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Xxxxxx Analgesics Xxxxxx (Narcotic/Opiate)<br />
2<br />
Name AETNA BCBSMA BMCHP FCHP HPHC HNE NHP NTWK MAHLTH THP<br />
HyDROCODONE/ACETAMINOPHEN<br />
[Liquicet]<br />
X X X X PA NC<br />
HyDROCODONE/ACETAMINOPHEN<br />
[Lorcet]<br />
X X PA X NC PA X<br />
HyDROCODONE/ACETAMINOPHEN<br />
[Lorcet Plus]<br />
X X PA X NC PA X<br />
HyDROCODONE/ACETAMINOPHEN<br />
[Lortab]<br />
X X PA X NC PA X<br />
HyDROCODONE/ACETAMINOPHEN<br />
[Vicodin]<br />
X NC PA X NC PA X<br />
HyDROCODONE/ACETAMINOPHEN<br />
[Vicodin Es]<br />
X NC PA X NC PA X<br />
HyDROCODONE/ACETAMINOPHEN<br />
[Xodol]<br />
X X X X NC PA X<br />
HyDROCODONE/ACETAMINOPHEN<br />
[zydone]<br />
FE X X X NC PA X<br />
HyDROCODONE/IBUPROFEN X* X* X X X X X X X X<br />
HyDROCODONE/IBUPROFEN<br />
[Reprexain]<br />
X X X X PA X<br />
HyDROMORPHONE X* X* DL X X X X X DL X<br />
HyDROMORPHONE [Dilaudid] X NC PA X NC PA X<br />
LEVORPHANOL X* X* X X X X X DL X<br />
MEPERIDINE X* X* X X X X X X PA X<br />
MEPERIDINE [Demerol] X X PA X NC PA X<br />
MEPERIDINE/PROMETHAzINE PA* X* NC X X X X X<br />
METHADONE X* X* X X X X X X DL X<br />
MORPHINE/NALTREXONE [Embeda] X NC X NC PA DL<br />
MORPHINE sULFATE X* X* X X X X X X DL X<br />
MORPHINE sULFATE CR X* X* X X X X X X DL DL<br />
MORPHINE sULFATE sR X* X* X X X X DL X PA DL<br />
MORPHINE sULFATE [Kadian] X* NC DL PA X DL sT PA DL<br />
MORPHINE sULFATE [Ms Contin] X X PA X NC PA DL<br />
MORPHINE sULFATE [Oramorph sR] X NC X X NC DL DL<br />
MORPHINE sULFATE [Roxanol] X X PA X X NC DL X<br />
MORPHINE sULFATE ER [Avinza] X* NC DL PA X DL sT PA DL
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