| Specialty Quantity Limit Cometriq P2018 |
| Specialty Quantity Limit Elelyso 1696 H P2019 |
| Specialty Quantity Limit Hepatitis C Medications 2184 H P2018a |
| Specialty Quantity Limit Hepatitis C Medications 2184 H P2018a |
| Specialty Quantity Limit Hepatitis C Medications 2184 H P2018a |
| Specialty Quantity Limit Hepatitis C Medications 2184 H P2018a |
| Specialty Quantity Limit Humira 2270 H P2019 |
| Specialty Quantity Limit Ibrance 1904 H P2019b |
| Specialty Quantity Limit Iclusig 1721 H P2019 |
| Specialty Quantity Limit imatinib Gleevec 1719 H P2019 |
| Specialty Quantity Limit Imbruvica P2017b |
| Specialty Quantity Limit Inbrija 2864 H P2019a |
| Specialty Quantity Limit Inlyta 2214 H P2019a |
| Specialty Quantity Limit Jakafi P2017 |
| Specialty Quantity Limit Juxtapid Kynamro P2018 |
| Specialty Quantity Limit Juxtapid Kynamro P2018 |
| Specialty Quantity Limit Kevzara P2017b |
| Specialty Quantity Limit Kisqali 1652 H P2019b |
| Specialty Quantity Limit Kisqali Femara Co Pack 2103 H P2019a |
| Specialty Quantity Limit Lenvima 1698 H P2019a |
