This formulary represents the preferred medications commonly prescribed. Drugs with a first tier copay are listed in lower case letters. Drugs with a second tier copay are listed in upper case letters. Your plan my cover additional drugs not on this list at a third tier (non-preferred) copay. This drug list is not inclusive nor does it guarantee coverage. Your specific prescription benefit plan may not cover certain medications regardless of their appearance on this document. The plan participant’s specific prescription benefit plan may have a different copay for specific products on the list. This formulary is subject to change without notice. The formulary is updated periodically and changes may appear prior to their effective date. For specific information regarding your prescription benefit and copay, please contact a CMC representative at 1-800-946-3338.
2009 Gantrisin suspension Atrovent Inhaler Donnatal Extentab ALPHA DRUG Cleocin vaginal cream, vaginal supp Avandamet LIST Climara Pro Duricef suspension DynaCirc (not CR) Glucofilm Test Strips Accu-Chek Active Test Strips Aventyl solution Dynapen suspension Glucometer Test Strips Accu-Chek Advantage Test Strips Glucostix Test Strips "E" Accu-Chek Aviv Test Strips E-Z Spacer (with or without mask) Accu-Chek Comfort Curve Test Clorpres Easivent Accu-Chek Compact Test Strips Golytely Efudex Accu-Chek Easy Test Strips Accu-Chek Instant Test Strips Grifulvin V
bacitracin/neo/poly b ophthalmic ointAccu-Chek Simplicity Test Strips Gris-Peg Accu-Chek Soft Touch Lancets Accu-Chek SoftClix Lancets Colestid BD Ultrafine Lancets Accolate Combipatch Gynodiol 1.5mg Combivent Inhaler Combivir HalfLytely Concerta (AL) Bentyl syrup Condylox gel BenzaClin Halotestin Cortef 5mg, 10mg Humalog Crestor Estrace Vaginal Cream Humalog Mix 75/25 Aclovate Crixivan Estraderm Humulin Insulin Activella Betapace AF Cuprimine Estratest Cutivate Estratest HS Acular LS Cyclessa Betoptic S Adderall XR (AL) Cyclogyl Biltricide Advair Diskus Blephamide Ethmozine Brethine Aerochanber (with or without mask) Agenerase Cymbalta "D" Aldactazide 50mg/50mg Fansidar Fareston Dantrium FastTake Test Strips Daraprim Alphagan "C" Inderal LA Darvon Compound Alphagan P Cafergot tablet Declomycin Inspirease Alupent Inhaler Canasa suppository Invirase Depakote Fentanyl* Iodoquinol powder Depakote ER Fexofenadine* Carafate suspension Isopto Carbachol Flovent HFA Isopto Homatropine Cardene SR Floxin Otic Isordil Tablet Catapress Patch Detrol LA Amoxil Pediatric Drops Fluorabon Drops Analpram HC Antabuse Dibenzyline CellCept K-Dur Cenestin Arimidex FML Forte Aristocort tablet Chemstrip BG Test Strips FML S.O.P. Aromasin Chloroquin Phosphate Ascenscia glucometers Fortovase Dilantin Ascenscia Auto Disc Lamictal Ascenscia Elite Strips Lamisil oral Asmanex Twisthaler Diovan HCT Frova (QL) Furadantin Susp Larodopa Diprolene lotion Furoxone Leukeran Levaquin
This formulary represents the preferred medications commonly prescribed. Drugs with a first tier copay are listed in lower case letters. Drugs with a second tier copay are listed in upper case letters. Your plan my cover additional drugs not on this list at a third tier (non-preferred) copay. This drug list is not inclusive nor does it guarantee coverage. Your specific prescription benefit plan may not cover certain medications regardless of their appearance on this document. The plan participant’s specific prescription benefit plan may have a different copay for specific products on the list. This formulary is subject to change without notice. The formulary is updated periodically and changes may appear prior to their effective date. For specific information regarding your prescription benefit and copay, please contact a CMC representative at 1-800-946-3338.
Tri-Norinyl Levemir/Levemir Flexpen
phenobarbital/belladonna alkaloidsTriphasil "S" Trizivir Sandimmune solution Phenytek "U" Uniretic Phospholine Urocit-K Serevent Diskus Seroquel "V" Livostin Nilandron Loestrin FE Singulair Poly-Vi-Flor w/Iron (0.25mg tabs) Velosulin BR Sodium Fluoride Ventolin HFA Nordette Somnote VePesid ($$) Noritate Soriatane ($$) Norpace CR Vesicare Spiriva Vesanoid ($$) Lumigan Videx Nova Max Test Strips Lysodren Pred Mild Sporanox Pulse Pak Macrobid Nulytely Strattera (AL) NuvaRing Premarin Viracept Premphase Viramune Matulane Maxalt (QL) Prempro Low Dose Vivelle-DOT Maxalt MLT (QL) Prenatal vitamins ** Voltaren Opthalmic PrevPac Vytorin SureStep Test Strips Primaquine Sustiva "W" OneTouch FastTake Test Strips Proair OneTouch FinePoint Lancets "X" OneTouch SureStep Test Strips "T" OneTouch Ultra Test Strips Tamiflu Menest Xeloda ($$) OneTouch UltraSoft Lancets Proctofoam HC Menostar Optichamber Prograf ($$) Targretin capsule "Y" Optihaler Tegretol suspension Tegretol XR Yaz Mephyton Oramorph SR Prometrium Mestinon syrup, CR tablet Yodoxin tablet "Z" Propantheline Teslac Oral Contraceptives ** Zantac syrup Ortho – Est Methergine Ortho Cyclen Thalitone Ortho Evra Methitest Ortho Micronor Thioguanine Ortho Tri-Cyclen Proventil HFA Zomig , ZMT, nasal spray (QL) Ortho Tri-Cyclen Lo Ortho-Novum 1/35 Zovirax topical Ortho-Novum 1/50 Tigan 100mg capsule Ortho-Novum 10/11 Zyprexa ZYDIS Ortho-Novum 7/7/7 Pulmicort Respules Otobiotic Tobradex ** = All generics covered unless "Q" Specific criteria may be required for Metrocream Oxybutynin ER a drug with the following: Metrogel AL = Max Age Limits ( PA required ) Toprol XL MetroGel-Vaginal $$ = Any Rx that exceeds $1000 will Metrolotion QL= Quantity Limits (PA required ) * =generic drug on 2nd tier Micardis "R" Micardis HCT "P" Micro-K 8mEq Relpax (QL) U p d a t e d 4 / 2 0 0 9 Rescriptor Restoril 7.5mg Mintezol Retin-A Liquid (AL) Mircette Retin-A Micro (AL) Retrovir Trilisate liquid Ribavirin Risperdal Mycobutin Risperdal M-Tab Tonocard Rowasa enema
Ageing and health costs: Managing the futureAustralia’s population is ageing—the evidence for this is clear and compelling. Falling fertility, the ageing of the ‘baby boomer’ generation, declining mortalityand increased life expectancy are combining to increase the number and proportionof the population that is elderly, that is, those aged 65 years or more. This trendwill accelerate over
ÄRZTLICHE PRAXIS Nr. 16 • 18. April 2006Stadtplan auf der Homepage: besteht, sich über die Rechte Dritter NACHGEFRAGT …Ohne Lizenz droht Abmahnung Homepage den Kartenausschnitt ei- anwalt Christian Hess von derVerlage lassen das Web nach Verletzungen des Urherberrechts durchforstenverlangte von dem Niedergelasse-nen, entweder einen LizenzvertragKARLSRUHE – Wer als Service
This formulary represents the preferred medications commonly prescribed. Drugs with a first tier copay are listed in lower case letters. Drugs with a second tier copay are listed in upper case letters. Your plan my cover additional drugs not on this list at a third tier (non-preferred) copay. This drug list is not inclusive nor does it guarantee coverage. Your specific prescription benefit plan may not cover certain medications regardless of their appearance on this document. The plan participant’s specific prescription benefit plan may have a different copay for specific products on the list. This formulary is subject to change without notice. The formulary is updated periodically and changes may appear prior to their effective date. For specific information regarding your prescription benefit and copay, please contact a CMC representative at 1-800-946-3338.
2009 
This formulary represents the preferred medications commonly prescribed. Drugs with a first tier copay are listed in lower case letters. Drugs with a second tier copay are listed in upper case letters. Your plan my cover additional drugs not on this list at a third tier (non-preferred) copay. This drug list is not inclusive nor does it guarantee coverage. Your specific prescription benefit plan may not cover certain medications regardless of their appearance on this document. The plan participant’s specific prescription benefit plan may have a different copay for specific products on the list. This formulary is subject to change without notice. The formulary is updated periodically and changes may appear prior to their effective date. For specific information regarding your prescription benefit and copay, please contact a CMC representative at 1-800-946-3338.
Tri-Norinyl