| Specialty Quantity Limit Otrexup P2018 |
| Specialty Quantity Limit Oxbryta 3444 H P2019 |
| Specialty Quantity Limit PAH 1771 H P2019 |
| Specialty Quantity Limit PAH 1771 H P2019 |
| Specialty Quantity Limit PAH 1771 H P2019 |
| Specialty Quantity Limit PAH 1771 H P2019 |
| Specialty Quantity Limit Prolia P2017a |
| Specialty Quantity Limit Promacta 1757 H P2019a |
| Specialty Quantity Limit Repatha Praluent 1777 H P2019 |
| Specialty Quantity Limit Revlimid P2018 |
| Specialty Quantity Limit Rubraca 1996 H P2019 |
| Specialty Quantity Limit Rydapt P2017a |
| Specialty Quantity Limit Sabril P2017 |
| Specialty Quantity Limit Sensipar P2018 |
| Specialty Quantity Limit Simponi Aria 2276 H P2019 |
| Specialty Quantity Limit Somatuline Depot 1710 H P2019 |
| Specialty Quantity Limit Somavert 1711 H P2019 |
| Specialty Quantity Limit Sprycel 1722 H P2019 |
| Specialty Quantity Limit Stivarga P2017 |
| Specialty Quantity Limit Sutent 2216 H P2019 |
