L.A. Care Covered Drug Formulary (pdf)

IndexBEXAROTENE................................................... 22, 46BEYAZ................................................................ 14, 65BIAXIN......................................................................38BICALUTAMIDE....................................................... 45BICHLORACETIC ACID...........................................21BIDIL.........................................................................13BIFERA RX...............................................................55BILTRICIDE.............................................................. 40BIMATOPROST..................................................33, 34BINOSTO......................................................31, 59, 65BIO GLO...................................................................34BIOCLATE................................................................ 34BIONECT..................................................................22BISAC/NACL/NAHCO3/KCL/PEG 3350...................44BISMUTH SAL/METRONID/TETRACYC................. 53BISMUTH/METRONID/TETRACYCLINE.................53BISOPROLOL FUMARATE...................................... 11BISOPROLOL FUMARATE/HCTZ........................... 12BLEPHAMIDE.......................................................... 33BLEPHAMIDE S.O.P................................................ 33BLOOD GLUCOSE CNTL HI & NORMAL................24BLOOD GLUCOSE CONTROL HIGH&LOW......24,2 5BLOOD GLUCOSE CONTROL(OTC)......................24BLOOD SUGAR DIAGNOSTIC................................24BLOODDIABETIC SUPPLIES,MISCELL................. 25BLOOD-GLUCOSE CALIB. CONTROL................... 25BLOOD-GLUCOSE CONTROL(OTC)......................26BLOOD-GLUCOSE CONTROL, HIGH.....................25BLOOD-GLUCOSE CONTROL, LOW................25, 26BLOOD-GLUCOSE CONTROL, NORMAL........ 26, 27BLOOD-GLUCOSE METER.....................................27BOCEPREVIR.......................................................... 41BONIVA(TAB)(150 MG)............................................ 31BONIVA(TAB)(2.5 MG)................................. 31, 59, 65BONTRIL PDM......................................................... 57BONTRIL SLOW-RELEASE.....................................57BOSENTAN.............................................................. 12BOSULIF............................................................ 45, 73BOSUTINIB.............................................................. 45BP WASH................................................................. 21BP-50% UREA......................................................... 21BPM............................................................................5BPM PSEUDO..........................................................15BPS.......................................................................... 21BRAVELLE............................................................... 30BREEZE 2(OTC)................................................ 25, 26BREZE......................................................................21BRILINTA............................................................35, 59BRIMONIDINE TARTRATE...................................... 33BRIMONIDINE TARTRATE/TIMOLOL......................33BRINZOLAMIDE.......................................................33BROMDAY................................................................32BROMFED DM......................................................... 16BROMFENAC SODIUM........................................... 32BROMOCRIPTINE MESYLATE......................... 23, 50BROMPHENIRA/PSEUDOEPHED/CODEIN........... 15BROMPHENIRAM/PE/DIHYDROCODEINE............ 15BROMPHENIRAMIN/PE/CODEINE......................... 15BROMPHENIRAMINE MALEATE.............................. 5BROMPHENIRAMINE TANNATE...............................5BROMPHENIRAMINE/DIPHENHYDRAM..................5BRONCOMAR GG..................................................... 6BRONCOMAR-1.........................................................6BRONCOTRON-D....................................................16BROVANA............................................................ 6, 59BROVEX.....................................................................5BROVEX CT...............................................................5BROVEX PB C......................................................... 15BROVEX PB CX.......................................................15BROVEX SR.............................................................15BUCALCIDE............................................................. 46BUCALSEP.............................................................. 43BUDESONIDE...................................................5-7, 42BUDESONIDE/FORMOTEROL FUMARATE............. 6BUMETANIDE.......................................................... 12BUPAP......................................................................46BUPHENYL.............................................................. 44BUPRENEX..............................................................49BUPRENORPHINE.................................................. 47BUPRENORPHINE HCL.......................................... 49BUPRENORPHINE HCL/NALOXONE HCL.............49BUPROBAN..............................................................51BUPROPION HBR......................................................7BUPROPION HCL................................................7, 51BUSPAR..................................................................... 8BUSPIRONE HCL...................................................... 8BUSULFAN...............................................................45BUTABARBITAL SODIUM..........................................9BUTALB/ACETAMINOPHEN/CAFFEINE................. 47BUTALBIT/ACETAMIN/CAFF/CODEINE..................49BUTALBITAL/ACETAMINOPHEN...................... 46, 47BUTALBITAL/ASPIRIN/CAFFEINE.......................... 47BUTALBITAL-ACETAMINOPHEN-CAFFE............... 47BUTALBITAL-ASPIRIN-CAFFEINE.......................... 47BUTENAFINE HCL...................................................17BUTISOL SODIUM.....................................................9BUTOCONAZOLE NITRATE....................................54BUTORPHANOL TARTRATE................................... 47BUTRANS.......................................................... 47, 59BUTYLATED HYDROXYTOLUENE......................... 16BUTYLATED HYDROXYTOLUENE(BHT)............... 16BYDUREON....................................................... 23, 59BYETTA(PEN INJCTR)(10MCG/0.04)..........23, 59, 65BYETTA(PEN INJCTR)(5MCG/0.02)............23, 59, 65BYSTOLIC................................................................ 12- C -C1 ESTERASE INHIBITOR......................................42CA CARB/D3/B-12/FA/B6/POLICOS........................56CABERGOLINE........................................................32CABOZANTINIB S-MALATE.................................... 45CADEXOMER IODINE............................................. 16CADUET.............................................................14, 59CAFCIT.......................................................................7CAFERGOT........................................................49, 59CAFFEINE CITRATED............................................... 7CAL CARB/MGOX/D3/B12/FA/B6/BOR................... 54CALAFOL RX........................................................... 56CALCIPOTRIENE...............................................23, 65CALCIPOTRIENE/BETAMETHASONE....................23CALCITONIN,SALMON,SYNTHETIC...................... 31CALCITRIOL...................................................... 23, 57CALCIUM ACETATE................................................ 30CALCIUM CARBONATE/MAG CARB/FA.................30CALFACTANT...........................................................46CALOMIST............................................................... 57CAMBIA..............................................................49, 59CAMILA.................................................................... 15CAMPRAL.................................................................. 8CAMRESE................................................................14CANASA...................................................................43CANDESARTAN CILEXETIL.................................... 11CANDESARTAN/HYDROCHLOROTHIAZID............11CANTIL.....................................................................53CAPECITABINE........................................................45CAPEX SHAMPOO.................................................. 19CAPITAL W-CODEINE............................................. 49CAPOTEN.................................................................11CAPRELSA........................................................ 45, 73CAPSAICIN.............................................................. 21CAPSAICIN/SKIN CLEANSER................................ 21CAPSICUM...............................................................21CAPTOPRIL..............................................................11CAPTOPRIL/HYDROCHLOROTHIAZIDE................10CAPTOPRIL-HYDROCHLOROTHIAZIDE............... 10CARAC..................................................................... 22CARAFATE(ORAL SUSP)........................................ 53CARAFATE(TAB)......................................................53CARBACHOL........................................................... 33CARBAGLU..............................................................44CARBAMAZEPINE...............................................8, 50CARBATROL............................................................ 50CARBIDOPA.............................................................50CARBIDOPA/LEVODOPA........................................ 50CARBIDOPA/LEVODOPA/ENTACAPONE...............50CARBINOXAMINE MALEATE.............................. 5, 58CARBIT/EQUIS XT/ETHAN/CHIT/MSM...................22CARDENE SR.......................................................... 12CARDIZEM CD.........................................................12CARDIZEM LA..........................................................12CARDURA................................................................10CARDURA XL...........................................................11CAREONE(OTC)......................................................27CARESENS N(EACH)(OTC)....................................27CARESENS(OTC)....................................................26CARGLUMIC ACID...................................................44CARISOPRODOL.....................................................51CARISOPRODOL COMPOUND.............................. 51CARISOPRODOL COMPOUND-CODEINE.............47CARISOPRODOL/ASPIRIN..................................... 51CARMOL HC............................................................ 19CARMOL SCALP..................................................... 20CARMUSTINE IN POLIFEPROSAN 20................... 45CARTEOLOL HCL....................................................33CARVEDILOL........................................................... 10CARVEDILOL PHOSPHATE.................................... 10CASODEX................................................................ 45CATAFLAM............................................................... 42CATAPRES............................................................... 11CATAPRES-TTS 1.................................................... 11CATAPRES-TTS 2.................................................... 11CATAPRES-TTS 3.................................................... 11CAVERJECT.......................................................30, 59CAYSTON...........................................................37, 73C-CLARIFYING SERUM.......................................... 22CEDAX..................................................................... 38CEENU..................................................................... 45CEFACLOR.............................................................. 37CEFADROXIL...........................................................37CEFADROXIL HYDRATE......................................... 37CEFDINIR.................................................................37CEFDITOREN PIVOXIL........................................... 37CEFIXIME.................................................................37CEFPODOXIME PROXETIL.................................... 37CEFPROZIL..............................................................37CEFTIBUTEN DIHYDRATE......................................38CEFTIN(SUSP RECON)...........................................37CEFTIN(TAB)............................................................37CEFUROXIME AXETIL............................................ 37CELEBREX.................................................. 42, 58, 65CELECOXIB............................................................. 42CELESTONE............................................................ 42CELEXA..................................................................... 7CELLCEPT(CAP)..................................................... 37CELLCEPT(SUSP RECON).....................................37CELLCEPT(TAB)...................................................... 37CELLULOSE,OXIDIZED.......................................... 36CELONTIN................................................................51CENESTIN................................................................36CENFOL................................................................... 57CENOLATE...............................................................57CENTANY AT........................................................... 17CEPHALEXIN...........................................................37CERON-DM..............................................................16CERTOLIZUMAB PEGOL........................................ 43CERVIDIL................................................................. 15CESAMET...................................................... 6, 59, 66CETACAINE............................................................. 22CETACAINE ANESTHETIC......................................22CETACAINE MEDICAL KIT E.................................. 22CETIRIZINE HCL........................................................5CETRAXAL...............................................................29CETRORELIX ACETATE..........................................31CETROTIDE.............................................................31CEVI-FER.................................................................55CEVIMELINE HCL....................................................45CHANTIX............................................................51, 59CHEMSTRIP BG DIARY(OTC)................................ 27CHEMSTRIP UGK(OTC)..........................................29CHENODAL..............................................................44CHENODIOL............................................................ 44CHILDRENS FEVER................................................44CHLORAL HYDRATE.................................................9CHLORAMBUCIL..................................................... 45CHLORDIAZEPOXIDE...............................................8CHLORDIAZEPOXIDE HCL.......................................8CHLORDIAZEPOXIDE/CLIDINIUM BR....................53CHLORDIAZEPOXIDE-AMITRIPTYLINE...................8CHLORHEXIDINE GLUCONATE............................. 46CHLOROQUINE PHOSPHATE................................ 40CHLOROTHIAZIDE..................................................13CHLOROXYLENOL/BENZOC/HYDROCORT..........30CHLOROXYLENOL/GLYC/PRAMOX/ZINC............. 29CHLOROXYLENOL/PRAMOXINE HCL...................29CHLOROXYLENOL-PRAMOXINE HCL...................29CHLORPHENIRAMINE MALEATE.............................5CHLORPHENIRAMINE TANNATE.............................5CHLORPHENIRAMINE/CODEINE PHOS..........15, 16CHLORPROMAZINE HCL..........................................9CHLORPROPAMIDE................................................24CHLORTHALIDONE.................................................13CHLORZOXAZONE................................................. 51CHLORZOXAZONE W/ACETAMINOPHEN.............51CHLORZOXAZONE/ACETAMINOPHEN................. 51CHOICEDM CLARUS CONTROL SOLN(OTC)....... 26CHOLESTYRAMINE (WITH SUGAR)......................13CHOLESTYRAMINE/ASPARTAME..........................13CHOLINE MAG TRISALICYLATE............................ 47CHOLINE SAL/MAG SALICYLATE.......................... 47CHORIONIC GONADOTROPIN...............................30CHORIONIC GONADOTROPIN, HUMAN............... 30CHROMAGEN FA.....................................................55CIALIS(TAB)(10 MG).......................................... 30, 59CIALIS(TAB)(2.5 MG)......................................... 30, 59CIALIS(TAB)(20 MG).......................................... 30, 59CIALIS(TAB)(5 MG)............................................ 30, 59CICLESONIDE....................................................... 5, 7Page 77 of 91