Prescription Drug Guide Comprehensive list of covered drugs

Iibandronate sodium .......................114ibuprofen ...........................................4imipenem/cilastatin .........................15imipramine hcl.................................30imipramine pamoate........................30imiquimod .......................................87imitrex .............................................36imovax rabies (h.d.c.v.).................112incivek .............................................52increlex............................................99indapamide ......................................78indocin...............................................4indomethacin .....................................5indomethacin er.................................5infanrix ..........................................112inlyta................................................39innopran xl.......................................68intelence ..........................................49intralipid ........................................132intron-a ............................................52intron-a w/diluent ............................52introvale.........................................103intuniv..............................................84invanz ..............................................15invega ........................................46, 47invega sustenna .........................46, 47invirase ............................................51ionosol-b/dextrose 5%...................132ipol inactivated ipv........................112ipratropium bromide..............120, 123ipratropium bromide/albuterol sulfate...................................................123irbesartan ...................................65, 75irbesartan/hydrochlorothiazide........75irinotecan.........................................39isentress ...........................................51isolyte-p/dextrose 5%....................132isoniazid ..........................................37isordil titradose................................80isosorbide dinitrate ....................80, 81isosorbide dinitrate er......................80isosorbide mononitrate ....................81isosorbide mononitrate er................81isotonic gentamicin .........................11isradipine .........................................71istalol .............................................117itraconazole .....................................34ixempra kit.......................................39ixiaro..............................................112Jjakafi ............................................... 39jalyn ................................................ 93jantoven........................................... 62janumet ........................................... 59janumet xr ....................................... 59januvia............................................. 57jevtana............................................. 39jinteli............................................. 103jolivette ......................................... 104junel 1.5/30 ................................... 103junel 1/20 ...................................... 103junel fe 1.5/30 ............................... 103junel fe 1/20 .................................. 103Kkaletra ............................................. 51kalydeco........................................ 123kanamycin sulfate ........................... 11kariva ............................................ 103kcl 0.075%/d5w/nacl 0.45% ......... 132kcl 0.15%/d5w/lr........................... 132kcl 0.15%/d5w/nacl 0.2% ............. 132kcl 0.15%/d5w/nacl 0.9% ............. 132kcl 0.3%/d5w/nacl 0.45% ............. 133kcl 0.3%/d5w/nacl 0.9% ............... 133kelnor 1/35 .................................... 103kenalog............................................ 97ketoconazole ................................... 34ketoprofen ......................................... 5ketoprofen er..................................... 5ketorolac tromethamine ............ 5, 116kineret ........................................... 110kionex ........................................... 125klor-con 10.................................... 125klor-con 8...................................... 125klor-con m15................................. 125klor-con m20................................. 125kombiglyze xr ................................. 59kristalose ......................................... 91kuvan............................................... 88Llabetalol hcl..................................... 68laclotion .......................................... 87lactated ringers irrigation.............. 133lactated ringers viaflex.................. 133lactulose .......................................... 91lamictal odt ............................... 22, 23lamictal starter/not takingcarbamazepine.............................23lamictal starter/takingcarbamazepine/not taking valproate.....................................................23lamictal starter/taking valproate......23lamictal xr........................................23lamivudine.......................................50lamivudine/zidovudine....................50lamotrigine ......................................23lanoxin.............................................72lansoprazole.....................................92lantus ...............................................60lantus solostar..................................60lastacaft..........................................116latanoprost .....................................118latuda ...............................................47leena ..............................................103leflunomide....................................111lescol xl ...........................................79lessina............................................103letairis............................................122letrozole...........................................39leucovorin calcium ..........................38leukeran ...........................................37leukine .............................................63leuprolide acetate...........................108levalbuterol....................................122levatol..............................................68levemir.............................................60levemir flexpen................................60levetiracetam ...................................20levetiracetam er ...............................20levobunolol hcl..............................117levocarnitine..................................133levocetirizine dihydrochloride.......120levofloxacin.....................................19levofloxacin in d5w.........................19levora 0.15/30-28 ..........................103levothroid ......................................105levothyroxine sodium............105, 106levoxyl...........................................106lexiva ...............................................51lialda..............................................113lidocaine ..........................................10lidocaine hcl ....................................10lidocaine hcl jelly ............................10lidocaine viscous .............................10lidocaine/prilocaine .........................10lidoderm ..........................................10lincocin............................................12lindane .............................................41Page 110