HIGH TECH LIST FEBRUARY 2017. DMA DMA NAME …

1 HIGH TECH LIST FEBRUARY CODEDMA NAMENON-PROP. NAMEFORMSTRENGTHUNIT OF SIZEPACK SIZE NAMEQTY CODECODING INSTRUCTIONPRICE PRICE DATE (ACCORD HEALTHCARE LTD.) SOLN. FOR IN PRE-FILLEDFILGRASTIMSYRINGE30 ML5 ML. X 5AQ (ACCORD HEALTHCARE LTD.) SOLN. FOR IN PRE-FILLEDFILGRASTIMSYRINGE48 ML5 ML. X 5AQ ACIDTABS30MG2828A FILM FILM COATEDRIOCIGUATTABS1MG4242A FILM FILM COATEDRIOCIGUATTABS2MG8484A FILM COATED PROLONGED PROLONGED RELEASETACROLIMUSCAPS1MG5050A PROLONGED RELEASETACROLIMUSCAPS3MG5050A PROLONGED RELEASETACROLIMUSCAPS5MG5050A PHENYLBUTYRATETABS500MG250250A PHENYLBUTYRATEGRANS940MG/G266266 GB SOLN FOR INJDARBEPOETIN ALFAINJ10 MCG4 4AF SOLN. FOR INJ. ANGDARBEPOETIN ALFAPRE FILLED SYR20 MCG4 4AQ SOLN.

2 FOR INJ. ANGDARBEPOETIN ALFAPRE FILLED SYR30 MCG4 4AQ SOLN. FOR INJ. ANGDARBEPOETIN ALFAPRE FILLED SYR40 MCG4 4AQ SOLN. FOR INJ. ANGDARBEPOETIN ALFAPRE FILLED SYR50 MCG4 4AQ SOLN. FOR INJ. ANGDARBEPOETIN ALFAPRE FILLED SYR60 MCG4 4AQ SOLN. FOR INJ. ANGDARBEPOETIN ALFAPRE FILLED SYR80 MCG4 4AQ SOLN. FOR INJ. ANGDARBEPOETIN ALFAPRE FILLED SYR100 MCG4 4AQ SOLN. FOR INJ. ANGDARBEPOETIN ALFAPRE FILLED SYR150 MCG4 4AQ SOLN. FOR INJ. ANGDARBEPOETIN ALFAPRE FILLED SYR300 MCG1 1AQ SOLN. FOR INJ. ANGDARBEPOETIN ALFAPRE FILLED SYR500 MCG1 1AQ SOLN. FOR INJ. SURECLICKDARBEPOETIN ALFAPRE FILLED 1AH SOLN. FOR INJ. SURECLICKDARBEPOETIN ALFAPRE FILLED PEN40 MCG1 1AH SOLN. FOR INJ. SURECLICKDARBEPOETIN ALFAPRE FILLED PEN60 MCG1 1AH SOLN.

3 FOR INJ. SURECLICKDARBEPOETIN ALFAPRE FILLED PEN80 MCG1 1AH SOLN. FOR INJ. SURECLICKDARBEPOETIN ALFAPRE FILLED PEN100 MCG1 1AH SOLN. FOR INJ. SURECLICKDARBEPOETIN ALFAPRE FILLED PEN150 MCG1 1AH SOLN. FOR INJ. SURECLICKDARBEPOETIN ALFAPRE FILLED PEN300 MCG1 1AH SOLN. FOR INJ. SURECLICKDARBEPOETIN ALFAPRE FILLED PEN500 MCG1 1AH FILM COATEDTERIFLUNOMIDETABS14MG2828A BIO-SETINTERFERON BETA-1 AINJ6 MIU/3ML4 4AF SOLN FOR INJINTERFERON BETA-1 APRE FILLED PEN30 4AH SOLN FOR INJINTERFERON BETA-1 APRE FILLED PEN30 SOLN. FOR BETA-1 APRE FILLED SYR30 4 X ENTECAVIRORAL mlB SOLN FOR INJ IN PRE-FILLED FOLLITROPIN ALFAPEN75IU1 1AH SOLN FOR INJ IN PRE-FILLED FOLLITROPIN ALFAPEN150IU1 1AH SOLN FOR INJ IN PRE-FILLED FOLLITROPIN ALFAPEN225IU1 1AH SOLN FOR INJ IN PRE-FILLED FOLLITROPIN ALFAPEN300IU1 1AH SOLN FOR INJ IN PRE-FILLED FOLLITROPIN ALFAPEN450IU1 1AH SOLN.

4 FOR INJ. INETANERCEPTPREFILLED PEN4 4A SOLN. FOR INJ. IN PREFILLEDETANERCEPTSYRINGE4 4A 3 MLINTERFERON (ACCORD HEALTHCARE LTD.) FILM COATEDBICALUTAMIDETABS50MG2828A TEVABICALUTAMIDETABS50MG2828A ACIDTABS800MG6060A FILM COATEDBOSUTINIBTABS100MG2828A FILM COATEDBOSUTINIBTABS500MG2828A SOLN300MG/4 ML5656 SINGLE DOSE VIALSAS PDR. AND SOLV. FOR INJ75IU1010AF (ACCORD HEALTHCARE LTD) FILM COATEDCAPECITABINETABS150MG6060A (ACCORD HEALTHCARE LTD) FILM COATEDCAPECITABINETABS500MG120120A (ACCORD HEALTHCARE LTD.) FILM COATEDCAPECITABINETABS300MG6060A (ACTAVIS) FILM COATEDCAPECITABINETABS150MG6060A (ACTAVIS) FILM COATEDCAPECITABINETABS500MG120120A SANDOZ (ROWEX) FILM COATEDCAPECITABINETABS150MG6060A SANDOZ (ROWEX) FILM COATEDCAPECITABINETABS500MG120120A FILM COATEDVANDETANIBTABS100MG3030A FILM COATEDVANDETANIBTABS300MG3030A (CLEAR PHARMACY)BICALUTAMIDETABS50MG2828A (IMBAT LTD.)

5 BICALUTAMIDETABS50MG2828A (IMED HEALTHCARE LTD.) FILM COATEDBICALUTAMIDETABS50MG2828A ( MFG.)BICALUTAMIDETABS50MG2828A (BICALUTAMIDE)BICALUTAMIDETABS50MG2828A TECH LIST FEBRUARY CODEDMA NAMENON-PROP. NAMEFORMSTRENGTHUNIT OF SIZEPACK SIZE NAMEQTY CODECODING INSTRUCTIONPRICE PRICE DATE PDR. & SOLV. FOR NEBULISERAZTREONAMSOLN75MG8484AS ACIDORAL SUSP1G/5ML175175 MLB ACIDCAPS250MG100100A ACIDTABS500MG5050A (CLEAR PHARMACY)MYCOPHENOLIC ACIDTABS500MG5050A (DONCASTER LTD.)MYCOPHENOLIC ACIDCAPS250MG100100A (DONCASTER LTD.) MYCOPHENOLIC ACIDCAPS500MG5050A (IMED HEALTHCARE LTD.)MYCOPHENOLIC ACIDCAPS250MG100100A (IMED HEALTHCARE LTD.)MYCOPHENOLIC ACIDTABS500MG5050A ( MFG.)MYCOPHENOLIC ACIDCAPS250MG100100A ( MFG.)MYCOPHENOLIC ACIDTABS500MG5050A PDR.

6 AND SOLV. FOR 1AF PDR. AND SOLV. FOR 7AF SOLN FOR INJ CERTOLIZUMAB PEGOL PRE FILLED SYR200MG/ML1 2 X 1ML COMPLETE PACKAL SOLN FOR INJ (AUTOCLICK)CERTOLIZUMAB PEGOLPRE FILLED PEN200MG/ML2 2 X 1 MLAH INHALATION POWDERCOLISTINHARD CAPS1,662,500IU5656A SOLN FOR INJGLATIRAMER ACETATEPRE FILLED SYR20MG/ML2828 X 1 MLAQ SOLN FOR INJ 1 ACETATEPRE FILLED SYR40MG/ML1212AQ SOLN. FOR INJ. IN PRE-FILLEDSECUKINUMABPEN150MG2 2AH SOLN. FOR INJ. IN PRE-FILLED SECUKINUMABPEN150MG1 1AH ( MFG.) 3 MONTH PACK PDR. AND SOLV. FOR SUSPTRIPTORELINFOR 3 MONTH PACK PDR. AND SOLV. FOR SUSP. 1AL 6 MONTH PACK PDR. AND SOLV. FOR PR 1AL 1A FILM COATEDFIDAXOMICINTABS200MG2020A FILM COATEDCAPECITABINETABS150MG6060A FILM COATEDCAPECITABINETABS500MG120120A PDR.

7 & SOLV. FOR 1AF PDR. & SOLV. FOR 1AF PDR. & SOLV. FOR INJ45MG1 1AF SOLN. FOR ALFAPRE FILLED SYR100 PACK 1AQ SOLN. FOR INJ. CORIFOLLITROPIN ALFAPRE FILLED SYR150 PACK 1AQ 4A PAED. SOLN. FOR INJ. PRE-FILLEDETANERCEPTSYRINGE25MG4 4AQ PDR. & SOLV. FOR PAED USEETANERCEPTSOLN FOR INJ10MG4 4AF SOLN FOR INJ PRE-FILLEDETANERCEPTSYRINGE25MG4 4A SOLN FOR INJ PRE-FILLEDETANERCEPTSYRINGE50MG4 4A SOLN. FOR INJ. PRE-FILLEDETANERCEPTPEN50MG4 4AH PROLONGED PROLONGED RELEASETACROLIMUSTABS1MG3030A PROLONGED RELEASETACROLIMUSTABS4MG3030A SOLN. FOR FILLED SYR4,000 ML6 6 X MLAQ SOLN. FOR FILLED SYR5,000 ML6 6 X 1 SOLN. FOR FILLED SYR10,000IU/1 ML6 6 X 1 SOLN. FOR INJ. ERYTHROPOIETINPRE FILLED SYR1,000 ML6 6 X MLAQ SOLN.

8 FOR INJ. ERYTHROPOIETINPRE FILLED SYR2,000 6 X SOLN. FOR INJ. ERYTHROPOIETINPRE FILLED SYR3,000 ML6 6 x SOLN. FOR INJ. ERYTHROPOIETINPRE FILLED SYR20,000IU/1 ML6 6 X 1 SOLN. FOR INJ. ERYTHROPOIETINPRE FILLED SYR30,000IU/1 ML4 4AQ PRE-FILLEDERYTHROPOIETINSYR5000IU/ML6 PRE-FILLEDERYTHROPOIETINSYR6000IU/ML6 PRE-FILLEDERYTHROPOIETINSYR8000IU/ML6 PRE-FILLEDERYTHROPOIETINSYRINGE20,000 ML1 1 X PRE-FILLEDERYTHROPOIETINSYRINGE30,000IU/ ML1 1 X MLA PRE-FILLEDERYTHROPOIETINSYR40000IU/ML1 1 X 1 PREFILLED 6A PREFILLED 6A PREFILLED 6A PREFILLED 6A PREFILLED 1 MLERYTHROPOIETINSYRINGE10000IU/ML6 6A CAPS267MG252252A 14 DAY STARTER KITPIRFENIDONEHARD CAPS267MG1 1AL (CLEAR PHARMACY) DEFERASIROXTABS250MG2828A (CLEAR PHARMACY)

9 DEFERASIROXTABS500MG2828A FILM COATEDDEFERASIROXTABS90MG3030A FILM COATEDDEFERASIROXTABS180MG3030A FILM COATEDDEFERASIROXTABS360MG3030A SOLN FOR INJFULVESTRANTPRE FILLED SYR250MG/5 ML2 2 X 5 MLAQ TECH LIST FEBRUARY CODEDMA NAMENON-PROP. NAMEFORMSTRENGTHUNIT OF SIZEPACK SIZE NAMEQTY CODECODING INSTRUCTIONPRICE PRICE DATE SOLN100MG/ML500500 MLB DEFERIPRONETABS500MG100100A SOLN. FOR INJ. INICATIBANTPRE FILLED SYR10MG/ML1 1 X 3 MLAQ PDR. & SOLV. FOR INJ80MG1 1AL PDR. & SOLV. FOR INJ120MG2 2AL 1 PACKAL 1AL ORALFLUDARABINETABS10MG1515A ORALFLUDARABINETABS10MG2020A (DONCASTER LTD.) SOLN FOR INJ IN PRE-FILLEDTERIPARATIDEPEN20 MCG/80 MCL1 1AH ( MFG.) SOLN. FOR INJ. IN PRE-FILLEDTERIPARATIDEPEN20 MCG/80 MCL1 1 X MLAH SOLN.

10 FOR FILLED PEN20 MCG/80 MCL1 1 x mlAH 1A 1A 7AQ 7AQ 7AQ 7AQ 7AQ 7AQ 7AQ 7AQ 7AQ 7AQ PRE-FILLED (GO QUICK) 1AH PRE-FILLED (GO QUICK)SOMATROPINPEN12MG1 1AH FILM COATEDAFATINIBTABS20MG2828A FILM COATEDAFATINIBTABS30MG2828A FILM COATEDAFATINIBTABS40MG2828A FILM COATEDAFATINIBTABS50MG2828A (CLEAR PHARMACY) FILM COATEDIMATINIBTABS100MG6060A (CLEAR PHARMACY) FILM COATEDIMATINIBTABS400MG3030A FILM COATEDIMATINIBTABS100MG6060A FILM COATEDIMATINIBTABS400MG3030A F PDR. AND SOLV. FOR ALFAFOR INJ75IU1 1AF F PDR. AND SOLV. FOR ALFAFOR INJ1050IU1 1AF F SOLN FOR INJ PRE-FILLEDFOLLITROPIN ALFAPEN300IU1 1AH F SOLN. FOR INJ. PRE-FILLEDFOLLITROPIN ALFAPEN450IU1 1AH F SOLN.