Maintenance Drug List - Valley Health Plan · labetalol hcl lactulose lamictal lamictal chewable...
14
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com Share a Clear View navitus.com Medi-Span drug data contains a field indicating whether it is a maintenance medication, signifying it is generally used chronically (greater than 30 days) to treat or prevent a condition. This code is used as part of some benefit setups chosen by clients including: • Mandatory Mail Order or 90-day Retail (medications on maintenance list required to be filled at 90-day retail or mail order) • Optional Mail Order (only medications on maintenance list allowed to be filled at 90- day retail or mail order) Maintenance Drug List Updated October 2019 N4042-1019 8-MOP ABACAVIR ABACAVIR SULFATE/ LAMIVUDINE ABILIFY ABILIFY DISCMELT ABILIFY MAINTENA ACAMPROSATE CALCIUM DR ACARBOSE ACCUPRIL ACCURETIC ACEBUTOLOL HCL ACEON ACETAZOLAMIDE ACETAZOLAMIDE ER ACIPHEX ACIPHEX SPRINKLE ACITRETIN ACTIGALL ACTIVELLA ACTIVE-PAC/GABAPENTIN ACTONEL ACTOPLUS MET ACTOPLUS MET XR ACTOS ADALAT CC ADVICOR ADVIL AFEDITAB CR AFREZZA AGGRENOX AGRYLIN ALBUTEROL SULFATE ALBUTEROL SULFATE ER ALDACTAZIDE ALDACTONE ALENDRONATE SODIUM ALEVE ALFUZOSIN HCL ER ALLEGRA ALLEGRA ODT ALLOPURINOL ALORA ALPHAGAN P ALTACE ALTAVERA ALTOPREV ALYACEN 1/35 ALYACEN 7/7/7 AMANTADINE HCL AMARYL AMETHIA AMETHIA LO AMETHYST AMILORIDE HCL AMILORIDE/ HYDROCHLOROTHIAZIDE AMIODARONE HCL AMITIZA AMITRIPTYLINE HCL AMLODIPINE BESYLATE AMLODIPINE BESYLATE/ ATORVASTATIN AMLODIPINE BESYLATE/ BENAZAPRIL AMLODIPINE BESYLATE/ VALSARTAN AMLODIPINE/ VALSARTAN/ HYDROCHLOROTHIAZIDE AMOXAPINE AMTURNIDE ANAFRANIL
Transcript of Maintenance Drug List - Valley Health Plan · labetalol hcl lactulose lamictal lamictal chewable...
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
Medi-Span drug data contains a field indicating whether it is a maintenance medication, signifying it is generally used chronically (greater than 30 days) to treat or prevent a condition. This code is used as part of some benefit setups chosen by clients including:
• Mandatory Mail Order or 90-day Retail (medications on maintenance list required to be filled at 90-day retail or mail order)
• Optional Mail Order (only medications on maintenance list allowed to be filled at 90-day retail or mail order)
Maintenance Drug ListUpdated October 2019
N4042-1019
8-MOPABACAVIRABACAVIR SULFATE/LAMIVUDINEABILIFYABILIFY DISCMELTABILIFY MAINTENA
ACAMPROSATE CALCIUM DRACARBOSEACCUPRILACCURETICACEBUTOLOL HCLACEONACETAZOLAMIDEACETAZOLAMIDE ERACIPHEXACIPHEX SPRINKLEACITRETINACTIGALLACTIVELLAACTIVE-PAC/GABAPENTINACTONELACTOPLUS METACTOPLUS MET XR
ACTOSADALAT CCADVICORADVILAFEDITAB CRAFREZZAAGGRENOXAGRYLINALBUTEROL SULFATEALBUTEROL SULFATE ERALDACTAZIDEALDACTONEALENDRONATE SODIUMALEVEALFUZOSIN HCL ERALLEGRAALLEGRA ODTALLOPURINOLALORAALPHAGAN PALTACEALTAVERAALTOPREVALYACEN 1/35ALYACEN 7/7/7
AMANTADINE HCLAMARYLAMETHIAAMETHIA LOAMETHYSTAMILORIDE HCLAMILORIDE/HYDROCHLOROTHIAZIDEAMIODARONE HCLAMITIZAAMITRIPTYLINE HCLAMLODIPINE BESYLATEAMLODIPINE BESYLATE/ATORVASTATINAMLODIPINE BESYLATE/BENAZAPRILAMLODIPINE BESYLATE/VALSARTANAMLODIPINE/VALSARTAN/HYDROCHLOROTHIAZIDEAMOXAPINEAMTURNIDEANAFRANIL
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
ANAGRELIDE HYDROCHLORIDEANAPROXANAPROX DSANASPAZANASTROZOLEANDRODERMANDROGELANDROGEL PUMPANGELIQANTABUSEANTARAAPLENZINAPRIAPRISOAPTIOMAPTIVUSARALENARANELLEARAVAARICEPTARICEPT ODTARIMIDEXARMOUR THYROIDAROMASINARTHROTEC 50ARTHROTEC 75ASTAGRAF XLATACANDATACAND HCTATELVIAATENOLOLATENOLOL/CHLORTHALIDONE
ATORVASTATIN CALCIUMATRIPLAATROPINE SULFATEAUBRAAURYXIAAVAILNEXAVALIDEAVANDAMETAVANDARYLAVANDIAAVAPROAVIANEAVODARTAXIDAXID ARAXIRONAYGESTINAZASANAZATADINEAZATHIOPRINEAZILECTAZOPTAZORAZULFIDINEAZULFIDINE EN-TABSAZURETTEBACLOFENBALZIVABANZELBARACLUDEBENAZEPRIL HCLBENAZEPRIL HCL/HYDROCHLOROTHIAZIDEBENICARBENICAR HCT
BENZTROPINE MESYLATEBETAGANBETAGAN C CAP QDBETAPACE
BETAPACE AFBETAXOLOL HCLBETIMOLBETOPTIC-SBEYAZBICALUTAMIDEBIDILBINOSTOBISOPROLOL FUMARATEBISOPROLOL FUMARATE/HYDROCHLOROTHIAZIDEBONIVABREVICON-28BRIELLYNBRILINTABRIMONIDINE TARTRATEBRINTELLIXBRISDELLEBROMOCRIPTINE MESYLATEBUDEPRION SRBUMETANIDEBUPHENYLBUPROPION HCLBUPROPION HCL XLBYDUREONBYETTABYSTOLICCADUETCALAN
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
CALAN SRCALCITRIOLCALCIUM ACETATECALPHRONCAMILACAMRESECAMRESE LOCANDESARTAN CILEXETILCANDESARTAN CILEXETIL/HYDROCHLOROTHIAZIDECAPTOPRILCAPTOPRIL/HYDROCHLOROTHIAZIDECARAFATECARBAMAZEPINECARBAMAZEPINE ERCARBATROLCARBIDOPACARBIDOPA/LEVODOPACARBIDOPA/LEVODOPA ODTCARBIDOPA/LEVODOPA/ENTACAPONECARDIZEMCARDIZEM CDCARDIZEM LACARDIZEM SRCARDURACARDURA XLCARNITORCARNITOR SFCARTEOLOL HCLCARTIA XT
CARVEDILOLCASODEXCATAPRESCATAPRES-TTSCAZIANTCELEBREXCELECOXIBCELEXACELONTINCESIACETIRIZINE HCLCHATEALCHEMETCHLOROQUINE PHOSPHATECHLOROTHIAZIDECHLORPROMAZINE HCLCHLORPROPAMIDECHLORTHALIDONECHOLESTYRAMINECHOLESTYRAMINE LIGHTCIALISCILOSTAZOLCIMETIDINECIMETIDINE HCLCITALOPRAM HYDROBROMIDECLARINEXCLARINEX REDITABSCLARITINCLIMARACLIMARA PROCLOMIPRAMINE HCLCLONIDINE HCL
CLONIDINE HCL ERCLOPIDOGRELCLORPRES
COLESTIDCOLESTID FLAVOREDCOLESTIPOL HCLCOMBIGANCOMBIPATCHCOMBIVIRCOMPAZINECOMPLERACOMTANCO-NATAL FACONSTULOSECORDARONECOREGCOREG CRCORGARDCORZIDECOSOPTCOSOPT PFCOVARYXCOVARYX HSCOZAARCREONCRESTORCRIXIVANCROMOLYN SODIUMCRYSELLE-28CUVPOSACYCLAFEM 1/35CYCLAFEM 7/7/7CYCLESSACYCLOGYL
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
CYCLOMYDRILCYCLOPENTOLATE HCLCYCLOSETCYCLOSPORINECYCLOSPORINE MODIFIEDCYMBALTACYPROHEPTADINE HCLCYSTADANECYTOMELCYTOTECDALIRESPDAPSONEDASETTA 1/35DASETTA 7/7/7DAYPRODAYSEEDDAVPDEBLITANEDELYLADELZICOLDEMADEXDEPAKENEDEPAKOTEDEPAKOTE ERDEPAKOTE SPRINKLESDEPRIZINE FUSEPAQDESIPRAMINE HCLDESLORATADINEDESLORATADINE ODTDESMOPRESSIN ACETATEDESOGENDESOGESTREL/ETHINYL ESTRADIOLDESVENLAFAXINE ER
DETROLDETROL LADEXILANTDEXMEDETOMIDINE HCLDIABETADIAMOXDICLOFENAC SODIUM ERDICLOFENAC SODIUM/MISOPROLOLDIDANOSINEDIFLUNISALDIGITEKDIGOXDIGOXINDILACOR XRDILANTINDILANTIN INFATABSDILANTIN-125DILATRATE SRDILT-CDDILTIA XTDILTIAZEM HCLDILTIAZEM HCL ERDILTIAZEM SRDILTIAZEM XRDILT-XRDILTZACDIOVANDIOVAN HCTDIPENTUMDIPYRIDAMOLEDISALCIDDISOPYRAMIDE PHOSPHATEDISULFIRAM
DITROPANDITROPAN XLDIURILDIVALPROEX SODIUMDIVALPROEX SODIUM DRDIVALPROEX SODIUM ERDIVIGELDONEPEZIL HCLDORZOLAMIDE HCLDORZOLAMIDE HCL/TIMOLOL MALEATEDOXAZOSIN MESYLATEDOXEPIN HCLDOXERCALCIFEROLDRISDOLDROSPIRENONE/ETHINYL ESTRADIOLDROXIADUAVEEDUETACTDUEXISDULOXETINE HCLDUTOPROLDYAZIDEDYRENIUMEC-NAPROSYNEDARBIEDARBYCLOREDECRINEDURANTEFFER-KEFFERVESCENT POTASSIUM CHLORIDEEFFEXOR XREFFIENT
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
ELDEPRYLELESTRINELINESTELIPHOSELIQUISELIXOPHYLLINEMCYTEMOQUETTEEMSAMEMTRIVAENABLEXENALAPRIL MALEATEENALAPRIL MALEATE/HYDROCHLOROTHIAZIDEENJUVIAENPRESSEENSKYCEENTACAPONEENTECAVIRENTERAGAMENULOSEEPANEDEPITOLEPIVIREPIVIR HBVEPLERENONEEPROSARTAN MESYLATEEPZICOMEQUETROERGOCALCIFEROLERGOLOID MESYLATESERRINESBRIETESCITALOPRAM OXALATEESOMEPRAZOLE STRONTIUM
ESTARYLLAESTERIFIED ESTROGENS/METHYLTESTOSTERONEESTRACEESTRADIOLESTRADIOL/NORETHINDRONE ACETATEESTRINGESTROGELESTROPIPATEESTROSTEP FEETHOSUXIMIDEETODOLACETODOLAC EREULEXINEVAMISTEVISTAEXELONEXEMESTANEEXFORGEEXFORGE HCTFALESSAFALMINAFAMOTIDINEFANAPTFANAPT TITRATION PACKFARESTONFARXIGAFELBAMATEFELBATOLFELDENEFELODIPINE ERFEMARAFEMCON FEFEMHRT LOW DOSE
FEMRINGFENOFIBRATEFENOFIBRATE MICRONIZEDFENOFIBRIC ACIDFENOFIBRIC ACID DRFENOGLIDEFENOPROFEN CALCIUMFETZIMAFEXOFENADINE HCLFIBRICORFINASTERIDEFIRST-LANSOPRAZOLEFIRST-OMEPRAZOLEFIRST-TESTOSTERONEFLAVOXATE HCLFLECAINIDE ACETATEFLOMAXFLORICALFLUDROCORTISONE ACETATEFLUORABONFLUOR-A-DAYFLUORIDEFLUORITABFLUOXETINEFLUOXETINE DRFLUOXETINE HCLFLUPHENAZINE HCLFLURA-DROPSFLURBIPROFENFLUTAMIDEFLUVASTATINFLUVOXAMINE MALEATEFLUVOXAMINE MALEATE ER
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
FORFIVO XLFORTAMETFORTESTAFOSAMAXFOSAMAX PLUS DFOSINOPRIL SODIUMFOSINOPRIL SODIUM/HYDROCHLOROTHIAZIDEFOSRENOLFUROSEMIDEFYCOMPAGABAPENTINGABITIDINEGABITRILGALANTAMINE HYDROBROMIDEGASTROCROMGELNIQUEGEMFIBROZILGENERESS FEGENERLACGENGRAFGEODONGIANVIGILDAGIAGILDESS 1.5/30GILDESS 1/20GILDESS FE 1.5/30GILDESS FE 1/20GLIMEPIRIDEGLIPIZIDEGLIPIZIDE/METFORMIN HCLGLUCOPHAGEGLUCOPHAGE XR
GLUCOTROLGLUCOTROL XLGLUCOVANCEGLUMETZAGLYBURIDEGLYBURIDE MICRONIZEDGLYBURIDE/METFORMIN HCLGLYNASEGLYSETGRALISEGRASTEKGUANFACINE ERGUANFACINE HCLGUANIDINE HCLHALOPERIDOLHEATHERHECTOROLHEMANGEOLHOMATROPAIREHORIZANTHUMALOGHUMALOG KWIKPENHUMALOG MIX 50/50 KWIKPENHUMALOG MIX 75/25HUMALOG MIX 75/25 KWIKPENHUMULIN 70/30HUMULIN 70/30 KWIKPENHUMULIN NHUMULIN N KWIKPENHYDRALAZINE/HYDROCHLOROTHIAZIDE
HYDREAHYDROCHLOROTHIAZIDEHYDROCHLOROTHIAZIDE /TRIAMTERENEHYDROXYCHLOROQUINE SULFATEHYDROXYUREAHYOMAX-SLHYOSCYAMINE SULFATEHYOSCYAMINE SULFATE ODTHYOSYNE
HYPERTENEVIDE-12.5
HYPERTENIPINE-2.5HYPERTENSOLOLHYZAARIBANDRONATE SODIUMIBUPROFENIMDURIMIPRAMINE HCLIMIPRAMINE PAMOATEIMURANINDAPAMIDEINDERAL LAINDERAL XLINDOCININDOMETHACININNOPRAN XLINSPRAINTELENCEINTROVALEINTUNIVINVEGAINVIRASE
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
INVOKAMETINVOKANAIRBESARTANIRBESARTAN/HYDROCHLOROTHIAZIDEISENTRESSISODITRATE ERISONIAZIDISOPTIN SRISOPTO ATROPINEISOPTO CARBACHOLISOPTO CARPINEISOPTO HOMATROPINEISOPTO HYOSCINEISORDIL TITRADOSEISOSORBIDE DINITRATEISOSORBIDE MONONITRATEISOSORBIDE MONONITRATE ERISOXSUPRINE HCLISRADIPINEISTALOLJALYNJANUMETJANUMET XRJANUVIA
JARDIANCEJENCYCLAJENTADUETOJINTELIJOLESSAJOLIVETTEJUNEL 1.5/30JUNEL 1/20
JUNEL FE 1.5/30JUNEL FE 1/20KALETRAKAPIDEXKARIDIUMKARIVAKAZANOK-BICARBK-EFFERVESCENTKELNOR 1/35KEPPRAKEPPRA XRKERLONEKETOPROFENKETOPROFEN ERKHEDEZLAKOMBIGLYZE XRK-PHOSK-PHOS NEUTRALK-PRIMEKRISTALOSEK-SOLK-TABKURVELOK-VESCENTLABETALOL HCLLACTULOSELAMICTALLAMICTAL CHEWABLE DISPERSLAMICTAL ODTLAMICTAL XRLAMIVUDINELAMIVUDINE/ZIDOVUDINE
LAMOTRIGINELAMOTRIGINE ERLANOXINLANSOPRAZOLELANTUSLANTUS SOLOSTARLARIN 1.5/30LARIN 1/20LARIN FE 1.5/30LARIN FE 1/20LASIXLATANOPROSTLATUDALEENALEFLUNOMIDELESCOLLESCOL XLLESSINALETROZOLELEVATOLLEVBIDLEVEMIRLEVEMIR FLEXPENLEVEMIR FLEXTOUCHLEVETIRACETAMLEVETIRACETAM ERLEVOBUNOLOL HCLLEVOCARNITINELEVOCETIRIZINELEVONESTLEVONORGESTREL/ETHINYL ESTRADIOLLEVORA 0.15/30LEVOTHYROXINE SODIUMLEVOXYL
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
LEVSINLEVSIN/SLLEXAPROLEXIVALINZESSLIOTHYRONINE SODIUMLIPITORLIPOFENLIPTRUZETLISINOPRILLISINOPRIL/HYDROCHLOROTHIAZIDELITHIUMLITHIUM CARBONATELITHIUM CARBONATE ERLITHOBIDLIVALOLO LOESTRIN FELODOSYNLOESTRIN 1.5/30LOESTRIN 1/20LOESTRIN FE 1.5/30LOESTRIN FE 1/20LOFIBRALOMEDIA 24 FELOPIDLOPREEZALOPRESSORLOPRESSOR HCTLORATADINELORYNALOSARTAN POTASSIUMLOSARTAN POTASSIUM/HYDROCHLOROTHIAZIDELOSEASONIQUELOTENSIN
LOTENSIN HCTLOTRELLOTRONEXLOVASTATINLOVAZALOW-OGESTRELLOXAPINELOXAPINE SUCCINATELOZI-FLURLUDENTLUFYLLINLUMIGANLURIDELUTERALYRICALYZAMAGNEBIND 200MAPROTILINE HCLMARLISSAMARPLANMATULANEMATZIM LAMAVIKMECLOFENAMATE SODIUMMEDIPROXENMEDROXY PROGESTERONE ACETATEMEFENAMIC ACIDMEFLOQUINE HCLMEGACE ESMEGACE ORALMEGESTROL ACETATEMELOXICAMMENESTMENOSTAR
MESTINONMESTINON TIMESPANMETAPROTERENOL SULFATEMETFORMIN HCLMETFORMIN HCL ERMETHAZOLAMIDEMETHIMAZOLEMETHOTREXATEMETHOTREXATE SODIUMMETHOXSALENMETHYCLOTHIAZIDEMETHYLDOPAMETHYLDOPA/HYDROCHLOROTHIAZIDEMETIPRANOLOLMETOLAZONEMETOPROLOL SUCCINATE ERMETOPROLOL TARTRATEMETOPROLOL/HYDROCHLOROTHIAZIDEMEVACORMEXILETINE HCLMICARDISMICARDIS HCTMICROGESTIN 1.5/30MICROGESTIN 1/20MICROGESTIN FEMICROGESTIN FE 1.5/30MICRO-KMICRONIZED COLESTIPOL HCLMICROZIDEMINASTRIN 24 FE
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
MINIPRESSMINITRANMINIVELLEMINOXIDILMIRAPEXMIRAPEX ERMIRCETTEMIRTAZAPINEMIRTAZAPINE ODTMISOPROSTOLMOBICMODICONMOEXIPRIL HCLMOEXIPRIL/HYDROCHLOROTHIAZIDEMONOCALMONO-LINYAHMONONESSAMONTELUKAST SODIUMMOTRINMULTAQMYDRALMYDRIACYLMYRBETRIQMYSOLINEMYTELASEMYZILRANABUMETONENADOLOLNADOLOL/ HYDROCHLOROTHIAZIDE FLUMETHIAZIDENAFRINSENAFRINSE DROPSNALFON
NAMENDANAMENDA XRNAPRELANNAPROSYNNAPROXENNAPROXEN DRNAPROXEN ECNAPROXEN SODIUMNARDILNASCOBALNATAZIANATEGLINIDENECON 0.5/35NECON 1/35NECON 1/50NECON 10/11NECON 7/7/7NEFAZODONE HCLNEORALNEPTAZANENESINANEUPRONEURONTINNEVIRAPINENEVIRAPINE ERNEXICLON XRNEXIUMNEXIUM 24HRNIACIN ERNIASPANNICARDIPINE HCLNIFEDIAC CCNIFEDICAL XLNIFEDIPINENIFEDIPINE ER
NIKKINIMODIPINENISOLDIPINENISOLDIPINE ERNITRO-BIDNITRO-DURNITROGLYCERIN TRANSDERMALNITROMISTNITROSTATNITRO-TIMENIZATIDINENOLAHISTNORA-BENORETHINDRONE ACETATENORETHINDRONE ACETATE/ETHINYL ESTRADIOLNORGESTIMATE/ETHINYL ESTRADIOLNORINYL 1+35NORINYL 1+50NORLYROCNORPACENORPACE CRNORPRAMINNOR-QDNORTREL 0.5/35NORTREL 1/35NORTREL 7/7/7NORTRIPTYLINE HCLNORVASCNORVIR
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
NOVOLIN 70/30NOVOLIN 70/30 RELIONNOVOLIN NNOVOLIN N RELIONNOVOLIN N U-100NOVOLOGNOVOLOG FLEXPENNOVOLOG MIX 70/30NOVOLOG MIX 70/30 PREFILLNOVOLOG PENFILLNOXAFILNUEDEXTANULEVNUVARINGOCELLAOFEVOGESTRELOLANZAPINEOLANZAPINE ODTOLANZAPINE/FLUOXETINEOLEPTROOMEGA-3-ACID ETHYL ESTERSOMEPRAZOLEOMEPRAZOLE + SYRSPEND SFOMEPRAZOLE/SODIUM BICARBONATEONFIONGLYZAOPSUMITORALAIRORAP
ORSYTHIAORTHO EVRAORTHO MICRONORORTHO TRI-CYCLENORTHO TRI-CYCLEN LOORTHO-CEPTORTHO-CYCLENORTHO-ESTORTHO-NOVUM 1/35ORTHO-NOVUM 7/7/7OSCIMINOSCIMIN SROSENIOSPHENAOTREXUPOVCON-35OXAPROZINOXCARBAZEPINEOXSORALEN ULTRAOXTELLAR XROXYBUTYNIN CHLORIDEOXYBUTYNIN CHLORIDE EROXYTROLOXYTROL FOR WOMENPACERONEPAMELORPANCREAZEPANCRELIPASEPANTOPRAZOLE SODIUMPARICALCITOLPARLODELPARNATEPAROXETINE HCLPAROXETINE HCL ERPAXIL
PAXIL CRPEGANONEPENTASAPEPCIDPERINDOPRIL ERBUMINEPERPHENAZINEPERPHENAZINE/AMITRIPTYLINEPERSANTINEPERTZYEPEXEVAPHENELZINE SULFATEPHENOBARBITALPHENYTEKPHENYTOINPHENYTOIN INFATABSPHENYTOIN SODIUM EXTENDEDPHILITHPHOSLOPHOSLYRAPHOSPHA 250 NEUTRALPHOSPHOLINE IODIDEPILOCARPINE HCLPILOCARPINE HYDROCHLORIDEPIMTREAPINDOLOLPIOGLITAZONE HCLPIOGLITAZONE HCL/GLIMEPIRIDEPIOGLITAZONE HCL/METFORMINPIRMELLA 1/35PIRMELLA 7/7/7
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
PIROXICAMPLAQUENILPLAVIXPLETALPOLICOSANOLPONSTELPORTIAPOTABAPOTASSIUM BICARBONATEPOTASSIUM CHLORIDEPOTASSIUM CHLORIDE SRPOTASSIUM GLUCONATEPOTIGAPRADAXAPRAMIPEXOLE DIHYDROCHLORIDEPRANDIMETPRANDINPRAVACHOLPRAVASTATIN SODIUMPRAZOSIN HCLPRECEDEXPRECOSEPREFESTPREMARINPREMPHASEPREMPROPREVACIDPREVACID 24HRPREVACID SOLUTABPREVALITEPREVIDENTPREVIFEMPREZISTA
PRILOSECPRIMIDONEPRINIVILPRISTIQPROBENECIDPROBENECID/COLCHICINEPROCARDIAPROCARDIA XLPROCHLORPERAZINE MALEATEPROGESTERONEPROGLYCEMPROMACTAPROMETRIUMPROPAFENONE HCLPROPAFENONE HCL ERPROPRANOLOL HCLPROPRANOLOL HCL ERPROPRANOLOL/HYDROCHLOROTHIAZIDEPROPYLTHIOURACILPROSCARPROSTIGMINPROTONIXPROTRIPTYLINE HCLPROVERAPROZACPROZAC WEEKLYPYRIDOSTIGMINE BROMIDEQUARTETTEQUASENSEQUDEXY XRQUESTRANQUESTRAN LIGHT
QUETIAPINE FUMARATEQUINAPRIL HCLQUINAPRIL/HYDROCHLOROTHIAZIDEQUINARETICQUINIDINE SULFATEQUINIDINE SULFATE ERRABEPRAZOLE SODIUMRAGWITEKRALOXIFENE HYDROCHLORIDERAMIPRILRANEXARANITIDINE 150RANITIDINE HCLRAPAFLORASUVORAZADYNERAZADYNE ERRECLIPSENREGONOLREMERONREMERON SOLTABRENAGELRENVELAREPAGLINIDEREQUIPREQUIP XLRESCRIPTORRESCULARESERPINERESTASISRETROVIRREVATIOREYATAZRHEUMATREX
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
RIDAURARILUTEKRILUZOLERIOMETRISEDRONATE SODIUMRISPERDALRISPERDAL M-TABRISPERIDONERISPERIDONE M-TABRISPERIDONE ODTRIVASTIGMINE TARTRATEROCALTROLROPINIROLE ERROPINIROLE HCLROZEREMRYTHMOLRYTHMOL SRSAFYRALSALAGENSALSALATESANDIMMUNESAPHRISSARAFEMSAVELLASAVELLA TITRATION PACKSEASONIQUESECTRALSELEGILINE HCLSELZENTRYSENTRADINESEROQUELSEROQUEL XRSERTRALINE HCLSHAROBELSILDENAFIL
SILDENAFIL CITRATESILENORSIMBRINZASIMCORSIMPONI ARIASIMVASTATINSINEMETSINEMET CRSINGULAIRSODIUM FLUORIDESODIUM PHENYLBUTYRATESOLIASOLTAMOXSORIATANESORIATANE CKSORINESOTALOL HCLSOTALOL HCL (AF)SPIRONOLACTONESPIRONOLACTONE/HYDROCHLOROTHIAZIDESPRINTECSRONYXSSKISTALEVOSTARLIXSTAVUDINESTAVZORSTIMATESTRATTERASTRIBILDSUCRALFATESULARSULFASALAZINE
SULFAZINESULFAZINE ECSULINDACSURMONTILSUSTIVASYEDASYMAX DUOTABSYMAX FASTABSSYMAX-SLSYMAX-SRSYMBYAXSYMLINPENSYNTHROIDTAMOXIFEN CITRATETAMSULOSIN HCLTANZEUMTAPAZOLETARINA FE 1/20TARKATASMARTAZTIA XTTEGRETOLTEGRETOL-XRTEKAMLOTEKTURNATEKTURNA HCTTELMISARTANTELMISARTAN/AMLODIPINETELMISARTAN/HYDROCHLOROTHIAZIDETENEXTENORETICTENORMINTENSILON
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
TERAZOSIN HCLTERBUTALINE SULFATETERFENADINETESLACTESTIMTESTOSTERONETESTOSTERONE PUMPTEVETENTEVETEN HCTTHEO-24THEOCHRONTHEOPHYLLINETHIORIDAZINE HCLTHIOTHIXENETHYROIDTIAGABINE HYDROCHLORIDETIAZACTICLOPIDINE HCLTIKOSYNTILIA FETIMOLOL MALEATETIMOLOL MALEATE OPHTHALMICTIMOPTICTIMOPTIC OCUDOSETIMOPTIC-XETIROSINTTIVICAYTIZANIDINE HCLTOFRANILTOFRANIL-PMTOLAZAMIDETOLBUTAMIDETOLMETIN SODIUM
TOLTERODINE TARTRATETOLTERODINE TARTRATE ERTOPAMAXTOPAMAX SPRINKLETOPIRAGENTOPIRAMATETOPIRAMATE ERTOPROL XLTORSEMIDETOVIAZTRADJENTATRANDATETRANDOLAPRILTRANYLCYPROMINE SULFATETRAVATAN ZTRAVOPROSTTRAZODONE HCLTREPOXICAM-7.5TREXALLTRIAMTERENE/HYDROCHLOROTHIAZIDETRIBENZORTRICORTRI-ESTARYLLATRIFLUOPERAZINE HCLTRIGLIDETRIHEXYPHENIDYL HCLTRI-LEGEST FETRILEPTALTRI-LINYAHTRILIPIXTRINESSATRI-NORINYL
TRI-PREVIFEMTRI-SPRINTECTRIUMEQTRIVORATRIZIVIRTROKENDI XRTROPICAMIDETROSPIUM CHLORIDETROSPIUM CHLORIDE ERTRULICITYTRUSOPTTRUVADATWYNSTATYBOSTTYZEKAULORICULTRESAUROXATRALURSO 250URSO FORTEURSODIOLVAGIFEMVALCYTEVALGANCICLOVIRVALPROIC ACIDVALSARTANVALSARTAN/HYDROCHLOROTHIAZIDEVALTURNAVASCAZENVASCEPAVASERETICVASOTECVECAMYLVELIVET
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK | www.navitus.com
Share a Clear Viewnavitus.com
VELPHOROVENLAFAXINE HCLVENLAFAXINE HCL ERVERAPAMIL HCLVERAPAMIL HCL ERVERELANVERELAN PMVESICAREVESTURAVICTOZAVIDEXVIDEX ECVIIBRYDVIMOVOVIMPATVIOKACEVIORELEVIRACEPTVIRAMUNEVIRAMUNE XRVIREADVIRT-PHOS 250 NEUTRALVITAMIN DVITAMIN D2VIVELLE-DOTVOGELXOVOGELXO PUMPVOLTAREN-XRVOSPIRE ERVYFEMLAVYTORINWELCHOLWELLBUTRINWELLBUTRIN SRWELLBUTRIN XL
WERAWESTHROIDWYMZYA FEXALATANXARELTOXIFAXANXIGDUO XRXULANEXYZALYASMINYAZZAFIRLUKASTZANAFLEXZANTACZANTAC 150ZARAHZARONTINZEBETAZEGERIDZEGERID OTCZELAPARZEMPLARZENCHENTZENCHENT FEZENPEPZERITZESTORETICZESTRILZETIAZIACZIAGENZIDOVUDINEZIOPTANZIPRASIDONE HCLZOCOR
ZOLOFTZONEGRANZONISAMIDEZONTIVITYZORTRESSZORVOLEXZOVIA 1/35EZOVIA 1/50EZYFLOZYFLO CRZYLOPRIMZYPREXAZYPREXA ZYDISZYRTEC
• Note: Not all medications may be covered on your formulary. Always refer to your formulary for a list of current covered drugs.
![ABACAVIR AND LAMIVUDINE - abacavir and lamivudine tablet ... · ABACAVIR and LAMIVUDINE tablets, for oral use I... abalami.xml[9/27/2019 12:54:52 PM] ABACAVIR AND LAMIVUDINE - abacavir](https://static.fdocuments.net/doc/165x107/5ecb80ec4dce2967c35acac8/abacavir-and-lamivudine-abacavir-and-lamivudine-tablet-abacavir-and-lamivudine.jpg)
