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>T4 antihemophilic factor, KOATE-DVIhumanT4 antihemophilic factor, MONOCLATE-PhumanT4 antihemophilic ALPHANATEfactor/vwfT4 antihemophilic HUMATE-Pfactor/vwfT4 antihemophilic WILATEfactor/vwfT4 anti-inhibitor coagulant FEIBA NFcomp.T4 anti-inhibitor coagulant FEIBA VH IMMUNOcomp.T4 coagulation factor NOVOSEVENviia,recombT4 coagulation factor NOVOSEVEN RTviia,recombBlood Factors,miscellaneousT4 factor xiiiCORIFACTCitrates As AnticoagulantsT1 citrate-phos-dexsolutionT1 sodium citrateDirect Factor Xa InhibitorsCITRATEPHOSPHATEDEXTROSESODIUM CITRATET3 apixaban ELIQUIS PA, QLT2 rivaroxabanXARELTO(TAB)(10 QLMG)T2 rivaroxabanXARELTO(TAB)(15 QLMG)T2 rivaroxabanXARELTO(TAB)(20MG)QLFactor Ix PreparationsT4 factor ixT4 factor ixT4 factor ix complexhumanT4 factor ix complexhumanT4 factor ix complexhumanT4 factor ix humanrecombinantHematinics,otherALPHANINE SDMONONINEBEBULINBEBULIN VHIMMUNOPROFILNINE SDBENEFIXT4 darbepoetin alfa in ARANESPPApolysorbatT4 epoetin alfa EPOGEN PAT4 epoetin alfa PROCRIT PAT4 peginesatide OMONTYS PAHemorrheologic AgentsT1 pentoxifyllinePENTOXIFYLLINEHeparin And Related PreparationsT4 dalteparinsodium,porcineFRAGMIN(DISPSYRINGE)T2 dalteparinFRAGMIN(VIAL)sodium,porcine (10000/ML)T4 dalteparinFRAGMIN(VIAL)sodium,porcine (25000/ML)T4 enoxaparin sodium LOVENOXT4 fondaparinux sodium ARIXTRAT1 heparin sod,porcine- HEPARIN FLUSH0.9 % naclT1 heparinHEPARIN SODIUMsodium,porcineT1 heparinHEPARIN SODIUM INsodium,porcine/d5w 5% DEXTROSET1 heparinHEP-PAK CVCsodium,porcine/nsT1 heparinHEPARIN SODIUMsodium,porcine/ns/pfNST1 heparinHEPARIN FLUSHsodium,porcine/pfT1 heparinHEP-LOCKsodium,porcine/pfT3 tinzaparinINNOHEPsodium,porcineLeukocyte (wbc) StimulantsT4 filgrastim NEUPOGEN PAT4 pegfilgrastim NEULASTA PAT4 sargramostim LEUKINE PAPlatelet Aggregation InhibitorsT3 aspirin/dipyridamole AGGRENOXT1 cilostazolPLETALT1 clopidogrel bisulfate PLAVIXT1 dipyridamole DIPYRIDAMOLET1 dipyridamole PERSANTINET2 prasugrel hcl EFFIENT QLT2 ticagrelor BRILINTA QLT1 ticlopidine hcl TICLOPIDINE HCLPlatelet Proliferation StimulantsT4 oprelvekinPlatelet Reducing AgentsT1 anagrelide hclT1 anagrelide hclNEUMEGASickle Cell Anemia AgentsT3 hydroxyureaAGRYLINANAGRELIDE HCLDROXIAThrombin Inhibitors,sel.,direct,&rev.-hirudinTypeT4 desirudin IPRIVASK PA, QLThrombin Inhibitors,selective,direct, &ReversibleT3 dabigatran etexilatemesylatePRADAXAThrombopoietin Receptor AgonistsT4 eltrombopag olamine PROMACTA PAPA, QLPage 35 of 91
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