Kansas Medical Assistance Program Aetna Better Health of KS Sunflower United Healthcare PA Phone 800-933-6593 PA Pharmacy Phone 855-221-5656 PA Pharmacy Phone 877-397-9526 PA Pharmacy Phone 800-310-6826 PA Fax 800-913-2229 PA Pharmacy Fax 844-807-8453 PA Pharmacy Fax 866-399-0929 PA Pharmacy Fax 866-940-7328 PA Medical Phone 855-221-5656 PA Medical Fax 888-453-4756 PA Medical Fax 866-943-6474 PA Medical Fax 855-225-4102 PA Medical Phone 877-644-4623 PA Medical Phone 866-604-3267

Acebutolol Bromocriptine Doxazosin

Acetazolamide Bumetanide Enalapril-Hydrochlorothiazide

Albuterol Calcitriol Enalapril Maleate

Alendronate Captopril Estradiol

Allopurinol Captopril-Hydrochlorothiazide Estradiol Norethindrone Acetate

Amantadine Carbidopa Levodopa Estradiol Transdermal

Amiloride Carteolol Ophthalmic Estrogen Methyltestosterone

Amiloride-Hydrochlorothiazide Carvedilol Estrogens Conjugated

Amlodipine Chlorothiazide Estrogens Esterified

Amlodipine-Benazepril Chlorpropamide Estropipate

Amlodipine-Valsartan Chlorthalidone Etodolac

Armour Thyroid Cholestyramine Famotidine

Aspirin Cholestyramine Light Felodipine ER

Atenolol Clonidine Transdermal Fenofibrate

Atenolol-Chlorthalidone Clonidine-Chlorthalidone Fenofibrate Micronized

Atorvastatin Colestipol Fenofibrate Nanocrystallized

Baclofen Diclofenac Flurbiprofen

Benazepril Digoxin Flurbiprofen Ophthalmic

Benazepril-Hydrochlorothiazide Diltiazem Fluvastatin

Betaxolol Diltiazem ER Fluvastatin ER

Betaxolol Ophthalmic Diovan Folic Acid

Bisoprolol Fumarate Dipyridamole Fosinopril

Bisoprolol-Hydrochlorothiazide Disopyramide Phosphate Fosinopril-Hydrochlorothiazide

Brimonidine Tartrate Ophthalmic Disulfiram Furosemide

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Kansas Medical Assistance Program Aetna Better Health of KS Sunflower United Healthcare PA Phone 800-933-6593 PA Pharmacy Phone 855-221-5656 PA Pharmacy Phone 877-397-9526 PA Pharmacy Phone 800-310-6826 PA Fax 800-913-2229 PA Pharmacy Fax 844-807-8453 PA Pharmacy Fax 866-399-0929 PA Pharmacy Fax 866-940-7328 PA Medical Phone 855-221-5656 PA Medical Fax 888-453-4756 PA Medical Fax 866-943-6474 PA Medical Fax 855-225-4102 PA Medical Phone 877-644-4623 PA Medical Phone 866-604-3267

Gemfibrozil Levetiracetam Metoprolol Succinate

Glimepiride Levobunolol Ophthalmic Metoprolol Tartrate

Glipizide Levothyroxine Metoprolol-Hydrochlorothiazide

Glipizide ER Liothyronine Mexiletine

Glipizide-Metformin Liotrix (Thyrolar) Minoxidil

Glyburide Lisinopril Moexipril

Glyburide Micronized Lisinopril-Hydrochlorothiazide Moexipril‐Hydrochlorothiazide

Glyburide-Metformin Loratadine Montelukast

Hydralazine Losartan Multivitamins

Hydralazine-Hydrochlorothiazide Losartan-Hydrochlorothiazide Nabumetone

Hydrochlorothiazide Lovastatin Nadolol

Ibuprofen Medroxyprogesterone Nadolol-Bendroflumethiazide

Indapamide Meloxicam Naproxen

Indomethacin Metaproterenol Niacin

Irbesartan Metformin Niaspan

Irbesartan-Hydrochlorothiazide Metformin ER Nicardipine

Isosorbide Dinitrate Methazolamide Nifedipine

Isosorbide Dinitrate Sublingual Methimazole Nifedipine ER

Isosorbide Mononitrate Methocarbamol Nitroglycerin

Isradipine Methyclothiazide Nitroglycerin Patch Transdermal

Ketoprofen Methyldopa Olmesartan

Labetalol Methyldopa-Hydrochlorothiazide Olmesartan-Hydrochlorothiazide

Lansoprazole Metipranolol Ophthalmic Omeprazole

Latanoprost Ophthalmic Metolazone Oral Contraceptives

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Kansas Medical Assistance Program Aetna Better Health of KS Sunflower United Healthcare PA Phone 800-933-6593 PA Pharmacy Phone 855-221-5656 PA Pharmacy Phone 877-397-9526 PA Pharmacy Phone 800-310-6826 PA Fax 800-913-2229 PA Pharmacy Fax 844-807-8453 PA Pharmacy Fax 866-399-0929 PA Pharmacy Fax 866-940-7328 PA Medical Phone 855-221-5656 PA Medical Fax 888-453-4756 PA Medical Fax 866-943-6474 PA Medical Fax 855-225-4102 PA Medical Phone 877-644-4623 PA Medical Phone 866-604-3267

Oxybutynin Chloride Reserpine Verapamil

Pantoprazole Rifampin Zafirlukast

Papaverine Selegiline Zetia

Phenytoin Simvastatin Zonisamide

Phenytoin Extended Sodium Fluoride

Pilocarpine Spironolactone

Pilocarpine Ophthalmic Spironolactone- Hydrochlorothiazide Pindolol Sulfasalazine Potassium Chloride Sulfasalazine DR Potassium Gluconate Sulindac Pravastatin Tamoxifen Citrate Prednisone Tamsulosin Premphase Terazosin Prempro Terbutaline Prenatal Vitamins Theophylline Primidone Theophylline Anhydrous Probenecid Timolol Propranolol Tolazamide Propranolol-Hydrochlorothiazide Tolbutamide Propylthiouracil Topiramate Quinapril-Hydrochlorothiazide Trandolapril Quinidine Trandolapril-Verapamil Ramipril Triamterene-Hydrochlorothiazide Ranitidine Valsartan-Hydrochlorothiazide 3