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Diabetes Management (Oral)
Name AETNA BCBSMA BMCHP FCHP HPHC HNE NHP NTWK MAHLTH THP
NATEgLINIDE [starlix] X* X X X X X NC PA X
PIOgLITAzONE [Actos] X* DL sT X X X sT sT X X X*
REPAgLINIDE [Prandin] X* X* X X X X PA X*
ROsIgLITAzONE [Avandia] X* DL sT X X sT sT X X X
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sAXAgLIPTIN [Onglyza] DL sT sT* X DL sT X
sITAgLIPTIN [Januvia] X* sT* sT DL X DL sT DL sT DL sT PA X*
sITAgLIPTIN/METFORMIN [Janumet] X* sT* sT DL X DL sT DL sT DL sT PA X*
TOLAzAMIDE X* X* X X X X X X X X
TOLBUTAMIDE X* X* X X X X X X X X
Hormone Replacement
CONJUgATED EsTROgENs [Cenestin] X NC X X X X X X
CONJUgATED EsTROgENs [Enjuvia] X* NC X X X X
CONJUgATED EsTROgENs [Premarin] X X X X X X X X X
CONJUgATED EsTROgENs/
MEDROXyPROgEsTERONE
[Premphase]
X X* X X X X X X X
DROsPIRENONE/EsTRADIOL [Angeliq] FE NC X X PA X
EsTERIFIED EsTROgEN [Menest] X* X* X X X X X X X
EsTERIFIED EsTROgEN/
METHyLTEsTOsTERONE
X* X* X X X X X X
EsTERIFIED EsTROgEN/
METHyLTEsTOsTERONE [Estratest]
X X X X X NC X
EsTERIFIED EsTROgEN/
METHyLTEsTOsTERONE H .s .
X* X* X X X X X X
EsTERIFIED EsTROgEN/
METHyLTEsTOsTERONE H .s .
[Estratest H .s .]
X X X X X NC X
EsTRADIOL tablets X* X* X X X X X X X X*
EsTRADIOL tablets [Femtrace] X NC X X NC PA X
EsTRADIOL topical [Estrasorb] FE NC DL X X X X
EsTRADIOL topical [Estrogel] FE NC DL X X X X
EsTRADIOL vaginal [Estrace] X NC X X X X X X X
EsTRADIOL vaginal [Premarin
Vaginal]
X X* X X X X X X X
EsTRADIOL transdermal patch DL* DL* X X X X X X X X*