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Xxxxxx Analgesics Xxxxxx (Narcotic/Opiate)<br />
Name AETNA BCBSMA BMCHP FCHP HPHC HNE NHP NTWK MAHLTH THP<br />
OPIUM TINCTURE X* X X X X X X X X<br />
OXyCODONE X* X* X X X X X X DL X<br />
OXyCODONE [OxyIR] X X PA X NC DL X<br />
OXyCODONE [Roxicodone] X X PA X DL X<br />
OXyCODONE [Roxicodone Intensol] X X X DL X<br />
OXyCODONE ER [Oxycontin] DL* DL* DL PA DL DL sT DL sT DL PA DL<br />
OXyCODONE/ACETAMINOPHEN X* X* DL X X X X X X X<br />
OXyCODONE/ACETAMINOPHEN FE X DL PA X NC PA NC<br />
[Magnacet]<br />
OXyCODONE/ACETAMINOPHEN<br />
[Percocet]<br />
FE NC DL PA X NC PA X<br />
OXyCODONE/ACETAMINOPHEN<br />
capsules [Tylox]<br />
X X DL PA X NC PA X<br />
OXyCODONE/ACETAMINOPHEN<br />
solution<br />
X* X* DL X X X X X X X<br />
OXyCODONE/ACETAMINOPHEN<br />
solution [Roxicet oral solution]<br />
FE X* DL X X X X X<br />
OXyCODONE/ACETAMINOPHEN<br />
tablets [Roxicet tablets]<br />
FE X* DL PA X X X X X<br />
OXyCODONE/AsPIRIN X* X* DL X X X X X X X<br />
OXyCODONE/AsPIRIN [Percodan] X X DL PA X NC PA X<br />
OXyCODONE/IBUPROFEN X X* DL X X X PA X<br />
OXyCODONE/IBUPROFEN DL FE NC DL PA X NC PA NC<br />
[Combunox] sT<br />
OXyMORPHONE [Opana] FE NC PA X NC PA NC<br />
OXyMORPHONE ER [Opana ER] X* NC DL PA X NC PA NC<br />
PENTAzOCINE/NALOXONE X* X* X X X X X PA X<br />
PENTAzOCINE/NALOXONE<br />
[Talwin NX]<br />
NC X X NC X<br />
PROPOXyPHENE HCL X* X* X X X X X X X X<br />
PROPOXyPHENE HCL [Darvon] X X PA X NC PA X<br />
PROPOXyPHENE NAPsyLATE<br />
[Darvon N]<br />
X X* X X X X<br />
PROPOXyPHENE NAPsyLATE/<br />
ACETAMINOPHEN<br />
X* X* X X X X X X X X<br />
PROPOXyPHENE/ACETAMINOPHEN X* X* X X X X X X X X<br />
3
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