Tier 2 cover - Health Plan of Nevada

Alphabetical Index
Drug Name PDL Section Drug Name PDL Section
AMITIZA 7-H
amitriptyline 4-B
amitriptyline-chlordiazepoxide 4-F
amlodipine 3-D
amlodipine-aliskiren 14-A
amlodipine-aliskiren-hctz 14-A
amlodipine-benazepril 3-I
amoxapine 4-B
amoxicillin 1-A
amoxicillin-clavulanate 1-A
AMOXIL 1-A
amphetamine-d-amphetamine 4-E
amphetamine-d-amphetamine SR 4-E
ampicillin 1-A
amprenavir 1-I
AMRIX 9-G
AMTURNIDE 14-A
amylase-lipase-protease 7-G
amy-lip-prot dr 7-G
ANADROL-50 13-I
ANAFRANIL 4-B
anagrelide 10-E
ANALPRAM ADVANCED KIT 14-A
ANALPRAM-HC 5-A
ANAMANTLE 5-I
ANAPROX 9-C
anastrozole 2-A
ANDROGEL 14-A
ANSAID 9-C
ANTABUSE 4-F
anthralin 5-F
antipyrine-benzocaine-polycosanol 14-A
ANUSOL-HC 5-A
APAP-butalbital 9-A
APAP-caffeine-butalbital 9-A
APAP-caffeine-butalbital 14-A
APAP-codeine 14-A
APAP-codeine 9-B
APAP-hydrocodone 14-A
APAP-hydrocodone 9-B
APAP-isometh-dichlor hydrate 9-E
APLENZIN 14-A
APOKYN 4-H
apomorphine 4-H
APRESOLINE 3-H
Apri 6-D
APRISO 7-H
AQUATENSEN 3-J
ARALEN 1-J
ARANESP 13-C
ARAVA 9-D
ARCALYST 13-I
ARICEPT 4-F
ARICEPT 14-A
ARIMIDEX 2-A
ARMOUR THYROID 6-I
AROMASIN 2-A
ARTANE 4-H
ASA-caffeine-butalbital 9-A
ASA-caffeine-but-codeine 9-B
ASA-codeine 9-B
ASACOL 7-H
ASACOL HD 7-H
ASENDIN 4-B
ASMALPRED 14-A
ASMALPRED PLUS 14-A
ASMANEX 12-E
ASTELIN 12-B
ASTEPRO 12-B
ATARAX 4-A
ATELVIA 14-A
atenolol 3-C
atenolol-chlorthalidone 3-I
ATIVAN 4-A
atorvastatin 3-L
ATRALIN 14-A
atropine ophth 11-E
ATROVENT (nebulizer) 12-D
ATROVENT HFA 12-D
ATROVENT INHALER 12-D
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2-Tier (closed) Drug Benefit Guide 01/04/12