L.A. Care Covered Drug Formulary (pdf)

Commercial FormularyT2 blood-glucose control,normalEVOLUTIONCONTROLSOLUTION(OTC)T2 blood-glucose control, EZ SMART(OTC)normalT2 blood-glucose control, FREESTYLEnormalCONTROLT2 blood-glucose control,normalSOLUTION(OTC)GE100 CONTROLSOLUTIONNORMAL(OTC)T2 blood-glucose control, GLUCOCARD 01normalCONTROL(OTC)T2 blood-glucose control, GLUCOCARDnormalEXPRESSION(OTC)T2 blood-glucose control, GLUCOCARD X-normalMETERT2 blood-glucose control,normalCONTROL(OTC)GLUCOCOMCONTROLSOLUTION(OTC)T2 blood-glucose control, GLUCOLABnormalCONTROL(OTC)T2 blood-glucose control, GLUCOLEADER(OTnormalC)T2 blood-glucose control, GLUCOSE CONTROLnormalSOLUTION(OTC)T2 blood-glucose control, GLUCOSEnormalCONTROL(OTC)T2 blood-glucose control, GMATE CONTROLnormalSOLUTION(OTC)T2 blood-glucose control, INFINITY CONTROLnormalSOLUTION(OTC)T2 blood-glucose control, LIBERTY CONTROLnormalSOLUTION(OTC)T2 blood-glucose control, LIBERTY LEV 2normalGLUCOSET2 blood-glucose control,normalCONTROL(OTC)MEDISENSEGLUCOSE KETONECONTR(OTC)T2 blood-glucose control, MEDISENSE(OTC)normalT2 blood-glucose control, METER-CHECK(OTC)normalT2 blood-glucose control, MICRODOT(OTC)normalT2 blood-glucose control, NOVA MAXnormalGLUCOSE CONTROLT2 blood-glucose control,normalT2 blood-glucose control,normalSOLN(OTC)ONE TOUCHGLUCOSE CONTROLSOLN(OTC)ONE TOUCH ULTRACONTROLSOLN(OTC)T2 blood-glucose control, ONE TOUCHnormalULTRA(OTC)T2 blood-glucose control, ONE TOUCHnormalVERIO(OTC)T2 blood-glucose control, QUICKTEK(OTC)normalT2 blood-glucose control, RIGHTEST CONTROLnormalSOLUTION(OTC)T2 blood-glucose control, SMARTEST(OTC)normalT2 blood-glucose control, SMS GLUCOSEnormalCONTROL(OTC)T2 blood-glucose control, SURE EDGEnormalGLUCOSE CONTROLSOLN(OTC)T2 blood-glucose control, SURESTEPnormalCONTROLSOLUTION(OTC)T2 blood-glucose control, SURESTEPnormalT2 blood-glucose control,normalPRO(OTC)SURE-TESTEASYPLUSMINI(OTC)T2 blood-glucose control, TRACER(OTC)normalT2 blood-glucose control, TRUETESTnormalGLUCOSECONTROL(OTC)T2 blood-glucose control, ULTRATRAK(OTC)normalT2 blood-glucose control, WAVESENSEnormalCONTROLSOLUTION(OTC)T2 blood-glucose control, XPRES(OTC)normalT2 blood-glucose meter CARESENSN(EACH)(OTC)T2 diabeticAUTOsupplies,miscell INJECTOR(OTC)T2 diabeticCHEMSTRIP BGsupplies,miscell DIARY(OTC)T2 diabeticMAGNI-GUIDEsupplies,miscell MAGNIFIER(OTC)T2 diabeticSOFT TOUCH II(OTC)supplies,miscellT2 lancing device ADJUSTABLELANCINGDEVICE(OTC)T2 lancing deviceT2 lancing deviceT2 lancing deviceT2 lancing deviceT2 lancing deviceT2 lancing deviceT2 lancing deviceT2 lancing deviceT2 lancing deviceT2 lancing deviceADVOCATE LANCINGDEVICE(OTC)ALTERNATE SITELANCINGDEVICE(OTC)AQUA LANCELANCINGDEVICE(OTC)AUTO-LANCETMINI(OTC)AUTO-LANCET(OTC)AUTOLET LANCINGDEVICE(OTC)AUTOLET LITECLINISAFE(OTC)AUTOLET LITE(OTC)AUTOLET MKIICLINISAFE(OTC)CAREONE(OTC)Page 27 of 91