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L.A. Care Covered Drug Formulary (pdf)

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IndexPHENDIMETRAZINE TARTRATE............................57PHENELZINE SULFATE............................................ 7PHENERGAN(AMPUL)(25 MG/ML)...........................5PHENERGAN(AMPUL)(50 MG/ML)...........................5PHENOBARB/HYOSCY/ATROPINE/SCOP.............52PHENOBARBITAL......................................................9PHENOL...................................................................20PHENOXYBENZAMINE HCL................................... 11PHENTERMINE HCL............................................... 57PHENTERMINE RESIN............................................57PHENTERMINE/TOPIRAMATE............................... 57PHENYLBUTAZONE................................................ 43PHENYLEPHRINE HCL........................................... 33PHENYLEPHRINE HCL/PROMETH HCL................15PHENYLEPHRINE HCL/SCOPOL HB..................... 34PHENYLEPHRINE/ANTIPY/B-CAINE......................29PHENYLEPHRINE/CHLOR-TAN..............................15PHENYTEK.............................................................. 51PHENYTOIN.............................................................51PHENYTOIN SODIUM EXTENDED.........................51PHISOHEX............................................................... 17PHOSLO...................................................................30PHOSLYRA.............................................................. 30PHOSPHA 250 NEUTRAL....................................... 54PHOSPHASAL......................................................... 38PHOSPHOLINE IODIDE.......................................... 33PHOSPHORUS #1................................................... 54PHRENILIN FORTE................................................. 47PHYTONADIONE..................................................... 36PICATO.....................................................................22PILOCARPINE HCL..................................... 33, 34, 45PILOPINE HS........................................................... 34PIMECROLIMUS......................................................23PIMOZIDE.................................................................. 8PINDOLOL............................................................... 12PIOGLITAZONE HCL............................................... 24PIOGLITAZONE HCL/GLIMEPIRIDE....................... 24PIOGLITAZONE HCL/METFORMIN HCL................ 24PIRBUTEROL ACETATE............................................6PIROXICAM..............................................................43PITAVASTATIN CALCIUM........................................ 13PLACIDYL.................................................................. 9PLAN B...............................................................14, 58PLAQUENIL............................................................. 40PLARETASE 8000....................................................52PLAVIX..................................................................... 35PLETAL.....................................................................35PLEXION.................................................................. 18PLIAGLIS..................................................................22PNV WITH CA,NO.71/IRON/FA............................... 56PNV,CA42/IRON/FA/LMEFOL CA/DHA................... 56PNV80/IRON FUMARATE/FA/DSS/DHA................. 56PNV-DHA PLUS....................................................... 56POCKETCHEM EZ(OTC).........................................26PODOCON-25..........................................................21PODOFILOX.............................................................21PODOPHYLLUM RESIN.......................................... 21POLY TAN.................................................................. 5POLYCIN-B...............................................................33POLYETHYLENE GLYCOL 3350............................. 44POLY-IRON 150 FORTE.......................................... 55POLYMYXIN B SULF/TRIMETHOPRIM...................33POLY-PRED............................................................. 32POLYTRIM................................................................33POLY-TUSSIN DHC..................................................15POLY-UREAURETHANE..........................................22POLYVITAMIN WITH IRON-FLUORIDE.................. 56POMALIDOMIDE......................................................45POMALYST(CAP)(1 MG)................................... 45, 73POMALYST(CAP)(2 MG)................................... 45, 73POMALYST(CAP)(3 MG)................................... 45, 73POMALYST(CAP)(4 MG)................................... 45, 73PONATINIB HCL...................................................... 45PONSTEL(CAP)(250 MG)........................................43PONTOCAINE.......................................................... 22PORACTANT ALFA.................................................. 46POSACONAZOLE....................................................39POT CHLORIDE/POT BICARB/CIT AC................... 30POTABA................................................................... 57POTABA ENVULE.................................................... 57POTASSIUM AMINOBENZOATE.............................57POTASSIUM BICARBONATE.................................. 30POTASSIUM BICARBONATE/CIT AC..................... 30POTASSIUM CHLORIDE......................................... 30POTASSIUM CHLORIDE/POT BICARB.................. 30POTASSIUM CITRATE.............................................54POTASSIUM CITRATE/CITRIC ACID...................... 54POTASSIUM GLUCONATE......................................30POTASSIUM HYDROXIDE...................................... 21POTASSIUM IODIDE............................................... 32POTASSIUM IODIDE/IODINE.................................. 32POTASSIUM OXALATE........................................... 46POTASSIUM PHOSPHATE,MONOBASIC...............54POTIGA(TAB)(200 MG)................................50, 61, 69POTIGA(TAB)(300 MG)................................50, 61, 69POTIGA(TAB)(400 MG)................................50, 61, 69POTIGA(TAB)(50 MG)..................................50, 61, 69POVIDONE-IODINE................................................. 32PR CREAM...............................................................22PRADAXA.................................................... 35, 61, 73PRAMCORT............................................................. 44PRAM-HCA...............................................................43PRAMIPEXOLE DI-HCL...........................................50PRAMLINTIDE ACETATE........................................ 23PRAMOSONE E.......................................................22PRAMOSONE(CREAM)...........................................22PRAMOSONE(LOTION)...........................................22PRAMOSONE(OINT)............................................... 22PRAMOX.................................................................. 22PRAMOXINE HCL....................................................22PRAMOXINE-HC......................................................29PRANDIMET.............................................................24PRANDIN..................................................................24PRASCION RA.........................................................18PRASUGREL HCL................................................... 35PRAVACHOL............................................................ 13PRAVASTATIN SODIUM.......................................... 13PRAZIQUANTEL...................................................... 40PRAZOSIN HCL....................................................... 11PRECISION GLUCOSE CONTROL(OTC)...............25PRECISION(OTC)....................................................25PRECOSE................................................................ 23PRED MILD.............................................................. 32PRED-G....................................................................32PREDNICARBATE................................................... 19PREDNISOL.............................................................32PREDNISOLONE..................................................... 42PREDNISOLONE ACETATE.............................. 32, 42PREDNISOLONE SOD PH/PEAK FLOW................ 42PREDNISOLONE SOD PHOSPHATE............... 32, 42PREDNISOLONE SODIUM PHOSPHATE...............42PREDNISONE..........................................................42PREDNISONE INTENSOL.......................................42PREFEST................................................................. 36PREGABALIN...........................................................51PREGNYL................................................................ 30PREMARIN.........................................................36, 54PREMPHASE........................................................... 36PREMPRO................................................................36PRENAISSANCE..................................................... 56PRENATAL FORMULA.............................................56PRENATAL VIT/IRON FUMARATE/FA.....................56PREPIDIL................................................................. 15PREPOPIK............................................................... 44PRESTIGE(OTC)......................................................25PREVACID(CAP DR)................................................53PREVACID(TAB RAP DR)........................................53PREVALITE.............................................................. 13PREVIDENT 5000 ENAMEL PROTECT.................. 54PREVIDENT 5000 SENSITIVE................................ 54PREVPAC...........................................................53, 61PREZISTA(ORAL SUSP)......................................... 40PREZISTA(TAB)(150 MG)........................................ 40PREZISTA(TAB)(300 MG)........................................ 40PREZISTA(TAB)(400 MG)........................................ 40PREZISTA(TAB)(600 MG)........................................ 40PREZISTA(TAB)(75 MG).......................................... 40PREZISTA(TAB)(800 MG)........................................ 40PRIFTIN....................................................................40PRILOSEC............................................................... 53PRIMALEV......................................................... 48, 61PRIMAQUINE...........................................................40PRIMAQUINE PHOSPHATE.................................... 40PRIMIDONE............................................................. 51PRIMLEV............................................................48, 61PRIMSOL..................................................................38PRINZIDE.................................................................10PRISTIQ ER................................................... 8, 61, 69PROAIR HFA..............................................................6PROAMATINE.......................................................... 14PROBANTHELINE W/PHENOBARBITAL................ 53PRO-BANTHINE.......................................................53PROBENECID..........................................................34PROBENECID-COLCHICINE...................................34PROCAINAMIDE HCL..............................................10PROCARBAZINE HCL............................................. 45PROCARDIA XL.......................................................12PROCENTRA............................................................. 8PROCHIEVE.............................................................30PROCHLORPERAZINE EDISYLATE.........................6PROCHLORPERAZINE MALEATE............................6PROCHLORPERAZINE/ISOPROPAMIDE...............53PROCORT................................................................44PROCRIT............................................................35, 73PROCTOCORT........................................................ 44PROCTOFOAM-HC..................................................44PROCTOSOL-HC.....................................................44PRODIGY CONTROL SOLUTION(OTC)................. 26PRODIGY LANCING DEVICE(OTC)........................28PRODRIN................................................................. 49PROFERRIN-FORTE............................................... 55PROFILNINE SD...................................................... 35PROGESTERONE............................................. 30, 37PROGESTERONE,MICRONIZED......................30, 37PROGLYCEM........................................................... 28PROMACTA........................................................35, 73PROMAR..................................................................56PROMETHAZINE HCL...........................................5, 6PROMETHAZINE HCL/CODEINE............................16PROMETHAZINE VC............................................... 15PROMETHAZINE VC-CODEINE..............................15PROMETHAZINE/PHENYLEPH/CODEINE.............15PROMETHAZINE-CODEINE....................................16PROMETHAZINE-DM.............................................. 16PROMETHEGAN........................................................6PROMETRIUM......................................................... 37PROMISEB...............................................................20PROMISEB COMPLETE..........................................20PRONESTYL............................................................10PROPAFENONE HCL.............................................. 10PROPANTHELINE BROMIDE..................................53PROPANTHELINE/PHENOBARBITAL.....................53PROPARACAINE HCL............................................. 32PROPARACAINE/FLUORESCEIN SOD.................. 33PROPINE..................................................................34PROPOXYPHENE HCL........................................... 49PROPOXYPHENE HCL/ACETAMINOPHEN........... 49PROPOXYPHENE HCL-ACETAMINOPHEN........... 49PROPOXYPHENE NAP/ACETAMINOPHEN........... 49PROPOXYPHENE NAPSYLATE..............................49PROPRANOLOL HCL.............................................. 12PROPRANOLOL/HYDROCHLOROTHIAZID...........12PROPRANOLOL-HYDROCHLOROTHIAZID...........12PROPYLTHIOURACIL..............................................32PROQUIN XR...........................................................38PROSCAR................................................................53PROSED-DS............................................................ 38PROSTIGMIN.............................................................7PROSTIN E2 VAGINAL SUPPOSITORY................. 15PROTECT BONE..................................................... 56PROTECT CARDIO..................................................56PROTECT CMB2/CERAMIDE 1,3,6-11....................22PROTECT IRON.......................................................56PROTECT PLUS...................................................... 56PROTECT PLUS NR................................................55PROTONIX(GRANPKT DR)............................... 53, 69PROTONIX(TAB DR)................................................53PROTOPIC................................................... 23, 58, 69PROTRIPTYLINE HCL...............................................8PROVENTIL HFA....................................................... 6PROVERA................................................................ 37PROVIGIL.............................................................9, 73PROZAC.....................................................................7PRUCLAIR................................................................20PRUDOXIN...............................................................20PRUMYX.................................................................. 20PRUTECT.................................................................20PRUVEL................................................................... 20PSEUDOEPHED/HYDROCODONE/CPM............... 15PSEUDOEPHEDRINE GG.......................................15PSEUDOEPHEDRINE HCL/ACRIVAS.......................5PSEUDOEPHEDRINE/BROMPHENIRAMIN........... 15PSORIATEC....................................................... 23, 69P-TEX......................................................................... 5PULMICORT FLEXHALER...................................6, 61PULMICORT(AMPUL-NEB)(0.25MG/2ML).......... 6, 61PULMICORT(AMPUL-NEB)(0.5 MG/2ML)........... 7, 61PULMICORT(AMPUL-NEB)(1 MG/2 ML)............. 7, 61PULMOZYME.....................................................46, 73PURINETHOL...........................................................45PYLERA................................................................... 53PYRAZINAMIDE.......................................................40PYRELLE HB........................................................... 54PYRIDIUM................................................................ 54PYRIDOSTIGMINE BROMIDE...................................7PYRIDOXINE HCL................................................... 57PYRILAMINE MAL/DEXBROMPHEN TAN................ 5Page 87 of 91

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