index=\"308\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Xeljanz-tofacitinib-PA-Form508.pdf&quot;&gt;Xeljanz\/Xeljanz XR (tofacitinib)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Xeljanz-tofacitinib-PA-Form508.pdf&quot;&gt;Xeljanz\/Xeljanz XR (tofacitinib)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/04\/Xeljanz-tofacitinib-PA-Form508.pdf\">Xeljanz\/Xeljanz XR (tofacitinib)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A309\" data-x=\"0\" data-y=\"309\" data-db-index=\"309\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xenazine-tetrabenazine-508.pdf&quot;&gt;Xenazine (tetrabenazine)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xenazine-tetrabenazine-508.pdf&quot;&gt;Xenazine (tetrabenazine)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xenazine-tetrabenazine-508.pdf\">Xenazine (tetrabenazine)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A310\" data-x=\"0\" data-y=\"310\" data-db-index=\"310\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xenleta-lefamulin-508.pdf&quot;&gt;Xenleta (lefamulin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xenleta-lefamulin-508.pdf&quot;&gt;Xenleta (lefamulin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xenleta-lefamulin-508.pdf\">Xenleta (lefamulin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A311\" data-x=\"0\" data-y=\"311\" data-db-index=\"311\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xifaxan-rifaximin-508.pdf&quot;&gt;Xifaxan (rifaximin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xifaxan-rifaximin-508.pdf&quot;&gt;Xifaxan (rifaximin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xifaxan-rifaximin-508.pdf\">Xifaxan (rifaximin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A312\" data-x=\"0\" data-y=\"312\" data-db-index=\"312\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/04\/Xolair-omalizumab-PA-Form.pdf&quot;&gt;Xolair (omalizumab)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/04\/Xolair-omalizumab-PA-Form.pdf&quot;&gt;Xolair (omalizumab)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/04\/Xolair-omalizumab-PA-Form.pdf\">Xolair (omalizumab)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A313\" data-x=\"0\" data-y=\"313\" data-db-index=\"313\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Xyrem-sodium-oxybate.pdf&quot;&gt;Xyrem (sodium oxybate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Xyrem-sodium-oxybate.pdf&quot;&gt;Xyrem (sodium oxybate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Xyrem-sodium-oxybate.pdf\">Xyrem (sodium oxybate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A314\" data-x=\"0\" data-y=\"314\" data-db-index=\"314\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Xywav-calcium-magnesium-potassium-sodium-oxybates.pdf&quot;&gt;Xywav (calcium, magnesium, potassium and sodium oxybates)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Xywav-calcium-magnesium-potassium-sodium-oxybates.pdf&quot;&gt;Xywav (calcium, magnesium, potassium and sodium oxybates)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Xywav-calcium-magnesium-potassium-sodium-oxybates.pdf\">Xywav (calcium, magnesium, potassium and sodium oxybates)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A315\" data-x=\"0\" data-y=\"315\" data-db-index=\"315\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Zavzpret-zavegepant-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Zavzpret (zavegepant)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Zavzpret-zavegepant-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Zavzpret (zavegepant)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Zavzpret-zavegepant-PA-Form.pdf\" target=\"_self\">Zavzpret (zavegepant)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A316\" data-x=\"0\" data-y=\"316\" data-db-index=\"316\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zegalogue-dasiglucagon-508.pdf&quot;&gt;Zegalogue (dasiglucagon)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zegalogue-dasiglucagon-508.pdf&quot;&gt;Zegalogue (dasiglucagon)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zegalogue-dasiglucagon-508.pdf\">Zegalogue (dasiglucagon)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A317\" data-x=\"0\" data-y=\"317\" data-db-index=\"317\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zelnorm-tegaserod-508.pdf&quot;&gt;Zelnorm (tegaserod)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zelnorm-tegaserod-508.pdf&quot;&gt;Zelnorm (tegaserod)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zelnorm-tegaserod-508.pdf\">Zelnorm (tegaserod)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A318\" data-x=\"0\" data-y=\"318\" data-db-index=\"318\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Zepatier-grazoprevir.pdf&quot;&gt;Zepatier (grazoprevir)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Zepatier-grazoprevir.pdf&quot;&gt;Zepatier (grazoprevir)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/10\/Zepatier-grazoprevir.pdf\">Zepatier (grazoprevir)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A319\" data-x=\"0\" data-y=\"319\" data-db-index=\"319\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Zeposia-ozanimod-PA-Form.pdf&quot;&gt;Zeposia (ozanimod)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Zeposia-ozanimod-PA-Form.pdf&quot;&gt;Zeposia (ozanimod)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Zeposia-ozanimod-PA-Form.pdf\">Zeposia (ozanimod)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A320\" data-x=\"0\" data-y=\"320\" data-db-index=\"320\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ziana-clindamycin-tretinoin-508.pdf&quot;&gt;Ziana (clindamycin-tretinoin)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ziana-clindamycin-tretinoin-508.pdf&quot;&gt;Ziana (clindamycin-tretinoin)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ziana-clindamycin-tretinoin-508.pdf\">Ziana (clindamycin-tretinoin)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A321\" data-x=\"0\" data-y=\"321\" data-db-index=\"321\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zohydro-hydrocodone-bitartrate-508.pdf&quot;&gt;Zohydro (hydrocodone bitartrate)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zohydro-hydrocodone-bitartrate-508.pdf&quot;&gt;Zohydro (hydrocodone bitartrate)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zohydro-hydrocodone-bitartrate-508.pdf\">Zohydro (hydrocodone bitartrate)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A322\" data-x=\"0\" data-y=\"322\" data-db-index=\"322\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zolpimist-zolpidem-oral-spray-508.pdf&quot;&gt;Zolpimist (zolpidem oral spray)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zolpimist-zolpidem-oral-spray-508.pdf&quot;&gt;Zolpimist (zolpidem oral spray)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zolpimist-zolpidem-oral-spray-508.pdf\">Zolpimist (zolpidem oral spray)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A323\" data-x=\"0\" data-y=\"323\" data-db-index=\"323\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zomig-zolmitriptan-508.pdf&quot;&gt;Zomig (zolmitriptan)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zomig-zolmitriptan-508.pdf&quot;&gt;Zomig (zolmitriptan)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zomig-zolmitriptan-508.pdf\">Zomig (zolmitriptan)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A324\" data-x=\"0\" data-y=\"324\" data-db-index=\"324\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Zoryve-roflumilast-Cream-and-Foam-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Zoryve (roflumilast) Cream and Foam&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Zoryve-roflumilast-Cream-and-Foam-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Zoryve (roflumilast) Cream and Foam&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Zoryve-roflumilast-Cream-and-Foam-PA-Form.pdf\" target=\"_self\">Zoryve (roflumilast) Cream and Foam<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A325\" data-x=\"0\" data-y=\"325\" data-db-index=\"325\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Ztalmy-ganaxolone-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Ztalmy (ganaxolone)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Ztalmy-ganaxolone-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Ztalmy (ganaxolone)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Ztalmy-ganaxolone-PA-Form.pdf\" target=\"_self\">Ztalmy (ganaxolone)<\/a> - PA Form <\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A326\" data-x=\"0\" data-y=\"326\" data-db-index=\"326\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zurampic-lesinurad-508.pdf&quot;&gt;Zurampic (lesinurad)&lt;\/a&gt;\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zurampic-lesinurad-508.pdf&quot;&gt;Zurampic (lesinurad)&lt;\/a&gt;\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zurampic-lesinurad-508.pdf\">Zurampic (lesinurad)<\/a><\/td><\/tr><tr style=\"height:px\" ><td data-cell-id=\"A327\" data-x=\"0\" data-y=\"327\" data-db-index=\"327\" class=\"\" data-cell-type=\"text\" data-original-value=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Zurzuvae-zuranolone-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Zurzuvae (zuranolone)&lt;\/a&gt; - PA Form\" data-order=\"&lt;a href=&quot;https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Zurzuvae-zuranolone-PA-Form.pdf&quot; target=&quot;_self&quot;&gt;Zurzuvae (zuranolone)&lt;\/a&gt; - PA Form\" style=\"min-width:100%; \" ><a href=\"https:\/\/www.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Zurzuvae-zuranolone-PA-Form.pdf\" target=\"_self\">Zurzuvae (zuranolone)<\/a> - PA Form <\/td><\/tr><\/tbody><\/table><!-- \/#supsystic-table-9.supsystic-table --><\/div><!-- \/.supsystic-tables-wrap --><!-- Tables Generator by Supsystic --><!-- Version:1.10.36 --><!-- http:\/\/supsystic.com\/ --><a title=\"WordPress Data Table Plugin\" style=\"display:none;\" href=\"https:\/\/supsystic.com\/plugins\/wordpress-data-table-plugin\/?utm_medium=love_link\" target=\"_blank\">WordPress Data Table Plugin<\/a>\n<p><!--div style=\"width: 50%; float: left;\"><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abilify-Maintena-aripiprazole-508.pdf\">Abilify Maintena (aripiprazole)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abilify-Mycite-aripiprazole-drug-device-combination-508.pdf\">Abilify Mycite (aripiprazole drug-device combination)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abilify-Solution-and-ODT-aripiprazole-508.pdf\">Abilify Solution and ODT (aripiprazole)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Abstral-fentanyl-sublingual-tablets-508.pdf\">Abstral (fentanyl sublingual tablets)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Actemra-tocilizumab-508.pdf\">Actemra (tocilizumab)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Acthar-Gel-repository-corticotropin-508.pdf\">Acthar Gel (repository corticotropin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Actiq-fentanyl-citrate-lozenges-508.pdf\">Actiq (fentanyl citrate lozenges)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Actos-pioglitazone-508.pdf\">Actos (pioglitazone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/05\/Actosplus-Met-pioglitazone-metformin-508.pdf\">Actosplus Met (pioglitazone-metformin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Adcirca-tadalafil-508.pdf\">Adcirca (tadalafil)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Adempas-riociguat-508.pdf\">Adempas (riociguat)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Afrezza-insulin-regular-human-inhalationa-508.pdf\">Afrezza (insulin regular &#091;human&#093; inhalation)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Aimovig-erenumab-aooe-PA-Form-508-Compliant-June-30-2021.pdf\">Aimovig (erenumab-aooe)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ajovy-fremanezumab-vfrm-PA-Form-508-Compliant-June-30-2021.pdf\">Ajovy (fremanezumab-vfrm)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aklief-trifarotene-508.pdf\">Aklief (trifaroten)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Albenza-albendazole.pdf\">Albenza (albendazole)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Altreno-tretinoin-508.pdf\">Altreno (tretinoin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Alyq-tadalafil-508.pdf\">Alyq (tadalafil)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Amerge-naratriptan-508.pdf\">Amerge (naratriptan)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Amitiza-lubiprostone-508.pdf\">Amitiza (lubiprostone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Ampyra-dalfampridine-PA-Form-508.pdf\">Ampyra (dalfampridine)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Apokyn-apomorphine-PA-Form-508-Compliant.pdf\">Apokyn (apomorphine)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aricept-23-donepezil-23-508.pdf\">Aricept 23 (donepezil 23)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Arikayce-amikacin-508.pdf\">Arikayce (amikacin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aristada-aripiprazole-508.pdf\">Aristada (aripiprazole)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Atralin-tretinoin-508.pdf\">Atralin (tretinoin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Aubagio-teriflunomide-508.pdf\">Aubagio (teriflunomide)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Austedo-deutetrabenazine-508.pdf\">Austedo (deutetrabenazine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Austedo-deutetrabenazine-PA-Form-for-Tardive-Dyskinesia-508.pdf\">Austedo (deutetrabenazine)<\/a> - PA Form for Tardive Dyskinesia\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Avandia-rosiglitazone-508.pdf\">Avandia (rosiglitazone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Avita-tretinoin-508.pdf\">Avita (tretinoin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Avonex-interferon-beta-1a-508.pdf\">Avonex (interferon beta-1a)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Bafiertam-monomethyl-fumarate-508.pdf\">Bafiertam (monomethyl fumarate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Banzel-rufinamide-508.pdf\">Banzel (rufinamide)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Baqsimi-glucagon-508.pdf\">Baqsimi (glucagon)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Belbuca-buprenorphine-hydrochloride-508.pdf\">Belbuca (buprenorphine hydrochloride)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Belsomra-suvorexant-PA-Form-508.pdf\">Belsomra (suvorexannt)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Benlysta-belimumab-PA-Form-508.pdf\">Benlysta (belimumab)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Betaseron-interferon-beta-1b-508.pdf\">Betaseron (interferon beta-1b)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Bethkis-tobramycin-508.pdf\">Bethkis (tobramycin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Bonjesta-doxylamine-succinate-and-pyridoxine-hydrochloride-508.pdf\">Bonjesta (doxylamine succinate and pyridoxine hydrochloride)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Brisdelle-paroxetine-508.pdf\">Brisdelle (paroxetine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Buprenorphine-containing-products-PA-Form-508.pdf\">Buprenorphine-containing Products<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Butrans-buprenorphine-transdermal-508.pdf\">Butrans (buprenorphine transdermal)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Byvalson-nebivolol-valsartan-508.pdf\">Byvalson (nebivolol-valsartan)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Calcitrene-calcipotriol-508.pdf\">Calcitrene (calcipotriol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cambia-diclofenac-508.pdf\">Cambia (diclofenac)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Carac-fluorouracil-508.pdf\">Carac (fluorouracil)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cayston-aztreonam-508.pdf\">Cayston (aztreonam)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Celexa-citalopram-508.pdf\">Celexa (citalopram)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Chenodal-chenodiol-508.pdf\">Chenodal (chenodiol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cholbam-cholic-acid-508.pdf\">Cholbam (cholic acid)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cialis-tadalafil-508.pdf\">Cialis (tadalafil)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cimzia-certolizumab-pegol-508.pdf\">Cimzia (certolizumab pegol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cinqair-reslizumab-PA-Form-508.pdf\">Cinqair (reslizumab)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Clindareach-Kit-clindamycin-508.pdf\">Clindareach Kit (clindamycin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Colcrys-colchicine-508.pdf\">Colcrys (colchicine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Condylox-Gel-podofilox-508.pdf\">Condylox Gel (podofilox)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Conzip-ER-tramadol-hydrochloride-508.pdf\">Conzip ER (tramadol hydrochloride)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Copaxone-glatiramer-acetate-injection-508.pdf\">Copaxone (glatiramer acetate injection)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Cosentyx-secukinumab-508.pdf\">Cosentyx (secukinumab)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Daliresp-roflumilast-508.pdf\">Daliresp (roflumilast)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Dayvigo-lemborexant-PA-Form-508.pdf\">Dayvigo (lemborexant)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Desoxyn-methamphetamine-508.pdf\">Desoxyn (mathamphetamine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Diacomit-stiripentol-508.pdf\">Diacomit (stiripentol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Diastat-Gel-diazepam-508.pdf\">Diastat Gel (diazepam)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Diclegis-doxylamine-succinate-and-pyridoxine-hydrochloride-508.pdf\">Diclegis (doxylamine succinate and pyridoxine hydrocholoride)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Differin-adapalene-508.pdf\">Differin (adapalene)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Dificid-fidaxomicin-508.pdf\">Dificid (fidaxomicin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Doptelet-avatrombopag-508.pdf\">Doptelet (avatrombopag)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Dovonex-calcipotriene-508.pdf\">Dovonex (calcipotriene)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Droxia-hydroxyurea-508.pdf\">Droxia (hydroxyurea)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Duetact-pioglitazone-glimepiride-508.pdf\">Duetact (pioglitazone-glimepiride)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Dupixent-dupilumab-PA-Form-508-Compliant.pdf\">Dupixent (dupilumab)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Durlaza-aspirin-508.pdf\">Durlaza (aspirin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Duzallo-lesinurad-allopurinol-508.pdf\">Duzallo (lesinurad-allpurinol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Edluar-zolpidem-tartrate-508.pdf\">Edluar (zolpidem tartrate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Effient-prasugrel-508.pdf\">Effient (prasugrel)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Efudex-fluorouracil-cream-508.pdf\">Efudex (fluorouracil cream)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Elaprase-idursulfase-508.pdf\">Elaprase (idursulfase)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Elidel-pimecrolimus-508.pdf\">Elidel (pimecrolimus)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Eliquis-apixaban-508.pdf\">Eliquis (apixaban)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Emend-aprepitant-508.pdf\">Emend (aprepitant)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Emflaza-deflazacort-PA-form-508.pdf\">Emflaza (deflazacort)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Emgality-galcanezumab-gnlm-PA-Form-508-Compliant-June-30-2021.pdf\">Emgality (galcanezumab-gnlm)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Emverm-mebendazole.pdf\">Emverm (mebendazole)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Enbrel-etanercept-508.pdf\">Enbrel (etanercept)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Enspryng-satralizumab-mwge-508.pdf\">Enspryng (satralizumab-mwge)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Enstilar-calcipotriene-betamethasone-dipropionate-508.pdf\">Enstilar (calcipotriene-betamethasone dipropionate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Entresto-sacubitril-valsartan.pdf\">Entresto (sacubitril-valsartan)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Entyvio-vedolizumab-508.pdf\">Entyvio (vedolizumab)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Epclusa-sofosbuvir-velpatasvir-PA-Form-508-Compliant.pdf\">Epclusa (sofosbuvir-velpatasvir)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Epidiolex-cannabidiol-508.pdf\">Epidiolex (cannabidiol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Epiduo-adapalene-benzoyl-peroxide-508.pdf\">Epiduo (adapalene-benzoyl peroxide)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Esbriet-pirfenidone-508.pdf\">Esbriet (pirfenidone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Etidronate-etidronic-acid-508.pdf\">Etidronate (etidronic acid)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Eucrisa-crisaborole-PA-Form-508.pdf\">Eucrisa (crisaborole)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Evrysdi-risdiplam-PA-Form-508.pdf\">Evrysdi (risdiplam)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Extavia-interferon-beta-1b-508.pdf\">Extavia (interferon beta-1b)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fabior-tazarotene-508.pdf\">Fabior (tazarotene)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Farxiga-dapagliflozin-508.pdf\">Farxiga (dapagliflozin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fasenra-benralizumab-PA-Form-508.pdf\">Fasenra (benralizumab)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fentora-fentanyl-buccal-tablet-508.pdf\">Fentora (fentanyl buccal tablet)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fintepla-fenfluramine-508.pdf\">Fintepla (fenfluramine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Fluorouracil-Solution-508.pdf\">Fluorouracil Solution<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Forteo-teriparatide-injection-508.pdf\">Forteo (teriparatide injection)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Frova-frovatriptan-508.pdf\">Frova (frovatriptan)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gabitril-tiagabine-508.pdf\">Gabitril (tiagabine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Galafold-migalastat-508.pdf\">Galafold (migalastat)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gilenya-fingolimod-508.pdf\">Gilenya (fingolimod)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glatopa-glatiramer-acetate-injection-508.pdf\">Glatopa (glatiramer acetate injection)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gloperba-colchicine-508.pdf\">Gloperba (colchicine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glucagon-Kit-508.pdf\">Glucagon Kit<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glycate-glycopyrrolate-508.pdf\">Glycate (glycopyrrolate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Glyxambi-empagliflozin-linagliptin-508.pdf\">Glyxambi (empagliflozin-linagliptin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gralise-gabapentin-508.pdf\">Gralise (gabapentin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Granisol-granisetron-508.pdf\">Granisol (granisetron)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Grastek-grass-pollen-allergen-extract-timothy-grass-508.pdf\">Grastek (grass pollen allergen extract - timothy grass)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Growth-Hormone-PA-Form-508-Compliant.pdf\">Growth Hormone<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Gvoke-glucagon-injectable-508.pdf\">Gvoke (glucagon injectable)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Harvoni-ledipasvir-sofosbuvir-PA-Form-508-Compliant.pdf\">Harvoni (ledipasvir-sofosbuvir)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Hetlioz-tasimelteon-508.pdf\">Hetlioz (tasimelteon)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Hetlioz-tasimelteon-PA-Form-508-Compliant.pdf\">Hetlioz (tasimelteon)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Horizant-gabapentin-enacarbil-508.pdf\">Horizant (gabapentin enacarbil)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Humira-adalimumab-508.pdf\">Humira (adalimumab)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Hysingla-ER-hydrocodone-bitartrate-508.pdf\">Hysingla ER (hydrocodone bitartrate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ilaris-canakinumab-508.pdf\">Ilaris (canakinumab)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ilumya-tildrakizumab-asmn-508.pdf\">Ilumya (tildrakizumab-asmn)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Imitrex-sumatriptan-508.pdf\">Imitrex (sumatriptan)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ingrezza-valbenazine-PA-Form-508.pdf\">Ingrezza (valbenazine)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Invega-Sustenna-paliperidone-508.pdf\">Invega Sustenna (paliperidone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Invega-Trinza-paliperidone.pdf\">Invega Trinza (paliperidone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Invokamet-canagliflozin-metformin-508.pdf\">Invokamet (canagliflozin-metformin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Invokana-canagliflozin-508.pdf\">Invokana (canagliflozin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Jardiance-empagliflozin-508.pdf\">Jardiance (empagliflozin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Jublia-efinaconazole-508.pdf\">Jublia (efinaconazole)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Juxtapid-lomitapide-508.pdf\">Juxtapid (lomitapide)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Jynarque-tolvaptan-508.pdf\">Jynarque (tolvaptan)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kalydeco-ivacaftor-508.pdf\">Kalydeco (ivacaftor)<\/a><\/div>\n\n\n\n\n<div><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Kerendia-finerenone-PA-Form-508-Compliant.pdf\">Kerendia (finerenone)<\/a> - PA Form<\/div>\n\n\n\n\n<div style=\"width: 50%; float: left;\"><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kerydin-tavaborole-topical-solution-508.pdf\">Kerydin (tavaborole topical solution)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kesimpta-ofatumumab-508.pdf\">Kesimpta (ofatumumab)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ketoconazole-Oral-508.pdf\">Ketoconazole Oral<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kevzara-sarilumab-508.pdf\">Kevzara (sarilumab)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kineret-anakinra-508.pdf\">Kineret (anakinra)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kitabis-tobramycin-508.pdf\">Kitabis (tobramycin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Krystexxa-pegloticase-508.pdf\">Krystexxa (egloticase)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kuvan-sapropterin-dihydrochloride-PA-Form-508.pdf\">Kuvan (sapropterin dihydrochloride)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Kynamro-mipomersen-sodium-508.pdf\">Kynamro (mipomersen sodium)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Kynmobi-apomorphine-HCl-PA-Form-508-Compliant..pdf\">Kynmobi (apomorphine HCI)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lamictal-ER-lamotrigine-ER-508.pdf\">Lamictal ER (lamotrigine ER)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lamictal-ODT-lamotrigine-508.pdf\">Lamictal ODT (lamotrigine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lazanda-fentanyl-nasal-spray-508.pdf\">Lazanda (fetanyl nasal spray)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Letairis-ambrisentan-508.pdf\">Letairis (ambrisentan)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lexapro-escitalopram-508.pdf\">Lexapro (escitalopram)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Linzess-linaclotide-508.pdf\">Linzess (linaclotide)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lotronex-alosetron-508.pdf\">Lotronex (alosetron)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Lovaza-omega-3-acid-ethyl-esters-508.pdf\">Lovaza (omega-3 acide ethyl esters)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Lupkynis-voclosporin-PA-Form-508-Compliant.pdf\">Lupkynis (voclosporin)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Luzu-luliconazole-cream-508.pdf\">Luzu (luliconazole cream)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Makena-hydroxyprogesterone-508.pdf\">Makena (hydroxyprogesterone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Marinol-dronabinol-508.pdf\">Marinol (dronabinol)<\/a><\/div>\n\n\n\n\n<div style=\"width: 49%; float: left;\"><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mavenclad-cladribine-508.pdf\">Mavenclad (cladribine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Mavyret-glecaprevir-pibrentasvir-PA-Form-508-Compliant.pdf\">Mavyret (glecaprevir-pibrentasvir)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Maxalt-rizatriptan-508.pdf\">Maxalt (rizatriptan)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mayzent-siponimod-508.pdf\">Mayzent (siponimod)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Methadone-PA-Form-508.pdf\">Methadone<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Metozolv-ODT-metoclopramide-508.pdf\">Metozolv ODT (metoclopramide)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Miacalcin-calcitonin-intranasal-508.pdf\">Miacalcin (calcitonin intranasal)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mirapex-ER-pramipexole-ER-508.pdf\">Mirapex ER (pramipexole ER)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Mitigare-colchicine-508.pdf\">Mitigare (colchicine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Motegrity-prucalopride-508.pdf\">Motegrity (prucalopride)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Movantik-naloxegol-508.pdf\">Movantik (naloxegol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Natpara-parathyroid-hormone-PA-Form-508.pdf\">Natpara (parathyroid hormone)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nayzilam-midazolam-nasal-spray-508.pdf\">Nayzilam (midazolam nasal spray)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nexiclon-XR-clonidine-508.pdf\">Nexiclon XR (clonidine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Nexletol-bempedoic-acid-PA-Form-508-Compliant.pdf\">Nexletol (bempedoic acid)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Nexlizet-bempedoic-acid-and-ezetimibe-PA-Form-508-Compliant.pdf\">Nexlizet (bempedoic acid and ezetimibe)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nicotrol-nicotine-system-508.pdf\">Nicotrol (nicotine system)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nocdurna-desmopressin-acetate-508.pdf\">Nocdurna (desmopressin acetate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Noctiva-desmopressin-acetate-508.pdf\">Noctiva (desmopressin acetate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nourianz-istradefylline-508.pdf\">Nourianz (istradefylline)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Noxafil-posaconazole-508.pdf\">Noxafil (posaconzaole)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nucala-mepolizumab-PA-Form-508.pdf\">Nucala (mepolizumab)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nucynta-ER-tapentadol-hydrochloride-508.pdf\">Nucynta ER (tapentadol hydrochloride)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nucynta-IR-tapentadol-508.pdf\">Nucynta IR (tapentadol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nuedexta-dextromethorphan-hydrobromide-quinidine-sulfatePA-Form-508.pdf\">Nuedexta (destromethorphan hydrobromide-quinidine sulfate)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/06\/Nuplazid-pimavanserin-508.pdf\">Nuplazid (pimavanserin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Nurtec-ODT-rimegepant-PA-Form-508-Compliant.pdf\">Nurtec ODT (rimegepant)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ocaliva-obeticholic-acid-508.pdf\">Ocaliva (obeticholic acid)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ofev-nintedanib-508.pdf\">Ofev (nintedanib)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Olumiant-baricitinib-508.pdf\">Olumiant (baricitinib)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Onfi-clobazam-508.pdf\">Onfi (clobazam)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Onsolis-fentanyl-buccal-soluble-film-508.pdf\">Onsolis (fentanyl buccal soluble film)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Opana-ER-oxymorphone-508.pdf\">Opana ER (oxymorphone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Opsumit-macitentan-508.pdf\">Opsumit (macitentan)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oralair-grass-pollen-allergen-extract-508.pdf\">Oralair (grass pollen allergen extract)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Orencia-abatacept-508.pdf\">Orencia (abatacept)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Orkambi-lumacaftor-ivacaftor-PA-Form-508.pdf\">Orkambi (lumacaftor-ivacaftor)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oseni-pioglitazone-alogliptin-508.pdf\">Oseni (pioglitazone-alogliptin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Otezla-apremilast-508.pdf\">Otezla (apremilast)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxaydo-oxycodone-508.pdf\">Oxaydo (oxycodone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxbryta-voxelotor-508.pdf\">Oxbryta (voxelotor)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxervate-cenegermin-bkbj-508.pdf\">Oxervate (cenegermin-bkbj)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Oxycontin-oxycodone-508.pdf\">Oxycontin (oxycodone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Palforzia-peanut-allergen-powder-508.pdf\">Palforzia (peanut allergen powder)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Palynziq-pegvaliase-PA-Form-508.pdf\">Palynziq (pegvaliase)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/PCSK-9-PA-Form-508.pdf\">PCSK-9<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Picato-ingenol-mebutate-508.pdf\">Picato (ingenol mebutate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Plegridy-peginterferon-beta-1a-508.pdf\">Plegridy (peginterferon beta-1a)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Pradaxa-dabigatran-etexilate-mesylate-508.pdf\">Pradaxa (dabigatran etexilate mesylate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Probenecid-Colchicine-Combination-508.pdf\">Probenecid-Colchicine Combination<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Promacta-eltrombopag-olaminePA-form-508.pdf\">Promacta (eltrombopag olamine)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Protopic-tacrolimus-508.pdf\">Protopic (tacrolumus)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Prozac-Weekly-fluoxetine-ER-508.pdf\">Prozac Weekly (fluoxetine ER)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Pulmozyme-dornase-alfa-508.pdf\">Pulmozyme (dornase alfa)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Qtern-dapagliflozin-saxagliptin-508.pdf\">Qtern (dapagliflozin-saxagliptin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ragwitek-short-ragweed-pollen-allergen-extract-508.pdf\">Ragwitek (short ragweed pollen allergen extract)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rayos-prednisone-508.pdf\">Rayos (prednisone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rebif-interferon-beta-1a-508.pdf\">Rebif (interferon beta-1a)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Relistor-methylnaltrexone-bromide-508.pdf\">Relistor (methylnaltrexone bromide)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Relpax-eletriptan-508.pdf\">Relpax (eletriptan)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Requip-ER-ropinirole-ER-508.pdf\">Requip ER (ropinirole ER)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Retin-A-tretinoin-508.pdf\">Retin-A (tretinoin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Revatio-sildenafil-citrate-508.pdf\">Revatio (sildenafil citrate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Nexlizet-bempedoic-acid-and-ezetimibe-PA-Form-508-Compliant.pdf\">Reyvow (lasmiditan)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rinvoq-upadacitinib-508.pdf\">Rinvoq (upadacitinib)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Risperdal-Consta-risperidone-508.pdf\">Risperdal Consta (risperidone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Rytary-carbidopa-levodopa-508.pdf\">Rytary (carbidopa-levodopa)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sancuso-granisetron-patch-508.pdf\">Sancuso (granisetron patch)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Savaysa-edoxaban-tosylate-508.pdf\">Savaysa (edoxaban tosylate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Savella-milnacipran-508.pdf\">Savella (milnacipran)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Secuado-asenapine-508.pdf\">Secuado (asenapine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Segluromet-ertugliflozin-metformin-508.pdf\">Segluromet (ertugliflozin-metformin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Serzone-nefazodone-508.pdf\">Serzone (nefazodone)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Silenor-doxepin-508.pdf\">Silenor (doxepin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Siliq-brodalumab-508.pdf\">Siliq (brodalumab)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Simponi-golimumab-508.pdf\">Simponi (golimumab)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sivextro-tedizolid-phosphate-508.pdf\">Sivextro (tedizolid phosphate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Skyrizi-risankizumab-rzaa-508.pdf\">Skyrizi (risankizumab-rzaa)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Solaraze-diclofenac-topical-508.pdf\">Solaraze (diclofenac topical)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Solodyn-minocycline-508.pdf\">Solodyn (minocycline)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Soma-carisoprodol-508.pdf\">Soma (carisoprodol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sorilux-calcipotriol-508.pdf\">Sorilux (calcipotriol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Sovaldi-sofosbuvir-PA-Form-508-Compliant.pdf\">Sovaldi (sofosbuvir)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Spinraza-nusinersen-PA-Form-508.pdf\">Spinraza (nusinersen)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Spiriva-Respimat-tiotropium-bromide-508.pdf\">Spiriva Respimat (tiotropium bromide)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sprix-ketorolac-tromethamine-508.pdf\">Sprix (ketorolac tromethamine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Steglatro-ertugliflozin-508.pdf\">Steglatro (ertugliflozin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Steglujan-ertugliflozin-sitagliptin-508.pdf\">Steglujan (ertugliflozin-sitagliptin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Stelara-ustekinumab-508.pdf\">Stelara (ustekinumab)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sublocade-buprenorphine-PA-Form-508.pdf\">Sublocade (buprenorphine)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Subsys-fentanyl-sublingual-spray-508.pdf\">Subsys (fentanyl sublingual spray)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sumavel-sumatriptan-injection-508.pdf\">Sumavel (sumatriptan injection)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sunosi-solriamfetol-508.pdf\">Sunosi (solriamfetol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Symbyax-olanzapine-fluoxetine-508.pdf\">Symbyax (olanzapine-fluoxetine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Symdeko-tezacaftor-ivacaftor-PA-Form-508.pdf\">Symdeko (tezacaftor-ivacaftor)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Sympazan-clobazam-film-508.pdf\">Sympazan (clobazam film)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Symproic-naldemedine-508.pdf\">Symproic (naldemedine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Synagis-palivizumab-PA-form-508-Compliant.pdf\">Synagis (palvizumab)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Synjardy-empagliflozin-metformin-508.pdf\">Synjardy (empagliflozin-metformin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Taclonex-calcipotriene-betamethasone-dipropionate-508.pdf\">Taclonex (calcipotriene-betamethasone dipropionate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Taltz-ixekizumab-508.pdf\">Taltz (ix ekizumab)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tavalisse-fostamatinib-PA-form-508.pdf\">Tavalisse (fostamatinib)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tazorac-tazarotene-508.pdf\">Tazorac (tazarotene)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tecfidera-dimethyl-fumarate-508.pdf\">Tecfidera (dimethyl fumarate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tegsedi-inotersen-508.pdf\">Tegsedi (inotersen)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tekturna-Tekturna-HCT-aliskiren-aliskiren-hydrochlorothiazide-508.pdf\">Tekturna\/Tekturna HCT (aliskiren, aliskiren-hydrochlorothiazide)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Testosterone-Containing-Products-PA-Form-508-Compliant.pdf\">Testosterone-containing Products<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tiglutik-riluzole-508.pdf\">Tiglutik (riluzole)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tivorbex-indomethacin-508.pdf\">Tivorbex (indomethacin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tobi-tobramycin-508.pdf\">Tobi (tobramycin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tobi-Podhaler-tobramycin-508.pdf\">Tobi Podhaler (tobramycin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tolak-fluorouracil-cream-508.pdf\">Tolak (fluorouracil cream)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Topamax-Sprinkles-topiramate-508.pdf\">Topamax Sprinkles (topiramate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tracleer-bosentan-508.pdf\">Tracleer (bosentan)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Trelegy-Ellipta-fluticasone-umeclidinium-vilanterol-508.pdf\">Trelegy Ellipta (fluticasone-umeclidinium-vilanterol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tremfya-guselkumab-508.pdf\">Tremfya (guselkumab)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Treximet-sumatritpan-naproxen-508.pdf\">Treximet (sumatritpan-naproxen)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Trijardy-XR-empagliflozin-metformin-linagliptin-508.pdf\">Trijardy XR (empagliflozin-metformin-linagliptin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Trikafta-elexacaftor-tezacaftor-ivacaftor-PA-Form-508-Compliant-June-30-2021.pdf\">Trikafta (elexacaftor-tezacaftor-ivacaftor)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Trulance-plecanatide-508.pdf\">Trulance (plecanatide)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tussionex-hydrocodone-chlorpheniramine-508.pdf\">Tussionex (hydrocodone-chlorpheniramine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Tyvaso-treprostinil-508.pdf\">Tyvaso (treprostinil)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Ubrelvy-ubrogepant-PA-Form-508-Compliant.pdf\">Ubrelvy (ubrogepant)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Uloric-febuxostat-508.pdf\">Uloric (febuxostat)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Uptravi-selexipag-508.pdf\">Uptravi (selexipag)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Valtoco-diazepam-nasal-spray-508.pdf\">Valtoco (diazepam nasal spray)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vascepa-icosapent-ethyl-508.pdf\">Vascepa (icosapent ethyl)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vectical-calcitriol-508.pdf\">Vectical (calcitriol)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ventavis-iloprost-508.pdf\">Ventavis (iloprost)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Verquvo-vericiguat-PA-Form-508-Compliant.pdf\">Verquvo (vericiquat)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Viberzi-eluxadoline-508.pdf\">Viberzi (eluxodoline)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vimpat-lacosamide-508.pdf\">Vimpat (lacosamide)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Vivitrol-naltrexone-PA-Form-508-Compliant.pdf\">Vivitrol (naltrexone)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Vosevi-sofosbuvir-velpatasvir-PA-Form-508-Compliant.pdf\">Vosevi (sofosbuvir-velpatasvir)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vraylar-cariprazine-508.pdf\">Vraylar (cariprazine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vumerity-diroximel-fumarate-508.pdf\">Vumerity (diroximel fumarate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vyndamax-tafamidis-508.pdf\">Vyndamax (tafamidis)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Vyndaqel-tafamidis-meglumine-508.pdf\">Vyndaqel (tafamidis meglumine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Wakix-pitolisant-hydrochloride-PA-Form-508.pdf\">Wakix (pitolisant hydrocholoride)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xanax-XR-alprazolam-508.pdf\">Xanax XR (alprazolam)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xarelto-rivaroxaban-508.pdf\">Xarelto (rivaroxaban)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xeljanz-Xeljanz-XR-tofacitinib-508.pdf\">Xeljanz\/Xeljanz XR (tofacitinib)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xenazine-tetrabenazine-508.pdf\">Xenazine (tetrabenazine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xenleta-lefamulin-508.pdf\">Xenleta (lefamulin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xifaxan-rifaximin-508.pdf\">Xifaxan (rifaximin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xigduo-dapagliflozin-metformin-508.pdf\">Xigduo (dapagliflozin-metformin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/10\/Xolair-omalizumab-PA-Form-508-Compliant.pdf\">Xolair (omalizumab)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xyrem-sodium-oxybate-508.pdf\">Xyrem (sodium oxybate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Xywav-calcium-magnesium-potassium-sodium-oxybates-508.pdf\">Xywav (calcium, magnesium, potassium and sodium oxybates)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zegalogue-dasiglucagon-508.pdf\">Zegalogue (dasiglucagon)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zelnorm-tegaserod-508.pdf\">Zelnorm (tegaserod)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/08\/Zepatier-grazoprevir-PA-Form-508-Compliant.pdf\">Zepatier (grazoprevir)<\/a> - PA Form\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zeposia-ozanimod-508.pdf\">Zeposia (ozanimod)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Ziana-clindamycin-tretinoin-508.pdf\">Ziana (clindamycin-tretinoin)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zohydro-hydrocodone-bitartrate-508.pdf\">Zohydro (hydrocodone bitartrate)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zolpimist-zolpidem-oral-spray-508.pdf\">Zolpimist (zolpidem oral spray)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zomig-zolmitriptan-508.pdf\">Zomig (zolmitriptan)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zurampic-lesinurad-508.pdf\">Zurampic (lesinurad)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zyprexa-Relprevv-olanzapine-508.pdf\">Zyprexa Relprevv (olanzapine)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zyprexa-Zydis-olanzapine-ODT-508.pdf\">Zyprexa Zydis (olanzapine ODT)<\/a>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/07\/Zyvox-linezolid-508.pdf\">Zyvox (linesolid)<\/a><\/div--> <\/div><\/div>\n<div class=\"su-spoiler su-spoiler-style-simple su-spoiler-icon-plus spoilertitle23 su-spoiler-closed\" data-anchor=\"spoilertitle23\" data-scroll-offset=\"0\" data-anchor-in-url=\"no\"><div class=\"su-spoiler-title\" tabindex=\"0\" role=\"button\"><span class=\"su-spoiler-icon\"><\/span><strong>Drug Utilization Review<\/strong><\/div><div class=\"su-spoiler-content su-u-clearfix su-u-trim\">\n<p>Mountain Pacific conducts drug utilization review. This means we collect, analyze, and interpret drug use patterns to improve the quality, safety, and economical use of medications in inpatient care. We review and study<\/p>\n<ul>\n<li>What drugs Montanans are being prescribed,<\/li>\n<li>How Montanans use those prescribed drugs and<\/li>\n<li>Evaluate the cost-effectiveness of these drug therapies using evidence-based guidelines.<\/li>\n<\/ul>\n<p>We also publish a quarterly newsletter for almost 1,000 Montana health care providers and pharmacies. This newsletter offers education about our reviews of prescription drug use in Montana and updates on newly implemented clinical drug criteria.<\/p>\n<p>As part of our drug utilization review services, Mountain Pacific also provides pharmacy case management services. Clinical pharmacists conduct telephone conferences with Medicaid providers and offer unbiased and evidence-based recommendations to assist providers in managing medications and patients\u2019 illnesses. By sharing information and drug recommendations with health care providers, we ultimately help patients and reduce health care costs. With thousands of different medications available, sometimes a prescription drug needs to be prior-authorized before it will be covered by Medicaid. Mountain Pacific helps Montanans get the safest, most effective, and reasonably priced prescriptions by offering drug prior authorization services.<\/p>\n<p>Our expert, call-center staff of pharmacists and certified pharmacy technicians provide expertise and data analysis to review prior authorization requests in support of<\/p>\n<ul>\n<li>The Medicaid Prescription Drug Program,<\/li>\n<li>The Medicaid Home Infusion Therapy Program,<\/li>\n<li>The Mental Health Services Plan Prescription Drug Program and<\/li>\n<li>The Healthy Montana Kids Prescription Plan.<\/li>\n<\/ul>\n<p>We help develop criteria used to make decisions about authorizing medications. We also review prior authorization requests using Preferred Drug List categories established by the Drug Utilization Review Board. We coordinate our prior authorization activities with our drug utilization review activities to better serve providers and pharmacists.<\/p>\n<p><strong>Newsletters<\/strong><\/p>\n\n\n<div class=\"su-posts su-posts-default-loop \">\n\n\t\n\t\t\t\t\t\n\t\t\t\n\t\t\t<div id=\"su-post-17204\" class=\"su-post \">\n\n\t\t\t\t\n\t\t\t\t<h2 class=\"su-post-title\"><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/dur-fall-newsletter-2024\/\">DUR Fall Newsletter 2024<\/a><\/h2>\n\n\t\t\t\t<div class=\"su-post-meta\">\n\t\t\t\t\tPosted: September 30, 2024\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"su-post-excerpt\">\n\t\t\t\t\t<p>October 1, 2024<\/p>\n<p><em><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/09\/DUR-Newsletter-Fall-2024-508-Compliant.pdf\" target=\"_blank\" rel=\"noopener\">Download<\/a> or see below.<\/em>&hellip; <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/dur-fall-newsletter-2024\/\" class=\"read-more\">Read the rest <\/a><\/p>\t\t\t\t<\/div>\n\n\t\t\t\t\n\t\t\t<\/div>\n\n\t\t\t\t\t\n\t\t\t\n\t\t\t<div id=\"su-post-17176\" class=\"su-post \">\n\n\t\t\t\t\n\t\t\t\t<h2 class=\"su-post-title\"><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/dur-summer-newsletter-2024\/\">DUR Summer Newsletter 2024<\/a><\/h2>\n\n\t\t\t\t<div class=\"su-post-meta\">\n\t\t\t\t\tPosted: July 15, 2024\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"su-post-excerpt\">\n\t\t\t\t\t<p>July 15, 2024<\/p>\n<p><em><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/DUR-Newsletter-Summer-2024-508-Compliant.pdf\" target=\"_blank\" rel=\"noopener\">Download<\/a> or see below.<\/em>&hellip; <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/dur-summer-newsletter-2024\/\" class=\"read-more\">Read the rest <\/a><\/p>\t\t\t\t<\/div>\n\n\t\t\t\t\n\t\t\t<\/div>\n\n\t\t\t\t\t\n\t\t\t\n\t\t\t<div id=\"su-post-16900\" class=\"su-post \">\n\n\t\t\t\t\n\t\t\t\t<h2 class=\"su-post-title\"><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/dur-spring-newsletter-2024\/\">DUR Spring Newsletter 2024<\/a><\/h2>\n\n\t\t\t\t<div class=\"su-post-meta\">\n\t\t\t\t\tPosted: April 16, 2024\t\t\t\t<\/div>\n\n\t\t\t\t<div class=\"su-post-excerpt\">\n\t\t\t\t\t<p>April 16, 2024<\/p>\n<p><em><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/04\/DUR-Newsletter-Spring-2024-508-Compliant.pdf\" target=\"_blank\" rel=\"noopener\">Download<\/a> or see below.<\/em>&hellip; <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/dur-spring-newsletter-2024\/\" class=\"read-more\">Read the rest <\/a><\/p>\t\t\t\t<\/div>\n\n\t\t\t\t\n\t\t\t<\/div>\n\n\t\t\n\t\n<\/div>\n\n<p><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/category\/dur-newsletter\/\">See All Newsletters<\/a> | <a href=\"http:\/\/www.bit.ly\/DURProgram\" target=\"_blank\" rel=\"noopener noreferrer\">\u00a0Get Newsletters Delivered to your Inbox<\/a><\/p>\n<\/div><\/div>\n<div class=\"su-spoiler su-spoiler-style-simple su-spoiler-icon-plus spoilertitle23 su-spoiler-closed\" data-anchor=\"spoilertitle23\" data-scroll-offset=\"0\" data-anchor-in-url=\"no\"><div class=\"su-spoiler-title\" tabindex=\"0\" role=\"button\"><span class=\"su-spoiler-icon\"><\/span><strong>Physician-Administered Drugs (PAD)<\/strong><\/div><div class=\"su-spoiler-content su-u-clearfix su-u-trim\">\n<p>Mountain Pacific administers a prior authorization program for several physician-administered drugs (PAD) for <a href=\"https:\/\/dphhs.mt.gov\/MontanahealthcarePrograms\/\" target=\"_blank\" rel=\"noopener\">Montana Healthcare Programs<\/a>. Our clinical pharmacy team reviews a provider\u2019s request for these complicated, often expensive treatments. Provider requests are submitted through our <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/medicaid-portal-home\/\">provider portal<\/a> and routed to our pharmacy experts who review the claim to make sure it satisfies\u00a0 state drug utilization board requirements. Via the portal, providers can access the claim in real-time to track its progress. They also receive an email notification when a decision is made. This process ensures streamlined communication and reduces the burden on providers and their staff.<\/p>\n<p>Providers can view a list of medications and their coverage below and contact our team for approval at 1-800-219-7035.<\/p>\n<p style=\"text-align: justify;\"><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Aduhelm.pdf\">Aduhelm<\/a> (aducanumab-avwa)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Amondys-45.pdf\">Amondys 45<\/a> (casimersen)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/06\/Brixadi-buprenorphine-extended-release-injection.pdf\">Brixadi<\/a> (buprenorphine extended release injection)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Cinqair.pdf\">Cinqair<\/a> (reslizumab)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/08\/Entyvio-vedolizumab-IV.pdf\">Entyvio<\/a> (vedolizumab) IV<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Entyvio-vedolizumab.pdf\">Entyvio<\/a> (vedolizumab) SQ<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Evenity.pdf\">Evenity<\/a> (romosozumab-aqqg)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Evkeeza.pdf\">Evkeeza<\/a> (evinacumab-dgnb)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Exondys-51.pdf\">Exondys 51<\/a> (eteplirsen)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Fasenra-benralizumab.pdf\">Fasenra<\/a> (benralizumab)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/11\/Ilumya-interim-update-State-Final.pdf\">Ilumya<\/a> (tildrakizumab-asmn)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Krystexxa.pdf\">Krystexxa<\/a> (pegloticase)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Lemtrada.pdf\">Lemtrada<\/a> (alemtuzumab)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Leqembi-lecanemab-irmb.pdf\">Leqembi<\/a> (lecanemab-irmb)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/PAD-Page-Update.pdf\" target=\"_blank\" rel=\"noopener\">Leqvio<\/a> (inclisiran)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2023\/05\/Nucala-mepolizumab.pdf\">Nucala<\/a> (mepolizumab)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/05\/Omvoh-mirikizumab-mrkz.pdf\">Omvoh<\/a> (mirikizumab-mrkz)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Prolia.pdf\">Prolia<\/a> (denosumab)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Simponi-Aria.pdf\">Simponi Aria<\/a> (golimumab infusion)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Skyrizi.pdf\">Skyrizi<\/a> (risankizumab-rzaa)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Spinraza.pdf\">Spinraza<\/a> (nusinersen)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Spravato.pdf\">Spravato<\/a> (esketamine)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Stelara.pdf\" target=\"_blank\" rel=\"noopener\">Stelara<\/a> (ustekinumab)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/06\/Sublocade-buprenorphine.pdf\">Sublocade<\/a> (buprenorphine extended-release)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Supprelin-LA.pdf\">Supprelin LA<\/a> (histrelin acetate)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/08\/Tezspire.pdf\" target=\"_blank\" rel=\"noopener\">Tezspire<\/a> (tezepelumab)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/12\/Tremfya.pdf\" target=\"_blank\" rel=\"noopener\">Tremfya<\/a> (guselkumab)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/01\/Tzield-teplizumab-mzwv.pdf\">Tzield<\/a> (teplizumab-mxwv)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Viltepso.pdf\">Viltepso<\/a> (viltolarsen)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/06\/Vivitrol-naltrexone-for-extended-release-injectable-suspension-1.pdf\">Vivitrol<\/a> (naltrexone extended-release injection)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Vyepti-eptinezumab-jjmr.pdf\">Vyepti<\/a> (eptinezumab-jjmr)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2022\/06\/Vyondys-53.pdf\">Vyondys 53<\/a> (golodirsen)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Xgeva.pdf\">Xgeva<\/a> (denosumab)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/07\/Xolair-omalizumab.pdf\">Xolair<\/a> (omalizumab)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2021\/09\/Zolgensma.pdf\">Zolgensma<\/a> (onasemnogene abeparvovec-xioi)<br \/>\n<a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/03\/Zulresso-brexanolone.pdf\">Zulresso<\/a> (brexanolone)<\/p>\n<\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>April 16, 2024<\/p>\n<p><em><a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/wp-content\/uploads\/2024\/04\/DUR-Newsletter-Spring-2024-508-Compliant.pdf\" target=\"_blank\" rel=\"noopener\">Download<\/a> or see below.<\/em>&hellip; <a href=\"https:\/\/dsiohn098w.mpqhf.org\/corporate\/dur-spring-newsletter-2024\/\" class=\"read-more\">Read the rest <\/a><\/p>","protected":false},"author":16,"featured_media":0,"parent":47,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"class_list":{"0":"post-61","1":"page","2":"type-page","3":"status-publish","5":"entry"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Mountain Pacific \u2013 Medicaid Pharmacy<\/title>\n<meta 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