CCHP Senior Select Program (HMO SNP) 東華智選(HMO SNP)計劃

注 意 = 任 何 特 殊 要 求 或 限 制 , 請 參 閱 本 冊 第 3 頁 。 特 約 藥 房 (LD): 這 些 藥 物 只 能 在 某 些 藥 房 提 供 。neomycin/ polymyxin/1dexamethasone ophth soln.neomycin/ polymyxin/ hc ophth susp. 1PRED MILD OPHTH SUSP. 2prednisolone ophth susp.1prednisolone sodium phosphate 1ophth soln.sulfacetamide sodium/ prednisolone 1ophth soln.tobramycin/ dexamethasone ophth 1soln.ZYLET OPHTH SUSP.2OPHTHALMICS - MISC.azelastine ophth soln.1bromfenac ophth soln.1cromolyn sodium ophth soln. 1diclofenac ophth soln.1dorzolamide ophth soln.1epinastine ophth soln.1flurbiprofen ophth soln.1ketorolac ophth soln.1PROSTAGLANDINS - OPHTHALMIClatanoprost ophth soln.1LUMIGAN OPHTH SOLN. 2TRAVATAN Z OPHTH DROPS 2OTIC AGENTSOTIC AGENTS - MISCELLANEOUS藥 物 名 稱acetic acid otic soln.OTIC ANTI-INFECTIVESofloxacin otic soln.OTIC COMBINATIONSCIPRODEX OTIC SUSP.neomycin/ polymyxin/ hc otic soln.neomycin/ polymyxin/ hc otic susp.OTIC STEROIDSfluocinolone acetonide otic oilhydrocortisone/ acetic acid otic soln.OXYTOCICSOXYTOCICS藥 物等 級methylergonovine maleate tab 1PASSIVE IMMUNIZING AGENTSIMMUNE SERUMSCARIMUNE NF INJ.2 PAGAMUNEX-C INJ.2HIZENTRA INJ.2 PA1121111特 殊要 求31PRIVIGEN INJ.2PENICILLINSAMINOPENICILLINSamoxicillin cap1amoxicillin chew tab1amoxicillin susp.1amoxicillin tab1ampicillin cap1ampicillin inj.1ampicillin susp.1NATURAL PENICILLINSpenicillin g potassium inj.1PENICILLIN G PROCAINE INJ. 1penicillin g sodium inj.1penicillin g/ dextrose1penicillin v potassium soln.1penicillin v potassium tab1PENICILLIN COMBINATIONSamoxicillin/ clavulanate chew tab 1amoxicillin/ clavulanate ER tab 1amoxicillin/ clavulanate susp. 1amoxicillin/ clavulanate tab 1ampicillin/ sulbactam inj. 2-1gm, 110-5gmpiperacillin/ tazobactam inj. 1PENICILLINASE-RESISTANT PENICILLINSdicloxacillin cap1nafcillin inj.1nafcillin/ dextrose inj.2OXACILLIN INJ 10MG2OXACILLIN INJ 1MG1OXACILLIN/ DEXTROSE INJ 11GM/ 50MLOXACILLIN/ DEXTROSE INJ 22GM/ 50MLPROGESTINSPROGESTINS藥 物 名 稱medroxyprogesterone tabMEGACE ES SUSP.norethindrone tabprogesterone cap藥 物等 級1211PSYCHOTHERAPEUTIC ANDNEUROLOGICAL AGENTS - MISC.特 殊要 求AGENTS FOR CHEMICAL DEPENDENCYCAMPRAL TAB2