Prescription Medication Reference List 2013

Your Pharmacy Program

Effective January 1, 2013

Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association

Table of ContentsAbout This Guide and Online Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Mail Service Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Your Pharmacy Cost Share and ID Card . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Top Covered Medications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Quality Care Dosing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Prior Authorization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Specialty Pharmacy Medications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Step Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Non-Covered Medications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Medication Resource List Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

New Medication Approval Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

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Pharmacy Program OverviewOur pharmacy program is designed to provide you and your doctor with access to a wide variety of safe, clinically effective medications . We have carefully developed a substantial formulary that includes many medications at affordable cost share levels .

About This GuideThis guide is up-to-date as of January 1, 2013, and is subject to change . Keep this guide handy, and use it as a reference whenever you need coverage information about a specific medication . To get the most current coverage information about a specific medication, visit our website at www.bluecrossma.com/pharmacy .

•TopCoveredMedications—includes many commonly prescribed covered medications and your cost share tier that applies

•QualityCareDosing—includes a list of medications subject to Quality Care Dosing limits

•PriorAuthorization—includes a list of medications that require prior authorization

•SpecialtyPharmacyMedications—includes a list of medications that are available through pharmacies in the Specialty Pharmacy Network

•StepTherapy—includes a list of medications subject to step therapy

•MedicationResourceListIndex—includes all prescription medications listed in this booklet, along with the page(s) on which they can be found

Online ResourcesFrom our main website, www.bluecrossma.com, to the www.express-scripts.com website, we offer a variety of online resources to help you manage your medications .

•SearchforMedicationInformation . To learn whether your medications will be covered, you can visit www.bluecrossma.com/pharmacy, and use the MedicationLookUp feature, listed on the left-hand side of the page . You can use this tool before you enroll . (The medication information represents our standard pharmacy coverage; your individual coverage may vary .)

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•MemberCentral . Want more detailed information about your health care coverage, claims, or deductibles? You can log on to Member Central by going to our website, www.bluecrossma.com/member-central . To register, click CreateanAccount, on the upper right-hand side of the page .

– If you’re already registered, just log in with your username and password .

•ExpressScriptsOnline . Once registered with Member Central, you can also get immediate, online access to information about your specific pharmacy benefit by visiting Express Scripts Inc ., (ESI), our pharmacy management partner, at www.express-scripts.com . Once there, you’ll have access to:

– Price a Drug

– Find a Pharmacy

– Mail Service features (which allow you to order refills and renew prescriptions)

Mail Service PharmacyWith the Mail Service Pharmacy (administered by ESI), you can enjoy the convenience of having certain prescriptions delivered to you . Depending on your specific coverage, you can use the Mail Service Pharmacy to order up to a 90-day supply of certain long-term maintenance medications (like those used to treat high blood pressure), for less than you may normally pay at a retail pharmacy .

It’s convenient, cost-effective, and completely confidential .

If you would like to use the Mail Service Pharmacy, you can download an order form and find additional information on our website . Go to www.bluecrossma.com/pharmacy and choose MailServicePharmacy from the menu on the left-hand side . If you’d like our Mail Service Pharmacy brochure mailed to you, please call 1-800-262-BLUE(2583) .

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Your Pharmacy Cost ShareOur pharmacy program formulary is based on a tiered cost share structure . When you fill a prescription, the amount you pay the pharmacy (your prescription cost share) is determined by the tier your medication is on . Medications are placed on tiers according to a variety of factors, including what they are used for, their cost, and whether equivalent or alternative medications are available . The pharmacy will advise you of the amount you owe . Usually, you will pay the least amount of cost share for Tier 1 medications and the most for Tier 3 medications .

Your cost share may include your copayment, co-insurance, deductibles, and maximums . For more about your specific prescription benefits, review the information in your benefit literature, which you should have received when you enrolled in your plan, or call the Member Service number listed on the front of your ID card, Monday through Friday, 8:00 a .m . to 9:00 p .m . ET .

Your ID CardYour ID card contains important information about your pharmacy benefits . Be sure to bring the card with you and give it to your pharmacist when you fill a prescription . A sample ID card is shown below .

JOHN Q PUBLIC

XXH88010124MEMBER SUFFIX: 00

HMO BlueTM

Copays OV 15BH 15 ER 40

Member Service 1-800-000-0000RxBin: 003858 PCN: A4RxGRP: MASA

(PA) prior authorization required (QCD) Quality Care Dosing limits apply

(ST) step therapy required4

Top Covered MedicationsOur pharmacy formulary includes over 4,000 covered prescription medications . The following sample list includes covered medications most commonly prescribed for our members .

This list is up-to-date as of January 1, 2013, and is subject to change at any time . You can find the most up-to-date information about a specific prescription medication on our website at www.bluecrossma.com/pharmacy .

Pleasenotethatthisisasampleoftopprescribedmedicationsbasedonourstandardformulary. For more information about your specific prescription benefits, review the information in your benefit literature, which you should have received when you enrolled in your plan, or call the Member Service number listed on the front of your ID card .

For members with a two-tier structure: The following covered medication list is based on a three-tier structure . All medications listed on Tier 3 are actually covered on your Tier 2 .

Abilify Tier 2Accu-Chek Aviva Plus (QCD) Tier 2Acetaminophen-Codeine Tier 1Actos (QCD) (ST) Tier 3Acyclovir Tier 1Advair Diskus (QCD) (ST) Tier 3Albuterol Sulfate Tier 1Alendronate Sodium (QCD) Tier 1Allopurinol Tier 1Alprazolam Tier 1Altavera Tier 1Amitriptyline HCl Tier 1Amlodipine Besylate (QCD) Tier 1Amlodipine Besylate-Benazepril Tier 1Amox Tr-Potassium Clavulanate Tier 1Amoxicillin Tier 1Amphetamine Salt Combo Tier 1Anastrozole Tier 1Apri Tier 1Armour Thyroid Tier 3Asacol Tier 2Atenolol Tier 1Atorvastatin Calcium (QCD) Tier 1Atripla Tier 2Avapro (ST) Tier 3

Aviane Tier 1Azithromycin Tier 1Baclofen Tier 1Benicar (ST) Tier 2Benicar HCT (ST) Tier 2Benzonatate Tier 1Betamethasone Dipropionate Tier 1Budesonide Tier 1Bupropion HCl Tier 1Bupropion HCl SR (QCD) Tier 1Bupropion XL (QCD) Tier 1Buspirone HCl Tier 1Butalbital-Acetaminophen-Caffe Tier 1Camila Tier 1Carbidopa-Levodopa Tier 1Carisoprodol Tier 1Carvedilol Tier 1Cefdinir Tier 1Cefuroxime Tier 1Celebrex (QCD) (ST) Tier 3Cephalexin Tier 1Chantix Tier 2Cheratussin AC Tier 1Chlorhexidine Gluconate Rinse Tier 1Chlorthalidone Tier 1

(PA) prior authorization required (QCD) Quality Care Dosing limits apply (ST) step therapy required 5

Cialis (QCD) Tier 3Ciprodex Tier 2Ciprofloxacin HCl Tier 1Citalopram HBr (QCD) Tier 1Clarithromycin Tier 1Clindamycin HCl Tier 1Clindamycin Phosphate Tier 1Clobetasol Propionate Tier 1Clonazepam Tier 1Clonidine HCl Tier 1Clopidogrel Tier 1Clotrimazole-Betamethasone Tier 1Colcrys Tier 1Combivent (QCD) Tier 2Crestor (QCD) (ST) Tier 2Cryselle Tier 1Cyanocobalamin injection Tier 1Cyclobenzaprine HCl Tier 1Cymbalta (QCD) (ST) Tier 3Desonide Tier 1Dexamethasone Tier 1Dextroamphetamine-Amphetamine (QCD) Tier 2Diazepam Tier 1Diclofenac Sodium Tier 1Dicyclomine HCl Tier 1Digoxin Tier 1Diltiazem 24hr CD Tier 1Diltiazem 24hr ER Tier 1Diltiazem ER Tier 1Diovan (ST) Tier 3Diovan HCT (ST) Tier 3Divalproex Sodium Tier 1Divalproex Sodium ER Tier 1Donepezil HCl Tier 1Dorzolamide-Timolol Tier 1Doxazosin Mesylate (QCD) Tier 1Doxycycline Hyclate Tier 1Doxycycline Monohydrate Tier 1Econazole Nitrate Tier 1Enalapril Maleate Tier 1Enbrel (PA) (QCD) Tier 2Endocet Tier 1Enoxaparin Sodium (QCD) Tier 2Enpresse Tier 1

Epipen Tier 2Erythromycin Tier 1Escitalopram Oxalate (QCD) Tier 1Estradiol Tier 1Etodolac Tier 1Evista Tier 2Fenofibrate Tier 1Fentanyl (PA) (QCD) Tier 1Finasteride Tier 1Flovent HFA (QCD) Tier 2Fluconazole Tier 1Fluocinonide Tier 1Fluoxetine HCl (QCD) Tier 1Fluticasone Propionate (QCD) Tier 1Folic Acid Tier 1Furosemide Tier 1Gabapentin Tier 1Gemfibrozil Tier 1Gianvi Tier 1Glimepiride Tier 1Glipizide Tier 1Glipizide ER Tier 1Glyburide Tier 1Humalog Tier 2Humira (PA) (QCD) Tier 2Hydrochlorothiazide Tier 1Hydrocodone-Acetaminophen Tier 1Hydrocortisone Tier 1Hydromorphone HCl Tier 1Hydroxychloroquine Sulfate Tier 1Hydroxyzine HCl Tier 1Ibuprofen Tier 1Indomethacin Tier 1Iophen-C NR Tier 1Irbesartan Tier 1Isosorbide Mononitrate ER Tier 1Januvia (ST) Tier 2Junel Tier 1Junel FE Tier 1Kariva Tier 1Ketoconazole Tier 1Ketorolac Tromethamine Tier 1Klor-Con 10 Tier 1Klor-Con M20 Tier 1Labetalol HCl Tier 1

(PA) prior authorization required (QCD) Quality Care Dosing limits apply

(ST) step therapy required6

Lamotrigine Tier 1Lansoprazole (PA) (QCD) Tier 1Lantus Tier 2Lantus Solostar Tier 2Latanoprost Tier 1Lessina Tier 1Levemir Tier 2Levetiracetam Tier 1Levitra (QCD) Tier 3Levofloxacin Tier 1Levothyroxine Sodium Tier 1Levoxyl Tier 1Lexapro (QCD) (ST) Tier 3Lidoderm (QCD) Tier 2Lisinopril Tier 1Lisinopril-Hydrochlorothiazide Tier 1Lithium Carbonate Tier 1Loestrin 24 FE Tier 3Lorazepam Tier 1Losartan Potassium Tier 1Losartan-Hydrochlorothiazide Tier 1Lovastatin (QCD) Tier 1Lumigan (ST) Tier 2Lunesta (QCD) (ST) Tier 3Lyrica (PA) Tier 3Medroxyprogesterone Acetate Tier 1Meloxicam (QCD) Tier 1Metadate CD (QCD) Tier 3Metformin HCl Tier 1Metformin HCl ER Tier 1Methimazole Tier 1Methocarbamol Tier 1Methotrexate Tier 1Methylphenidate ER (QCD) Tier 1Methylphenidate HCl Tier 1Methylprednisolone Tier 1Metoclopramide HCl Tier 1Metoprolol Succinate Tier 1Metoprolol Tartrate Tier 1Metronidazole Tier 1Microgestin FE Tier 1Minocycline HCl Tier 1Mirtazapine (QCD) Tier 1Mometasone Furoate Tier 1Montelukast Sodium (PA) Tier 1

Morphine Sulfate ER (PA) (QCD) Tier 1Mupirocin Tier 1Nabumetone Tier 1Nadolol Tier 1Namenda Tier 2Naproxen Tier 1Necon Tier 1Neomycin-Polymyxin-HC Tier 1Niaspan Tier 2Nifedipine ER Tier 1Nitrofurantoin Mono-Macro Tier 1Nitrostat Tier 2Norgestimate-Ethinyl Estradiol Tier 1Nortrel Tier 1Nortriptyline HCl Tier 1NovoLog Tier 2Nuvaring Tier 3Nystatin Tier 1Nystatin-Triamcinolone Tier 1Ocella Tier 1Ofloxacin Tier 1Olanzapine Tier 1Omeprazole (PA) (QCD) Tier 1Ondansetron HCl (QCD) Tier 1Ondansetron ODT (QCD) Tier 1One Touch Ultra test strips (QCD) Tier 2Ortho Tri-Cyclen Lo Tier 3Oxcarbazepine Tier 1Oxybutynin Chloride Tier 1Oxybutynin Chloride ER Tier 1Oxycodone HCl Tier 1Oxycodone HCl-Acetaminophen Tier 1Oxycodone-Acetaminophen Tier 1OxyContin (PA) (QCD) Tier 2Pantoprazole Sodium (PA) (QCD) Tier 1Paroxetine HCl (QCD) Tier 1Penicillin V Potassium Tier 1Phenazopyridine HCl Tier 1Plavix Tier 3Polymyxin B Sul-Trimethoprim Tier 1Portia Tier 1Potassium Chloride Tier 1Pradaxa (PA) Tier 3Pramipexole Dihydrochloride Tier 1Pravastatin Sodium (QCD) Tier 1

(PA) prior authorization required (QCD) Quality Care Dosing limits apply (ST) step therapy required 7

Prednisolone Acetate Tier 1Prednisolone Sodium Phosphate Tier 1Prednisone Tier 1Premarin Tier 3Prempro Tier 2Prenatal Plus Tier 1ProAir HFA (QCD) Tier 2Prochlorperazine Maleate Tier 1Promethazine HCl Tier 1Promethazine-Codeine Tier 1Propranolol HCl Tier 1Pulmicort Flexhaler (QCD) Tier 2Quetiapine Fumarate Tier 1Quinapril HCl Tier 1QVAR (QCD) Tier 2Ramipril Tier 1Ranitidine HCl (excluding 150mg) Tier 1Restasis (PA) Tier 3Risperidone Tier 1Ropinirole HCl Tier 1Seroquel Tier 3Sertraline HCl (QCD) Tier 1Simvastatin (QCD) Tier 1Singulair (PA) Tier 3Spiriva (QCD) Tier 2Spironolactone Tier 1Sprintec Tier 1Strattera (QCD) (ST) Tier 3Suboxone (PA) (QCD) Tier 2Sulfamethoxazole-Trimethoprim Tier 1Sumatriptan Succinate (QCD) Tier 1Symbicort (QCD) (ST) Tier 2

Synthroid Tier 3Tamoxifen Citrate Tier 1Tamsulosin HCl Tier 1Temazepam Tier 1Terazosin HCl (QCD) Tier 1Testim Tier 2Timolol Maleate Tier 1Tizanidine HCl Tier 1Tobramycin-Dexamethasone Tier 1Topiramate Tier 1Toprol XL Tier 3Tramadol HCl Tier 1Trazodone HCl Tier 1Tretinoin (PA) Tier 1Triamcinolone Acetonide Tier 1Triamterene-HCTZ Tier 1Tri-Sprintec Tier 1Vagifem Tier 2Valacyclovir (QCD) Tier 1Venlafaxine HCl Tier 1Venlafaxine HCl ER (QCD) Tier 1Verapamil ER Tier 1Vesicare (ST) Tier 2Viagra (QCD) Tier 3Vigamox (QCD) Tier 3Vivelle-Dot (QCD) Tier 3Warfarin Sodium Tier 1Zetia (QCD) (ST) Tier 3Zolpidem Tartrate (QCD) Tier 1Zolpidem Tartrate ER (QCD) Tier 1Zomig (QCD) (ST) Tier 2Zovia 1-35e Tier 1

* (non-covered medication) Quality Care Dosing limits apply for members with approved formulary exceptions** (new to market drug; non-covered while under review) quantity limits apply to members with approved formulary exceptions

(PA) prior authorization required(PA17) prior authorization required for members who are 17 years of age or older

(SP) medication is part of the specialty pharmacy network(SPO) benefits are not available for this medication when administered in an outpatient setting such as

a doctor’s office or hospital, unless the medication is obtained from a specialty pharmacy(ST) step therapy required8

Quality Care DosingOur Quality Care Dosing program helps to ensure that the quantity and dose of medications you receive comply with Food and Drug Administration (FDA) recommendations, as well as manufacturer and clinical information .

When you fill a prescription for one of the following medications, it is checked electronically in two ways:

•DoseConsolidation—Checks to see whether you’re taking two or more pills a day that can be replaced with one pill providing the same daily dosage .

•RecommendedMonthlyDosingLevel—Checks to see that your monthly dosage is consistent with the manufacturer’s and FDA’s monthly dosing recommendations and clinical information .

We will get your doctor’s approval before making any changes to your prescribed medications .

For the most up-to-date list of medications subject to Quality Care Dosing, along with associated dosing limits, please visit our website at www.bluecrossma.com/pharmacy and proceed to the QualityCareDosing section .

Please note: Your doctor may request an exception from the guidelines for medications that are subject to Quality Care Dosing (when medically necessary) .

Quality Care Dosing ListThis list of medications that are in our Quality Care Dosing program is up-to-date as of January 1, 2013, and may change from time to time .

Abstral * (PA)AcipHex * (PA)Actiq * (PA)Actonel (ST)ACTOplus Met (ST)ACTOplus Met XR (ST)Actos (ST)Acular PFAcular/LS *Adderall XR

Advair Discus (ST)Advair HFA (ST)Advicor (ST)Aerobid *Aerobid-M *AlendronateAlora *Alsuma (ST)Altoprev (ST)Alupent inhaler

* (non-covered medication) Quality Care Dosing limits apply for members with approved formulary exceptions** (new to market drug; non-covered while under review) quantity limits apply to members with approved formulary exceptions(PA) prior authorization required(PA17) prior authorization required for members who are 17 years of age or older(SP) medication is part of the specialty pharmacy network(SPO) benefits are not available for this medication when administered in an outpatient setting such as a doctor’s office or hospital, unless the medication is obtained from a specialty pharmacy(ST) step therapy required 9

Alvesco *Ambien * (ST)Ambien CR * (ST)Amerge (ST)AmitizaAmlodipineAmlodipine-AtorvastatinAmpyra (PA) (SP)Anzemet *Aplenzin ER * (ST)Aranesp (PA) (SP) (SPO)Arava *Arcapta Neohaler *Arixtra *Asmanex Twisthaler *AstelinAstepro *Atelvia DR * (ST)Atrovent (nasal spray)Atrovent HFAAvandamet (ST)Avandia (ST)Avinza *Avonex (SP) (SPO)Axert * (ST)Azmacort *Beconase AQ *Betaseron (SP) (SPO)Binosto * (ST)Boniva tablets * (ST)Budeprion SRBudeprion XLBudesonide (ampules)Bupropion SRBupropion XLButorphanol NSButrans *CabergolineCaduet * (ST)Cardura *Cardura XL *

Catapres TTSCelebrex (ST)Celexa * (ST)Cesamet *Ciclodin solution/kitCiclopirox nail lacquerCitalopramClimaraClimara ProClonidine patchCNL 8 nail kit *CombiventCombivent Respimat **ConcertaCopaxone (SP) (SPO)Crestor (ST)Crolom ophthalmicCromolyn ophthalmicCymbalta (ST)Dexilant * (PA)Dextroamphetamine/Amphetamine ERDiflucan (150 mg only)DoxazosinDulera (ST)Duragesic * (PA)Dymista *Edular * (ST)Effexor XR * (ST)Embeda *EmendEnbrel (PA) (SP) (SPO)EnoxaparinEpogen (PA) (SP) (SPO)EscitalopramEstradermEstradiol patchEstrasorb *Estrogel *Evamist *Exalgo *Extavia (SP)





FamciclovirFamvir *Fentanyl oral/mucosal (PA)Fentanyl patch (PA)Fentora * (PA)Flonase *Flovent/HFAFluconazole (150 mg only)FlunisolideFluoxetineFluoxetine DRFluticasoneFluvastatinFluvoxamineFocalin XR *FondaparinuxForadilForteo (PA) (SP) (SPO)Fosamax * (ST)Fosamax Plus D (ST)Fragmin *Frova * (ST)Gilenya (PA) (SP)Glucose testing strips (all)GranisetronGranisolHumira (PA) (SP) (SPO)Hytrin *IbandronateImitrex (ST)Infergen (PA) (SP) (SPO)Intermezzo * (ST)Ipratropium NSItraconazoleKadian * (PA)Ketorolac ophthalmicKytril *Lamisil *Lansoprazole (PA)Lazanda * (PA)Leflunomide

Lescol * (ST)Lescol XL * (ST)Lexapro (ST)LidodermLipitor * (ST)Livalo * (ST)LotronexLovastatinLovenox *Lunesta (ST)Luvox CR * (ST)Lysteda *Maxair Autohaler *Maxalt * (ST)Maxalt-MLT * (ST)MeloxicamMenostar *Metadate CDMethylphenidate ERMevacor * (ST)MigranalMirtazapineMirtazapine Rapid DissolveMobic *Morphine Sulfate ER (PA)MoxezaMS Contin (PA)NaratriptanNasacort AQ *Nasonex *NebuPentNeulasta (PA) (SP)Neupogen (PA) (SP)Nexium * (PA)Norvasc *Olanzepine-FluoxetineOmeprazole (PA)Omeprazole-Sod. Bicarbonate * (PA)Omnaris *Omontys (PA) (SP)Ondansetron

* (non-covered medication) Quality Care Dosing limits apply for members with approved formulary exceptions** (new to market drug; non-covered while under review) quantity limits apply to members with approved formulary exceptions(PA) prior authorization required(PA17) prior authorization required for members who are 17 years of age or older(SP) medication is part of the specialty pharmacy network(SPO) benefits are not available for this medication when administered in an outpatient setting such as a doctor’s office or hospital, unless the medication is obtained from a specialty pharmacy(ST) step therapy required 11

Ondasetron ODTOnsolis * (PA)Opana ER *Optivar *Oramorph SR * (PA)Oxycodone ER (PA)OxyContin (PA)Oxymorphone ER (PA)Pantoprazole (PA)ParoxetineParoxetine CRPatanase *Paxil * (ST)Paxil CR * (ST)Pediapirox-4Pegasys (PA) (SP) (SPO)PEG-Intron (PA) (SP) (SPO)Penlac *Pexeva * (ST)Pioglitazone (ST)Pioglitazone-Metformin (ST)Pravachol * (ST)PravastatinPrevacid * (PA)PrevpacPrilosec * (PA)Pristiq * (ST)ProAir HFAProcrit (PA) (SP) (SPO)Protonix * (PA)Proventil HFA *Prozac * (ST)Prozac Weekly * (ST)Pulmicort FlexhalerPulmicort RespulesQNASL *QualaquinQutenza (SP)QVARRapafluxRebif (SP) (SPO)

Relpax (ST)Remeron *Remeron Soltab *Restasis (PA)Rhinocort Aqua *Ritalin LA *Rozerem (ST)Sancuso *Sarafem * (ST)SelfermaSerevent DiskusSertralineSilenor * (ST)Simcor * (ST)Simponi (PA) (SP)SimvastatinSonata (ST)SpirivaSporanox *Strattera (PA17)Subsys * (PA)SumatriptanSumavel Dosepro * (ST)Symbicort (ST)SymbyaxTerazosinTerbinafineTerbinex *Treximet * (ST)Triamcinolone (nasal spray)Tudorza **ValacylovirValtrexVenlafaxine ER capsuleVenlafaxine ER tablet (ST)Ventolin HFA *Veramyst *VigamoxViibryd * (ST)VivelleVivelle-Dot





Vytorin * (ST)Vyvanse *Wellbutrin SR * (ST)Wellbutrin XL * (ST)Xopenex HFA *ZaleplonZegerid * (PA)Zetia (ST)Zetonna **Zocor * (ST)Zofran *

Zofran ODT *Zoloft * (ST)ZolpidemZolpidem ERZolpimist * (ST)Zomig (ST)Zomig ZMT (ST)Zuplenz *ZymarZymaxid *

* (non-covered medication) prior authorization required for members with approved formulary exceptions** covered under medical benefit only(PA17) prior authorization required for members who are 17 years of age or older(PA30) prior authorization required for members who are 30 years of age or older(QCD) Quality Care Dosing limits apply(SP) medication is part of the specialty pharmacy network(SPO) benefits are not available for this medication when administered in an outpatient setting such as a doctor’s office or hospital, unless the medication is obtained from a specialty pharmacy 13

Prior AuthorizationYour doctor is required to obtain prior authorization before prescribing specific medications . This ensures that your doctor has determined that this medication is necessary to treat you, based on specific medical standards .

For the most up-to-date list of medications that require prior authorization, please visit our website, www.bluecrossma.com/pharmacy, click on PharmacyManagementProgram, and proceed to PriorAuthorization .

Another part of our prior authorization program is step therapy . Please refer to page 19 for a list of medications that require step therapy .

Prior Authorization ListThis list of medications that require prior authorization is up-to-date as of January 1, 2013, and may change from time to time .

Abstral * (QCD)AcipHex * (QCD)Actemra (SP)Acthar (SP)Actiq * (QCD)Adcirca (SP)Amevive **Amphetamines (e.g Amphetamine, Methamphetamine, Liquadd, Procentra)Ampyra (QCD) (SP)Aralast **Aralast NP **Aranesp (QCD) (SP) (SPO)Avinza * (QCD)Boniva syringe * (SP)Botulinum toxinBuprenorphine (QCD)Butrans * (QCD)Ceredase **Cerezyme **Cimzia (SP) (SPO)Cinryze **Desoxyn (PA17)Dexilant * (QCD)

Dextroamphetamines (e.g. Dexedrine) (PA17)DisketsDolophineDuragesic * (QCD)Egrifta (SP)ElidelEmbeda * (QCD)Enbrel (QCD) (SP) (SPO)Enteral formulaEpogen (QCD) (SP) (SPO)Erbitux **EuflexxaExalgo * (QCD)Eylea **Factor VIII, VIIIa, IX, XIII **Fentanyl oral/mucosal (QCD)Fentanyl patch (QCD)Fentora * (QCD)First-lansoprazoleFirst-omeprazoleForteo (QCD) (SP) (SPO)Gilenya (QCD) (SP)Growth Hormone (SP) (SPO)Humira (QCD) (SP) (SPO)

* (non-covered medication) prior authorization required for members with approved formulary exceptions** covered under medical benefit only

(PA17) prior authorization required for members who are 17 years of age or older(PA30) prior authorization required for members who are 30 years of age or older

(QCD) Quality Care Dosing limits apply(SP) medication is part of the specialty pharmacy network

(SPO) benefits are not available for this medication when administered in an outpatient setting such as a doctor’s office or hospital, unless the medication is obtained from a specialty pharmacy14

HyalganIlaris (SP)Incivek (SP)Interferons (alpha, gamma) (QCD) (SP) (SPO)IV Immunoglobulin **Kadian * (QCD)KalydecoKineret (SP) (SPO)Lansoprazole (QCD)Lazanda * (QCD)Leukine (SP)Lucentis **LyricaMacugen **Makena (SP)MethadoneMethadoseModafinilMorphine Sulfate CR (QCD)Morphine Sulfate ER (QCD)MS Contin (QCD)Neulasta (QCD) (SP)Neupogen (QCD) (SP)Nexium * (QCD)Nucynta ER *Nuvigil * (PA17)Omeprazole (QCD)Omeprazole -Sod. Bicarbonate * (QCD)Omontys (SP) (SPO)Onsolis * (QCD)Opana ER * (QCD)Oramorph SR * (QCD)Orencia (SP)OrthoviscOxycodone ER (QCD)Oxycontin (QCD)Oxymorphone ER (QCD)Pantoprazole (QCD)PradaxaPreservative-Free Morphine **

Prevacid * (QCD)Prilosec * (QCD)Procrit (QCD) (SP) (SPO)Prolastin **Prolastin C **Proleukin (SP)Prolia (SP)Protonix * (QCD)ProtopicProvigil (PA17)Raptiva (SP)Reclast **RegranexRemicade (SP)Respiratory SyncytialVirus IG/Synagis **Restasis (QCD)Revatio (SP)Rituxan (SP)Simponi (QCD) (SP)Stelara * (SP)Strattera (PA17) (QCD)Suboxone (QCD)Subsys * (QCD)SupartzSynviscSynvisc OneTopical Retinoic Acid derivatives (e.g. Retin A) (PA30)TPN (total parenteral nutrition) **Tysabri **Vectibix **Victrelis (SP)Xalkori (SP)Xgeva (SP)Xiaflex **Xolair **Zegerid * (QCD)Zelboraf (SP)Zometa **

* (non-covered medication) step therapy required for members with approved formulary exceptions(PA) prior authorization required | (QCD) Quality Care Dosing limits apply(SPO) benefits are not available for this medication when administered in an outpatient setting such as a doctor’s office or hospital, unless the medication is obtained from a specialty pharmacy 15

Specialty Pharmacy MedicationsBlue Cross Blue Shield of Massachusetts has set up a network of retail specialty pharmacies to dispense certain medications classified as specialty . The following is a list of medications that can only be purchased from one of the pharmacies in this network in order for coverage to be available .

This list is up-to-date as of January 1, 2013 . You can find the latest information about your medications and look up pharmacy contact information by visiting www.bluecrossma.com/pharmacy .

Network Pharmacy InformationAcariaHealth 1-866-892-1202 www.acariahealth.comAccredo Health Group, Inc. 1-877-988-0058 www.accredo.comCVS Caremark, Inc. 1-866-846-3096 www.caremark.comCuraScript, a subsidiary of Express Scripts, Inc. 1-888-823-9070 www.curascript.comOncoMed, the Oncology Pharmacy 1-877-662-6633 www.oncomed.net

Network Pharmacy Information for Medications Most Commonly Used for FertilityBriovaRx 1-800-850-9122 www.briovarx.comFreedom Fertility Pharmacy 1-866-297-9452 www.freedomfertility.comMetro Drugs 1-888-258-0106 www.metrodrugs.comVillage Fertility Pharmacy 1-877-334-1610 www.villagefertilitypharmacy.com

Fertility MedicationsBravelle * (SPO)CetrotideClomidClomipheneEndometrinFollistim AQ * (SPO)Ganirelix (SPO)Gonal F/Gonal F RFF (SPO)Human Chorionic Gonadotropin (HCG) (SPO)Leuprolide (SPO)Leuprolide AcetateLupron DepotLupron Depot PedLuveris (SPO)

Menopur (SPO)NovarelOvidrelPregnyl (SPO)Repronex (SPO)Serophene

Injectable MedicationsAbraxaneActemra (PA)Acthar (PA)Actimmune (PA) (SPO)Adriamycin PFSAdrucilAlferon N (PA)

* (non-covered medication) step therapy required for members with approved formulary exceptions(PA) prior authorization required | (QCD) Quality Care Dosing limits apply


AlkeranApokynAranesp (PA) (QCD) (SPO)Arcalyst InjectionArediaArzerraAvonex (QCD) (SPO)Betaseron (QCD) (SPO)BiCNuBleomycin SulfateBoniva Injection * (PA)BusulfexCalcium folinateCamptosarCarboplatinCerubidineCimzia (PA) (SPO)CisplatinCladribineCopaxone (QCD) (SPO)CosmegenCyclophosphamideCytarabineCytoxanDacarbazineDactinomycinDaunorubicin HCLDaunoXomeDDAVP *DepocytDesmopressin AcetateDocefrexDocetaxelDoxilDoxorubicin HClDTIC-DomeEgrifta (PA)EligardEllenceEloxatinElsparEnbrel (PA) (QCD) (SPO)EpirubicinEpogen (PA) (QCD) (SPO)

EthyolEtopophosEtoposideExtavia * (QCD)FaslodexFirazyrFirmagonFloxuridineFludaraFludarabine phosphateFluorouracilForteo (PA) (QCD) (SPO)FUDRFusilev I.V.Fuzeon (SPO)GemcitabineGemzarGenotropin * (PA) (SPO)HerceptinHumatrope (PA) (SPO)Humira (PA) (QCD) (SPO)HycamtinIdamycin PFSIdarubicinIfexIfosfamideIfosfamide/MesnaIlaris (PA)Increlex (PA) (SPO)Infergen (PA) (QCD) (SPO)Intron A (PA) (SPO)IrinotecanIstodaxKenalogKineret (PA) (SPO)Leucovorin CalciumLeukine (PA)Leuprolide Acetate (SPO)LeustatinLipodoxLipodox-50Lupron DepotLupron Depot-PedMakena (PA)

* (non-covered medication) step therapy required for members with approved formulary exceptions(PA) prior authorization required | (QCD) Quality Care Dosing limits apply(SPO) benefits are not available for this medication when administered in an outpatient setting such as a doctor’s office or hospital, unless the medication is obtained from a specialty pharmacy 17

MesnaMethotrexateMexnexMitomycinMitoxantroneMozobilMustargenMylotargNavelbineNeosarNeulasta (PA) (QCD)NeumegaNeupogen (PA) (QCD)NipentNorditropin * (PA) (SPO)Norditropin Flexpro * (PA) (SPO)Norditropin Nordiflex * (PA) (SPO)NovantroneNplateNutropin (PA) (SPO)Nutropin AQ (PA) (SPO)Nutropin AQ Nuspin (PA) (SPO)Octreotide injection (SPO)Omnitrope * (PA) (SPO)Omontys (PA) (QCD)OncasparOntakOnxolOrencia (PA)OxaliplatinPaclitaxelPamidronatePamidronate disodiumPegasys (PA) (QCD) (SPO)Peg-Intron (PA) (QCD) (SPO)PhotofrinProcrit (PA) (QCD) (SPO)Proleukin (PA)Prolia (PA)Rebif (QCD) (SPO)Remicade (PA)Revatio (PA)Rituxan (PA)Saizen * (PA) (SPO)

Sandostatin (SPO)Sandostatin-LARSerostim (PA) (SPO)Simponi (PA) (QCD)SimulectSomatulineSomavertStelara * (PA)Sylatron (PA)SynagisTarabineTaxolTaxotereTev-Tropin * (PA) (SPO)TheraCysThiotepaThyrogenToposarTotectTrelstarTrelstar DepotTrelstar LAVelcadeVePesidVinBLAStineVinCRIStineVinorelbineVumonXgeva (PA)ZanosarZenapaxZinecardZoladexZorbtive (PA) (SPO)

Oral Medications8-MopAdcirca (PA)AfinitorAlkeranAmpyra (PA) (QCD)CarbagluCopegus (SPO)CystagonCytoxan

* (non-covered medication) step therapy required for members with approved formulary exceptions(PA) prior authorization required | (QCD) Quality Care Dosing limits apply


ErivedgeEtoposideExjadeGilenyaGleevecHycamtinIncivek (PA)InlytaIressaJakafiKalydeco (PA)KorlymKuvanLetairisMesnexNexavarOfortaOnsolis * (PA) (QCD)OrfadinPromactaPulmozyme (SPO)Rebetol (SPO)Revatio (PA)RevlimidRibapak (SPO)Ribasphere (SPO)RibatabRibavirin (SPO)

RilutekSabrilSprycelSucraidSutentTarcevaTasignaTemodarThalomidTOBI (SPO)TracleerTykerbTyvasoVictrelis (PA)VotrientXalkoriXelodaXenazineXtandi **XyremZavescaZelboraf (PA)ZolinzaZytiga

TopicalPanretinQutenza (QCD)

* (non-covered medication) step therapy required for members with approved formulary exceptions** (new to market drug; non-covered while under review) quantity limits apply to members with approved formulary exceptions(QCD) Quality Care Dosing limits apply 19

Step TherapyStep therapy is a key part of our prior authorization program that allows us to help your doctor provide you with an appropriate and affordable drug treatment . Before coverage is allowed for certain costly “second-step” medications, we require that you first try an effective, but less expensive, “first-step” medication . Some medications may have multiple steps .

Step Therapy ListThis list is up-to-date as of January 1, 2013, and is subject to change at any time . For the most up-to-date list of medications that require step therapy, please visit our website www.bluecrossma.com/pharmacy, click on PharmacyManagementProgram, and proceed to StepTherapy .

Antidepressant DrugsAplenzin ER * (QCD)Celexa * (QCD)Cymbalta (QCD)Effexor *Effexor XR * (QCD)Fluoxetine 60mg tablet (QCD)Lexapro (QCD)Luvox CR * (QCD)Paxil * (QCD)Paxil CR * (QCD)Pexeva * (QCD)Pristiq * (QCD)Prozac * (QCD)Prozac Weekly * (QCD)Sarafem * (QCD)Venlafaxine ER tablet (QCD)Viibryd * (QCD)Wellbutrin *Wellbutrin SR * (QCD)Wellbutrin XL * (QCD)Zoloft * (QCD)

Asthma ManagementAccolate *Advair Discus (QCD)Advair HFA (QCD)Dulera (QCD)Montelukast

SingulairSymbicort (QCD)ZafirlukastZyflo *Zyflo CR *

Cholesterol TreatmentAdvicor (QCD)Altoprev * (QCD)Caduet * (QCD)Crestor (QCD)Lescol * (QCD)Lescol XL * (QCD)Lipitor * (QCD)Livalo * (QCD)Mevacor * (QCD)Pravachol * (QCD)Simcor * (QCD)Vytorin * (QCD)Zetia (QCD)Zocor * (QCD)

Diabetes ManagementACTOplus met (QCD)Actoplus Met XR (QCD)Actos (QCD)Avandamet (QCD)AvandarylAvandia (QCD)

* (non-covered medication) step therapy required for members with approved formulary exceptions** (new to market drug; non-covered while under review) quantity limits apply to

members with approved formulary exceptions(QCD) Quality Care Dosing limits apply20

DuetactJanumetJanumet XRJanuviaJentadueto *Kombiglyze XROnglyzaPioglitazone (QCD)Pioglitazone-Metformin (QCD)Tradjenta *Victoza

GlaucomaLumiganTravatanTravatan ZXalatan

Heart/Blood Modifiers/CirculationAmturnide *Atacand *Atacand HCT *AvalideAvaproAzorBenicarBenicar HCTCozaar *DiovanDiovan HCTEdarbi *Edarbyclor *ExforgeExforge-HCTHyzaar *Micardis *Micardis HCT *Tekamlo *Tekturna *Tekturna HCT *Teveten *Teveten HCT *TribenzorTwynsta *Valturna *

Insomnia TreatmentAmbien * (QCD)Ambien CR * (QCD)Edular * (QCD)Lunesta (QCD)Rozerem (QCD)Sonata (QCD)Zolpimist * (QCD)

Migraine TreatmentAlsuma (QCD)Amerge * (QCD)Axert * (QCD)Frova * (QCD)Imitrex (QCD)Maxalt * (QCD)Maxalt MLT * (QCD)Relpax (QCD)Sumavel Dosepro * (QCD)Treximet * (QCD)Zomig (QCD)Zomig ZMT (QCD)

Osteoporosis Treatment (Oral)Actonel (QCD)Atelvia DR * (QCD)Binosto * (QCD)Boniva tablets * (QCD)Fosamax * (QCD)Fosamax Plus D (QCD)

Overactive Bladder TreatmentDetrol *Detrol LA *Ditropan *Ditropan XL *Enablex *Gelnique *Myrbetriq **Oxytrol *Sanctura *Sanctura XR *Toviaz *Vesicare

* (non-covered medication) step therapy required for members with approved formulary exceptions** (new to market drug; non-covered while under review) quantity limits apply to members with approved formulary exceptions(QCD) Quality Care Dosing limits apply 21

Pain Relievers (Cox II Inhibitors)Celebrex (QCD)

Parkinson’s Disease TreatmentMirapexMirapex ER *Requip *Requip XL *

Prostate TreatmentAvodartJalynProscar *

Topical TestosteroneAndrodermAndrogel *Axiron *Fortesta *

(PA) prior authorization required for members with approved formulary exceptions(PA30) prior authorization required for members who are 30 years of age or older

(QCD) Quality Care Dosing limits apply for members with approved formulary exceptions(SP) medication is part of the specialty pharmacy network

(ST) step therapy required for members with approved formulary exceptions22

Non-Covered MedicationsYour pharmacy program provides coverage for over 4,000 prescription medications . Most medications on our non-covered list have equally safe, effective, covered alternatives for treating the same medical conditions . Check with your doctor about appropriate alternatives if you currently take any of these medications .

For the most up-to-date list of medications that are not covered and their covered alternatives, please visit our website, www.bluecrossma.com/pharmacy, click on MedicationLookUp, and proceed to the MedicationsthatarenotCovered section .

Please note: Your doctor may request coverage for a non-covered medication if no covered alternative is appropriate for treating your condition .

Non-Covered Medication ListThis list of non-covered medications is up-to-date as of January 1, 2013, and may change from time to time .

Abilify DiscMeltAbstral (PA) (QCD)AcanyaAccolate (ST)AccuNebAccuprilAccureticAccutaneAceonAcipHex (PA) (QCD)ActigallActiq (PA) (QCD)ActivellaACTOplus Met XR (QCD) (ST)Acular (QCD)Acular LS (QCD)AcuvailAczoneAdalat CCAdderallAdoxa CKAdoxa TTAerobid (QCD)

Aerobid-M (QCD)AiretAlodoxAloquinAlora (QCD)AltabaxAltaceAltoprev (QCD) (ST)AluveaAlvesco (QCD)Ambien (QCD) (ST)Ambien CR (QCD) (ST)AmrixAmturnide (ST)AnafranilAnalpram AdvancedAnalpram-E kitAndrogel (ST)AngeliqAntaraAnzemet (QCD)ApidraAplenzin ER (QCD) (ST)

(PA) prior authorization required for members with approved formulary exceptions(PA30) prior authorization required for members who are 30 years of age or older(QCD) Quality Care Dosing limits apply for members with approved formulary exceptions(SP) medication is part of the specialty pharmacy network(ST) step therapy required for members with approved formulary exceptions 23

Appformin-DAqua Glycolic HCArava (QCD)Arcapta Neohaler (QCD)Arixtra (QCD)Ascensia diabetic testing supplies (QCD)Asmanex Twisthaler (QCD)Assure Pro diabetic testing supplies (QCD)Astepro (QCD)Atacand (ST)Atacand HCT (ST)Atelvia (QCD) (ST)AtivanAtopiclairAtralinAtrapro Dermal SprayAtrapro HydrogelAtropenAugmentin XRAurstatAveloxAvidoxyAvidoxy DKAvinza (PA) (QCD)AvitaAxert (QCD) (ST)AxidAxiron (ST)AzasiteAzmacort (QCD)B-D diabetic testing supplies (QCD)Beconase AQ (QCD)BenzaClin kitBepreveBesivanceBinosto (QCD) (ST)BionectBoniva syringe (PA) (SP)Boniva tablets (QCD) (ST)Bravelle (SP)BreviconBromdayBrovanaButrans (PA) (QCD)

BystolicCaduet (QCD)Calcitriol TopicalCambiaCaphosolCapotenCardeneCardene SRCardizem CDCardizem LACardura XL (QCD)CataflamCeclorCeclor CDCedaxCelexa (QCD) (ST)Cem-UreaCenestinCentanyCentany ATCesamet (QCD)CetraxelChenodalChibroxin OcumeterCipro-XRCleanse and TreatCleervue-MCleocin TClindacin PACClindagelClindamaxClindareachClindetsClobeta + PlusCNL 8 nail kit (QCD)ColazalCombiganCombunoxContour Next diabetic testing supplies (QCD)ConzipCoregCoreg CRCosopt PFCozaar (ST)




DalirespDarvocet N-100DayproDaytranaDDAVPDemulenDepo-Sub Q Provera 104Derma-Smoothe/FSDermOticDesogenDesonil + PlusDesOwen kitDetrol (ST)Detrol LA (ST)Dexedrine (PA)Dexilant (PA) (QCD)DificidDilacor XRDilaudidDipentumDispermoxDitropan (ST)Ditropan XL (ST)DivigelDoryxDuexisDuragesic (PA) (QCD)DurezolDymista (QCD)DynabacDynacinDynacircDynacirc CRDytanEdarbi (ST)Edarbyclor (ST)Edular (QCD) (ST)Effexor (ST)Effexor XR (QCD) (ST)ElestrinEletoneEmbeda (QCD)EmsamEnablex (ST)

EnjuviaEpiCeramEpiduoEquetroErtaczoEstraceEstrasorb (QCD)Estrogel (QCD)Evamist (QCD)EvoclinExacTech diabetic testing supplies (QCD)Exalgo (PA) (QCD)ExtaviaExtinaFactiveFamvir (QCD)FanaptFazaCloFemtraceFenoglideFentora (PA) (QCD)Fertinex (SP)FexmidFibracorFinacea PlusFioricetFiorinalFiorinal with CodeineFlagylFlagyl ERFlagyl IVFlectorFlonase (QCD)FocalinFocalin XR (QCD)Follistim AQ (SP)FortametFortesta (ST)Fosamax (QCD) (ST)Fragmin (QCD)Freestyle diabetic supplies (QCD)Fresh KoteFrova (QCD) (ST)Garamide


GelclairGelnique (ST)Genotropin (PA) (SP)Glucometer diabetic supplies (QCD)GlucophageGlucophage XRGlumetzaHalonateHalotinHorizantHPR PlusHydrocortisone-Lidocaine kitHylaseHylatopicHylatopic PlusHylatopic Plus-AurstatHyliraHytrin (QCD)Hyzaar (ST)IB-StatIC400 kitIC800 kitImuranInderal LAInnohepInnoPran XLIntunivInvegaIquixIstalolJentadueto (ST)Kadian (PA) (QCD)KapvayKeppra XRKeralyt kitKetocon + PlusKlonopinKytril (QCD)Lamictal ODTLamisil (QCD)Lamisil Granules (QCD)LatudaLazanda (PA) (QCD)Lescol (QCD) (ST)

Lescol XL (QCD) (ST)LevaquinLevlenLexxelLialdaLidovirLipitor (QCD) (ST)LipofenLivalo (QCD) (ST)LodineLodine XLLofibraLopressorLorabidLoSeasoniqueLotensinLotensin HCTLovazaLovenox (QCD)Luvox CR (QCD) (ST)Lysteda (QCD)LytensoprilMavikMaxair Autohaler (QCD)Maxalt/Maxalt-MLT (QCD) (ST)MaxipimeMegace ESMenostar (QCD)MetaglipMetozolv ODTMetrogel kitMevacor (QCD) (ST)Micardis (ST)Micardis HCT (ST)MinocinMinocin Combo PackMirapex ER (ST)Mobic (QCD)MomexinMonodoxMonoprilMonopril HCTMorgidoxMoxatag




MyoxinNaprelanNaprosynNaprosyn ECNasacort AQ (QCD)Nasarel (QCD)Nasonex (QCD)NataziaNeosalusNeuproNeurontinNeutraSalNevanacNexavirNexiclon XRNexium (PA) (QCD)NiravamNorditropin (PA) (SP)NorinylNoroxinNor-Q-DNorvasc (QCD)NovacortNuCortNucyntaNucynta ER (PA)NuedextaNutriDoxNuvigil (PA)Ocudox kitOleptro EROluxOmeprazole/Sodium Bicarb (PA) (QCD)Omnaris (QCD)OmnicefOmnitrope (PA) (SP)Onsolis (PA) (QCD)OpanaOpana ER (PA) (QCD)OptaseOptivar (QCD)OraceaOramorph SR (PA) (QCD)Orapred ODT

OravigOrtho-PrefestOvconOxectaOxytrol (ST)PamelorPamine FQPancreazePaptasePatanase (QCD)Paxil (QCD) (ST)Paxil CR (QCD) (ST)PCEPCE DispertabPediaderm AFPediaderm HCPediaderm TAPenlac (QCD)PennsaidPepcidPercocetPexeva (QCD) (ST)PhoslyraPlaquenilPramcortPram-HCAPramosone EPrandiMetPravachol (QCD) (ST)PR-CreamPrecision diabetic supplies (QCD)Prestige diabetic testing supplies (QCD)Prevacid (PA) (QCD)Prevacid NapraPACPrilosec (PA) (QCD)PrinivilPrinzidePristiq (QCD) (ST)Procentra (PA)ProcortProdigy diabetic testing supplies (QCD)PromisebPromiseb LightProquin XR


Protonix (PA) (QCD)Proventil HFA (QCD)Proventil inhaler (QCD)Proventil/RepetabProzac (QCD) (ST)Prozac Weekly (QCD) (ST)PurinetholQNASL (QCD)QuixinRadiaPlex RxRadigelRaniclorRapafloRayosRecothromRelafenRemeron (QCD)Remeron Soltab (QCD)Requip (ST)Requip XL (ST)ResculaRestorilRetin-A Micro (PA30)Rhinocort Aqua (QCD)RinnoviRisperdal M-TabRitalinRitalin LA (QCD)Ritalin SRRosadanRosanilRybixRybix ODTRynatanRythmolRyzoltSaizen (PA) (SP)Salicylic Acid-Ceramide kitSalkeraSalvaxSalvax DuoSalvax Duo PlusSanctura (ST)Sanctura XR (ST)

Sancuso (QCD)SaphrisSarafem (QCD) (ST)ScalacortSeasoniqueSenophyllineSilenor (QCD)Simcor (QCD) (ST)SinemetSkelidSof-Tact diabetic supplies (QCD)SolodynSoltamoxSomaSpectracefSporanox (QCD)SprixStavzorStelara (PA)StriantSubsys (PA) (QCD)SularSumadanSumavel Dosepro (QCD) (ST)SumaxinSumaxin CPSumaxin TSTagametTekamlo (ST)Tekturna (ST)Tekturna HCT (ST)TenorminTequinTerbinex (QCD)TersiTetrixTeveten (ST)Teveten HCT (ST)Tev-Tropin (PA) (SP)TherapentinTheraproxinTiamateTiazacTindamax




TirosintTobraDex STTofranilTornalateToviaz (ST)Tradjenta (ST)Tranxene T-TabTretin-X (PA)Treximet (QCD) (ST)TricorTriglideTri-LevlenTrilipixTrinalinTri-NorinylTriOxinTritecTropazoneTrueTest diabetic supplies (QCD)TrueTrack diabetic supplies (QCD)Twynsta (ST)UltracetUltram/ERUltravate PACUltravate XUramaxinUrea kitValiumValturna (ST)VanosVantinVasereticVasolexVasotecVecticalVectrinVeltin (PA30)Ventolin HFA (QCD)Veramyst (QCD)VeregenVicodinVicodin ESViibryd (QCD) (ST)Vimovo

VirasalVoltarenVoltaren XRVusionVytorin (QCD) (ST)Vyvanse (QCD)WelcholWellbutrinWellbutrin SR (QCD) (ST)Wellbutrin XL (QCD) (ST)XanaxXanax XRX-ClairXenadermXereseXibromXifaxanXolegelXoloxXopenex HFA (QCD)Xopenex nebulesXyralidZanaflexZantacZebetaZegerid (PA) (QCD)ZelaparZenievaZestrilZianaZinoticZinotic ESZipsorZithromaxZmaxZocor (QCD) (ST)Zofran (QCD)Zofran ODT (QCD)Zoloft (QCD) (ST)Zolpimist (QCD)ZoviraxZ-PramZuplenz (QCD)Zyflo (ST)


Zyflo CR (ST)ZymaxidZypram

Zyprexa IMZyprexa RelprevvZytopic

30

Medication Resource List IndexSymbols8-Mop . . . . . . . . . . . . . . . . . . . 17

AAbilify . . . . . . . . . . . . . . . . . . . . 4Abilify DiscMelt . . . . . . . . . . 22Abraxane . . . . . . . . . . . . . . . . 15Abstral . . . . . . . . . . . . 8, 13, 22Acanya . . . . . . . . . . . . . . . . . . 22Accolate . . . . . . . . . . . . . 19, 22Accu-Chek Aviva Plus . . . . . 4AccuNeb . . . . . . . . . . . . . . . . 22Accupril . . . . . . . . . . . . . . . . . 22Accuretic . . . . . . . . . . . . . . . . 22Accutane . . . . . . . . . . . . . . . . 22Aceon . . . . . . . . . . . . . . . . . . . 22Acetaminophen-Codeine . . 4AcipHex . . . . . . . . . . . 8, 13, 22Actemra . . . . . . . . . . . . . 13, 15Acthar . . . . . . . . . . . . . . . 13, 15Actigall . . . . . . . . . . . . . . . . . . 22Actimmune . . . . . . . . . . . . . . 15Actiq . . . . . . . . . . . . . . 8, 13, 22Activella . . . . . . . . . . . . . . . . . 22Actonel . . . . . . . . . . . . . . . 8, 20ACTOplus met . . . . . . . . . . . 19ACTOplus Met . . . . . . . . . . . . 8Actoplus Met XR . . . . . . . . . 19ACTOplus Met XR . . . . 8, 22Actos . . . . . . . . . . . . . . . 4, 8, 19Acular . . . . . . . . . . . . . . . . . . . 22Acular LS . . . . . . . . . . . . . . . . 22Acular/LS . . . . . . . . . . . . . . . . 8Acular PF . . . . . . . . . . . . . . . . . 8Acuvail . . . . . . . . . . . . . . . . . . 22Acyclovir . . . . . . . . . . . . . . . . . . 4Aczone . . . . . . . . . . . . . . . . . . 22Adalat CC . . . . . . . . . . . . . . . 22Adcirca . . . . . . . . . . . . . . .13, 17Adderall . . . . . . . . . . . . . . . . . 22Adderall XR . . . . . . . . . . . . . . 8Adoxa CK . . . . . . . . . . . . . . . 22Adoxa TT . . . . . . . . . . . . . . . . 22Adriamycin PFS . . . . . . . . . . 15Adrucil . . . . . . . . . . . . . . . . . . 15

Advair Discus . . . . . . . . . .8, 19Advair Diskus . . . . . . . . . . . . . 4Advair HFA . . . . . . . . . . . .8, 19Advicor . . . . . . . . . . . . . . . .8, 19Aerobid . . . . . . . . . . . . . . . 8, 22Aerobid-M . . . . . . . . . . . . 8, 22Afinitor . . . . . . . . . . . . . . . . . . 17Airet . . . . . . . . . . . . . . . . . . . . 22Albuterol Sulfate . . . . . . . . . . 4Alendronate . . . . . . . . . . . . . . 8Alendronate Sodium . . . . . . . 4Alferon N . . . . . . . . . . . . . . . . 15Alkeran . . . . . . . . . . . . . . .16, 17Allopurinol . . . . . . . . . . . . . . . . 4Alodox . . . . . . . . . . . . . . . . . . 22Aloquin . . . . . . . . . . . . . . . . . . 22Alora . . . . . . . . . . . . . . . . . 8, 22Alprazolam . . . . . . . . . . . . . . . . 4Alsuma . . . . . . . . . . . . . . . 8, 20Altabax . . . . . . . . . . . . . . . . . . 22Altace . . . . . . . . . . . . . . . . . . . 22Altavera . . . . . . . . . . . . . . . . . . 4Altoprev . . . . . . . . . . . 8, 19, 22Alupent inhaler . . . . . . . . . . . . 8Aluvea . . . . . . . . . . . . . . . . . . . 22Alvesco . . . . . . . . . . . . . . . .9, 22Ambien . . . . . . . . . . . . 9, 20, 22Ambien CR . . . . . . . . 9, 20, 22Amerge . . . . . . . . . . . . . . 9, 20Amevive . . . . . . . . . . . . . . . . . 13Amitiza . . . . . . . . . . . . . . . . . . . 9Amitriptyline HCl . . . . . . . . . . 4Amlodipine . . . . . . . . . . . . . . . 9Amlodipine-Atorvastatin . . . 9Amlodipine Besylate . . . . . . . 4Amlodipine Besylate-

Benazepril . . . . . . . . . . . . . . 4Amoxicillin . . . . . . . . . . . . . . . . 4Amox Tr-Potassium

Clavulanate . . . . . . . . . . . . . 4Amphetamines . . . . . . . . . . . 13Amphetamine Salt Combo . 4Ampyra . . . . . . . . . . . . 9, 13, 17Amrix . . . . . . . . . . . . . . . . . . . . 22Amturnide . . . . . . . . . . . 20, 22Anafranil . . . . . . . . . . . . . . . . 22

Analpram Advanced . . . . . . 22Analpram-E kit . . . . . . . . . . . 22Anastrozole . . . . . . . . . . . . . . . 4Androderm . . . . . . . . . . . . . . 21Androgel . . . . . . . . . . . . 21, 22Angeliq . . . . . . . . . . . . . . . . . . 22Antara . . . . . . . . . . . . . . . . . . . 22Anzemet . . . . . . . . . . . . . . .9, 22Apidra . . . . . . . . . . . . . . . . . . . 22Aplenzin ER . . . . . . . 9, 19, 22Apokyn . . . . . . . . . . . . . . . . . . 16Appformin-D . . . . . . . . . . . . . 23Apri . . . . . . . . . . . . . . . . . . . . . . 4Aqua Glycolic HC . . . . . . . . 23Aralast . . . . . . . . . . . . . . . . . . 13Aralast NP . . . . . . . . . . . . . . . 13Aranesp . . . . . . . . . . . 9, 13, 16Arava . . . . . . . . . . . . . . . . . .9, 23Arcalyst Injection . . . . . . . . . 16Arcapta Neohaler . . . . . .9, 23Aredia . . . . . . . . . . . . . . . . . . . 16Arixtra . . . . . . . . . . . . . . . . .9, 23Armour Thyroid . . . . . . . . . . . 4Arzerra . . . . . . . . . . . . . . . . . . 16Asacol . . . . . . . . . . . . . . . . . . . . 4Ascensia diabetic testing

supplies . . . . . . . . . . . . . . . 23Asmanex Twisthaler . . . .9, 23Assure Pro diabetic

testing supplies . . . . . . . . 23Astelin . . . . . . . . . . . . . . . . . . . 9Astepro . . . . . . . . . . . . . . . .9, 23Atacand . . . . . . . . . . . . . 20, 23Atacand HCT . . . . . . . . 20, 23Atelvia . . . . . . . . . . . . . . . . . . . 23Atelvia DR . . . . . . . . . . . . 9, 20Atenolol . . . . . . . . . . . . . . . . . . 4Ativan . . . . . . . . . . . . . . . . . . . 23Atopiclair . . . . . . . . . . . . . . . . 23Atorvastatin Calcium . . . . . . 4Atralin . . . . . . . . . . . . . . . . . . . 23Atrapro Dermal Spray . . . . 23Atrapro Hydrogel . . . . . . . . . 23Atripla . . . . . . . . . . . . . . . . . . . . 4Atropen . . . . . . . . . . . . . . . . . 23Atrovent . . . . . . . . . . . . . . . . . . 9

31

Atrovent HFA . . . . . . . . . . . . . 9Augmentin XR . . . . . . . . . . . 23Aurstat . . . . . . . . . . . . . . . . . . 23Avalide . . . . . . . . . . . . . . . . . . 20Avandamet . . . . . . . . . . . .9, 19Avandaryl . . . . . . . . . . . . . . . . 19Avandia . . . . . . . . . . . . . . .9, 19Avapro . . . . . . . . . . . . . . . 4, 20Avelox . . . . . . . . . . . . . . . . . . . 23Aviane . . . . . . . . . . . . . . . . . . . . 4Avidoxy . . . . . . . . . . . . . . . . . . 23Avidoxy DK . . . . . . . . . . . . . . 23Avinza . . . . . . . . . . . . . 9, 13, 23Avita . . . . . . . . . . . . . . . . . . . . 23Avodart . . . . . . . . . . . . . . . . . . 21Avonex . . . . . . . . . . . . . . . .9, 16Axert . . . . . . . . . . . . . . 9, 20, 23Axid . . . . . . . . . . . . . . . . . . . . . 23Axiron . . . . . . . . . . . . . . . 21, 23Azasite . . . . . . . . . . . . . . . . . . 23Azithromycin . . . . . . . . . . . . . . 4Azmacort . . . . . . . . . . . . . .9, 23Azor . . . . . . . . . . . . . . . . . . . . . 20

BBaclofen . . . . . . . . . . . . . . . . . 4B-D diabetic testing

supplies . . . . . . . . . . . . . . . 23Beconase AQ . . . . . . . . . .9, 23Benicar . . . . . . . . . . . . . . . 4, 20Benicar HCT . . . . . . . . . 4, 20BenzaClin kit . . . . . . . . . . . . 23Benzonatate . . . . . . . . . . . . . . 4Bepreve . . . . . . . . . . . . . . . . . 23Besivance . . . . . . . . . . . . . . . 23Betamethasone

Dipropionate . . . . . . . . . . . 4Betaseron . . . . . . . . . . . . .9, 16BiCNu . . . . . . . . . . . . . . . . . . 16Binosto . . . . . . . . . . . . 9, 20, 23Bionect . . . . . . . . . . . . . . . . . . 23Bleomycin Sulfate . . . . . . . . 16Boniva Injection . . . . . . . . . . 16Boniva syringe . . . . . . . 13, 23Boniva tablets . . . . . 9, 20, 23Botulinum toxin . . . . . . . . . . 13Bravelle . . . . . . . . . . . . . 15, 23Brevicon . . . . . . . . . . . . . . . . . 23

Bromday . . . . . . . . . . . . . . . . 23Brovana . . . . . . . . . . . . . . . . . 23Budeprion SR . . . . . . . . . . . . 9Budeprion XL . . . . . . . . . . . . . 9Budesonide . . . . . . . . . . . . 4, 9Buprenorphine . . . . . . . . . . . 13Bupropion HCl . . . . . . . . . . . . 4Bupropion HCl SR . . . . . . . . 4Bupropion SR . . . . . . . . . . . . 9Bupropion XL . . . . . . . . . . . 4, 9Buspirone HCl . . . . . . . . . . . . 4Busulfex . . . . . . . . . . . . . . . . . 16Butalbital-

Acetaminophen-Caffe . . . 4Butorphanol NS . . . . . . . . . . . 9Butrans . . . . . . . . . . . 9, 13, 23Bystolic . . . . . . . . . . . . . . . . . 23

CCabergoline . . . . . . . . . . . . . . 9Caduet . . . . . . . . . . . . 9, 19, 23Calcitriol Topical . . . . . . . . . . 23Calcium folinate . . . . . . . . . . 16Cambia . . . . . . . . . . . . . . . . . . 23Camila . . . . . . . . . . . . . . . . . . . 4Camptosar . . . . . . . . . . . . . . 16Caphosol . . . . . . . . . . . . . . . . 23Capoten . . . . . . . . . . . . . . . . . 23Carbaglu . . . . . . . . . . . . . . . . 17Carbidopa-Levodopa . . . . . . 4Carboplatin . . . . . . . . . . . . . . 16Cardene . . . . . . . . . . . . . . . . . 23Cardene SR . . . . . . . . . . . . . 23Cardizem CD . . . . . . . . . . . . 23Cardizem LA . . . . . . . . . . . . . 23Cardura . . . . . . . . . . . . . . . . . . 9Cardura XL . . . . . . . . . . . .9, 23Carisoprodol . . . . . . . . . . . . . . 4Carvedilol . . . . . . . . . . . . . . . . . 4Cataflam . . . . . . . . . . . . . . . . 23Catapres TTS . . . . . . . . . . . . . 9Ceclor . . . . . . . . . . . . . . . . . . . 23Ceclor CD . . . . . . . . . . . . . . . 23Cedax . . . . . . . . . . . . . . . . . . . 23Cefdinir . . . . . . . . . . . . . . . . . . 4Cefuroxime . . . . . . . . . . . . . . . 4Celebrex . . . . . . . . . . . .4, 9, 21Celexa . . . . . . . . . . . . 9, 19, 23

Cem-Urea . . . . . . . . . . . . . . . 23Cenestin . . . . . . . . . . . . . . . . 23Centany . . . . . . . . . . . . . . . . . 23Centany AT . . . . . . . . . . . . . . 23Cephalexin . . . . . . . . . . . . . . . 4Ceredase . . . . . . . . . . . . . . . . 13Cerezyme . . . . . . . . . . . . . . . 13Cerubidine . . . . . . . . . . . . . . . 16Cesamet . . . . . . . . . . . . . .9, 23Cetraxel . . . . . . . . . . . . . . . . . 23Cetrotide . . . . . . . . . . . . . . . . 15Chantix . . . . . . . . . . . . . . . . . . . 4Chenodal . . . . . . . . . . . . . . . . 23Cheratussin AC . . . . . . . . . . . 4Chibroxin Ocumeter . . . . . . 23Chlorhexidine Gluconate

Rinse . . . . . . . . . . . . . . . . . . 4Chlorthalidone . . . . . . . . . . . . 4Cialis . . . . . . . . . . . . . . . . . . . . . 5Ciclodin solution/kit . . . . . . . 9Ciclopirox nail lacquer . . . . . 9Cimzia . . . . . . . . . . . . . . . 13, 16Cinryze . . . . . . . . . . . . . . . . . . 13Ciprodex . . . . . . . . . . . . . . . . . 5Ciprofloxacin HCl . . . . . . . . . 5Cipro-XR . . . . . . . . . . . . . . . . 23Cisplatin . . . . . . . . . . . . . . . . . 16Citalopram . . . . . . . . . . . . . . . . 9Citalopram HBr . . . . . . . . . . . 5Cladribine . . . . . . . . . . . . . . . 16Clarithromycin . . . . . . . . . . . . 5Cleanse and Treat . . . . . . . . 23Cleervue-M . . . . . . . . . . . . . . 23Cleocin T . . . . . . . . . . . . . . . . 23Climara . . . . . . . . . . . . . . . . . . . 9Climara Pro . . . . . . . . . . . . . . . 9Clindacin PAC . . . . . . . . . . . 23Clindagel . . . . . . . . . . . . . . . . 23Clindamax . . . . . . . . . . . . . . . 23Clindamycin HCl . . . . . . . . . . 5Clindamycin Phosphate . . . . 5Clindareach . . . . . . . . . . . . . . 23Clindets . . . . . . . . . . . . . . . . . 23Clobeta + Plus . . . . . . . . . . . 23Clobetasol Propionate . . . . . 5Clomid . . . . . . . . . . . . . . . . . . 15Clomiphene . . . . . . . . . . . . . . 15Clonazepam . . . . . . . . . . . . . . 5

32

Clonidine HCl . . . . . . . . . . . . . 5Clonidine patch . . . . . . . . . . . 9Clopidogrel . . . . . . . . . . . . . . . 5Clotrimazole-

Betamethasone . . . . . . . . 5CNL 8 nail kit . . . . . . . . . .9, 23Colazal . . . . . . . . . . . . . . . . . . 23Colcrys . . . . . . . . . . . . . . . . . . . 5Combigan . . . . . . . . . . . . . . . 23Combivent . . . . . . . . . . . . . . 5, 9Combivent Respimat . . . . . . 9Combunox . . . . . . . . . . . . . . . 23Concerta . . . . . . . . . . . . . . . . . 9Contour Next diabetic

testing supplies . . . . . . . . 23Conzip . . . . . . . . . . . . . . . . . . 23Copaxone . . . . . . . . . . . . .9, 16Copegus . . . . . . . . . . . . . . . . 17Coreg . . . . . . . . . . . . . . . . . . . 23Coreg CR . . . . . . . . . . . . . . . 23Cosmegen . . . . . . . . . . . . . . . 16Cosopt PF . . . . . . . . . . . . . . . 23Cozaar . . . . . . . . . . . . . . 20, 23Crestor . . . . . . . . . . . . . 5, 9, 19Crolom ophthalmic . . . . . . . . 9Cromolyn ophthalmic . . . . . . 9Cryselle . . . . . . . . . . . . . . . . . . 5Cyanocobalamin injection . . 5Cyclobenzaprine HCl . . . . . . 5Cyclophosphamide . . . . . . . 16Cymbalta . . . . . . . . . . . 5, 9, 19Cystagon . . . . . . . . . . . . . . . . 17Cytarabine . . . . . . . . . . . . . . . 16Cytoxan . . . . . . . . . . . . . .16, 17

DDacarbazine . . . . . . . . . . . . . 16Dactinomycin . . . . . . . . . . . . 16Daliresp . . . . . . . . . . . . . . . . . 24Darvocet N-100 . . . . . . . . . 24Daunorubicin HCL . . . . . . . 16DaunoXome . . . . . . . . . . . . . 16Daypro . . . . . . . . . . . . . . . . . . 24Daytrana . . . . . . . . . . . . . . . . 24DDAVP . . . . . . . . . . . . . . 16, 24Demulen . . . . . . . . . . . . . . . . 24Depocyt . . . . . . . . . . . . . . . . . 16Depo-Sub Q Provera 104 24

Derma-Smoothe/FS . . . . . 24DermOtic . . . . . . . . . . . . . . . . 24Desmopressin Acetate . . . 16Desogen . . . . . . . . . . . . . . . . 24Desonide . . . . . . . . . . . . . . . . . 5Desonil + Plus . . . . . . . . . . . 24DesOwen kit . . . . . . . . . . . . . 24Desoxyn . . . . . . . . . . . . . . . . . 13Detrol . . . . . . . . . . . . . . . 20, 24Detrol LA . . . . . . . . . . . . 20, 24Dexamethasone . . . . . . . . . . 5Dexedrine . . . . . . . . . . . . . . . 24Dexilant . . . . . . . . . . . 9, 13, 24Dextroamphetamine-

Amphetamine . . . . . . . . . . 5Dextroamphetamine/

Amphetamine ER . . . . . . . 9Dextroamphetamines . . . . . 13Diazepam . . . . . . . . . . . . . . . . 5Diclofenac Sodium . . . . . . . . 5Dicyclomine HCl . . . . . . . . . . 5Dificid . . . . . . . . . . . . . . . . . . . 24Diflucan . . . . . . . . . . . . . . . . . . 9Digoxin . . . . . . . . . . . . . . . . . . . 5Dilacor XR . . . . . . . . . . . . . . . 24Dilaudid . . . . . . . . . . . . . . . . . 24Diltiazem 24hr CD . . . . . . . . 5Diltiazem 24hr ER . . . . . . . . 5Diltiazem ER . . . . . . . . . . . . . . 5Diovan . . . . . . . . . . . . . . . 5, 20Diovan HCT . . . . . . . . . . 5, 20Dipentum . . . . . . . . . . . . . . . . 24Diskets . . . . . . . . . . . . . . . . . . 13Dispermox . . . . . . . . . . . . . . . 24Ditropan . . . . . . . . . . . . . 20, 24Ditropan XL . . . . . . . . . 20, 24Divalproex Sodium . . . . . . . . 5Divalproex Sodium ER . . . . . 5Divigel . . . . . . . . . . . . . . . . . . 24Docefrex . . . . . . . . . . . . . . . . 16Docetaxel . . . . . . . . . . . . . . . 16Dolophine . . . . . . . . . . . . . . . 13Donepezil HCl . . . . . . . . . . . . 5Doryx . . . . . . . . . . . . . . . . . . . 24Dorzolamide-Timolol . . . . . . . 5Doxazosin . . . . . . . . . . . . . . . . 9Doxazosin Mesylate . . . . . . . 5Doxil . . . . . . . . . . . . . . . . . . . . 16

Doxorubicin HCl . . . . . . . . . 16Doxycycline Hyclate . . . . . . . 5Doxycycline Monohydrate . . 5DTIC-Dome . . . . . . . . . . . . . 16Duetact . . . . . . . . . . . . . . . . . 20Duexis . . . . . . . . . . . . . . . . . . 24Dulera . . . . . . . . . . . . . . . . .9, 19Duragesic . . . . . . . . . 9, 13, 24Durezol . . . . . . . . . . . . . . . . . . 24Dymista . . . . . . . . . . . . . . .9, 24Dynabac . . . . . . . . . . . . . . . . . 24Dynacin . . . . . . . . . . . . . . . . . 24Dynacirc . . . . . . . . . . . . . . . . . 24Dynacirc CR . . . . . . . . . . . . . 24Dytan . . . . . . . . . . . . . . . . . . . 24

EEconazole Nitrate . . . . . . . . . 5Edarbi . . . . . . . . . . . . . . . 20, 24Edarbyclor . . . . . . . . . . . 20, 24Edular . . . . . . . . . . . . . 9, 20, 24Effexor . . . . . . . . . . . . . . 19, 24Effexor XR . . . . . . . . 9, 19, 24Egrifta . . . . . . . . . . . . . . . 13, 16Elestrin . . . . . . . . . . . . . . . . . . 24Eletone . . . . . . . . . . . . . . . . . . 24Elidel . . . . . . . . . . . . . . . . . . . . 13Eligard . . . . . . . . . . . . . . . . . . 16Ellence . . . . . . . . . . . . . . . . . . 16Eloxatin . . . . . . . . . . . . . . . . . 16Elspar . . . . . . . . . . . . . . . . . . . 16Embeda . . . . . . . . . . . 9, 13, 24Emend . . . . . . . . . . . . . . . . . . . 9Emsam . . . . . . . . . . . . . . . . . . 24Enablex . . . . . . . . . . . . . 20, 24Enalapril Maleate . . . . . . . . . 5Enbrel . . . . . . . . . . .5, 9, 13, 16Endocet . . . . . . . . . . . . . . . . . . 5Endometrin . . . . . . . . . . . . . . 15Enjuvia . . . . . . . . . . . . . . . . . . 24Enoxaparin . . . . . . . . . . . . . . . 9Enoxaparin Sodium . . . . . . . 5Enpresse . . . . . . . . . . . . . . . . . 5Enteral formula . . . . . . . . . . 13EpiCeram . . . . . . . . . . . . . . . 24Epiduo . . . . . . . . . . . . . . . . . . 24Epipen . . . . . . . . . . . . . . . . . . . 5Epirubicin . . . . . . . . . . . . . . . 16

33

Epogen . . . . . . . . . . . 9, 13, 16Equetro . . . . . . . . . . . . . . . . . 24Erbitux . . . . . . . . . . . . . . . . . . 13Erivedge . . . . . . . . . . . . . . . . . 18Ertaczo . . . . . . . . . . . . . . . . . . 24Erythromycin . . . . . . . . . . . . . 5Escitalopram . . . . . . . . . . . . . . 9Escitalopram Oxalate . . . . . . 5Estrace . . . . . . . . . . . . . . . . . . 24Estraderm . . . . . . . . . . . . . . . . 9Estradiol . . . . . . . . . . . . . . . . . . 5Estradiol patch . . . . . . . . . . . . 9Estrasorb . . . . . . . . . . . . . .9, 24Estrogel . . . . . . . . . . . . . . .9, 24Ethyol . . . . . . . . . . . . . . . . . . . 16Etodolac . . . . . . . . . . . . . . . . . . 5Etopophos . . . . . . . . . . . . . . . 16Etoposide . . . . . . . . . . . 16, 18Euflexxa . . . . . . . . . . . . . . . . . 13Evamist . . . . . . . . . . . . . . .9, 24Evista . . . . . . . . . . . . . . . . . . . . 5Evoclin . . . . . . . . . . . . . . . . . . 24ExacTech diabetic

testing supplies . . . . . . . . 24Exalgo . . . . . . . . . . . . 9, 13, 24Exforge . . . . . . . . . . . . . . . . . 20Exforge-HCT . . . . . . . . . . . . 20Exjade . . . . . . . . . . . . . . . . . . 18Extavia . . . . . . . . . . . . 9, 16, 24Extina . . . . . . . . . . . . . . . . . . . 24Eylea . . . . . . . . . . . . . . . . . . . . 13

FFactive . . . . . . . . . . . . . . . . . . 24Factor VIII, VIIIa, IX, XIII . . 13Famciclovir . . . . . . . . . . . . . . 10Famvir . . . . . . . . . . . . . . . 10, 24Fanapt . . . . . . . . . . . . . . . . . . 24Faslodex . . . . . . . . . . . . . . . . 16FazaClo . . . . . . . . . . . . . . . . . 24Femtrace . . . . . . . . . . . . . . . . 24Fenofibrate . . . . . . . . . . . . . . . 5Fenoglide . . . . . . . . . . . . . . . . 24Fentanyl . . . . . . . . . . . . . . . . . . 5Fentanyl oral/mucosal 10, 13Fentanyl patch . . . . . . . 10, 13Fentora . . . . . . . . . . . 10, 13, 24Fertinex . . . . . . . . . . . . . . . . . 24

Fexmid . . . . . . . . . . . . . . . . . . 24Fibracor . . . . . . . . . . . . . . . . . 24Finacea Plus . . . . . . . . . . . . . 24Finasteride . . . . . . . . . . . . . . . 5Fioricet . . . . . . . . . . . . . . . . . . 24Fiorinal . . . . . . . . . . . . . . . . . . 24Fiorinal with Codeine . . . . . 24Firazyr . . . . . . . . . . . . . . . . . . . 16Firmagon . . . . . . . . . . . . . . . . 16First-lansoprazole . . . . . . . . 13First-omeprazole . . . . . . . . . 13Flagyl . . . . . . . . . . . . . . . . . . . 24Flagyl ER . . . . . . . . . . . . . . . . 24Flagyl IV . . . . . . . . . . . . . . . . . 24Flector . . . . . . . . . . . . . . . . . . 24Flonase . . . . . . . . . . . . . 10, 24Flovent HFA . . . . . . . . . . . . . . 5Flovent/HFA . . . . . . . . . . . . 10Floxuridine . . . . . . . . . . . . . . 16Fluconazole . . . . . . . . . . . .5, 10Fludara . . . . . . . . . . . . . . . . . . 16Fludarabine phosphate . . . 16Flunisolide . . . . . . . . . . . . . . . 10Fluocinonide . . . . . . . . . . . . . . 5Fluorouracil . . . . . . . . . . . . . . 16Fluoxetine . . . . . . . . . . . . . . . 10Fluoxetine 60mg tablet . . . 19Fluoxetine DR . . . . . . . . . . . 10Fluoxetine HCl . . . . . . . . . . . . 5Fluticasone . . . . . . . . . . . . . . 10Fluticasone Propionate . . . . 5Fluvastatin . . . . . . . . . . . . . . . 10Fluvoxamine . . . . . . . . . . . . . 10Focalin . . . . . . . . . . . . . . . . . . 24Focalin XR . . . . . . . . . . 10, 24Folic Acid . . . . . . . . . . . . . . . . . 5Follistim AQ . . . . . . . . . 15, 24Fondaparinux . . . . . . . . . . . . 10Foradil . . . . . . . . . . . . . . . . . . 10Fortamet . . . . . . . . . . . . . . . . 24Forteo . . . . . . . . . . . . 10, 13, 16Fortesta . . . . . . . . . . . . . .21, 24Fosamax . . . . . . . . .10, 20, 24Fosamax Plus D . . . . . 10, 20Fragmin . . . . . . . . . . . . . 10, 24Freestyle diabetic supplies 24Fresh Kote . . . . . . . . . . . . . . 24Frova . . . . . . . . . . . . .10, 20, 24

FUDR . . . . . . . . . . . . . . . . . . . 16Furosemide . . . . . . . . . . . . . . . 5Fusilev I.V. . . . . . . . . . . . . . . . 16Fuzeon . . . . . . . . . . . . . . . . . . 16

GGabapentin . . . . . . . . . . . . . . . 5Ganirelix . . . . . . . . . . . . . . . . . 15Garamide . . . . . . . . . . . . . . . . 24Gelclair . . . . . . . . . . . . . . . . . . 25Gelnique . . . . . . . . . . . . 20, 25Gemcitabine . . . . . . . . . . . . . 16Gemfibrozil . . . . . . . . . . . . . . . 5Gemzar . . . . . . . . . . . . . . . . . . 16Genotropin . . . . . . . . . . 16, 25Gianvi . . . . . . . . . . . . . . . . . . . . 5Gilenya . . . . . . . . . . . 10, 13, 18Gleevec . . . . . . . . . . . . . . . . . 18Glimepiride . . . . . . . . . . . . . . . 5Glipizide . . . . . . . . . . . . . . . . . . 5Glipizide ER . . . . . . . . . . . . . . 5Glucometer diabetic

supplies . . . . . . . . . . . . . . . 25Glucophage . . . . . . . . . . . . . 25Glucophage XR . . . . . . . . . . 25Glucose testing strips . . . . 10Glumetza . . . . . . . . . . . . . . . . 25Glyburide . . . . . . . . . . . . . . . . . 5Gonal F/Gonal F RFF . . . . 15Granisetron . . . . . . . . . . . . . . 10Granisol . . . . . . . . . . . . . . . . . 10Growth Hormone . . . . . . . . 13

HHalonate . . . . . . . . . . . . . . . . 25Halotin . . . . . . . . . . . . . . . . . . 25Herceptin . . . . . . . . . . . . . . . 16Horizant . . . . . . . . . . . . . . . . . 25HPR Plus . . . . . . . . . . . . . . . 25Humalog . . . . . . . . . . . . . . . . . 5Human Chorionic

Gonadotropin (HCG) . . . 15Humatrope . . . . . . . . . . . . . . 16Humira . . . . . . . . 5, 10, 13, 16Hyalgan . . . . . . . . . . . . . . . . . 14Hycamtin . . . . . . . . . . . . 16, 18Hydrochlorothiazide . . . . . . . 5

34

Hydrocodone-Acetaminophen . . . . . . . . . 5

Hydrocortisone . . . . . . . . . . . 5Hydrocortisone-

Lidocaine kit . . . . . . . . . . 25Hydromorphone HCl . . . . . . 5Hydroxychloroquine Sulfate 5Hydroxyzine HCl . . . . . . . . . . 5Hylase . . . . . . . . . . . . . . . . . . 25Hylatopic . . . . . . . . . . . . . . . . 25Hylatopic Plus . . . . . . . . . . . 25Hylatopic Plus-Aurstat . . . . 25Hylira . . . . . . . . . . . . . . . . . . . 25Hytrin . . . . . . . . . . . . . . . 10, 25Hyzaar . . . . . . . . . . . . . . 20, 25

IIbandronate . . . . . . . . . . . . . . 10IB-Stat . . . . . . . . . . . . . . . . . . 25Ibuprofen . . . . . . . . . . . . . . . . . 5IC400 kit . . . . . . . . . . . . . . . . 25IC800 kit . . . . . . . . . . . . . . . . 25Idamycin PFS . . . . . . . . . . . . 16Idarubicin . . . . . . . . . . . . . . . . 16Ifex . . . . . . . . . . . . . . . . . . . . . 16Ifosfamide . . . . . . . . . . . . . . . 16Ifosfamide/Mesna . . . . . . . 16Ilaris . . . . . . . . . . . . . . . . 14, 16Imitrex . . . . . . . . . . . . . . . 10, 20Imuran . . . . . . . . . . . . . . . . . . 25Incivek . . . . . . . . . . . . . . 14, 18Increlex . . . . . . . . . . . . . . . . . 16Inderal LA . . . . . . . . . . . . . . . 25Indomethacin . . . . . . . . . . . . . 5Infergen . . . . . . . . . . . . . 10, 16Inlyta . . . . . . . . . . . . . . . . . . . . 18Innohep . . . . . . . . . . . . . . . . . 25InnoPran XL . . . . . . . . . . . . . 25Interferons . . . . . . . . . . . . . . . 14Intermezzo . . . . . . . . . . . . . . . 10Intron A . . . . . . . . . . . . . . . . . 16Intuniv . . . . . . . . . . . . . . . . . . . 25Invega . . . . . . . . . . . . . . . . . . . 25Iophen-C NR . . . . . . . . . . . . . 5Ipratropium NS . . . . . . . . . . 10Iquix . . . . . . . . . . . . . . . . . . . . 25Irbesartan . . . . . . . . . . . . . . . . 5Iressa . . . . . . . . . . . . . . . . . . . 18

Irinotecan . . . . . . . . . . . . . . . 16Isosorbide Mononitrate ER 5Istalol . . . . . . . . . . . . . . . . . . . 25Istodax . . . . . . . . . . . . . . . . . . 16Itraconazole . . . . . . . . . . . . . 10IV Immunoglobulin . . . . . . . 14

JJakafi . . . . . . . . . . . . . . . . . . . 18Jalyn . . . . . . . . . . . . . . . . . . . . 21Janumet . . . . . . . . . . . . . . . . . 20Janumet XR . . . . . . . . . . . . . 20Januvia . . . . . . . . . . . . . . . 5, 20Jentadueto . . . . . . . . . . 20, 25Junel . . . . . . . . . . . . . . . . . . . . . 5Junel FE . . . . . . . . . . . . . . . . . . 5

KKadian . . . . . . . . . . . 10, 14, 25Kalydeco . . . . . . . . . . . . 14, 18Kapvay . . . . . . . . . . . . . . . . . . 25Kariva . . . . . . . . . . . . . . . . . . . . 5Kenalog . . . . . . . . . . . . . . . . . 16Keppra XR . . . . . . . . . . . . . . 25Keralyt kit . . . . . . . . . . . . . . . 25Ketoconazole . . . . . . . . . . . . . 5Ketocon + Plus . . . . . . . . . . 25Ketorolac ophthalmic . . . . . 10Ketorolac Tromethamine . . . 5Kineret . . . . . . . . . . . . . . 14, 16Klonopin . . . . . . . . . . . . . . . . 25Klor-Con 10 . . . . . . . . . . . . . . 5Klor-Con M20 . . . . . . . . . . . . 5Kombiglyze XR . . . . . . . . . . 20Korlym . . . . . . . . . . . . . . . . . . 18Kuvan . . . . . . . . . . . . . . . . . . . 18Kytril . . . . . . . . . . . . . . . . 10, 25

LLabetalol HCl . . . . . . . . . . . . . 5Lamictal ODT . . . . . . . . . . . . 25Lamisil . . . . . . . . . . . . . . 10, 25Lamisil Granules . . . . . . . . . 25Lamotrigine . . . . . . . . . . . . . . . 6Lansoprazole . . . . . . 6, 10, 14Lantus . . . . . . . . . . . . . . . . . . . 6Lantus Solostar . . . . . . . . . . . 6

Latanoprost . . . . . . . . . . . . . . 6Latuda . . . . . . . . . . . . . . . . . . 25Lazanda . . . . . . . . . . 10, 14, 25Leflunomide . . . . . . . . . . . . . 10Lescol . . . . . . . . . . . . 10, 19, 25Lescol XL . . . . . . . . 10, 19, 25Lessina . . . . . . . . . . . . . . . . . . . 6Letairis . . . . . . . . . . . . . . . . . . 18Leucovorin Calcium . . . . . . 16Leukine . . . . . . . . . . . . . 14, 16Leuprolide . . . . . . . . . . . . . . . 15Leuprolide Acetate . . . 15, 16Leustatin . . . . . . . . . . . . . . . . 16Levaquin . . . . . . . . . . . . . . . . 25Levemir . . . . . . . . . . . . . . . . . . 6Levetiracetam . . . . . . . . . . . . 6Levitra . . . . . . . . . . . . . . . . . . . 6Levlen . . . . . . . . . . . . . . . . . . . 25Levofloxacin . . . . . . . . . . . . . . 6Levothyroxine Sodium . . . . . 6Levoxyl . . . . . . . . . . . . . . . . . . . 6Lexapro . . . . . . . . . . . 6, 10, 19Lexxel . . . . . . . . . . . . . . . . . . . 25Lialda . . . . . . . . . . . . . . . . . . . 25Lidoderm . . . . . . . . . . . . . .6, 10Lidovir . . . . . . . . . . . . . . . . . . . 25Lipitor . . . . . . . . . . . . 10, 19, 25Lipodox . . . . . . . . . . . . . . . . . 16Lipodox-50 . . . . . . . . . . . . . . 16Lipofen . . . . . . . . . . . . . . . . . . 25Lisinopril . . . . . . . . . . . . . . . . . 6Lisinopril-

Hydrochlorothiazide . . . . . 6Lithium Carbonate . . . . . . . . 6Livalo . . . . . . . . . . . . 10, 19, 25Lodine . . . . . . . . . . . . . . . . . . 25Lodine XL . . . . . . . . . . . . . . . 25Loestrin 24 FE . . . . . . . . . . . . 6Lofibra . . . . . . . . . . . . . . . . . . 25Lopressor . . . . . . . . . . . . . . . 25Lorabid . . . . . . . . . . . . . . . . . . 25Lorazepam . . . . . . . . . . . . . . . 6Losartan-

Hydrochlorothiazide . . . . . 6Losartan Potassium . . . . . . . 6LoSeasonique . . . . . . . . . . . 25Lotensin . . . . . . . . . . . . . . . . . 25Lotensin HCT . . . . . . . . . . . . 25

35

Lotronex . . . . . . . . . . . . . . . . 10Lovastatin . . . . . . . . . . . . .6, 10Lovaza . . . . . . . . . . . . . . . . . . 25Lovenox . . . . . . . . . . . . . 10, 25Lucentis . . . . . . . . . . . . . . . . . 14Lumigan . . . . . . . . . . . . . . 6, 20Lunesta . . . . . . . . . . . 6, 10, 20Lupron Depot . . . . . . . . 15, 16Lupron Depot Ped . . . . . . . 15Lupron Depot-Ped . . . . . . . 16Luveris . . . . . . . . . . . . . . . . . . 15Luvox CR . . . . . . . . . 10, 19, 25Lyrica . . . . . . . . . . . . . . . . .6, 14Lysteda . . . . . . . . . . . . . 10, 25Lytensopril . . . . . . . . . . . . . . . 25

MMacugen . . . . . . . . . . . . . . . . 14Makena . . . . . . . . . . . . . 14, 16Mavik . . . . . . . . . . . . . . . . . . . 25Maxair Autohaler . . . . . 10, 25Maxalt . . . . . . . . . . . . . . . 10, 20Maxalt/Maxalt-MLT . . . . . . 25Maxalt MLT . . . . . . . . . . . . . . 20Maxalt-MLT . . . . . . . . . . . . . . 10Maxipime . . . . . . . . . . . . . . . . 25Medroxyprogesterone

Acetate . . . . . . . . . . . . . . . . 6Megace ES . . . . . . . . . . . . . . 25Meloxicam . . . . . . . . . . . . .6, 10Menopur . . . . . . . . . . . . . . . . 15Menostar . . . . . . . . . . . . 10, 25Mesna . . . . . . . . . . . . . . . . . . 17Mesnex . . . . . . . . . . . . . . . . . 18Metadate CD . . . . . . . . . .6, 10Metaglip . . . . . . . . . . . . . . . . . 25Metformin HCl . . . . . . . . . . . . 6Metformin HCl ER . . . . . . . . 6Methadone . . . . . . . . . . . . . . 14Methadose . . . . . . . . . . . . . . 14Methimazole . . . . . . . . . . . . . . 6Methocarbamol . . . . . . . . . . . 6Methotrexate . . . . . . . . . . 6, 17Methylphenidate ER . . . .6, 10Methylphenidate HCl . . . . . . 6Methylprednisolone . . . . . . . 6Metoclopramide HCl . . . . . . 6Metoprolol Succinate . . . . . . 6

Metoprolol Tartrate . . . . . . . . 6Metozolv ODT . . . . . . . . . . . 25Metrogel kit . . . . . . . . . . . . . 25Metronidazole . . . . . . . . . . . . . 6Mevacor . . . . . . . . . . 10, 19, 25Mexnex . . . . . . . . . . . . . . . . . 17Micardis . . . . . . . . . . . . . 20, 25Micardis HCT . . . . . . . . 20, 25Microgestin FE . . . . . . . . . . . 6Migranal . . . . . . . . . . . . . . . . . 10Minocin . . . . . . . . . . . . . . . . . 25Minocin Combo Pack . . . . . 25Minocycline HCl . . . . . . . . . . 6Mirapex . . . . . . . . . . . . . . . . . 21Mirapex ER . . . . . . . . . . 21, 25Mirtazapine . . . . . . . . . . . .6, 10Mirtazapine Rapid

Dissolve . . . . . . . . . . . . . . . 10Mitomycin . . . . . . . . . . . . . . . 17Mitoxantrone . . . . . . . . . . . . 17Mobic . . . . . . . . . . . . . . . 10, 25Modafinil . . . . . . . . . . . . . . . . 14Mometasone Furoate . . . . . . 6Momexin . . . . . . . . . . . . . . . . 25Monodox . . . . . . . . . . . . . . . . 25Monopril . . . . . . . . . . . . . . . . . 25Monopril HCT . . . . . . . . . . . . 25Montelukast . . . . . . . . . . . . . 19Montelukast Sodium . . . . . . 6Morgidox . . . . . . . . . . . . . . . . 25Morphine Sulfate CR . . . . . 14Morphine Sulfate

ER . . . . . . . . . . . . . . 6, 10, 14Moxatag . . . . . . . . . . . . . . . . . 25Moxeza . . . . . . . . . . . . . . . . . . 10Mozobil . . . . . . . . . . . . . . . . . . 17MS Contin . . . . . . . . . . . .10, 14Mupirocin . . . . . . . . . . . . . . . . . 6Mustargen . . . . . . . . . . . . . . . 17Mylotarg . . . . . . . . . . . . . . . . . 17Myoxin . . . . . . . . . . . . . . . . . . 26Myrbetriq . . . . . . . . . . . . . . . . 20

NNabumetone . . . . . . . . . . . . . . 6Nadolol . . . . . . . . . . . . . . . . . . . 6Namenda . . . . . . . . . . . . . . . . . 6Naprelan . . . . . . . . . . . . . . . . 26

Naprosyn . . . . . . . . . . . . . . . . 26Naprosyn EC . . . . . . . . . . . . 26Naproxen . . . . . . . . . . . . . . . . . 6Naratriptan . . . . . . . . . . . . . . 10Nasacort AQ . . . . . . . . . 10, 26Nasarel . . . . . . . . . . . . . . . . . . 26Nasonex . . . . . . . . . . . . 10, 26Natazia . . . . . . . . . . . . . . . . . . 26Navelbine . . . . . . . . . . . . . . . 17NebuPent . . . . . . . . . . . . . . . 10Necon . . . . . . . . . . . . . . . . . . . . 6Neomycin-Polymyxin-HC . . 6Neosalus . . . . . . . . . . . . . . . . 26Neosar . . . . . . . . . . . . . . . . . . 17Neulasta . . . . . . . . . 10, 14, 17Neumega . . . . . . . . . . . . . . . . 17Neupogen . . . . . . . . 10, 14, 17Neupro . . . . . . . . . . . . . . . . . . 26Neurontin . . . . . . . . . . . . . . . 26NeutraSal . . . . . . . . . . . . . . . 26Nevanac . . . . . . . . . . . . . . . . . 26Nexavar . . . . . . . . . . . . . . . . . 18Nexavir . . . . . . . . . . . . . . . . . . 26Nexiclon XR . . . . . . . . . . . . . 26Nexium . . . . . . . . . . .10, 14, 26Niaspan . . . . . . . . . . . . . . . . . . 6Nifedipine ER . . . . . . . . . . . . . 6Nipent . . . . . . . . . . . . . . . . . . . 17Niravam . . . . . . . . . . . . . . . . . 26Nitrofurantoin Mono-Macro 6Nitrostat . . . . . . . . . . . . . . . . . . 6Norditropin . . . . . . . . . . .17, 26Norditropin Flexpro . . . . . . . 17Norditropin Nordiflex . . . . . 17Norgestimate-Ethinyl

Estradiol . . . . . . . . . . . . . . . 6Norinyl . . . . . . . . . . . . . . . . . . 26Noroxin . . . . . . . . . . . . . . . . . 26Nor-Q-D . . . . . . . . . . . . . . . . 26Nortrel . . . . . . . . . . . . . . . . . . . 6Nortriptyline HCl . . . . . . . . . . 6Norvasc . . . . . . . . . . . . . 10, 26Novacort . . . . . . . . . . . . . . . . 26Novantrone . . . . . . . . . . . . . . 17Novarel . . . . . . . . . . . . . . . . . . 15NovoLog . . . . . . . . . . . . . . . . . 6Nplate . . . . . . . . . . . . . . . . . . . 17NuCort . . . . . . . . . . . . . . . . . . 26

36

Nucynta . . . . . . . . . . . . . . . . . 26Nucynta ER . . . . . . . . . 14, 26Nuedexta . . . . . . . . . . . . . . . . 26NutriDox . . . . . . . . . . . . . . . . 26Nutropin . . . . . . . . . . . . . . . . . 17Nutropin AQ . . . . . . . . . . . . . 17Nutropin AQ Nuspin . . . . . . 17Nuvaring . . . . . . . . . . . . . . . . . 6Nuvigil . . . . . . . . . . . . . . 14, 26Nystatin . . . . . . . . . . . . . . . . . . 6Nystatin-Triamcinolone . . . . 6

OOcella . . . . . . . . . . . . . . . . . . . . 6Octreotide injection . . . . . . 17Ocudox kit . . . . . . . . . . . . . . . 26Ofloxacin . . . . . . . . . . . . . . . . . 6Oforta . . . . . . . . . . . . . . . . . . . 18Olanzapine . . . . . . . . . . . . . . . 6Olanzepine-Fluoxetine . . . . 10Oleptro ER . . . . . . . . . . . . . . 26Olux . . . . . . . . . . . . . . . . . . . . . 26Omeprazole . . . . . . . . 6, 10, 14Omeprazole -Sod.

Bicarbonate . . . . . . . . . . . 14Omeprazole-Sod.

Bicarbonate . . . . . . . . . . . 10Omeprazole/Sodium

Bicarb . . . . . . . . . . . . . . . . 26Omnaris . . . . . . . . . . . . . 10, 26Omnicef . . . . . . . . . . . . . . . . . 26Omnitrope . . . . . . . . . . . .17, 26Omontys . . . . . . . . . 10, 14, 17Oncaspar . . . . . . . . . . . . . . . . 17Ondansetron . . . . . . . . . . . . . 10Ondansetron HCl . . . . . . . . . 6Ondansetron ODT . . . . . . . . . 6Ondasetron ODT . . . . . . . . . 11One Touch Ultra test strips . 6Onglyza . . . . . . . . . . . . . . . . . 20Onsolis . . . . . . . 11, 14, 18, 26Ontak . . . . . . . . . . . . . . . . . . . 17Onxol . . . . . . . . . . . . . . . . . . . 17Opana . . . . . . . . . . . . . . . . . . . 26Opana ER . . . . . . . . 11, 14, 26Optase . . . . . . . . . . . . . . . . . . 26Optivar . . . . . . . . . . . . . . .11, 26Oracea . . . . . . . . . . . . . . . . . . 26

Oramorph SR . . . . . 11, 14, 26Orapred ODT . . . . . . . . . . . . 26Oravig . . . . . . . . . . . . . . . . . . . 26Orencia . . . . . . . . . . . . . . 14, 17Orfadin . . . . . . . . . . . . . . . . . . 18Ortho-Prefest . . . . . . . . . . . . 26Ortho Tri-Cyclen Lo . . . . . . . 6Orthovisc . . . . . . . . . . . . . . . . 14Ovcon . . . . . . . . . . . . . . . . . . . 26Ovidrel . . . . . . . . . . . . . . . . . . 15Oxaliplatin . . . . . . . . . . . . . . . 17Oxcarbazepine . . . . . . . . . . . . 6Oxecta . . . . . . . . . . . . . . . . . . 26Oxybutynin Chloride . . . . . . . 6Oxybutynin Chloride ER . . . 6Oxycodone-Acetaminophen 6Oxycodone ER . . . . . . . . 11, 14Oxycodone HCl . . . . . . . . . . . 6Oxycodone HCl-

Acetaminophen . . . . . . . . . 6Oxycontin . . . . . . . . . . . . . . . 14OxyContin . . . . . . . . . . . . . 6, 11Oxymorphone ER . . . . . 11, 14Oxytrol . . . . . . . . . . . . . . 20, 26

PPaclitaxel . . . . . . . . . . . . . . . . 17Pamelor . . . . . . . . . . . . . . . . . 26Pamidronate . . . . . . . . . . . . . 17Pamidronate disodium . . . . 17Pamine FQ . . . . . . . . . . . . . . 26Pancreaze . . . . . . . . . . . . . . . 26Panretin . . . . . . . . . . . . . . . . . 18Pantoprazole . . . . . . . . . 11, 14Pantoprazole Sodium . . . . . . 6Paptase . . . . . . . . . . . . . . . . . 26Paroxetine . . . . . . . . . . . . . . . 11Paroxetine CR . . . . . . . . . . . 11Paroxetine HCl . . . . . . . . . . . 6Patanase . . . . . . . . . . . . .11, 26Paxil . . . . . . . . . . . . . 11, 19, 26Paxil CR . . . . . . . . . . 11, 19, 26PCE . . . . . . . . . . . . . . . . . . . . 26PCE Dispertab . . . . . . . . . . . 26Pediaderm AF . . . . . . . . . . . 26Pediaderm HC . . . . . . . . . . . 26Pediaderm TA . . . . . . . . . . . . 26Pediapirox-4 . . . . . . . . . . . . . 11

Pegasys . . . . . . . . . . . . . . 11, 17Peg-Intron . . . . . . . . . . . . . . . 17PEG-Intron . . . . . . . . . . . . . . 11Penicillin V Potassium . . . . . 6Penlac . . . . . . . . . . . . . . .11, 26Pennsaid . . . . . . . . . . . . . . . . 26Pepcid . . . . . . . . . . . . . . . . . . 26Percocet . . . . . . . . . . . . . . . . 26Pexeva . . . . . . . . . . . 11, 19, 26Phenazopyridine HCl . . . . . . 6Phoslyra . . . . . . . . . . . . . . . . . 26Photofrin . . . . . . . . . . . . . . . . 17Pioglitazone . . . . . . . . . .11, 20Pioglitazone-

Metformin . . . . . . . . . .11, 20Plaquenil . . . . . . . . . . . . . . . . 26Plavix . . . . . . . . . . . . . . . . . . . . 6Polymyxin B Sul-

Trimethoprim . . . . . . . . . . . . 6Portia . . . . . . . . . . . . . . . . . . . . 6Potassium Chloride . . . . . . . 6Pradaxa . . . . . . . . . . . . . . .6, 14Pramcort . . . . . . . . . . . . . . . . 26Pram-HCA . . . . . . . . . . . . . . 26Pramipexole

Dihydrochloride . . . . . . . . . 6Pramosone E . . . . . . . . . . . . 26PrandiMet . . . . . . . . . . . . . . . 26Pravachol . . . . . . . . . 11, 19, 26Pravastatin . . . . . . . . . . . . . . 11Pravastatin Sodium . . . . . . . 6PR-Cream . . . . . . . . . . . . . . . 26Precision diabetic

supplies . . . . . . . . . . . . . . . 26Prednisolone Acetate . . . . . 7Prednisolone Sodium

Phosphate . . . . . . . . . . . . . 7Prednisone . . . . . . . . . . . . . . . 7Pregnyl . . . . . . . . . . . . . . . . . . 15Premarin . . . . . . . . . . . . . . . . . 7Prempro . . . . . . . . . . . . . . . . . . 7Prenatal Plus . . . . . . . . . . . . . 7Preservative-Free

Morphine . . . . . . . . . . . . . . 14Prestige diabetic testing

supplies . . . . . . . . . . . . . . . 26Prevacid . . . . . . . . . . 11, 14, 26Prevacid NapraPAC . . . . . . 26

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Prevpac . . . . . . . . . . . . . . . . . 11Prilosec . . . . . . . . . . 11, 14, 26Prinivil . . . . . . . . . . . . . . . . . . . 26Prinzide . . . . . . . . . . . . . . . . . 26Pristiq . . . . . . . . . . . . 11, 19, 26ProAir HFA . . . . . . . . . . . . 7, 11Procentra . . . . . . . . . . . . . . . . 26Prochlorperazine Maleate . . 7Procort . . . . . . . . . . . . . . . . . . 26Procrit . . . . . . . . . . . . .11, 14, 17Prodigy diabetic testing

supplies . . . . . . . . . . . . . . . 26Prolastin . . . . . . . . . . . . . . . . . 14Prolastin C . . . . . . . . . . . . . . 14Proleukin . . . . . . . . . . . . . 14, 17Prolia . . . . . . . . . . . . . . . . 14, 17Promacta . . . . . . . . . . . . . . . . 18Promethazine-Codeine . . . . 7Promethazine HCl . . . . . . . . . 7Promiseb . . . . . . . . . . . . . . . . 26Promiseb Light . . . . . . . . . . 26Propranolol HCl . . . . . . . . . . . 7Proquin XR . . . . . . . . . . . . . . 26Proscar . . . . . . . . . . . . . . . . . . 21Protonix . . . . . . . . . . 11, 14, 27Protopic . . . . . . . . . . . . . . . . . 14Proventil HFA . . . . . . . . . 11, 27Proventil inhaler . . . . . . . . . . 27Proventil/Repetab . . . . . . . 27Provigil . . . . . . . . . . . . . . . . . . 14Prozac . . . . . . . . . . . 11, 19, 27Prozac Weekly . . . . 11, 19, 27Pulmicort Flexhaler . . . . . 7, 11Pulmicort Respules . . . . . . . 11Pulmozyme . . . . . . . . . . . . . . 18Purinethol . . . . . . . . . . . . . . . 27

QQNASL . . . . . . . . . . . . . . . 11, 27Qualaquin . . . . . . . . . . . . . . . 11Quetiapine Fumarate . . . . . . 7Quinapril HCl . . . . . . . . . . . . . 7Quixin . . . . . . . . . . . . . . . . . . . 27Qutenza . . . . . . . . . . . . . .11, 18QVAR . . . . . . . . . . . . . . . . . 7, 11

RRadiaPlex Rx . . . . . . . . . . . . 27Radigel . . . . . . . . . . . . . . . . . . 27Ramipril . . . . . . . . . . . . . . . . . . 7Raniclor . . . . . . . . . . . . . . . . . 27Ranitidine HCl

(excluding 150mg) . . . . . . 7Rapaflo . . . . . . . . . . . . . . . . . . 27Rapaflux . . . . . . . . . . . . . . . . 11Raptiva . . . . . . . . . . . . . . . . . . 14Rayos . . . . . . . . . . . . . . . . . . . 27Rebetol . . . . . . . . . . . . . . . . . 18Rebif . . . . . . . . . . . . . . . . . 11, 17Reclast . . . . . . . . . . . . . . . . . . 14Recothrom . . . . . . . . . . . . . . 27Regranex . . . . . . . . . . . . . . . . 14Relafen . . . . . . . . . . . . . . . . . . 27Relpax . . . . . . . . . . . . . . .11, 20Remeron . . . . . . . . . . . . . 11, 27Remeron Soltab . . . . . . 11, 27Remicade . . . . . . . . . . . . 14, 17Repronex . . . . . . . . . . . . . . . . 15Requip . . . . . . . . . . . . . . .21, 27Requip XL . . . . . . . . . . . .21, 27Rescula . . . . . . . . . . . . . . . . . 27Respiratory

SyncytialVirus IG/Synagis . . . . . . . . . . . . . . . 14

Restasis . . . . . . . . . . . .7, 11, 14Restoril . . . . . . . . . . . . . . . . . . 27Retin-A Micro . . . . . . . . . . . . 27Revatio . . . . . . . . . . . 14, 17, 18Revlimid . . . . . . . . . . . . . . . . . 18Rhinocort Aqua . . . . . . . 11, 27Ribapak . . . . . . . . . . . . . . . . . 18Ribasphere . . . . . . . . . . . . . . 18Ribatab . . . . . . . . . . . . . . . . . . 18Ribavirin . . . . . . . . . . . . . . . . . 18Rilutek . . . . . . . . . . . . . . . . . . 18Rinnovi . . . . . . . . . . . . . . . . . . 27Risperdal M-Tab . . . . . . . . . . 27Risperidone . . . . . . . . . . . . . . . 7Ritalin . . . . . . . . . . . . . . . . . . . 27Ritalin LA . . . . . . . . . . . . . 11, 27Ritalin SR . . . . . . . . . . . . . . . 27Rituxan . . . . . . . . . . . . . . . 14, 17Ropinirole HCl . . . . . . . . . . . . 7

Rosadan . . . . . . . . . . . . . . . . 27Rosanil . . . . . . . . . . . . . . . . . . 27Rozerem . . . . . . . . . . . . .11, 20Rybix . . . . . . . . . . . . . . . . . . . . 27Rybix ODT . . . . . . . . . . . . . . . 27Rynatan . . . . . . . . . . . . . . . . . 27Rythmol . . . . . . . . . . . . . . . . . 27Ryzolt . . . . . . . . . . . . . . . . . . . 27

SSabril . . . . . . . . . . . . . . . . . . . . 18Saizen . . . . . . . . . . . . . . . . 17, 27Salicylic Acid-Ceramide

kit . . . . . . . . . . . . . . . . . . . . 27Salkera . . . . . . . . . . . . . . . . . . 27Salvax . . . . . . . . . . . . . . . . . . . 27Salvax Duo . . . . . . . . . . . . . . 27Salvax Duo Plus . . . . . . . . . 27Sanctura . . . . . . . . . . . . 20, 27Sanctura XR . . . . . . . . . 20, 27Sancuso . . . . . . . . . . . . . . 11, 27Sandostatin . . . . . . . . . . . . . . 17Sandostatin-LAR . . . . . . . . . 17Saphris . . . . . . . . . . . . . . . . . . 27Sarafem . . . . . . . . . . 11, 19, 27Scalacort . . . . . . . . . . . . . . . . 27Seasonique . . . . . . . . . . . . . . 27Selferma . . . . . . . . . . . . . . . . 11Senophylline . . . . . . . . . . . . . 27Serevent Diskus . . . . . . . . . 11Serophene . . . . . . . . . . . . . . . 15Seroquel . . . . . . . . . . . . . . . . . 7Serostim . . . . . . . . . . . . . . . . . 17Sertraline . . . . . . . . . . . . . . . . 11Sertraline HCl . . . . . . . . . . . . 7Silenor . . . . . . . . . . . . . . . 11, 27Simcor . . . . . . . . . . . 11, 19, 27Simponi . . . . . . . . . . .11, 14, 17Simulect . . . . . . . . . . . . . . . . . 17Simvastatin . . . . . . . . . . . . 7, 11Sinemet . . . . . . . . . . . . . . . . . 27Singulair . . . . . . . . . . . . . . . 7, 19Skelid . . . . . . . . . . . . . . . . . . . 27Sof-Tact diabetic supplies . 27Solodyn . . . . . . . . . . . . . . . . . 27Soltamox . . . . . . . . . . . . . . . . 27Soma . . . . . . . . . . . . . . . . . . . 27Somatuline . . . . . . . . . . . . . . 17

38

Somavert . . . . . . . . . . . . . . . . 17Sonata . . . . . . . . . . . . . . .11, 20Spectracef . . . . . . . . . . . . . . . 27Spiriva . . . . . . . . . . . . . . . . . 7, 11Spironolactone . . . . . . . . . . . . 7Sporanox . . . . . . . . . . . . . 11, 27Sprintec . . . . . . . . . . . . . . . . . . 7Sprix . . . . . . . . . . . . . . . . . . . . 27Sprycel . . . . . . . . . . . . . . . . . . 18Stavzor . . . . . . . . . . . . . . . . . . 27Stelara . . . . . . . . . . . 14, 17, 27Strattera . . . . . . . . . . . .7, 11, 14Striant . . . . . . . . . . . . . . . . . . . 27Suboxone . . . . . . . . . . . . . 7, 14Subsys . . . . . . . . . . . 11, 14, 27Sucraid . . . . . . . . . . . . . . . . . . 18Sular . . . . . . . . . . . . . . . . . . . . 27Sulfamethoxazole-

Trimethoprim . . . . . . . . . . . . 7Sumadan . . . . . . . . . . . . . . . . 27Sumatriptan . . . . . . . . . . . . . 11Sumatriptan Succinate . . . . 7Sumavel Dosepro . 11, 20, 27Sumaxin . . . . . . . . . . . . . . . . . 27Sumaxin CP . . . . . . . . . . . . . 27Sumaxin TS . . . . . . . . . . . . . . 27Supartz . . . . . . . . . . . . . . . . . . 14Sutent . . . . . . . . . . . . . . . . . . . 18Sylatron . . . . . . . . . . . . . . . . . 17Symbicort . . . . . . . . . .7, 11, 19Symbyax . . . . . . . . . . . . . . . . 11Synagis . . . . . . . . . . . . . . . . . 17Synthroid . . . . . . . . . . . . . . . . . 7Synvisc . . . . . . . . . . . . . . . . . . 14Synvisc One . . . . . . . . . . . . . 14

TTagamet . . . . . . . . . . . . . . . . . 27Tamoxifen Citrate . . . . . . . . . . 7Tamsulosin HCl . . . . . . . . . . . 7Tarabine . . . . . . . . . . . . . . . . . 17Tarceva . . . . . . . . . . . . . . . . . . 18Tasigna . . . . . . . . . . . . . . . . . . 18Taxol . . . . . . . . . . . . . . . . . . . . 17Taxotere . . . . . . . . . . . . . . . . . 17Tekamlo . . . . . . . . . . . . . 20, 27Tekturna . . . . . . . . . . . . . 20, 27Tekturna HCT . . . . . . . . 20, 27

Temazepam . . . . . . . . . . . . . . . 7Temodar . . . . . . . . . . . . . . . . . 18Tenormin . . . . . . . . . . . . . . . . 27Tequin . . . . . . . . . . . . . . . . . . . 27Terazosin . . . . . . . . . . . . . . . . 11Terazosin HCl . . . . . . . . . . . . . 7Terbinafine . . . . . . . . . . . . . . . 11Terbinex . . . . . . . . . . . . . . 11, 27Tersi . . . . . . . . . . . . . . . . . . . . . 27Testim . . . . . . . . . . . . . . . . . . . . 7Tetrix . . . . . . . . . . . . . . . . . . . . 27Teveten . . . . . . . . . . . . . . 20, 27Teveten HCT . . . . . . . . . 20, 27Tev-Tropin . . . . . . . . . . . . . 17, 27Thalomid . . . . . . . . . . . . . . . . . 18TheraCys . . . . . . . . . . . . . . . . 17Therapentin . . . . . . . . . . . . . . 27Theraproxin . . . . . . . . . . . . . . 27Thiotepa . . . . . . . . . . . . . . . . . 17Thyrogen . . . . . . . . . . . . . . . . 17Tiamate . . . . . . . . . . . . . . . . . . 27Tiazac . . . . . . . . . . . . . . . . . . . 27Timolol Maleate . . . . . . . . . . . 7Tindamax . . . . . . . . . . . . . . . . 27Tirosint . . . . . . . . . . . . . . . . . . 28Tizanidine HCl . . . . . . . . . . . . 7TOBI . . . . . . . . . . . . . . . . . . . . 18TobraDex ST . . . . . . . . . . . . . 28Tobramycin-Dexamethasone 7Tofranil . . . . . . . . . . . . . . . . . . 28Topical Retinoic Acid

derivatives . . . . . . . . . . . . . 14Topiramate . . . . . . . . . . . . . . . . 7Toposar . . . . . . . . . . . . . . . . . . 17Toprol XL . . . . . . . . . . . . . . . . . 7Tornalate . . . . . . . . . . . . . . . . 28Totect . . . . . . . . . . . . . . . . . . . 17Toviaz . . . . . . . . . . . . . . . . 20, 28TPN . . . . . . . . . . . . . . . . . . . . . 14Tracleer . . . . . . . . . . . . . . . . . . 18Tradjenta . . . . . . . . . . . . 20, 28Tramadol HCl . . . . . . . . . . . . . 7Tranxene T-Tab . . . . . . . . . . . 28Travatan . . . . . . . . . . . . . . . . . 20Travatan Z . . . . . . . . . . . . . . . 20Trazodone HCl . . . . . . . . . . . . 7Trelstar . . . . . . . . . . . . . . . . . . 17Trelstar Depot . . . . . . . . . . . . 17

Trelstar LA . . . . . . . . . . . . . . . 17Tretinoin . . . . . . . . . . . . . . . . . . 7Tretin-X . . . . . . . . . . . . . . . . . . 28Treximet . . . . . . . . . . 11, 20, 28Triamcinolone . . . . . . . . . . . . 11Triamcinolone Acetonide . . . 7Triamterene-HCTZ . . . . . . . . 7Tribenzor . . . . . . . . . . . . . . . . . 20Tricor . . . . . . . . . . . . . . . . . . . . 28Triglide . . . . . . . . . . . . . . . . . . 28Tri-Levlen . . . . . . . . . . . . . . . . 28Trilipix . . . . . . . . . . . . . . . . . . . 28Trinalin . . . . . . . . . . . . . . . . . . 28Tri-Norinyl . . . . . . . . . . . . . . . 28TriOxin . . . . . . . . . . . . . . . . . . . 28Tri-Sprintec . . . . . . . . . . . . . . . 7Tritec . . . . . . . . . . . . . . . . . . . . 28Tropazone . . . . . . . . . . . . . . . 28TrueTest diabetic supplies . 28TrueTrack diabetic

supplies . . . . . . . . . . . . . . . 28Tudorza . . . . . . . . . . . . . . . . . . 11Twynsta . . . . . . . . . . . . . . 20, 28Tykerb . . . . . . . . . . . . . . . . . . . 18Tysabri . . . . . . . . . . . . . . . . . . . 14Tyvaso . . . . . . . . . . . . . . . . . . . 18

UUltracet . . . . . . . . . . . . . . . . . 28Ultram/ER . . . . . . . . . . . . . . 28Ultravate PAC . . . . . . . . . . . . 28Ultravate X . . . . . . . . . . . . . . 28Uramaxin . . . . . . . . . . . . . . . . 28Urea kit . . . . . . . . . . . . . . . . . 28

VVagifem . . . . . . . . . . . . . . . . . . 7Valacyclovir . . . . . . . . . . . . . . . 7Valacylovir . . . . . . . . . . . . . . . 11Valium . . . . . . . . . . . . . . . . . . . 28Valtrex . . . . . . . . . . . . . . . . . . . 11Valturna . . . . . . . . . . . . . 20, 28Vanos . . . . . . . . . . . . . . . . . . . 28Vantin . . . . . . . . . . . . . . . . . . . 28Vaseretic . . . . . . . . . . . . . . . . 28Vasolex . . . . . . . . . . . . . . . . . . 28Vasotec . . . . . . . . . . . . . . . . . 28

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Vectibix . . . . . . . . . . . . . . . . . . 14Vectical . . . . . . . . . . . . . . . . . . 28Vectrin . . . . . . . . . . . . . . . . . . 28Velcade . . . . . . . . . . . . . . . . . 17Veltin . . . . . . . . . . . . . . . . . . . . 28Venlafaxine ER capsule . . 11Venlafaxine ER tablet .11, 19Venlafaxine HCl . . . . . . . . . . . 7Venlafaxine HCl ER . . . . . . . 7Ventolin HFA . . . . . . . . .11, 28VePesid . . . . . . . . . . . . . . . . . 17Veramyst . . . . . . . . . . . . .11, 28Verapamil ER . . . . . . . . . . . . . 7Veregen . . . . . . . . . . . . . . . . . 28Vesicare . . . . . . . . . . . . . . .7, 20Viagra . . . . . . . . . . . . . . . . . . . . 7Vicodin . . . . . . . . . . . . . . . . . . 28Vicodin ES . . . . . . . . . . . . . . . 28Victoza . . . . . . . . . . . . . . . . . . 20Victrelis . . . . . . . . . . . . . . 14, 18Vigamox . . . . . . . . . . . . . . . 7, 11Viibryd . . . . . . . . . . . . 11, 19, 28Vimovo . . . . . . . . . . . . . . . . . . 28VinBLAStine . . . . . . . . . . . . . 17VinCRIStine . . . . . . . . . . . . . 17Vinorelbine . . . . . . . . . . . . . . 17Virasal . . . . . . . . . . . . . . . . . . . 28Vivelle . . . . . . . . . . . . . . . . . . . 11Vivelle-Dot . . . . . . . . . . . . . 7, 11Voltaren . . . . . . . . . . . . . . . . . 28Voltaren XR . . . . . . . . . . . . . . 28Votrient . . . . . . . . . . . . . . . . . . 18Vumon . . . . . . . . . . . . . . . . . . 17Vusion . . . . . . . . . . . . . . . . . . . 28Vytorin . . . . . . . . . . .12, 19, 28Vyvanse . . . . . . . . . . . . . 12, 28

WWarfarin Sodium . . . . . . . . . . 7

Welchol . . . . . . . . . . . . . . . . . 28Wellbutrin . . . . . . . . . . . 19, 28Wellbutrin SR . . . . .12, 19, 28Wellbutrin XL . . . . .12, 19, 28

XXalatan . . . . . . . . . . . . . . . . . . 20Xalkori . . . . . . . . . . . . . . 14, 18Xanax . . . . . . . . . . . . . . . . . . . 28Xanax XR . . . . . . . . . . . . . . . 28X-Clair . . . . . . . . . . . . . . . . . . 28Xeloda . . . . . . . . . . . . . . . . . . 18Xenaderm . . . . . . . . . . . . . . . 28Xenazine . . . . . . . . . . . . . . . . 18Xerese . . . . . . . . . . . . . . . . . . 28Xgeva . . . . . . . . . . . . . . . . 14, 17Xiaflex . . . . . . . . . . . . . . . . . . . 14Xibrom . . . . . . . . . . . . . . . . . . 28Xifaxan . . . . . . . . . . . . . . . . . . 28Xolair . . . . . . . . . . . . . . . . . . . . 14Xolegel . . . . . . . . . . . . . . . . . . 28Xolox . . . . . . . . . . . . . . . . . . . . 28Xopenex HFA . . . . . . . . 12, 28Xopenex nebules . . . . . . . . . 28Xtandi . . . . . . . . . . . . . . . . . . . 18Xyralid . . . . . . . . . . . . . . . . . . . 28Xyrem . . . . . . . . . . . . . . . . . . . 18

ZZafirlukast . . . . . . . . . . . . . . . 19Zaleplon . . . . . . . . . . . . . . . . . 12Zanaflex . . . . . . . . . . . . . . . . . 28Zanosar . . . . . . . . . . . . . . . . . 17Zantac . . . . . . . . . . . . . . . . . . . 28Zavesca . . . . . . . . . . . . . . . . . 18Zebeta . . . . . . . . . . . . . . . . . . 28Zegerid . . . . . . . . . . . 12, 14, 28Zelapar . . . . . . . . . . . . . . . . . . 28Zelboraf . . . . . . . . . . . . . 14, 18

Zenapax . . . . . . . . . . . . . . . . . 17Zenieva . . . . . . . . . . . . . . . . . . 28Zestril . . . . . . . . . . . . . . . . . . . 28Zetia . . . . . . . . . . . . . . 7, 12, 19Zetonna . . . . . . . . . . . . . . . . . 12Ziana . . . . . . . . . . . . . . . . . . . . 28Zinecard . . . . . . . . . . . . . . . . . 17Zinotic . . . . . . . . . . . . . . . . . . . 28Zinotic ES . . . . . . . . . . . . . . . 28Zipsor . . . . . . . . . . . . . . . . . . . 28Zithromax . . . . . . . . . . . . . . . . 28Zmax . . . . . . . . . . . . . . . . . . . . 28Zocor . . . . . . . . . . . . .12, 19, 28Zofran . . . . . . . . . . . . . . . 12, 28Zofran ODT . . . . . . . . . . 12, 28Zoladex . . . . . . . . . . . . . . . . . . 17Zolinza . . . . . . . . . . . . . . . . . . 18Zoloft . . . . . . . . . . . . .12, 19, 28Zolpidem . . . . . . . . . . . . . . . . 12Zolpidem ER . . . . . . . . . . . . . 12Zolpidem Tartrate . . . . . . . . . 7Zolpidem Tartrate ER . . . . . . 7Zolpimist . . . . . . . . .12, 20, 28Zometa . . . . . . . . . . . . . . . . . . 14Zomig . . . . . . . . . . . . . 7, 12, 20Zomig ZMT . . . . . . . . . . 12, 20Zorbtive . . . . . . . . . . . . . . . . . 17Zovia 1-35e . . . . . . . . . . . . . . 7Zovirax . . . . . . . . . . . . . . . . . . 28Z-Pram . . . . . . . . . . . . . . . . . . 28Zuplenz . . . . . . . . . . . . . . 12, 28Zyflo . . . . . . . . . . . . . . . . 19, 28Zyflo CR . . . . . . . . . . . . . 19, 29Zymar . . . . . . . . . . . . . . . . . . . 12Zymaxid . . . . . . . . . . . . . 12, 29Zypram . . . . . . . . . . . . . . . . . . 29Zyprexa IM . . . . . . . . . . . . . . . 29Zyprexa Relprevv . . . . . . . . . 29Zytiga . . . . . . . . . . . . . . . . . . . 18Zytopic . . . . . . . . . . . . . . . . . . 29

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New Medication Approval ProcessOur Pharmacy and Therapeutics Committee, which is made up of pharmacists and doctors of various specialties, reviews the effectiveness and overall value of new medications approved by the FDA on an ongoing basis . The Committee provides expertise and advice to help us give our members prescription drug options that meet their medical needs and achieve desired treatment goals .

While under review, new medications will not be covered by your plan . As with other medications that are not covered, your doctor may request coverage when medically necessary .

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® Registered Marks of the Blue Cross and Blue Shield Association. © 2012 Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.#119267M 55-0071 (10/12) 100M

Documents

Prescription Medication Reference List 2013