L.A. Care Covered Drug Formulary (pdf)

IndexVAGIFEM..................................................................54VALACYCLOVIR HCL.............................................. 40VALCYTE..................................................................40VALGANCICLOVIR HCL.......................................... 40VALIUM.......................................................................8VALPROATE SODIUM............................................. 51VALPROIC ACID...................................................... 51VALSARTAN............................................................. 11VALSARTAN/HYDROCHLOROTHIAZIDE............... 11VALTREX..................................................................40VALTURNA......................................................... 13, 73VANCOCIN HCL.................................................40, 61VANCOMYCIN HCL................................................. 40VANDAZOLE............................................................ 54VANDETANIB..................................................... 45, 74VANIQA.................................................................... 23VANOS..................................................................... 19VANOXIDE-HC......................................................... 16VANSPAR................................................................... 8VANTAS....................................................................31VARDENAFIL HCL................................................... 30VARENICLINE TARTRATE.......................................51VASCEPA........................................................... 14, 61VASELINE WHITE PETROLEUM............................ 20VASERETIC..............................................................10VASOTEC................................................................. 11V-C FORTE...............................................................56VECAMYL...........................................................11, 74VECTICAL.......................................................... 23, 71VEHICLE-N...............................................................20VEHICLE-N MILD.....................................................20VELTIN..................................................................... 16VEMURAFENIB........................................................45VENLAFAXINE HCL...................................................8VENLAFAXINE HCL ER.............................................8VENTAVIS.......................................................... 12, 74VENTOLIN HFA..........................................................6VERAMYST....................................................5, 61, 71VERAPAMIL ER....................................................... 12VERAPAMIL HCL..................................................... 12VERDESO................................................................ 19VEREGEN................................................................ 18VERELAN.................................................................12VERIPRED 20.......................................................... 42VESANOID............................................................... 45VESICARE......................................................... 54, 71VEXOL......................................................................32VFEND(SUSP RECON)........................................... 39VFEND(TAB)............................................................ 39VIAGRA.............................................................. 30, 61VIBRAMYCIN........................................................... 39VI-CERT C1000 WITH B12...................................... 56VICODIN ES.......................................................48, 61VICODIN HP.......................................................48, 61VICTORY(OTC)........................................................25VICTOZA 2-PAK........................................... 23, 61, 71VICTOZA 3-PAK........................................... 23, 61, 71VICTRELIS......................................................... 41, 74VIDEX.......................................................................41VIDEX EC.................................................................41VIGABATRIN............................................................ 51VIGAMOX.................................................................33VIIBRYD(TAB DS PK).......................................... 8, 71VIIBRYD(TAB)................................................ 8, 61, 71VILAZODONE HYDROCHLORIDE............................8VIMOVO............................................................. 42, 71VIMPAT(SOLUTION)................................................ 50VIMPAT(TAB)................................................50, 61, 71VIOKACE..................................................................52VIOKASE..................................................................52VIRACEPT(POWDER)............................................. 41VIRACEPT(TAB).......................................................41VIRAMUNE...............................................................41VIRAMUNE XR(TAB ER 24H)(100 MG)...................41VIRAMUNE XR(TAB ER 24H)(400 MG)...................41VIRASAL.................................................................. 21VIRAZOLE................................................................40VIREAD.................................................................... 41VIROPTIC.................................................................32VIRT-VITE PLUS...................................................... 57VISICOL................................................................... 44VISMODEGIB...........................................................45VISTARIL.................................................................... 5VIT A,C,E/ZINC/COPPER/LUT/ZEAX......................54VIT B CMPLX #9/FA/VIT C/VIT E.............................57VIT B CMPLX #9/IRON/FA/VIT C&E........................57VIT B CMPLX 3/FA/VIT C/BIOTIN............................57VIT B CMPLX NO3/FA/C/BIOT/ZINC....................... 57VIT B COMPLEX & C NO.13/FA/D3.........................57VIT B CPLX #11/FA/C/BIOT/ZN OX......................... 57VIT E/LIDOCAIN/ALO VER/COLAGN......................22VITAFOL................................................................... 55VITAJECT................................................................. 57VITAL-D RX.............................................................. 56VITAMAX.................................................................. 56VITAMIN B COMP AND VIT C NO.6........................ 56VITAMIN B COMPLEX............................................. 57VITAMIN B12-INTRINSIC FACTOR......................... 57VITAMINS B1,B2,B3,B5,& B6...................................57VITA-RESPA.............................................................56VITE AC/GRAPE/HYALURONIC ACID.................... 20VITE CON FORTE....................................................56VITMAIN B-12...........................................................57VIVACTIL.................................................................... 8VIVAGLOBIN............................................................ 37VIVELLE............................................................. 36, 61VIVELLE-DOT.................................................... 36, 61VIVOTIF BERNA...................................................... 37VOCAL POINT GLUCOSE CONTROL(OTC).......... 25VOCALPOINT GLUCOSE CONTROL(OTC)........... 26VOLTAREN...................................................20, 32, 42VOLTAREN-XR.........................................................42VORICONAZOLE..................................................... 39VORINOSTAT...........................................................45VOSOL..................................................................... 29VOSPIRE ER..............................................................6VOTRIENT..........................................................45, 74VUSION....................................................................17VYTORIN(TAB)(10 MG-10MG).................... 13, 61, 71VYTORIN(TAB)(10 MG-20MG).................... 13, 61, 71VYTORIN(TAB)(10 MG-40MG).................... 13, 61, 71VYTORIN(TAB)(10 MG-80MG).......................... 13, 61VYVANSE....................................................... 8, 61, 71- W -WARFARIN SODIUM............................................... 34WATER..................................................................... 20WATER FOR IRRIGATION,STERILE.......................20WAVESENSE CONTROL SOLUTION(OTC)........... 27WELCHOL................................................................13WELLBUTRIN SR.......................................................7WESTCORT............................................................. 19WIDE SEAL DIAPHRAGM....................................... 15WILATE.....................................................................35- X -XALATAN..................................................................33XALKORI............................................................ 45, 74XANAX........................................................................8XARELTO(TAB)(10 MG).....................................35, 61XARELTO(TAB)(15 MG).....................................35, 62XARELTO(TAB)(20 MG).....................................35, 62XCLAIR.....................................................................20XELJANZ............................................................42, 74XELODA............................................................. 45, 74XENADERM............................................................. 22XENAZINE................................................................46XENICAL.................................................................. 57XERAC AC............................................................... 20XERESE................................................................... 18XIBROM....................................................................32XIFAXAN(TAB)(200 MG).......................................... 40XIFAXAN(TAB)(550 MG).............................. 40, 62, 71XOLEGEL.................................................................17XOPENEX HFA.......................................................... 6XOPENEX(VIAL-NEB)(0.31MG/3ML)........................ 6XOPENEX(VIAL-NEB)(0.63MG/3ML)........................ 6XOPENEX(VIAL-NEB)(1.25MG/3ML)........................ 6XPRES(OTC)............................................................27XTANDI...............................................................45, 74XYNTHA................................................................... 34XYNTHA SOLOFUSE...............................................34XYRALID.................................................................. 22XYRALID LP.............................................................22XYRALID RC............................................................ 44XYREM.......................................................................8XYZAL(SOLUTION)....................................... 5, 62, 71XYZAL(TAB)............................................................... 5- Y -YODOXIN................................................................. 40YOHIMAR.................................................................30YOHIMBINE HCL..................................................... 30YOHIMBINE HCL/ZINC SULFATE........................... 30- Z -ZACARE................................................................... 21ZAFIRLUKAST........................................................... 7ZALEPLON.................................................................9ZAMICET............................................................48, 62ZANAFLEX............................................................... 51ZANAMIVIR.............................................................. 40ZANTAC....................................................................53ZANTAC 25...............................................................53ZARONTIN............................................................... 50ZAROXOLYN............................................................13ZEBETA.................................................................... 11ZEBUTAL..................................................................47ZEGERID(CAP)............................................53, 62, 71ZEGERID(PACKET)..................................... 53, 62, 71ZELAPAR............................................................50, 62ZELBORAF.........................................................45, 74ZEMPLAR.................................................................31ZENCIA.....................................................................18ZENIEVA...................................................................20ZENPEP(CAP DR)(10-34-55K)................................ 52ZENPEP(CAP DR)(15-51-82K)................................ 52ZENPEP(CAP DR)(20-68-109K).............................. 52ZENPEP(CAP DR)(25-85-136K).............................. 52ZENPEP(CAP DR)(3K-10K-16K)............................. 52ZENPEP(CAP DR)(5K-17K-27K)............................. 52ZERIT....................................................................... 41ZESTORETIC........................................................... 10ZESTRIL................................................................... 11ZETACET..................................................................18ZETIA................................................................. 13, 62ZETONNA.......................................................5, 62, 71ZIAC..........................................................................12ZIAGEN.................................................................... 41ZIANA....................................................................... 16ZIDOVUDINE............................................................41ZILEUTON.................................................................. 6ZINC CL/B-CAINE/CETYLPYRD CL........................46ZINC SULFATE.........................................................57ZINOTIC................................................................... 29ZINOTIC ES..............................................................29ZIOPTAN...................................................... 34, 62, 71ZIPRASIDONE HCL................................................... 9ZIPSOR.................................................................... 42ZIRGAN.................................................................... 32ZITHRANOL....................................................... 23, 71ZITHRANOL-RR.................................................23, 71ZITHROMAX.............................................................38ZITHROMAX TRI-PAK..............................................38ZMAX........................................................................38ZMAX PEDIATRIC....................................................38ZOCOR.....................................................................13ZODERM(CLEANSER)............................................ 21ZODERM(CREAM)...................................................21ZODERM(GEL).........................................................21ZODERM(MED PAD)(4.5%-10%).............................21ZODERM(MED PAD)(6.5%-10%).............................21ZODERM(MED PAD)(8.5%-10%).............................21ZOFRAN ODT............................................................ 6ZOFRAN(SOLUTION).......................................... 6, 62ZOFRAN(TAB)............................................................6ZOLINZA...................................................................45ZOLMITRIPTAN........................................................49ZOLOFT......................................................................8ZOLPIDEM TARTRATE........................................9, 62ZOLPIMIST.....................................................9, 62, 71ZOMIG(SPRAY)............................................49, 62, 71ZOMIG(TAB).................................................49, 62, 71ZONALON................................................................ 20ZONATUSS.............................................................. 15ZONEGRAN............................................................. 51ZONISAMIDE........................................................... 51ZORBTIVE..........................................................31, 74ZORPRIN..................................................................47ZORTRESS.............................................................. 37ZOVIA 1-35E............................................................ 14ZOVIRAX............................................................18, 40Z-TUSS AC...............................................................16ZUPLENZ(FILM)(4 MG)..................................6, 62, 71ZUPLENZ(FILM)(8 MG)..................................6, 62, 71ZUTRIPRO............................................................... 15ZYCLARA........................................................... 37, 74ZYDONE.............................................................48, 62ZYFLO........................................................................ 6ZYFLO CR..................................................................6ZYLET.......................................................................32ZYLOPRIM............................................................... 34ZYMAR..................................................................... 33ZYMAXID..................................................................33ZYMINE XR................................................................ 5ZYPRAM...................................................................43ZYPREXA.............................................................9, 62ZYTIGA...............................................................45, 74ZYTOPIC.................................................................. 19ZYVOX............................................................... 38, 74Page 91 of 91