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>T1 fa/vitbcomp&c/se/minaa/znT1 folic acid/b complex& c no.17T1 folic acid/vitbcomp&c/cu/znoxT1 folic acid/vitamin bcomp w-cT3 folic acid/vitamin b6/vitb12T3 lysine hcl/vit bcomp/fa/zincT3 lysine/vitamin bcomplex/fa/znT1 mecobalamin/lmefolate/b6phosT3 mgox/e ac succ/b-12/fa/b6T3 multivit,mincmb#11/folic acidT3 multivitamin, mincmb#25/fa/d3T3 mv, mincmb#26/fa/ala/luteinT1 potassiumaminobenzoateT3 potassiumaminobenzoateT1 potassiumaminobenzoateT1 vit b cmplx #9/fa/vitc/vit eT1 vit b cmplx#9/iron/fa/vit c&eT1 vit b cmplx 3/fa/vitc/biotinT1 vit b cmplxno3/fa/c/biot/zincT3 vit b complex & cno.13/fa/d3T1 vit b cplx#11/fa/c/biot/zn oxT1 vitamin b complexT1 vitaminsb1,b2,b3,b5,& b6Vitamin B1 PreparationsT1 thiamine hclDIALYVITE 3000VIRT-VITE PLUSDIATX ZNRENAL CAPSCENFOLSUPERVITELYSIPLEXFOLASTVitamin B12 PreparationsFOLPACE RXDIALYVITE 5000DIALYVITE SUPREMEDSYNAGEXAMINOBENZOATEPOTASSIUMPOTABAPOTABA ENVULERENATABSRENATABS WITHIRONRENA-VITE RXNEPHPLEX RXNEPHROCAPS QTDIALYVITE ZINCVITAMIN B COMPLEXB-COMPLEXTHIAMINE HCLT1 cyanocobalamin VITMAIN B-12T3 cyanocobalamin CALOMIST(vitamin b-12)T1 cyanocobalamin CYANOCOBALAMIN(vitamin b-12) INJECTIONT3 cyanocobalamin NASCOBAL(vitamin b-12)T1 cyanocobalamin/mec NEURIN-SLobalaminT3 cyanocobalamin/thiami NERVIDOXneT1 cyanocobalamin/thia TIA DOCEmineT3 cyanocobalamin/vit VITAJECTbcomp&cT1 hydroxocobalamin HYDROXOCOBALAMINT1 vitamin b12-intrinsic MARTINICfactorVitamin B6 PreparationsT1 pyridoxine hclVitamin C PreparationsT3 ascorbate sodiumT1 ascorbic acidVitamin D PreparationsT1 calcitriolT2 dihydrotachysterolT1 ergocalciferol(vitamin d2)Zinc ReplacementT1 zinc sulfateWEIGHT REDUCTIONAnorexic AgentsPYRIDOXINE HCLCENOLATEASCORBIC ACIDROCALTROLDHTDRISDOLZINC SULFATET1 benzphetamine hcl DIDREXT3 benzphetamine hcl REGIMEXT1 diethylpropion hcl DIETHYLPROPIONHCLT1 phendimetrazine BONTRIL PDMtartrateT1 phendimetrazinetartrateBONTRIL SLOW-RELEASET1 phentermine hcl ADIPEX-PT1 phentermine hcl PHENTERMINE HCLT3 phentermine hcl SUPRENZA ODT QL, STT3 phentermine resin IONAMINT3 phentermine/topiramat QSYMIAPAeT3 sibutramine hcl m- MERIDIAhydrateFat Absorption Decreasing AgentsT3 orlistatXENICALPage 57 of 91
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