Prescription Drug Guide Comprehensive list of covered drugs

IndexAabacavir.....................................22abelcet.......................................14abilify discmelt tbdp 10mg .......21abilify discmelt tbdp 15mg .......21abilify inj ..................................21abilify oral soln.........................21abilify tabs 10mg, 15mg, 2mg, 5mg..............................................21abilify tabs 20mg, 30mg ...........21abstral subl 100mcg....................3abstral subl 200mcg, 800mcg .....3acarbose ....................................25acebutolol hcl............................31acetaminophen/caffeine/dihydrocodeinebitartrate .................................1acetaminophen/codeine #3 .........1acetaminophen/codeine soln.......1acetaminophen/codeine tabs 300mg,15mg.......................................1acetaminophen/codeine tabs 300mg,60mg.......................................1acetasol hc ................................52acetazolamide ...........................33acetazolamide er .......................33acetic acid ...................................5acetylcysteine soln....................55actemra inj 200mg/10ml...........48acthar hp ...................................42acthib ........................................48actimmune ................................48actonel tabs 150mg ...................50actonel tabs 30mg, 5mg............50actonel tabs 35mg .....................50actoplus met..............................27actoplus met xr..........................27actos..........................................25acuvail.......................................51acyclovir ...................................24acyclovir sodium inj 500mg .....24aczone.......................................16adacel........................................48adagen.......................................38adapalene ..................................37adcirca.......................................55adderall xr cp24 1.25mg, 1.25mg,1.25mg, 1.25mg....................35adderall xr cp24 2.5mg, 2.5mg, 2.5mg,2.5mg, 3.75mg, 3.75mg, 3.75mg,3.75mg, 5mg, 5mg, 5mg, 5mg,6.25mg, 6.25mg, 6.25mg, 6.25mg,7.5mg, 7.5mg, 7.5mg, 7.5mg35adriamycin inj 2mg/ml..............17advair diskus.............................55advair hfa..................................55advicor tb24 20mg, 1000mg, 20mg,500mg, 20mg, 750mg...........32advicor tb24 40mg, 1000mg.....32afeditab cr .................................31afinitor ................................18, 47afinitor tabs 10mg.....................18afinitor tabs 5mg.......................18afinitor tabs 7.5mg....................18aggrenox ...................................29a-hydrocort ...............................41akne-mycin .................................8albenza......................................19albuterol sulfate er tb12 4mg ....54albuterol sulfate er tb12 8mg ....54albuterol sulfate nebu 0.083%, 0.5%..............................................54albuterol sulfate nebu 0.63mg/3ml,1.25mg/3ml ..........................54albuterol sulfate syrp, tabs........54alclometasone dipropionate ......41Alcohol Deterrents/ Anti-craving4alcohol preps pads ......................5aldactazide ................................32aldurazyme ...............................38alendronate sodium...................50alfuzosin hcl er..........................40alimta ........................................17alinia tabs..................................19Alkylating Agents.....................16allopurinol.................................15alocril........................................51alomide .....................................51alora pttw 0.025mg/24hr...........43alora pttw 0.05mg/24hr, 0.075mg/24hr,0.1mg/24hr ...........................43aloxi ..........................................13Alpha-adrenergic Agonists.......29Alpha-adrenergic Blocking Agents..............................................29alphagan p soln 0.1%................52alprazolam er tb24 0.5mg .........24alprazolam intensol...................24alprazolam odt tbdp 0.25mg, 0.5mg..............................................24alprazolam odt tbdp 1mg, 2mg .25alprazolam tabs 0.25mg, 0.5mg25alprazolam tabs 1mg, 2mg........25alprazolam xr tb24 1mg, 2mg, 3mg..............................................25alrex ..........................................51altabax.........................................5alvesco ......................................53amantadine hcl..........................20ambisome..................................14amcinonide ...............................41amethia .....................................44amethyst....................................44amifostine .................................17amikacin sulfate inj 1gm/4ml .....5amiloride hcl.............................33amiloride/hydrochlorothiazide..32Aminoglycosides ........................5aminophylline...........................54Aminosalicylates ......................49aminosyn ii ...............................56aminosyn m ..............................56aminosyn-hbc ...........................56aminosyn-pf..............................57aminosyn-pf 7%........................57amiodarone hcl tabs 400mg......30amitiza ......................................39amitriptyline hcl........................13amlodipine besylate............31, 32amlodipine besylate/benazepril hcl..............................................32amlodipine besylate/benazeprilhydrochloride .......................32ammonium lactate ....................37amnesteem ................................37amoxapine tabs 100mg, 25mg, 50mg..............................................13amoxicillin caps, susr, tabs.........7amoxicillin chew 250mg ............7amoxicillin/clavulanate potassium chew................................................7amoxicillin/clavulanate potassium er................................................7amoxicillin/clavulanate potassium susr250mg/5ml, 62.5mg/5ml,400mg/5ml, 57mg/5ml, 600mg/5ml,42.9mg/5ml ............................7amoxicillin/clavulanate potassium tabs250mg, 125mg........................7amoxicillin/potassium clavulanate susr200mg/5ml, 28.5mg/5ml........7amoxicillin/potassium clavulanate tabs................................................7amphetamine/dextroamphetamine cp24..............................................35amphetamine/dextroamphetamine tabs..............................................35amphotec inj 50mg ...................14amphotericin b..........................14ampicillin caps............................7ampicillin sodium inj 125mg, 1gm................................................759