2013 PHP Salud Formulary/Preferred Drug Listing By Therapeutic ...

More documents

Recommendations

Info

Drug Name Dosage Form Notecalciferol SOLN (OTC)calcium acetateCAPScalcium/vitamin d TABS (OTC)calcium/vitamin d TABS (OTC)clinpro 5000CUPRIMINEcytra-2DEPEN TITRATABSPSTECAPSSOLNTABSdexferrum SOLN (PA)dialyviteeffervescent potassiumTABSTBEFferosul ELIX (AG)FERRLECIT SOLN (PA)FERROUS GLUCONATE TABS (OTC)ferrous gluconate TABS (OTC)ferrous gluconate iron TABS (OTC)FERROUS SULFATE SYRP (AG)FLUORABON SOLN (AG)FLURA-DROPS SOLN (AG)flura-drops SOLN (AG)folic acidgildess fe 1.5/30gildess fe 1/20TABSTABSTABSinfed SOLN (PA)junel fe 1.5/30junel fe 1/20TABSTABSK-BICARB CAPS (OTC)kalexatePOWDkionex *klor-conklor-con 10KLOR-CON 25klor-con 8klor-con m10KLOR-CON M15klor-con m20klor-con/efLOESTRIN 24 FEPACKTBCRPACKTBCRTBCRTBCRTBCRTBEFTABSLOZI-FLUR LOZG (AG)MEPHYTONmicrogestin femicrogestin fe 1.5/30multi-vit/fluoridemulti-vit/iron/fluorideTABSTABSTABSSOLNSOLN[MPC031203] Page 44 of 48 August 15, 2013
Drug Name Dosage Form Notemultivitamins/fluorideMYNATALnephronexCHEWCAPSTABSniacin TABS (OTC)niacin er CPCR (OTC)niacin sr TBCR (OTC)NIACIN TR TBCR (OTC)niacin tr TBCR (OTC)NIACORORACITTABSSOLNoyster shell calcium/vitamin d TABS (OTC)phos-flurPHOSLYRAphospha 250 neutralpotassium chloridePOTASSIUM CHLORIDEGELSOLNTABSLIQDLIQDpotassium chloride er *potassium chloride erPOTASSIUM CITRATETBCRTBCRrena-vite TABS (OTC)rena-vite rxrenalrenalprenreno capsTABSCAPSCAPSCAPSs.s.s. tonic LIQD (OTC)sfGELsodium ferric gluconate complex/sucrose SOLN (PA)sodium fluoride * (AG)strovite plusTABSsuper b-complex/vitamin c TABS (OTC)tilia fetri-legest fetriphrocapsUROCIT-K 15TABSTABSCAPSTBCRVENOFER SOLN (PA)vitamin dvol-care rxCAPSTABSUnClassifiedDrug Name Dosage Form NoteADCETRIS SOLR (PA)CHEMSTRIP UGKSTRP[MPC031203] Page 45 of 48 August 15, 2013
Page 1 and 2: 2013 PHP Salud Formulary/Preferred
Page 3 and 4: Drug Name Dosage Form NoteMETHADONE
Page 5 and 6: Drug Name Dosage Form Noteibuprofen
Page 7 and 8: Drug Name Dosage Form NoteMACRODANT
Page 9 and 10: Drug Name Dosage Form NoteDrug Name
Page 11 and 12: Drug Name Dosage Form Notechlorprom
Page 13 and 14: Drug Name Dosage Form Notetopiramat
Page 15 and 16: Drug Name Dosage Form NoteZOLINZA C
Page 17 and 18: Drug Name Dosage Form NoteRISPERDAL
Page 19 and 20: Drug Name Dosage Form NoteVIREAD *
Page 21 and 22: Drug Name Dosage Form Notequetiapin
Page 23 and 24: Drug Name Dosage Form Noteenoxapari
Page 25 and 26: Drug Name Dosage Form Notefosinopri
Page 27: Drug Name Dosage Form Noteamphetami
Page 30 and 31: Drug Name Dosage Form Notetretinoin
Page 32 and 33: Drug Name Dosage Form Notebetametha
Page 34 and 35: Drug Name Dosage Form Notedrospiren
Page 36 and 37: Drug Name Dosage Form NotevelivetTA
Page 38 and 39: Drug Name Dosage Form NoteGAMMAGARD
Page 40 and 41: Drug Name Dosage Form NoteKALBITOR
Page 42 and 43: Drug Name Dosage Form NoteATROVENT
Page 46 and 47: Drug Name Dosage Form NoteFERAHEME
Page 48: Pharmacy Prior Authorization Form.

2013 PHP Salud Formulary/Preferred Drug Listing By Therapeutic ...

Create successful ePaper yourself

Delete template?

Save as template?