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>T3 pilocarpine hcl ISOPTOCARPINE(DROPS)(8%)T1 pilocarpine hcl PILOCARPINE HCLT3 pilocarpine hcl PILOPINE HST3 tafluprost/pf ZIOPTAN QL, STT2 timololBETIMOLT3 timolol maleate ISTALOLT1 timolol maleate TIMOPTICT1 timolol maleate TIMOPTIC-XET2 travoprost TRAVATAN Z QLT3 unoprostone isopropyl RESCULAQL, STMydriaticsT1 atropine sulfate ATROPINE SULFATET1 atropine sulfate ISOPTO ATROPINET1 atropine sulfate/pf ATROPINE SULFATET2 cyclopentolate hcl CYCLOGYL(DROPS)(0.5 %)T1 cyclopentolate hcl CYCLOGYL(DROPS)(1 %)T1 cyclopentolate hcl CYCLOGYL(DROPS)(2 %)T3 cyclopentolate/phenyle CYCLOMYDRILphrineT2 dipivefrin hcl PROPINET1 homatropine hbr HOMATROPAIRET2 homatropine hbr ISOPTOHOMATROPINET3 hydroxyamphetamine/t PAREMYDropicamideT3 phenylephrine MUROCOLL-2hcl/scopol hbT3 scopolamine ISOPTO HYOSCINEhydrobromideT1 tropicamide MYDRALOphthalmic Antifibrotic AgentsT3 mitomycinMITOSOLEYE - MISCELLANEOUSArtificial TearsT3 hydroxypropylcelluloseEye Diagnostic AgentsT1 fluorescein sodiumT3 fluorescein sodiumT3 fluorescein sodiumT3 fluorescein sodiumT1 lissamine greenT3 oftasceindisod/benoxinate hclT1 rose bengal sodiumLACRISERTBIO GLOFLUORETSFLUOR-I-STRIP ATFUL-GLOLISSAMINEFLURA-SAFEROSE BENGALEye Preparations, MiscellaneousT3 gelatinT3 homeopathic drugsGELFILMCINERARIA 3XTopical Hypertrichotic Agents, EyelashesT3 bimatoprostLATISSEGOUT AND RELATED DISEASESColchicineT1 colchicineCOLCHICINET2 colchicineCOLCRYST1 colchicine/probeneci PROBENECIDdCOLCHICINEHyperuricemia Tx - Purine InhibitorsT1 allopurinolT2 febuxostatUricosuric AgentsT1 probenecidZYLOPRIMULORICPROBENECIDHEMATOLOGICAL DISORDERSAnticoagulants,coumarin TypeT1 warfarin sodiumAntifibrinolytic AgentsT1 aminocaproic acidT3 aminocaproic acidT1 aminocaproic acidT1 aminocaproic acidT1 tranexamic acidAntihemophilic FactorsT4 antihemoph.fviiiplas/alb freeT4 antihemoph.fviiiplas/alb freeT4 antihemoph.fviiiplas/alb freeT4 antihemoph.fviiiplas/alb freeT4 antihemoph.fviiiplas/alb freeT4 antihemoph.fviiiplas/alb freeT4 antihemoph.fviiiplas/alb freeT4 antihemoph.fviiiplas/alb freeT4 antihemophilic factor,hum recT4 antihemophilic factor,hum recT4 antihemophilic factor,hum recT4 antihemophilic factor,hum recT4 antihemophilic factor,hum recT3 antihemophilic factor,humanT4 antihemophilic factor,humanCOUMADINAMICAR(SOLUTION)AMICAR(TAB)(1000MG)AMICAR(TAB)(500MG)AMINOCAPROICACIDLYSTEDAADVATEADVATE HADVATE LADVATE MADVATE SHADVATE UHXYNTHAXYNTHA SOLOFUSEBIOCLATEHELIXATE FSKOGENATE FSRECOMBINATEREFACTOALPHANATEHEMOFIL MPage 34 of 91
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