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& Injectible <br />All Lilly Insulins <br />All Novo Insulins <br />Glucophage XR <br />Glucotrol XI, <br />Metaglip <br />metformin <br />Starlix <br />-Oral, Inhaled <br />G P NP <br />$$ <br />__ _ _ <br />_ _ - <br /> <br /> <br /> $$$$ <br />$$ <br />$$ <br /> $s~ <br />$$ <br />$$ _ _ <br /> $$$$ <br />$$ __ <br />_- <br />$$ , <br /> $$$$ <br />__ <br />$$ <br /> $$$$ <br /> <br />Cardiovascular -Beta Blockers <br />(~ P NP <br />acebutolol <br />atenolol <br />betaxolol ~ - <br />bisoprolol ? <br />Cartrol $$$$ <br />Coreg $$ <br />labetalol <br />__ <br />metoprolol - <br />nadolol <br />pindolol S <br />propranolol <br />propranolol la <br />sotalol - <br />- _ __- <br />timolol <br />Toprol XL $$ <br />Zebeta y$$$ <br />Cardiovascular -Calcium <br />Channel Blockers <br />(, P NP <br />Cardene SR $$ <br />Cardizem $$$$ <br />Cardizem CD $$$$ <br />Covera HS $$ <br />Dilator XR, $$ <br />diltiazem (non-SR) <br />diltiazem SR <br />- <br />_ <br /> <br />Dynacirc - <br />$$ _ _ -- <br />Isoptin SR $$$$ <br />'nifedipine (non-SR) <br />Norvasc $ $ <br />_ <br />Plendil $,5 <br />Procardia XL $$$$ <br />Sular $S <br />Tiazac $$ _._ __ <br />verapamil (non-SR) <br />verapamil SR <br />Asthma - Oral and Inhaled <br /> (; _P NP <br />Accolate $$ <br />Advair $ $ <br />Aerobid $$$$ <br />Aerobid M $$$$ <br />albuterol <br />- <br />- <br /> <br />Alupent __ <br />$$ <br /> <br />Azmacort ---_ <br />$$ __ <br />Beclovent $$ <br />__--- <br />Combivent $$ <br />Flovent $$ <br />Foradil $$ <br />Maxair $$ <br />Maxair Autohaler $$ <br />--- <br />Pulmicort $$ <br />QV?,R, $$ <br /> <br />Serevent <br />$ $ _ <br />Singulair $$$$ <br />Vanceril $$$$ <br />Vanceril DS $$$$ <br />Zyflo __ $$$$ <br />Osteoporosis Agents -Oral, <br />Inhaled & Injectible <br />G P NP <br />Forteo j- $$ <br />Fosamax * _ $$$$ <br />Miacalcin Nasal Spray $$$$ <br />Actonel * $$ <br />All drugs NOT listed are paid <br />as generic or preferred. <br />Key <br />* - Quantity limits based on FDA <br />dosing guidelines <br />~ - Paid as Preferred with Prior <br />Authorization (PA) approval <br />Migraine Agents -Oral, <br />Inhaled & Injectible <br />C. P NP <br />Amerge * $$$$ <br />. <br />Axert * $$$$ <br />ergotamine/caffeine <br /> <br />Frova * _ - <br />$$ <br />Imitrex * $$ <br /> <br />Maxalt * __ <br />$$$$ <br />Migranal $$ <br />Relpax * $$$$ <br />Zomig * $$ <br />All drugs used in the <br />treatment of HIV <br />t <br />(_ P'' NP <br />$$ <br /> <br />S$ <br /> $$$$ <br /> $$$$ <br />$$ <br />_ <br />_ <br /> _ <br />$$$$ <br />'Antilipemic Cholesterol <br />Lowering Agents <br />G P NP <br />Advicor SS;, , <br /> <br />Altocor _ <br />$$ _ _ __ <br /> <br />cholestyramine __ - - <br />clofibrate <br />Colestid $$$$ <br />Crestor* $$ '- <br />gemfibrozil <br />Lescol * $$ <br />Lescol XL * } $$ <br />Lipitor * $$ <br />lovastatin <br /> <br />Niaspan <br />$$ _ __ <br />Pravachol * $$$$ <br />Welchol $$$$ <br />Zetia <br />_- $$$$ <br />Zocor * $$$S <br />Oral Contraceptives <br />G P '' NP <br />All brand name $$ <br />oral contraceptives <br />