medical staff–approved therapeutic interchanges - Pharmacy
Allegra-D® PO. 60 mg/120 mg (1 tab) ... 2 mg. Aripiprazole PO. (Abilify®). 2.5 mg. Aristocort A® 0.025% Cream,. Ointment ...... See Norfloxacin PO. Novolin® ...
therapeutic_interchange_list.pdf

---

UnitedHealthcare & Affiliated Companies - UnitedHealthcareOnline
Doxycycline Monohydrate 50, 100 mg Capsule. (Monodox) ... Noroxin. Sulfas & Related Agents. Tier 1. Sulfadiazine (Sulfadiazine) ...... Cardizem LA 120 mg.
PDL_Phys_Bk.pdf

---

2017 Preferred Drug List - Ambetter from Sunshine Health
mg) generic. 0. FAL Female - 55 to 79 yrs old. MAL Male - 45 to 79 yrs old aspirin tab delayed release ..... 120 mg generic. 1. MDD 2 per day loratadine & pseudoephedrine tab sr 24hr 10-. 240 mg generic. 1 ..... NOROXIN. BRAND. 3 ofloxacin.
2017_fl_formulary.PDF

---

2012 Formulary Print document - Geisinger Health Plan
Oct 1, 2016 ... ... the use of a contracted specialty pharmacy vendor for purchase. .... Aspirin Products – Low dose (81 mg) aspirin products for females and .... AVINZA cpmp 24hr: 45mg, 75mg, 90mg,. 120mg. 4. PA. BUTRANS ..... NOROXIN.
marketplace_formulary1.pdf

---

preferred drug list - Health Republic Insurance of New Jersey
Jan 1, 2015 ... carbonyl iron susp 15 mg/1.25ml (elemental iron) generic. 0 ..... XENICAL CAP 120 MG. BRAND. 3 ...... NOROXIN TAB 400 MG. BRAND. 3.
2015-hrinj-formulary

---

Ambetter 2016 (test)
nicotine (patch 24hr 7 mg/24hr, patch 24hr 21 mg/24hr .... 120 mg generic. 1. QL. 60 / 30 DAYS fexofenadine-pseudoephedrine tab sr 24hr 180- ...... NOROXIN.
IL-FORMULARY-AMBETTER_2016_FINAL.PDF

---

The Most Spectacular Sights & Sounds of - Stockyard Institute
... herbal silagra online apotheke in germany carvedilol pfizer 25 mg ára buy real 120mg orlistat review dexamethasone in cancer care doxepin in pruritis how to ...
Anil-s-Ghost.pdf

---

Project Cycology - Stockyard Institute
will taking 5 mg cialis work michigan reciprocal real estate license how to take ... pantoprazole sod 40 mg ta buy kamagra goldcoast venta de orlistat 120 mg en ... the counter medicine like nexium generic name noroxin nombre generico plavix  ...
Project-Cycology.pdf

---

Social Medias - KiteSurf.com
ovral g price in india how many mg of omeprazole can i take kamagra gel cheap ... for lipitor cheap elocon buy online xenical orlistat 120 mg price canada prilosec ... noroxin 400 mg tablets apple buy diovan medication comprar calcetas altace ...
Little-Book-of-A--Z-Cricket--World-Cup-Special-Edition.pdf

---

Drug Formulary - MyPrime
chew tab 250 mg. 1 amoxicillin (trihydrate) cap 250 mg. 1 ..... NOROXIN - norfloxacin tab 400 mg. 4 ofloxacin tab 200 ... pyrazinamide tab 50-120-300 mg. 4. • •.
NC_Exchange_Basic_Drug_List.pdf

---

Four-Tier Prescription Member Guide - Blue Cross and Blue Shield
Generally, you will pay the least out of pocket when you buy value drugs - or drugs that are in Tier ..... NOROXIN ..... LATUDA ORAL TABLET 120 MG, 20 MG, 40.
2015_4Tier_Formulary.pdf

---

Providence Health Insurance Marketplace Formulary
Visit the Consumer Reports Best-Buy Drug website for more information regarding safe and effective ..... gentamicin in nacl, iso-osm 120mg/0.1l ..... NOROXIN.
prescription drug coverage.pdf

---

Covered Drugs - HealthSpan
network pharmacy where you purchase your drugs, and your drug's cost-sharing tier on our formulary. Please refer to .... HYSINGLA ER ORAL TABLET,ORAL. ONLY,EXT.REL.24 HR 100 MG, 120 MG, 80. MG. 5. NM ..... NOROXIN. 4 ofloxacin ...
HIC_15282.001_Comprehensive_(Cost).pdf

---

View Drug Formulary - Apex-HealthSolutions.com
90mg, 120mg. (Avinza). 2 ... 1.2mg, 50mg-2mg, 60mg-2.4mg, 80mg-. 3.2mg. 3. QL: 60 in 30 days. ESGIC. 3. ESGIC-PLUS. 3 ..... NOROXIN. 3. Sulfonamides.
formulary.pdf

---

Antimicrobial Prophylaxis in Adults - Mayo Clinic Proceedings
on Antimicrobial Therapy will be available for purchase from our Web site .... nonpregnant women13-15. Trimethoprim. 100 mg. Norfloxacin. 200 mg. Ciprofloxacin. 125 mg ...... be started 90 to 120 minutes before surgical incision be-.
AB PROFILACTICOS.pdf

---

HSA Preferred Drug List - Medica
PA, QL: 120 in 30 days fentanyl. (Duragesic). 1. QL: 10 in 30 ..... NOROXIN. 3. Sulfonamides .... Drug List). REVLIMID capsule: 2.5mg, 5mg, 15mg,. 20mg, 25mg .
hsa_preferred_drug_list_2016.pdf?la=en

---

SWHP ACA Compliant Formulary - Scott & White Health Plan
may still purchase the medication for the full price. What drugs are not .... Form. Strength. Pref. Coverage Details. Comment. PROMETHAZINE HCL. TABS. 12.5 MG. T1 ..... NOROXIN. TABS. 400MG. T3 ..... 120MCG/0.5ML. T4. PEG-INTRON ...
exchange-members-pharmacy-information

---

List of Covered Drugs - Cigna
QL (120 EA per 30 days) PA fentanyl citrate oral ... hydrocodone bitartrate/ acetaminophen solution 7.5mg &. 325mg/15ml. 2 .... NOROXIN. 4 ofloxacin. 2.
823099_f_2014_PDP_Formulary_Comp_Secure_v10_508.pdf

---