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Diabetes Agents - Oral, Inhaled <br />& Injectible ~ ~> P NP <br />All Lilly Insulins $$ <br />All Novo Insulins $$-- <br />Actos $$ __ __ <br />Amaryl <br />- $$$$_ <br /> <br />Avandia -- <br />_ <br />$$ <br />Avandamet $ $ <br />glipizide <br />Glucophage XR $$$$ <br />Glucotrol XL $$ <br />Glucovance $$ <br />glyburide <br />Glyset $$$S <br /> <br />Lantus <br />$$ __ <br /> <br />Metaglip <br />$$ <br />_ ____ <br /> <br />_- <br />metformin <br /> <br />Prandin -- __ ._ <br />$$$$ <br />Precose $$ <br /> <br />Starlix __ <br />$$$$ <br />Cardiovascular -Beta Blockers <br /> (; P NP <br />acebutolol <br />atenolol <br />_- - <br />betaxolol <br />bisoprolol <br />Cartrol $$$$ <br />Coreg <br />__ __ <br />$$ <br />labetalol <br />metoprolol <br />nadolol <br />_ <br /> <br />pindolol ...___ <br />propranolol <br />propranolol la <br />sotalol <br />timolol <br />Toprol XL $$ <br />Zebeta $$$$ <br />Cardiovascular -Calcium <br />Channel Blockers <br />~s P NP <br />Cardene SR $$ <br />Cardizem $$$$ <br />Cardizem CD $$$$ <br />Covera HS $$ <br />Dilator XR, $$ <br />diltiazem (non-SR) > <br />diltiazem SR s <br /> <br />Dynacirc ~ _. _ <br />$$ __. <br />Isoptin SR $$$$ <br />nifedipine (non-SR) <br />Norvasc $$ <br />Plendil ~ $$ <br />Procardia XL $$$$ <br />Sular $$ <br />Tiazac $$ ....... <br />verapamil (non-SR) <br />verapamil SR <br />N~All)s Yain/lnflammation <br /> G P NP <br />Arthrotec $$$$ <br />Bextra '~ $ $ <br />Celebrex # $$ <br />choline mag trisal <br />diclofenac ;! <br />diflunisal } _ <br />etodolac <br />etodolac SA _ <br />fenoprofen <br />flurbiprofen ~: <br />ibuprofen <br />indomethacin <br />ketoprofen <br />ketorolac <br />meclofenamate <br />Mobic $$$$ <br />nabumetone <br />Naprelan <br />- $$$$ <br />-- <br />naproxen <br />naproxen sodium <br />____ <br />Oruvail $$$$ <br />oxaprozin <br />_____- <br />piroxicam <br />salsalate <br />sulindac <br />Vioxx ~ $$ <br />Asthma - Oral and Inhaled <br /> (~ P NP <br />Accolate ~$' <br />_ <br />- <br />Advair $$ _ <br />Aerobid $$$$ <br />Aerobid M $$$$ <br />albuterol >: <br />Alupent $$ <br />Azmacort $$ <br />Beclovent $$ ' <br />Combivent $$ <br />Flovent $$ <br />Foradil $$ <br />Maxair $$ <br />Maxair Autohaler $$ <br />Pulmicort $$ <br />- <br />QVAR $$ <br />Serevent $$ <br />Singulair $$$$ <br />Vanceril $$$$ <br />Vanceril DS $$$$ <br />Zyflo $$$$ <br />Osteoporosis Agents -Oral, <br />Inhaled &Injectible <br />(i P NP <br />IForteo ~- $$ <br />Fosamax * $$$$ <br />Miacalcin Nasal Spray $$$$ <br />Actonel * :~$ <br />All drugs NOT listed are paid <br />as generic or preferred. <br />Key <br />* - Quantity limits based on FDA <br />dosing guidelines <br />~ - Paid as Preferred with Prior <br />Authorization (PA) approval <br />Migraine Agents - Oral, <br />Inhaled &Injectible <br />G ' P NP <br />Amerge * $$$$ <br />__ <br />Axert * $$$$ <br />ergotamine/caffeine ? <br />Frova * $$ <br />Imitrex * $$ <br /> <br />Maxalt * - -_ <br />$$$$ <br />Migranal $$ <br />Relpax * $$$$ <br />Zomig * $$ <br />Anti-Viral Agents <br />G P NP <br />All drugs used in the $$ - <br />treatment of HIV <br />acyclovir <br />amantadine <br />Famvir $$ <br />Relenza ~ $$$$ <br />rimantadine <br /> <br />Tamiflu -~ -- <br />$$$$ <br />Valtrex $$ <br />Vfend t $$$$ <br />Antilipemic Cholesterol <br />Lowering Agents <br />C'. P NP <br />Advicor `$$ <br />__ <br />_ <br />Altocor $$ <br />cholestyramine <br />clofibrate <br />Colestid _ $$$$ <br />Crestor* $$ <br />gemfibrozil <br /> <br />Lescol * _ <br />$$ <br />Lescol XL * $$ <br />Lipitor * $$ ' <br />lovastatin <br />Niaspan $$ <br />Pravachol * $$$$ <br />Welchol $$$$ <br />Zetia $$$$ <br />Zocor * $$$$ <br />Oral Contracepti~ c~~; <br />G P NP <br />All brand name $$ <br />oral contraceptives <br />