The Following Drugs Have Been Removed from the Madatory 90 Day
Total Page:16
File Type:pdf, Size:1020Kb
The following drugs have been removed from the madatory 90 day supply requirement Brand Name Generic Name Asthma INCRUSE ELLIPTA UMECLIDINIUM BROMIDE SPIRIVA TIOTROPIUM BROMIDE SPIRIVA RESPIMAT TIOTROPIUM BROMIDE LEVALBUTEROL CONCENTRATE LEVALBUTEROL HCL LEVALBUTEROL HCL LEVALBUTEROL HCL PROAIR HFA ALBUTEROL SULFATE PROAIR RESPICLICK ALBUTEROL SULFATE VENTOLIN HFA ALBUTEROL SULFATE STRIVERDI RESPIMAT OLODATEROL HCL SEREVENT DISKUS SALMETEROL XINAFOATE ANORO ELLIPTA UMECLIDINIUM BROMIDE/VILANTEROL TRIFENATATE COMBIVENT RESPIMAT IPRATROPIUM BROMIDE/ALBUTEROL SULFATE IPRATROPIUM-ALBUTEROL IPRATROPIUM BROMIDE/ALBUTEROL SULFATE STIOLTO RESPIMAT TIOTROPIUM BROMIDE/OLODATEROL HCL ADVAIR DISKUS FLUTICASONE PROPIONATE/SALMETEROL XINAFOATE ADVAIR HFA FLUTICASONE PROPIONATE/SALMETEROL XINAFOATE BREO ELLIPTA FLUTICASONE FUROATE/VILANTEROL TRIFENATATE SYMBICORT BUDESONIDE/FORMOTEROL FUMARATE AEROSPAN FLUNISOLIDE ARNUITY ELLIPTA FLUTICASONE FUROATE BUDESONIDE BUDESONIDE FLOVENT DISKUS FLUTICASONE PROPIONATE FLOVENT HFA FLUTICASONE PROPIONATE PULMICORT FLEXHALER BUDESONIDE CROMOLYN SODIUM CROMOLYN SODIUM Blood Thinner COUMADIN WARFARIN SODIUM JANTOVEN WARFARIN SODIUM WARFARIN SODIUM WARFARIN SODIUM XARELTO RIVAROXABAN PRADAXA DABIGATRAN ETEXILATE MESYLATE Diabetes BYDUREON EXENATIDE MICROSPHERES BYDUREON PEN EXENATIDE MICROSPHERES BYETTA EXENATIDE TRULICITY DULAGLUTIDE VICTOZA 2-PAK LIRAGLUTIDE VICTOZA 3-PAK LIRAGLUTIDE SYMLINPEN 120 PRAMLINTIDE ACETATE SYMLINPEN 60 PRAMLINTIDE ACETATE HUMALOG INSULIN LISPRO HUMALOG KWIKPEN U-100 INSULIN LISPRO HUMALOG KWIKPEN U-200 INSULIN LISPRO HUMALOG MIX 50-50 INSULIN LISPRO PROTAMINE AND INSULIN LISPRO HUMALOG MIX 50-50 KWIKPEN INSULIN LISPRO PROTAMINE AND INSULIN LISPRO HUMALOG MIX 75-25 INSULIN LISPRO PROTAMINE AND INSULIN LISPRO HUMALOG MIX 75-25 KWIKPEN INSULIN LISPRO PROTAMINE AND INSULIN LISPRO HUMULIN 70/30 KWIKPEN INSULIN NPH HUMAN ISOPHANE/INSULIN REGULAR, HUMAN HUMULIN 70-30 INSULIN NPH HUMAN ISOPHANE/INSULIN REGULAR, HUMAN HUMULIN N INSULIN NPH HUMAN ISOPHANE HUMULIN N KWIKPEN INSULIN NPH HUMAN ISOPHANE HUMULIN R INSULIN REGULAR, HUMAN HUMULIN R U-500 INSULIN REGULAR, HUMAN HUMULIN R U-500 KWIKPEN INSULIN REGULAR, HUMAN LANTUS INSULIN GLARGINE,HUMAN RECOMBINANT ANALOG LANTUS SOLOSTAR INSULIN GLARGINE,HUMAN RECOMBINANT ANALOG TOUJEO SOLOSTAR INSULIN GLARGINE,HUMAN RECOMBINANT ANALOG EARS, EYES, NOSE, THROAT ALPHAGAN P BRIMONIDINE TARTRATE AZOPT BRINZOLAMIDE BIMATOPROST BIMATOPROST BRIMONIDINE TARTRATE BRIMONIDINE TARTRATE CARTEOLOL HCL CARTEOLOL HCL COMBIGAN BRIMONIDINE TARTRATE/TIMOLOL MALEATE DORZOLAMIDE HCL DORZOLAMIDE HCL DORZOLAMIDE-TIMOLOL DORZOLAMIDE HCL/TIMOLOL MALEATE LATANOPROST LATANOPROST LEVOBUNOLOL HCL LEVOBUNOLOL HCL LUMIGAN BIMATOPROST METIPRANOLOL METIPRANOLOL TRAVATAN Z TRAVOPROST TRAVOPROST TRAVOPROST (BENZALKONIUM) ATROPINE SULFATE ATROPINE SULFATE HOMATROPAIRE HOMATROPINE HBR HOMATROPINE HYDROBROMIDE HOMATROPINE HBR AZELASTINE HCL AZELASTINE HCL FLUNISOLIDE FLUNISOLIDE FLUTICASONE PROPIONATE FLUTICASONE PROPIONATE MOMETASONE FUROATE MOMETASONE FUROATE TRIAMCINOLONE ACETONIDE TRIAMCINOLONE ACETONIDE IPRATROPIUM BROMIDE IPRATROPIUM BROMIDE RESTASIS CYCLOSPORINE RESTASIS MULTIDOSE CYCLOSPORINE PSYCHOTHERAPEUTIC DRUGS PSYCHOTHERAPEUTIC DRUGS CLOZAPINE PSYCHOTHERAPEUTIC DRUGS CLOZAPINE.