Medicare Advantage Flex, Medicare Advantage $0 Premium Plans: Preferred Drug List Changes
|
|
|
- Jesse Waters
- 6 years ago
- Views:
Transcription
1 ACTEMRA SYRINGE ACTHAR HP GEL INJECTABLE CORICOSTEROID (SOLU MEDROL, DEPO MEDROL) AUBAGIO TABLET BETASERON INJECTION 0.3MG, TYSABRI INJECTION 300MG/15ML, GILENYA CAPSULE 0.5MG AVONEX 30MCG PEN & PEN KIT BETASERON INJECTION 0.3MG, TYSABRI INJECTION 300MG/15ML, GILENYA CAPSULE 0.5MG CIMZIA PREFILLED PEN KIT 200MG/ML ENBREL INJECTION, SYRINGE & SURECLICK SYRINGE EPIPEN 2 PACK KIT 0.3MG EPINEPHRINE SOLUTIONUTION AUTO-INJECTOR 0.3 MG/0.3ML (1:1000) EPIPEN-JR 2 PACK KIT 0.15MG EPINEPHRINE SOLUTIONUTION AUTO-INJECTOR 0.3 MG/0.3ML (1:1000) LANTUS SOLOSTAR PEN & LANTUS VIAL 100U/ML BASAGLAR KWIKPEN INJECTION 100UNIT ORENCIA CLICK SYRINGE & PREFILLED SYRINGE OTEZLA TABLET & OTEZLA STARTER PACK REBIF SOLUTION FOR INJECTION & REBIDOSE SYRINGE FOR INJECTION BETASERON INJECTION 0.3MG, TYSABRI INJECTION 300MG/15ML GILENYA CAPSULE 0.5MG SIMPONI SMARTJECT & PREFILLED SYRINGE SORILUX TOPICAL FOAM TAZORAC GEL 0.05%, TAZORAC GEL 0.1%, TAZORAC CREAM 0.05%, CALCIPOTRIEN SOLUTION 0.005% TECFIDERA CAPSULE & STARTER PACK BETASERON INJECTION 0.3MG, TYSABRI INJECTION 300MG/15ML GILENYA CAPSULE 0.5MG TENORMIN TABLET ATENOLOL TABLET TOUJEO 300UNITS/ML SOLOSTAR PEN BASAGLAR KWIKPEN INJECTION 100UNIT/ML FORTAMET TABLET METFORMIN TABLET 1000MG ER, 500MG ER (Generic Glucophage XR) METFORMIN TAB 500MG ER, 1000MG ER (Generic Fortamet) METFORMIN TABLET 1000MG ER, 500MG ER (Generic Glucophage XR) EPZICOM TABLET MG ABACAVIR/LAMIVUDINE TABLET MG SORIATANE CAPSULE ACITRETIN CAPSULE HEPSERA TABLET ADEFOVIR DIPIVOXIL TABLET FOSAMAX TAB 70MG ALENDRONATE TABLET 70MG OSENI TABLET ALOGLIPTIN/PIOGLITAZONE TABLET NESINA TABLET ALOGLIPTIN TABLET KAZANO TABLET ALOGLIPTIN/ METFORMIN TABLET XANAX TABLET ALPRAZOLAM TABLET CADUET TABLET AMLODIPINE/ATORVASTATIN TABLET LOTREL CAPSULE AMLODIPINE/BENAZEPRIL CAPSULE AZOR TABLET AMLODIPINE/OLMESARTAN TABLET EXFORGE TABLET AMLODIPINE/VALSARTAN TABLET NORVASC TABLET AMLODIPINE TABLET ADDERALL XR CAPSULE AMPHETAMINE/DEXTROAMPHETAMINE ER CAPSULE ARIMIDEX TABLET ANASTROZOLE TABLET TYLENOL/CODIENE TABLET #3 ACETAMINOPHEN/CODEINE TABLET #3 EMEND TRIFOLD KIT APREPITANT PAK
2 ABILIFY TABLET ARIPIPRAZOLE TABLET NUVIGIL TABLET ARMODAFINIL TABLET AGGRENOX CAPSULE ASPIRIN/DIPYRIDAMOLE CAPSULE STRATTERA CAPSULE ATOMOXETINE CAPSULE LIPITOR TABLET ATORVASTATIN TABLET MEPRON SUSPENSION ATOVAQUONE SUSPENSION ASTEPRO NASAL SPRAY AZELASTINE NASAL SPRAY ALPHAGAN-P OPTHALMIC SOLUTION BRIMONIDINE SOLUTION 0.15% WELLBUTRN SR TABLET BUPROPION TABLET SR WELLBUTRN XL TABLET BUPROPN HCL TABLET XL ATACAND HCT TABLET CANDESARTAN/HCT TABLET ATACAND TABLET CANDESARTAN TABLET SINEMET TABLET CARBDOPA/LEVODOPA TABLET CARBATROL ER CAPSULE CARBAMAZEPINE CAPSULE ER COREG TABLET CARVEDILOL TABLET CELEBREX CAPSULE CELECOXIB CAPSULE EVOXAC CAPSULE CEVIMELINE CAPSULE CELEXA TABLET CITALOPRAM TABLET ZIANA GEL CLINDAMYCIN/TRETINOIN GEL CLEOCIN VIAL CLINDAMYCIN INJECTION KLONOPIN TABLET CLONAZEPAM TABLET PLAVIX TABLET CLOPIDOGREL TABLET CUBICIN VIAL 500MG DAPTOMYCIN INJECTION ENABLEX TABLET DARIFENACIN TABLET VALIUM TABLET DIAZEPAM TABLET ARTHROTEC TABLET DICLOFENAC/MISOPROSTOL TABLET VOLTAREN GEL DICLOFENAC GEL LANOXIN TABLET DIGOXIN TABLET LOMOTIL TABLET DIPHENOXYLATE/ATROPINE TABLET DEPAKOTE DR TABLET DIVALPROEX TABLET DR DEPAKOTE ER TABLET DIVALPROEX TABLET ER TIKOSYN CAPSULE DOFETILIDE CAPSULE ARICEPT TABLET DONEPEZIL TABLET COSOPT OPTHALMIC SOLUTION DORZOLAMIDE/TIMOL SOLUTION CARDURA TABLET DOXAZOSIN TABLET CYMBALTA CAPSULE 20MG, 30MG, 60MG DULOXETINE CAPSULE 20MG, 30MG, 60MG
3 JALYN CAPSULE AVODART CAPSULE PERCOCET TABLET BARACLUDE TABLET LEXAPRO TABLET LEXAPRO TABLET NEXIUM CAPSULE VYTORIN TABLET ZETIA TABLET TRILIPIX DR CAPSULE DURAGESIC PATCH PROSCAR TABLET PROZAC CAPSULE LESCOL XL TABLET LASIX TABLET NEURONTIN CAPSULE ZYMAXID OPHTALMIC SOLUTION COPAXONE SYRINGE 20MG/ML AMARYL TABLET GLUCOTROL XL TABLET BONIVA TABLET GLEEVEC TABLET AVAPRO TABLET STROMECTOL TABLET EPIVIR TABLET LAMICTAL TABLET LAMICTAL ODT TABLET LAMICTAL XR TABLET PREVACID CAPSULE XALATAN OPTHALMIC SOLUTION XOPENEX NEBULIZER SOLUTION 0.63MG/3ML KEPPRA TABLET KEPPRA XR TABLET LIDODERM 5% PATCH ZYVOX SOLUTION ZESTRIL TABLET DUTASTERIDE/TAMSULOSIN CAPSULE DUTASTERIDE CAPSULE ENDOCET TABLET ENTECAVIR TABLET ESCITALOPRAM TABLET ESCITALOPRAM TABLET ESOMEPRAZOLE MAGNESIUM CAPSULE EZETIMBE/SIMVASTATIN TABLET EZETIMIBE TABLET FENOFIBRIC DR CAPSULE FENTANYL PATCH FINASTERIDE TABLET FLUOXETINE CAPSULE FLUVASTATIN ER TABLET FUROSEMIDE TABLET GABAPENTIN CAPSULE GATIFLOXACIN OPTHALMIC SOLUTION GLATOPA INJECTION 20MG/ML GLIMEPIRIDE TABLET GLIPIZIDE ER TABLET IBANDRONATE TABLET IMATINIB MESYLATE TABLET IRBESARTAN TABLET IVERMECTIN TABLET LAMIVUDINE TABLET LAMOTRIGINE TABLET LAMOTRIGINE ODT TABLET LAMOTRIGINE ER TABLET LANSOPRAZOLE DR CAPSULE LATANOPROST OPTHALMIC SOLUTION LEVALBUTEROL NEBULIZER SOLUTION 0.63MG LEVETIRACETAM TABLET LEVETIRACETAM ER TABLET LIDOCAINE 5% PATCH LINEZOLID INJECTION LISINOPRIL TABLET
4 ATIVAN TABLET LORAZEPAM TABLET COZAAR TABLET LOSARTAN POTASSIUM TABLET NAMENDA TABLET MEMANTINE TABLET HCL GLUCOPHAGE TABLET METFORMIN TABLET GLUCOPHGE XR TABLET METFORMIN ER TABLET 500MG (Generic Glucophage XR) RITALIN TABLET METHYLPHENIDATE TABLET SOLU-MEDROL VIAL METHYLPREDNISOLONE SOLUTION INJECTION MEDROL TABLET METHYLPREDNISOLONE TABLET MEDROL DOSE PACK METHYLPREDNISOLONE TABLET LOPRESSOR TABLET METOPROL TARTRATE TABLET TOPROL XL TABLET METOPROLOL ER TABLET METROGEL 1% METRONIDAZOL GEL 1% PROVIGIL TABLET MODAFINIL TABLET ELOCON CREAM 0.1% MOMETASONE CREAM 0.1% SINGULAIR TABLET MONTELUKAST TABLET KADIAN ER CAPSULE MORPHINE SULFATE ER CAPSULE CELLCEPT CAPSULE MYCOPHENOLATATE CAPSULE CELLCEPT TABLET MYCOPHENOLATATE TABLET VIRAMUNE XR TABLET NEVIRAPINE ER TABLET NIASPAN ER TABLET NIACIN ER TABLET SULAR ER TABLET NISOLDIPINE ER TABLET NITROSTAT SUBLINGUAL TABLET NITROGLYCERN SUBLINGUAL TABLET ZYPREXA TABLET OLANZAPINE TABLET TRIBENZOR TABLET OLMESARTAN/AMLODIPINE/HCTZ TABLET BENICAR HCT TABLET OLMESARTAN/HCT TABLET BENICAR TABLET OLMESARTAN MEDOXOMIL TABLET PATANOL OPTHALMIC SOLUTION 0.1% OLOPATADINE OPTHALMIC SOLUTION 0.1% PATADAY OTHALMIC SOLUTION 0.2% OLOPATADINE OPTHALMIC SOLUTION 0.2% PATANASE NASAL SPRAY 0.6% OLOPATADINE NASAL SPRAY 0.6% LOVAZA CAPSULE OMEGA-3-ACID CAPSULE ZOFRAN ODT TABLET ONDANSETRON ORALLY DISINTEGRATING TABLET 4MG ZOFRAN TABLET ONDANSETRON TABLET TAMIFLU CAPSULE OSELTAMIVIR CAPSULE ROXICODONE TABLET OXYCODONE TABLET INVEGA ER TABLET PALIPERIDONE ER TABLET PROTONIX DR TALET PANTOPRAZOLE DR TABLET
5 PAXIL CR TABLET PAROXETINE ER TABLET ACTOS TABLET PIOGLITAZONE TABLET K-TAB 20MEQ POTASSIUM CHLORIDE TABLET 20MEQ ER PRED FORTE OPTHALMIC SUSPENSION PREDNISOLONE OPTHALMIC SUSPENSION MYSOLINE TABLET PRIMIDONE TABLET RYTHMOL SR CAPSULE PROPAFENONE SR CAPSULE INDERAL LA CAPSULE PROPRANOLOL ER CAPSULE SEROQUEL TAB 100MG QUETIAPINE TABLET 100MG SEROQUEL XR TABLET QUETIAPINE ER TABLET SEROQUEL TABLET 25MG QUETIAPINE TABLET ACCUPRIL TAB 40MG QUINAPRIL TABLET 40MG EVISTA TAB 60MG RALOXIFENE TABLET 60MG ALTACE CAP 10MG RAMIPRIL CAPSULE 10MG ACTONEL TABLET PACK RISEDRONATE TABLET EXELON PATCH RIVASTIGMINE PATCH REQUIP TABLET ROPINIROLE TABLET REQUIP XL TABLET ROPINIROLE ER TABLET CRESTOR TABLET ROSUVASTATIN TABLET KEPPRA TABLET LEVETIRACETAM TABLET SILVADENE CREAM 1% SILVER SULFADIAZINE CREAM 1% ZOCOR TAB SIMVASTATIN TABLET ALDACTONE TABLET SPIRONOLACTONE TABLET PROGRAF CAPSULE TACROLIMUS CAPSULE FLOMAX CAPSULE TAMSULOSIN CAPSULE MICARDIS HCT TABLET TELMISARTAN/HCT TABLET MICARDIS TABLET TELMISARTAN TABLET DEPO-TESTOSTERONE MULTI-DOSE VIAL 100MG/ML TESTOSTERONE CYPIONATE INJECTION 100MG/ML DEPO-TESTOSTERONE SINGLE DOSE VIAL 200MG/ML TESTOSTERONE CYPIONATE INJECTION 200MG/ML XENAZINE TABLET TETRABENAZINE TABLET ZANAFLEX CAPSULE TIZANIDINE CAPSULE DETROL LA CAPSULE TOLTERODINE ER CAPSULE TOPAMAX TABLET TOPIRAMATE TABLET DEMADEX TABLET TORSEMIDE TABLET CONZIP CAPSULE TRAMADOL HCL ER CAPSULE ULTRAM TABLET TRAMADOL HCL TABLET DYAZIDE CAPSULE OLMESARTAN/AMLODIPINE/HCTZ CAPSULE
6 MAXZIDE TABLET VALTREX TABLET DIOVAN HCT TABLET DIOVAN TABLET EFFEXOR XR CAPSULE CALAN SR TABLET VAGIFEM VAGINAL TABLET ZYFLO CR TABLET AMBIEN TABLET OLMESARTAN/AMLODIPINE/HCTZ TABLET VALACYCLOVIR TABLET VALSARTAN/HCT TABLET VALSARTAN TABLET VENLAFAXINE ER CAPSULE VERAPAMIL ER TABLET YUVAFEM VAGINAL TABLET ZILEUTON ER TABLET ZOLPIDEM TABLET
Ontario Drug Benefit Formulary/Comparative Drug Index
Ministry of Health and Long-Term Care Ontario Drug Benefit Formulary/Comparative Drug Index Edition 43 Pan-Canadian Select Molecule Price Initiative for Generic Drugs Effective April 1, 2018 Drug Programs
SHORT DATED OFFERING SHEET (BY PRODUCT NAME) AS OF
16729-089-10 Finasteride 1mg 30ct Tablet; Film Coated Propecia Accord 1 09/30/2018 $ 1.51 65862-595-05 Divalproex ER 500mg 500 Tablet Depakote ER Aurobindo 2 09/30/2018 $ 104.54 67877-251-30 Triamcinolone
GCN NDC Label Name MAC Price Effective Date Prev Price Reason DICYCLOMINE 20 MG/2 ML VIAL /23/2018 New Add Newly Added NDC
GCN NDC Label Name MAC Price Effective Date Prev Price Reason 4922 517198001 DICYCLOMINE 20 MG/2 ML VIAL 1.2870 2/23/2018 New Add Newly Added NDC 4922 517198005 DICYCLOMINE 20 MG/2 ML VIAL 1.2870 2/23/2018
OXYCODON ACETAMINOPHEN /11/2018 New Add Newly Added NDC
Published 5/15/2018 Changes Effective 5/8/2018 to 5/14/2018 GCN NDC Label Name MAC Price Effective Date Prev Price Reason 77264 24590801 KEVZARA 150 MG/1.14 ML SYRINGE 268.4211 5/11/2018 New Add Newly
PRSMEDDPRSMCC1 PRSMEDDPRSMPACE PRSMEDCPRSMPACE
Published 5/15/2018 Changes effective 5/8/2018 to 5/14/2018 GCN NDC Label Name MAC Price Effective Date Prev Price Reason 77264 24590801 KEVZARA 150 MG/1.14 ML SYRINGE 363.1579 5/11/2018 New Add Newly
MHPILMCD RXMCDP OXYCODON ACETAMINOPHEN /11/2018 New Add Newly Added NDC
Published 5/15/2018 Changes effective 5/8/2018 to 5/14/2018 GCN NDC Label Name MAC Effective Date Previous Price Reason 77264 24590801 KEVZARA 150 MG/1.14 ML SYRINGE 236.8421 5/11/2018 New Add Newly Added
HPMMCR MHPMICOMP MHPILCOMPB
Published 5/15/2018 Changes Effective 5/8/2018 to 5/14/2018 GCN NDC Label Name MAC Price Effective Date Prev Price Reason 77264 24590801 KEVZARA 150 MG/1.14 ML SYRINGE 236.8421 5/11/2018 New Add Newly
Canadian Pharmaceutical Corporation Products
SUPPLIER EXCAN DISTRIBUTORS INC. 3390 MIDLAND AVENUE, UNIT #9 SCARBOROUGH, ONTARIO M1V 5K3, CANADA TEL: 416-261-2611 / FAX: 416-261-2417 E-mail: excandist@rogers.com DATE: Visit our website @ www.excan.com
Highlighted medications are NOT covered by Wal-Mart's Plan!!
Important Roanoke Rapids Extensions Gene Minton (Owner, CEO) x140 Drew Huggins (COO) - x114 Angela Coggins (Pharmacy Manager) x111 Dial All Pharmacists on Duty x168 (No waiting on hold!!) DRUGCO GENERICS
UPDATE AQ Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective February 28, 2013 SUMMARY OF CHANGES
UPDATE AQ Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective February 28, 2013 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 3 Off Formulary
PNEC Calculated from Chronic Data. 5-fluorouracil Vestel et al abiraterone acetate Vestel et al. 2016
These predicted no-effect concentrations, PNECs, are provided to facilitate environmental risk assessment of pharmaceuticals in surface water downstream of the mixing zone (i.e., not at the point of discharge
Highlighted medications are NOT covered by Wal-Mart's Plan!!
Important Roanoke Rapids Extensions Gene Minton (Owner, CEO) x140 Drew Huggins (COO) - x114 Angela Coggins (Pharmacy Manager) x111 Dial All Pharmacists on Duty x168 (No waiting on hold!!) DRUGCO GENERICS
UPDATE AD Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective January 19, 2012 SUMMARY OF CHANGES
UPDATE AD Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective January 19, 2012 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 3 Off Formulary
UPDATE AB Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective October 25, 2011 SUMMARY OF CHANGES
UPDATE AB Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective October 25, 2011 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 5 Off Formulary
2016 Formulary Annual Notice of Change. Medicare Advantage Plans (MAPD)
2016 Formulary Annual Notice of Change Updated: October 1, 2015 Medicare Advantage Plans (MAPD) This is a listing of the changes that have occurred to the 2016 MAPD formulary. For a complete list, please
PRINCE EDWARD ISLAND DRUG PROGRAMS INTERCHANGEABLE/MAXIMUM REIMBURSABLE PRICE LIST EFFECTIVE DATE APRIL 22, 2019
PRINCE EDWARD ISLAND DRUG PROGRAMS INTERCHANGEABLE/MAXIMUM REIMBURSABLE PRICE LIST EFFECTIVE DATE APRIL 22, 2019 An interchangeable product is defined as one containing the same amounts of the same active
UPDATE AC Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective December 15, 2011 SUMMARY OF CHANGES
UPDATE AC Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective December 15, 2011 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 5 Off Formulary
UPDATE AH Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective May 29, 2012 SUMMARY OF CHANGES
UPDATE AH Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective May 29, 2012 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 3 Off Formulary
UPDATE AL Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective 28 September, 2012 SUMMARY OF CHANGES
UPDATE AL Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective 28 September, 2012 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 3 Off
UPDATE AY Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective September 27, 2013 SUMMARY OF CHANGES
UPDATE AY Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective September 27, 2013 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 4 Off
UPDATE AX Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective August 29, 2013 SUMMARY OF CHANGES
UPDATE AX Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective August 29, 2013 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 4 Off Formulary
UPDATE AZ Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective October 31, 2013 SUMMARY OF CHANGES
UPDATE AZ Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective October 31, 2013 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 5 Off Formulary
Product Selection Committee / Comité de sélection des produits
New Brunswick Pharmaceutical Society and New Brunswick Department of Health Product Selection Committee / Comité de sélection des produits L Ordre des pharmaciens P.O. Box / C.P. 5100, Fredericton NB E3B
UPDATE AV Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective June 27, 2013 SUMMARY OF CHANGES
UPDATE AV Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective June 27, 2013 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 3 Off Formulary
UPDATE Q Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective April 23, 2010 SUMMARY OF CHANGES
UPDATE Q Ontario Drug Benefit Formulary/Comparative Drug Index No. 41 Effective April 23, 2010 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 4 Off Formulary
Apotex Products Canada
Apotex Products Canada Updated December 21, 2017 www.apotex.ca/products Apotex Products Canada NATIONAL CUSTOMER CONTACT INFORMATION Toll Free: 1-877-427-6839 Toll Free Fax: 1-800-665-2854 Email: orderdesk@apotex.com
PRESCRIPTION DRUG PROGRAM FORMULARY UPDATES Value Formulary July 1, 2018 Updates. Formulary. Alternatives
PRESCRIPTION DRUG PROGRAM FORMULARY UPDATES Value July 1, 2018 Updates Drug Name oseltamivir sus 6mg/ml (Brand = Tamiflu ) carvedilol cap ER 10mg, 20mg, 40mg, 80mg (Brand = Coreg CR ) timolol maleate sol
COVERAGE DETERMINATION REQUEST FORM
Atypical Antipsychotics-3 Medicare (Vraylar) Member/Subscriber Number: Fax: Phone: Date of Birth: Office Contact: Group Number: NPI: State Lic ID: Address: Address: City, State ZIP: City, State ZIP: Primary
HPLC&LC-MS/MS 用試薬キット対応一覧表 - ( 株 ) エスエイエス ( )
Acebutolol Ajmaline Alanine Alprazolam MassTox TDM Series A Benzodiazepines 2 Amiodarone Amisulpride MassTox TDM Series A Neuroleptics 2 Amitriptyline MassTox TDM Series A Tricyclic Antidepressants TCA
Value-Priced Medication List
Value-Priced Medication List In addition to the discounts on thousands of brand-name and most other generic medications that Walgreens Prescription Savings Club members enjoy, club members receive greater
Value-Priced Medication List
Value-Priced Medication List In addition to the discounts on thousands of brand-name and most other generic medications that Walgreens Prescription Savings Club members enjoy, club members receive greater
Table 1: Medicare Formulary New Preauthorization Effective January 1, 2014
Table 1: Medicare Formulary New Preauthorization Effective January 1, 2014 Category Medication Rationale/Criteria Applies to New Rx Only? Analgesics Subsys FDA-approved indications/appropriate use ---
2017 Formulary Annual Notice of Change
Updated: October 10, 2016 2017 Formulary Annual Notice of Change Commercial 5 Tier - Qualified Health Plans (QHP) This is a listing of the changes that have occurred to the 2017 Commercial Qualified Health
PRESCRIPTION DRUG PROGRAM FORMULARY UPDATES Select Formulary July 1, 2018 Updates Formulary. Alternatives
oseltamivir sus 6mg/ml (Brand = Tamiflu ) carvedilol cap ER 10mg, 20mg, 40mg, 80mg (Brand = Coreg CR ) timolol maleate sol 0.5% (Brand = Istalol Sol 0.5% OP) tenofovir 300mg (Brand = Viread ) efavirenz
Prescription Pharmaceuticals DETAIL & PRICES AVAILABLE UPON REQUEST. All Available Products, Details & Prices Available Upon Enquiry GENERICS
Prescription Pharmaceuticals DETAIL & PRICES AVAILABLE UPON REQUEST GENERICS 1157494 ACARBOSE TABS 50MG 90 1157502 ACARBOSE TABS 100MG 90 7874894 ACECLOFENAC TABS 100MG 60 7843915 ACETAZOLAMIDE TABS 250MG
COMPASS LABORATORY SERVICES COLLECTION PROCEDURES AND FAQS
COMPASS LABORATORY SERVICES COLLECTION PROCEDURES AND FAQS COMPANY CONTACTS For any questions regarding your account, specimen collection, IT troubleshooting, or to order more supplies, please contact
Value-Priced Medication List
Value-Priced Medication List In addition to the discounts on thousands of brand-name and all generic medications that Walgreens Prescription Savings Club members enjoy, club members may now receive even
BESTMED MEDICINE FORMULARY FOR CDL-CHRONIC (CHRONIC DISEASE LIST) CONDITIONS
BESTMED MEDICINE FORMULARY FOR CDL-CHRONIC (CHRONIC DISEASE LIST) CONDITIONS Benefits are subject to the following: Pre-authorisation BESTmed guidelines BESTmed protocols Mediscor Reference Price (MRP)
Magellan Rx Medicare Basic (PDP) 2019 Formulary
Magellan Rx Medicare Basic (PDP) 2019 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE S WE COVER IN THIS PLAN Formulary File 19170, Version 19 This formulary
FREE PRESCRIPTIONS * * $5 OFF THE STANDARD SUBSIDISED PRESCRIPTION CHARGE
FREE PRESCRIPTIONS * * $5 OFF THE STANDARD SUBSIDISED PRESCRIPTION CHARGE ABOUT US Kia ora! Chemist Warehouse is excited to open its doors in New Zealand and make the very best healthcare available to
AFFINITY MEDICARE. Passport Essentials (HMO) Passport Essentials NYC (HMO) Solutions (HMO-SNP) Ultimate (HMO-SNP)
20 18 AFFINITY MEDICARE Passport Essentials (HMO) Passport Essentials NYC (HMO) Solutions (HMO-SNP) Ultimate (HMO-SNP) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN.
UPDATE 12 Ontario Drug Benefit Formulary/Comparative Drug Index No. 40 Effective MAY 16, 2008 SUMMARY OF CHANGES
UPDATE 12 Ontario Drug Benefit Formulary/Comparative Drug Index No. 40 Effective MAY 16, 2008 SUMMARY OF CHANGES TABLE OF CONTENTS Page New Single Source Drug(s) 2 New Multi-Source Drug(s) 3 Manufacturer
Discovery Health PBR formulary and benchmark pricing
Discovery Health PBR formulary and benchmark pricing Period: 2017 Quarter 1 and 2 Implementation date: 1 January 2017 PBR is a voluntarily program which is designed to additionally remunerate pharmacists
YES = formulary NO = non-formulary NO BENEFT = excluded
Benefits are subject to the following: Pre-authorisation Bestmed guidelines Bestmed protocols Mediscor Reference Price (MRP) This price represents the reasonable price in the market place for a particular
BESTMED MEDICINE FORMULARY FOR CDL-CHRONIC (CHRONIC DISEASE LIST) CONDITIONS
BESTMED MEDICINE FORMULARY FOR CDL-CHRONIC (CHRONIC DISEASE LIST) CONDITIONS Benefits are subject to the following: Pre-authorisation BESTmed guidelines BESTmed protocols Mediscor Reference Price (MRP)
PEI PROVINCIAL INTERCHANGEABLE DRUG LIST
PEI PROVINCIAL INTERCHANGEABLE DRUG LIST QUARTERLY UPDATE JULY 15, 2018 PROVINCIAL INTERCHANGEABLE DRUG LIST INTRODUCTION The Provincial Interchangeable Drug List (PIDL) is a listing of interchangeable
SUPPORTING INFORMATION. Prediction of Synthetic Accessibility Based on Commercially Available Compound Databases
UPPRTIG IRMATI Prediction of ynthetic Accessibility Based on Commercially Available Compound Databases Yoshifumi ukunishi 1,2 *, Takashi Kurosawa 2,3, Yoshiaki Mikami 2,3, and aruki akamura 4 1 Molecular
Prescription Drug List
Your 2016 Prescription Drug List Effective January 1, 2016 Oxford Connecticut Advantage Three- Please read: This document contains information about commonly prescribed medications. For additional information:
EnvisionRxPlus (PDP) 2017 Comprehensive Formulary. (List of Covered Drugs)
EnvisionRxPlus (PDP) 2017 Comprehensive Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN HPMS Approved Formulary File Submission 17453,
Medicare Blue Choice Optimum (HMO-POS) Medicare Blue Choice Select (HMO-POS) Medicare Blue Choice Value (HMO) Medicare Blue Choice Value Plus (HMO)
A nonprofit independent licensee of the Blue Cross Blue Shield Association Medicare Blue Choice Optimum (HMO-POS) Medicare Blue Choice Select (HMO-POS) Medicare Blue Choice Value (HMO) Medicare Blue Choice
Establishing and Executing Cleaning Validation
Establishing and Executing Cleaning Validation in a Risk-Based Environment Richard J. Forsyth AAPS Annual Meeting November 12, 2007 Determination and Use of Visible Residue Limits (VRL) Agenda Limits Viewing
Prescription Drug List
Your 2017 Four- Prescription Drug List effective January 1, 2017 Connecticut Advantage Four- Please read: This document contains information about commonly prescribed medications. This Prescription Drug
Excellus BlueCross BlueShield Medicare Employer Group Plans
Excellus BlueCross BlueShield Medicare Employer Group Plans A nonprofit independent licensee of the Blue Cross Blue Shield Association 2019 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT
Premium Prescription Drug List January 2018
Premium Prescription Drug List January 2018 Introduction The ProAct Prescription Drug List references the most commonly prescribed medications available to treat a variety of conditions. The medications
Current Effective Date
Drug Form Current Effective Date MAC price Date Updated Acarbose 100mg TABS 0.65500 6/26/2008 6/26/2008 Acarbose 25mg TABS 0.55500 6/26/2008 6/26/2008 Acarbose 50mg TABS 0.55500 6/26/2008 6/26/2008 Accu-check
Select Prescription Drug List March 2017
Select Prescription Drug List March 2017 Introduction The ProAct Prescription Drug List references the most commonly prescribed medications available to treat a variety of conditions. The medications are
PRINCE EDWARD ISLAND DRUG PROGRAMS INTERCHANGEABLE/MAXIMUM ALLOWABLE COST LIST. EFFECTIVE DATE January 18, 2010
The Interchangeable/Maximum Allowable Cost (MAC) List identifies the interchangeable products covered by the PEI Drug Programs and sets the maximum amount that pharmacies will be reimbursed for products
2017 Drug Formulary. Effective November For members covered through large employer groups with a 3-tier in-network pharmacy
Effective November 2017 2017 Drug Formulary For members covered through large employer groups with a 3-tier in-network pharmacy benefit or members with an out-of-network pharmacy benefit Access PPO Alliance
Prescription Drug List
Your 2016 Prescription Drug List Effective January 1, 2016 Oxford Connecticut Traditional Three- Please read: This document contains information about commonly prescribed medications. For additional information:
PUBLIC PROCUREMENT AUTHORITY
PUBLIC PROCUREMENT AUTHORITY DEVELOPMENT OF DATABASE / RECORD OF PRICES FOR COMMON USER ITEMS AVERAGE PRICE LIST OF COMMON USER ITEMS Prepared p by: y Presented to FAS CONSULT The Chief Executive Public
Prescription Drug List
Your 2015 Prescription Drug List Effective January 1, 2015 Oxford Connecticut Advantage Three- Please read: This document contains information about commonly prescribed medications. For additional information:
2019 Drug Formulary. Effective April For federal employees and retirees on the Federal Employees Health Benefits Program
Effective April 2019 2019 Drug Formulary For federal employees and retirees on the Federal Employees Health Benefits Program All plans offered and underwritten by Kaiser Foundation Health Plan of Washington
Prescription Drug List
Your 2016 Prescription Drug List Effective July 1, 2016 Oxford Connecticut Traditional Three- Please read: This document contains information about commonly prescribed medications. For more information:
PUBLIC PROCUREMENT AUTHORITY
REPUBLIC OF GHANA PUBLIC PROCUREMENT AUTHORITY UPDATE OF PRICES FOR COMMON USER ITEMS Prepared by: Presented to FAS CONSULT LTD. The Chief Executive Public Procurement Authority P. O. Box GP. 17494 P.M.B
2019 Drug Formulary. Effective March For federal employees and retirees on the Federal Employees Health Benefits Program
Effective March 2019 2019 Drug Formulary For federal employees and retirees on the Federal Employees Health Benefits Program All plans offered and underwritten by Kaiser Foundation Health Plan of Washington
PUBLIC PROCUREMENT AUTHORITY UPDATE OF PRICES FOR COMMON USER ITEMS
PUBLIC PROCUREMENT AUTHORITY UPDATE OF PRICES FOR COMMON USER ITEMS Prepared by: Presented to FAS CONSULT The Chief Executive Public Procurement Authority P.M.B 30 Ministries P. O. Box GP. 17494 Accra
U.S. PHARMACEUTICAL APPLICATION
1 1650 N Indianwood Avenue, Broken Arrow, OK 74012 Phone: 918.250.8101 Fax: 918.250.1281 Email: order@blessing.org www.blessing.org U.S. PHARMACEUTICAL APPLICATION *PLEASE FILL OUT COMPLETELY*A NEW APPLICATION
Venous Access Smart Chart GENERIC BRAND ph OSMOLARITY PIV Acyclovir Zovirax <600 * Amikacin Amikin <600 * Amiodarone Cordarone 4.
Venous Access Smart Chart GENERIC BRAND ph OSMOLARIT PIV Acyclovir Zovirax 10.5-11.8
BESTMED MEDICINE FORMULARY FOR CDL-CHRONIC (CHRONIC DISEASE LIST) CONDITIONS
BESTMED MEDICINE FORMULARY FOR CDL-CHRONIC (CHRONIC DISEASE LIST) CONDITIONS Benefits are subject to the following: Pre-authorisation BESTmed guidelines BESTmed protocols Mediscor Reference Price (MRP)
ALL PAGES OF THE ORDER FORM HAVE TO BE FAXED SPECIAL NOTICES
ALL PAGES OF THE ORDER FORM HAVE TO BE FAXED SPECIAL NOTICES Notice: Please check the "ship to" address to make sure it is correct. Incorrect shipping addresses will incur a surcharge of $12 per box in
Pharmaceutics Laboratory PHM188P, Spring 2017 Syllabus/First Day Handout
Pharmaceutics Laboratory PHM188P, Spring 2017 Syllabus/First Day Handout Course Description: This course will introduce the student to the knowledge and skills of fundamental mathematical calculations
Release Document for ChartMaker 2016 (fv6.1.4) Last Updated: 04/19/2016
Release Document for ChartMaker 2016 (fv6.1.4) Last Updated: 04/19/2016 ChartMaker Clinical ***Please note that the ChartMaker Medical Suite can no longer be installed on computers using the Windows XP
Emblem Medicaid 4Q18 Formulary Updates
AFLURIA 2018-2019 SYRINGE Added to Formulary (BRAND) 10/1/2018 AFLURIA 2018-2019 VIAL Added to Formulary (BRAND) 10/1/2018 AFLURIA QUAD 2018-2019 SYRINGE Added to Formulary (BRAND) 10/1/2018 AFLURIA QUAD
YES = formulary NO = non-formulary NO BENEFIT = excluded
Benefits are subject to the following: Pre-authorisation Bestmed guidelines Bestmed protocols Mediscor Reference Price (MRP) This price represents the reasonable price in the market place for a particular
2018 Drug Formulary. Effective October For large employer groups with a 5-tier in-network pharmacy benefit. PEBB SoundChoice.
Effective October 2018 2018 Drug Formulary For large employer groups with a 5-tier in-network pharmacy benefit PEBB SoundChoice PEBB Value All plans offered and underwritten by Kaiser Foundation Health
Prescription Price List
A ABBOCILLIN SUSP 150MG/5ML 100 X 2 $26.90 ABBOCILLIN VK TABS 250MG 25 X 2 $11.95 ABBOCILLIN VK TABS 500MG 25 X 2 $13.95 ABISART HCT TABS 150MG/12.5MG 30 $9.95 ABISART HCT TABS 300MG/12.5MG 30 $11.50 ABISART
Medtech32 WDHB SafeRx Update
Medtech32 WDHB SafeRx Update Release Notes These Release Notes contain important information for all Medtech Users. Please ensure that they are circulated amongst all your staff. We suggest that they are
Compendium of Notified Ceiling Prices NLEM 2011
Compendium of Notified Ceiling Prices NLEM 2011 The Compendium of Notified Ceiling Prices of Scheduled Drugs as per NLEM 2011 has been brought out with the objective of disseminating information related
Davidson County Emergency Services
Davidson County Emergency Services Date: / / Unit Number Personnel Numbers / Shift: FRONT OUTSIDE POCKET CLEAR DRUG BOX IO BAG 1-BP CUFF x / 13- EPI-1:10,000 mg 1- EZ-IO DRILL 1-STETHOSCOPE x / 1- D-50
PUBLIC PROCUREMENT AUTHORITY
REPUBLIC OF GHANA PUBLIC PROCUREMENT AUTHORITY UPDATE OF PRICES FOR COMMON USER ITEMS Prepared by: Presented to FAS CONSULT LTD. The Chief Executive Public Procurement Authority P. O. Box GP. 17494 P.M.B
Davidson County Emergency Services
Davidson County Emergency Services Date: / / Unit Number Personnel Numbers / Shift: FRONT OUTSIDE POCKET CLEAR DRUG BOX IO BAG 1-BP CUFF x / 6- EPI- 1:10,000 1mg 1- EZ-IO DRILL 1-STETHOSCOPE x / 1- D-50
Davidson County Emergency Services
Davidson County Emergency Services Date: / / Unit Number Personnel Numbers / Shift: FRONT OUTSIDE POCKET INSIDE LOWER ZIPPER POCKET IO BAG 1-BP CUFF x / 8- EPI-1:10,000 mg 1- EZ-IO DRILL 1-STETHOSCOPE
Neurotransmitter Assessment Form (NTAF)
Neurotransmitter Assessment Form (NTAF) Name: Age: Sex: Date: Please circle the appropriate number on all questions below. 0 as the least/never to 3 as the most/always. SECTION A Is your memory noticeably
Release Document for ChartMaker 2016 (fv6.1.4) Last Updated: 04/19/2016
Release Document for ChartMaker 2016 (fv6.1.4) Last Updated: 04/19/2016 ChartMaker Clinical ***Please note that the ChartMaker Medical Suite can no longer be installed on computers using the Windows XP
YES = formulary NO = non-formulary NO BENEFIT = excluded
Benefits are subject to the following: Pre-authorisation Bestmed guidelines Bestmed protocols Mediscor Reference Price (MRP) This price represents the reasonable price in the market place for a particular
Atorvastatin Tablets 20 Mg La Thuoc Gi
Atorvastatin Tablets 20 Mg La Thuoc Gi Maybe you are curious about whether there is travel journey on the horizon. price of atorvastatin Also, some Alberta pharmacists can give injections and prescribe
The electronic Medicines Compendium ( emc )
1 www.medicineslearningportal.org The electronic Medicines Compendium ( emc ) Learning outcomes By the end of this learning module you will be able to describe the role of the electronic Medicines Compendium
Prescription Pricelist
A Augmentin Susp 125mg/31.25mg/5ml 75ml $10.95 Aurorix Tabs 150mg 60 $17.95 Aurorix Tabs 300mg 60 $25.50 Avamys Nasal Spray 120 dose $42.95 Avanza Sol-Tabs 15mg 30 $17.40 Avanza Sol-Tabs 30mg 30 $18.95
Item Description Packaging Price
Aciclovir 200mg tab (Virest) box of 25's 615.00 Aciclovir 400mg tab (Virest) box of 25's 1006.25 Allopurinol 100mg tab (Elavil) box of 100's 60.00 Allopurinol 100mg tab (Scheele-Generic) box of 100's 60.00
DESCRIPTION FORMULA UNIT PACK
HUMAN PRODUCTS LIST - TABLETS DESCRIPTION FORMULA UNIT PACK ALLUCID TABLETS Each tablet contains:- 100 Dried Alluminium Hydroxide B.P 120mg Magnesium Trisilicate B.P 250mg ALLUCID TABLETS (with 'G' Mark)
OLD DOMINION EMERGENCY MEDICAL SERVICES ALLIANCE
OLD DOMINION EMERGENCY MEDICAL SERVICES ALLIANCE 2018 REGIONAL PREHOSPITAL PATIENT CARE PROTOCOLS 1421 Johnston-Willis Drive Richmond, Virginia 23235 (804) 560-3300 www.odemsa.vaems.org This page intentionally
Borders Formulary Committee. Annual report 2012/13
Borders Formulary Committee Annual report 2012/13 1. Purpose Borders Formulary Committee is a sub committee of the Area Drug and Therapeutics Committee and is accountable to the Strategy Group. Its purpose
REGION XI EMS SYSTEM REQUIRED DRUG, EQUIPMENT AND SUPPLY INVENTORY
REGION XI EMS SYSTEM REQUIRED DRUG, EQUIPMENT AND SUPPLY INVENTORY MDC Review: 08/5/08; 11/5/2013; 5/6/14; 11/14; 10/15; 7/16; 4/17 MDC Approval: 01/13/09; 3/6/12; 11/5/13; 5/19/14; 12/2/14; 10/5/15; 7/7/16;
4-Tier Drug Program. Preferred Drug List. Powered By:
4-Tier Drug Program Preferred Drug List Powered By: PHARMACY NETWORK Your prescription card is accepted at over 54,000 participating pharmacies throughout the United States. The network includes pharmacy
Using Drug Resources iphone Version. FSU College of Medicine Nancy Clark
Using Drug Resources iphone Version FSU College of Medicine 2011 2012 2012 Nancy Clark Table of Contents Topic Page Drug References on the Library Web site 3 Accessing Library Resources Off Campus using
Atorvastatin 40 Mg Price Walmart
Atorvastatin 40 Mg Price Walmart 1 atorvastatin canada 2 caduet 5/10 mg pret 3 pfizer caduet coupon 4 atorvastatin 80 mg in acute coronary syndrome 5 atorvastatin fenofibrate uses 6 atorvastatin cost Punitives
ChartMaker Clinical Release Notes ChartMaker 2016 (fv6.2.2)
ChartMaker Clinical Release Notes ChartMaker 2016 (fv6.2.2) ***Please note that the ChartMaker Medical Suite can no longer be installed on computers using the Windows XP or Windows 2003 Server operating
Global Pharmaceutical Review
Global Pharmaceutical Review Assessing Opportunities in a Challenging World - Part 1 Carl J. Fearn Sales Director - International Services IMS HEALTH IMS Health - Horizons Seminar Seoul, Korea - 18 February
Codonics SLS Total Dose/Total Volume
Codonics SLS Total Dose/Total Volume Technical Brief Overview This document describes how to setup and use the Total Dose/Total Volume (TD/TV) drug preparation method with the Codonics Safe Label System
Doxepin (sinequan) 10 Mg Capsule
Doxepin (sinequan) 10 Mg Capsule sinequan package insert sinequan online doxepin 5 mg for sleep sinequan salad sinequan toxicity sinequan 10 mg doxepin mylan 4250 sinequan for migraine sinequan benefits