L.A. Care Covered Drug Formulary (pdf)
L.A. Care Covered Drug Formulary (pdf)
L.A. Care Covered Drug Formulary (pdf)
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Commercial <strong>Formulary</strong>Lhrh(gnrh)agnst Pit.sup-central PrecociousPubertyT4 histrelin acSUPPRELIN LALuteinizing Hormone Releasing Hormone-lhrhT2 gonadorelin acetateLUTREPULSEPituitary Suppressive AgentsT1 cabergolineT1 danazolCABERGOLINEDANAZOLENDOCRINE DISORDER - THYROIDAntithyroid PreparationsT1 methimazoleT1 propylthiouracilIodine Containing AgentsT1 potassium iodideT1 potassiumiodide/iodineThyroid HormonesMETHIMAZOLEPROPYLTHIOURACILSSKISTRONG IODINET3 levothyroxine sodium TIROSINTT1 levothyroxine UNITHROIDsodiumT1 liothyronine sodium CYTOMELT3 liotrixTHYROLAR-1T3 liotrixTHYROLAR-1/2T3 liotrixTHYROLAR-1/4T3 liotrixTHYROLAR-2T3 liotrixTHYROLAR-3T1 thyroidTHYROIDT2 thyroid,porkARMOUR THYROIDT1 thyroid,pork NP THYROIDEYE - GENERAL DISORDERSEye Antibiotic-corticoid CombinationsT3 gentamicin/prednisolacT1 neo/polymyx bsulf/dexamethT1 neo/polymyx bsulf/dexamethT1 neomy sulf/bacitraczn/poly/hcPRED-GMAXITROLNEOMYCIN-POLYMYXIN-DEXAMETHNEOMYCIN-BACITRACIN-POLY-HCPOLY-PREDT2 neomy sulf/polymyx bsulf/predT1 neomycin sulfate/dex NEOMYCINna phW/DEXAMETHASONET3 tobramycin/dexametha TOBRADEX STsoneT1 tobramycin/dexamet TOBRADEX(DROPShasoneSUSP)T2 tobramycin/dexametha TOBRADEX(OINT)soneT2 tobramycin/lotepred ZYLETetabEye AntihistaminesT3 alcaftadineLASTACAFTT1 azelastine hcl OPTIVART3 bepotastine besilate BEPREVET3 emedastine difumarate EMADINET1 epinastine hcl ELESTATT2 olopatadine hcl PATADAYT2 olopatadine hcl PATANOLEye Anti-infectivesT3 povidone-iodineBETADINEEye Antiinflammatory AgentsT3 bromfenac sodium BROMDAYT1 bromfenac sodium BROMFENACSODIUMT3 bromfenac sodium XIBROMT3 dexamethasone MAXIDEXT3 dexamethasone sod DECADRONphosphateT1 dexamethasone sod DEXASOLphosphateT1 diclofenac sodium VOLTARENT2 difluprednate DUREZOLT1 fluorometholone FLUOROMETHOLONET2 fluorometholone FMLT2 fluorometholone FML FORTET2 fluorometholone FML S.O.P.T2 fluorometholone FLAREXacetateT1 flurbiprofen sodium OCUFENT1 ketorolacACULARtromethamineT1 ketorolacACULAR LStromethamineT3 ketorolacACUVAILtromethamine/pfT2 loteprednol etabonate ALREXT2 loteprednol etabonate LOTEMAXT2 nepafenacILEVROT2 nepafenacNEVANACT1 prednisolone acetate OMNIPREDT2 prednisolone acetate PRED MILDT1 prednisolone sod PREDNISOLphosphateT3 rimexoloneVEXOLEye AntiviralsT2 ganciclovirT1 trifluridineEye Local AnestheticsT1 benoxinatehcl/fluorescein naT3 lidocaine hcl/pfT1 proparacaine hclZIRGANVIROPTICFLURESSAKTENPROPARACAINE HCLPage 32 of 91
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