Preventive Drug List - Preferred Admin

2y ago
21 Views
3 Downloads
515.61 KB
9 Pages
Last View : 2d ago
Last Download : 2m ago
Upload by : Nixon Dill
Transcription

navitus.comShare a Clear ViewPreventive Drug ListUpdated October 2020Your employer is making an effort to reduce your health care costs by giving you toolsto help you stay healthy and productive. Below are the medications your employer haschosen to be included on your Preventive Drug List. These medications help protectagainst or manage some high risk medical conditions. Taking these medications asdirected by your prescriber can help avoid serious health problems. That may meanfewer doctor visits and hospitalizations, reducing your total health care costs.In the drug list below, generic drugs are shown in lowercase type. Brand name drugs areshown in uppercase type.ANTIANGINAL AGENTSDILATRATE SR CAPISOSORBIDE DINITRATE ER TABisosorbide dinitrate SL tabisosorbide dinitrate tabisosorbide dinitrate tab 40mgisosorbide mononitrate ER tabisosorbide mononitrate tabNITRO-BID OINTNITRO-DUR PATCH 0.3MG/HR, 0.8MG/HRNITROGLYCERIN ER CAPnitroglycerin lingual spraynitroglycerin patchnitroglycerin SL tabNITROMIST SPRAYranolazine tabANTIARRHYTHMICSamiodarone tabdisopyramide capdisopyramide ER cap dofetilide capflecainide tabmexiletine hcl capMULTAQ TABNORPACE CR CAPpropafenone ER cappropafenone tabquinidine gluconate CR tabQUINIDINE SULFATE ER TABQUINIDINE SULFATE TABANTIDIABETICSacarbose tabACTOPLUS MET XR TABAVANDAMET TABAVANDARYL TABAVANDIA TABBAQSIMI NASAL POWDERB-D INSULIN SYRINGEB-D PEN NEEDLEBYDUREON BCISE AUTO INJBYDUREON INJNote: The list is subject to change and not all drugs listed may be covered on yourformulary. Please refer to your Navitus formulary for a complete list of covered products.CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK www.navitus.comN3935-1020

navitus.comShare a Clear ViewBYDUREON PEN INJBYETTA INJCHLORPROPAMIDE TABCYCLOSET TABDIABETA TABdiazoxide suspFARXIGA TABFIASP FLEXTOUCH INJFIASP INJFIASP PENFILL INJglimepiride tabglipizide ER tabglipizide tabglipizide/metformin tabGLUCAGEN HYPOKIT INJGLUCAGON INJ KITglyburide micronized tabglyburide tabglyburide/metformin tabGLYXAMBI TABGVOKE INJGVOKE PFS INJHUMULIN R INJ U-500HUMULIN R U-500 KWIKPEN INJINSULIN ASPART FLEXPEN INJINSULIN ASPART INJINSULIN ASPART MIX FLEXPEN INJINSULIN ASPART MIX INJINSULIN ASPART PENFILL INJJANUMET TABJANUMET XR TABJANUVIA TABJARDIANCE TABJENTADUETO TABJENTADUETO XR TAB KORLYM TABLANTUS INJLANTUS SOLOSTAR INJLEVEMIR FLEXTOUCH INJLEVEMIR INJmetformin ER tabmetformin solnmetformin tabmiglitol tabnateglinide tabNOVOFINE PEN NEEDLENOVOLIN 70/30 FLEXPEN INJNOVOLIN INJNOVOLIN N FLEXPEN INJNOVOLIN R FLEXPEN INJNOVOLOG FLEXPEN INJNOVOLOG INJNOVOLOG MIX FLEXPEN INJNOVOLOG MIX INJNOVOLOG PENFILL INJNOVOTWIST PEN NEEDLENOVOTWIST/NOVOFINE PEN NEEDLEOZEMPIC INJpioglitazone tabPUMP SUPPLIESrepaglinide tabRIOMET ER SUSPRYBELSUS TABSOLIQUA INJSYNJARDY TABSYNJARDY XR TAB 10-1000MG, 251000MGSYNJARDY XR TAB 5-1000MG, 12.51000MGTOLAZAMIDE TABNote: The list is subject to change. Please always refer to your Navitus formulary fora complete list of covered products.CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK www.navitus.com

navitus.comShare a Clear ViewTOLBUTAMIDE TABTOUJEO MAX SOLOSTAR INJTOUJEO SOLOSTAR INJTRADJENTA TABTRESIBA FLEXTOUCH INJTRESIBA INJTRIJARDY XR TAB 10-5-1000MG, 25-51000MGTRIJARDY XR TAB 5-25-1000MG, 12.52.5-1000MGTRULICITY INJVICTOZA INJXIGDUO XR TAB 2.5-1000MG,5-1000MGXIGDUO XR TAB 5-500MG, 10-500MG,10-1000MGXULTOPHY INJANTIHYPERLIPIDEMICSatorvastatin tab 10mgatorvastatin tab 20mgatorvastatin tab 40mgatorvastatin tab 80mgcholestyramine lite powdercholestyramine lite powder packcholestyramine powdercholestyramine powder packcolesevelam packcolesevelam tabcolestipol granulecolestipol powder packetcolestipol tabezetimibe tabezetimibe/simvastatin tabfenofibrate cap 67mg, 134mg, 200mg fenofibrate tab 48mg, 54mg, 145mg,160mgfenofibric acid DR capFENOFIBRIC TAB, FIBRICOR TABfluvastatin capfluvastatin ER tabgemfibrozil tabLIVALO TABlovastatin tabniacin ER tabomega-3-acid ethyl esters cappravastatin tabrosuvastatin tab 10mgrosuvastatin tab 20mgrosuvastatin tab 40mgrosuvastatin tab 5mgsimvastatin tabVASCEPA CAPANTIHYPERTENSIVESaliskiren tabALTACE TABamlodipine/benazepril capamlodipine/olmesartan tabamlodipine/valsartan tabamlodipine/valsartan/hydrochlorothiazide tabAMTURNIDE TABatenolol/chlorthalidone tabbenazepril tabbenazepril/hydrochlorothiazide tabbisoprolol/hydrochlorothiazide tabcaptopril tabCAPTOPRIL/HYDROCHLOROTHIAZIDETABNote: The list is subject to change. Please always refer to your Navitus formulary for acomplete list of covered products.CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK www.navitus.com

navitus.comShare a Clear Viewclonidine patchclonidine tabCORZIDE TAB 80-5MGdoxazosin tabenalapril tabenalapril/hydrochlorothiazide tabEPANED PREMIXED SOLNEPANED SOLNeplerenone tabfosinopril tabfosinopril/hydrochlorothiazide tabGUANABENZ TABguanfacine IR tabhydralazine tabirbesartan tabirbesartan/hydrochlorothiazide tablisinopril tablisinopril/hydrochlorothiazide tablosartan tablosartan/hydrochlorothiazide tabmethyldopa ROCHLOROTHIAZIDETABminoxidil tabmoexipril lumethiazide tabNEXICLON XR SUSPNEXICLON XR TABolmesartan tabolmesartan/hydrochlorothiazide tabperindopril tab phenoxybenzamine capprazosin capPROPRANOLOL/HYDROCHLOROTHIAZIDE TABQBRELIS SOLNquinapril tabquinapril/hydrochlorothiazide tabramipril capRESERPINE TABTARKA TABTEKAMLO TABTEKTURNA HCT TABtelmisartan tabterazosin captrandolapril tabtrandolapril/verapamil ER tabvalsartan tabvalsartan/hydrochlorothiazide tabVALTURNA TABANTINEOPLASTICS AND ADJUNCTIVETHERAPIESabiraterone tab 250mganastrozole tabbicalutamide tabEMCYT CAPERLEADA TABexemestane tabflutamide capletrozole tableuprolide injLYSODREN TABmegestrol suspmegestrol tabnilutamide tabNUBEQA TABNote: The list is subject to change. Please always refer to your Navitus formulary for acomplete list of covered products.CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK www.navitus.com

navitus.comShare a Clear Viewtamoxifen tabtoremifene tabTRELSTAR INJBETA BLOCKERSacebutolol capatenolol tabbetaxolol tabbisoprolol tabBYSTOLIC TABcarvedilol tabFIRST ATENOLOL SOLNFIRST METOPROLOL ORAL SOLNlabetalol tabLEVATOL TABmetoprolol ER tabmetoprolol tabnadolol tabpindolol tabpropranolol ER capPROPRANOLOL SOLNpropranolol tabsotalol AF tabsotalol tabtimolol maleate tabCALCIUM CHANNEL BLOCKERSamlodipine tabCARDENE SR CAPCARDIZEM LA TABCOVERA-HS TABdiltiazem ER capdiltiazem ER tabdiltiazem tabDYNACIRC CR TABfelodipine ER tabisradipine cap nicardipine capnifedipine capnifedipine ER tabnimodipine capnisoldipine ER tabNISOLDIPINE ER TAB 20MG, 30MG,40MGNISOLDIPINE ER TAB 25.5MGVERAPAMIL CAP 100MGVERAPAMIL ER CAP 200MGVERAPAMIL ER CAP 300MGverapamil SR capVERAPAMIL SR CAP 360mgverapamil SR tabverapamil tabVERELAN PM ER CAP 100MG, 300MGVERELAN SR CAP 360mgCARDIAC GLYCOSIDESDIGOXIN SOLNdigoxin tabCARDIOVASCULAR AGENTS - MISC.amlodipine/atorvastatin tabENTRESTO TABCONTRACEPTIVESamethyst tabashlyna tab, daysee tabCERVICAL CAPCONCEPTROL GELCONTRACEPTIVE FILMCONTRACEPTIVE FOAMCONTRACEPTIVE GELCONTRACEPTIVE SUPPcryselle tabDEPO-PROVERA SC INJ 104MGDIAPHRAGMNote: The list is subject to change. Please always refer to your Navitus formulary for acomplete list of covered products.CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK www.navitus.com

navitus.comShare a Clear ViewELLA TABenpresse tabFEMALE CONDOMSgianvi tab, ocella tabIMPLANON IMPLANT, NEXPLANONIMPLANTisibloom tab, enskyce tab, apri tabjunel FE tabjunel tabkelnor tablayolis FE tab, wymzya FE tablevonorgestrel tabLEVONORGESTREL TAB 0.75MGLO LOESTRIN TABLOESTRIN 24 FE TABmedroxyprogesterone injmibelas chew tabMIRENA IUDNATAZIA TABNECON TABnorethindrone tabnortrel 7/7/7 tab, pirmella 7/7/7 tabnortrel tabNUVARINGOGESTREL TABPARAGARD IUDPLAN B TABSLYND TABsprintec 28 tabTODAY SPONGEtri-legest tabtri-sprintec tabvcf vaginal gelvelivet tab vienva tab, lessina tab, kurvelo tabviorele tab, kariva tabXULANE PATCHDIAGNOSTIC PRODUCTSACCU-CHEK AVIVA PLUS METERACCU-CHEK AVIVA PLUS TEST STRIPACCU-CHEK GUIDE CARE METERACCU-CHEK GUIDE ME KITACCU-CHEK GUIDE TEST STRIPACCU-CHEK NANO METERACCU-CHEK SMARTVIEW TEST STRIPACCU-CHEK TEST STRIPCALIBRATION LIQUIDCLINISTIX TEST STRIPDEXCOM G6 RECEIVERDEXCOM G6 SENSORDEXCOM G6 TRANSMITTERDIABETIC PUMPFREESTYLE FREEDOM LITE METERFREESTYLE INSULINX METERFREESTYLE INSULINX TEST STRIPFREESTYLE LIBRE 2 RECEIVERFREESTYLE LIBRE 2 SENSORFREESTYLE LIBRE RECEIVERFREESTYLE LIBRE SENSOR (10-DAY)FREESTYLE LIBRE SENSOR (14-DAY)FREESTYLE LITE METERFREESTYLE LITE TEST STRIPFREESTYLE PRECISION NEO METERFREESTYLE PRECISION NEO TEST STRIPFREESTYLE TEST STRIPKETO-DIASTIX TEST STRIPKETOSTIXLANCET DEVICELANCET KITNote: The list is subject to change. Please always refer to your Navitus formulary for acomplete list of covered products.CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK www.navitus.com

navitus.comShare a Clear ViewLANCETSOMNIPOD 5 PACK PODSOMNIPOD DASH PODSOMNIPOD STARTER KITPRECISION XTRA KETONE TEST STRIPPRECISION XTRA METERPRECISION XTRA TEST STRIPPUMP SUPPLIESV-GO INJ KITDIURETICSacetazolamide ER capacetazolamide tabALDACTAZIDE TAB 50-50MGamiloride tabamiloride/hydrochlorothiazide tabbumetanide tabCHLOROTHIAZIDE TABCHLORTHALIDONE TABDIURIL SUSPethacrynic tabFUROSEMIDE SOLNfurosemide tabhydrochlorothiazide caphydrochlorothiazide tabindapamide tabmethazolamide tabMETHYCLOTHIAZIDE TABmetolazone tabspironolactone tabspironolactone/hydrochlorothiazide tabtorsemide tabtriamterene captriamterene/hydrochlorothiazide capTRIAMTERENE/HYDROCHLOROTHIAZIDE CAP 50-25mgtriamterene/hydrochlorothiazide tab ENDOCRINE AND METABOLIC AGENTS MISC.ALENDRONATE SOLNalendronate tabALENDRONATE TAB 40MGcalcitonin nasal sprayETIDRONATE DISODIUM TAB 400MGFORTEO INJFORTICAL NASAL SPRAYFOSAMAX D TABibandronate tab 150mgMIACALCIN INJNATPARA INJrisedronate DR tabrisedronate tabSKELID TABTYMLOS INJHEMATOLOGICAL AGENTS - MISC.anagrelide capaspirin/dipyridamole capBRILINTA TABCABLIVI INJ KITcilostazol tabclopidogrel tab 75mgdipyridamole tabpentoxifylline ER tabprasugrel tabTICLOPIDINE TABZONTIVITY TABLAXATIVESCLENPIQ SOLNGAVILYTE-C SOLNKRISTALOSE PACKKRISTALOSE PACKETlactulose solnpeg 3350/electrolytes solnNote: The list is subject to change. Please always refer to your Navitus formulary for acomplete list of covered products.CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK www.navitus.com

navitus.comShare a Clear Viewtrilyte solnMINERALS & ELECTROLYTESFLUORABON SOLNFLUOR-A-DAY CHEW TABGALZIN CAPKLOR-CON M15 TABKLOR-CON POWDER PACKET 25MEQK-PHOS TABK-TABLURIDE CHEW TABLURIDE SOLNphospha 250 neutral tabPOT/CHLORIDE EFFER TABpotassium bicarbonate effer tabpotassium chloride effer tabpotassium chloride ER cappotassium chloride ER tabpotassium chloride micro tabpotassium chloride powder packetpotassium chloride solnsodium fluoride chew tabSODIUM FLUORIDE LOZENGEsodium fluoride solnSODIUM FLUORIDE TABzinc sulfate capMOUTH/THROAT/DENTAL AGENTSchlorhexidine gluconate solnPREVIDENT 5000 PLUS CREAMPREVIDENT GELPREVIDENT PASTEPREVIDENT RINSEsodium fluoride creamsodium fluoride gelsodium fluoride pastesodium fluoride rinse sodium fluoride/potassium nitratepastetriamcinolone in orabase pasteSMOKING CESSATIONbupropion SR tabCHANTIX PAKCHANTIX TABNICODERM PATCHNICORETTE GUMNICORETTE LOZENGEnicotine gumNICOTINE KITnicotine lozengenicotine patchNICOTROL INHALERNICOTROL NASAL SPRAYZYBAN TABVACCINESADACEL/BOOSTRIX INJAFLURIA INJAFLURIA INJ, FLUZONE INJBEXSERO INJCERVARIX INJENGERIX-B INJENGERIX-B INJ, RECOMBIVAX-HB INJFLUAD INJFLUAD QUAD INJFLUBLOK INJFLUBLOK QUAD PF INJFLUCELVAX INJFLUCELVAX QUAD INJFLULAVAL QUAD INJ, FLUZONE QUADINJFLUMIST QUADRIVALENT NASAL SUSPFLUVIRIN INJNote: The list is subject to change. Please always refer to your Navitus formulary for acomplete list of covered products.CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK www.navitus.com

navitus.comShare a Clear ViewFLUVIRIN PF INJFLUZONE HD PF INJFLUZONE HIGH DOSE PF INJFLUZONE INTRADERMAL INJFLUZONE QUAD INJFLUZONE/FLUARIX QUAD INJGARDASIL 9 INJGARDASIL INJHAVRIX INJ, VAQTA INJHEPLISAV-B INJMENACTRA INJMENHIBRIX INJMENOMUNE INJMENVEO INJM-M-R II INJPNEUMOVAX INJPREVNAR 13 INJSHINGRIX INJTETANUS/DIPHTHERIA TOXOID INJTRUMENBA INJTWINRIX INJVARIVAX INJVAXCHORA SUSPVIVOTIF CAPZOSTAVAX INJVITAMINSCONCEPT DHA CAPMYNATAL-Z TABPRENATABS RX TABPRENATAL 19 CHEW TABPRENATAL 19 TABPRENATAL VITAMINS (NON-PREFERRED)PRENATAL VITAMINS (PRENATAL PLUS,PREPLUS, PRENAPLUS) VITAFOL STRIPSVP-PNV-DHA CAPNote: The list is subject to change. Please always refer to your Navitus formulary for acomplete list of covered products.CUSTOMER CARE: 24 HOURS A DAY, 7 DAYS A WEEK www.navitus.com

NOVOTWIST/NOVOFINE PEN NEEDLE OZEMPIC INJ pioglitazone tab PUMP SUPPLIES repaglinide tab RIOMET ER SUSP RYBELSUS TAB SOLIQUA INJ SYNJARDY TAB SYNJARDY XR TAB 10-1000MG, 25- . FORTEO INJ FORTICAL NASAL SPRAY FOSAMAX D TAB ibandronate tab 150mg MIACALCIN INJ NATPARA INJ risedronate DR tab risedronate tab SKELID TAB TYMLOS INJ

Related Documents:

Preventive Medicine and Public Health Preventive Medicine and Pediatrics Healthcare and Primary Care Preventive Medicines and Vaccinations Occupational Health and Safety Preventive Medicine and Pathology Preventive Medicine and Diabetes Preventive Medicine and Geriatrics 13:10-13:15 GROUP PHOTO 13:15-14:00 LUNCH BREAK MEETING HALL 01 MEETING .

filter True for user-level API (default is False – admin API) persistent_auth True for using API REST sessions (default is False) . UI Plugin API (Demo) Scheduling API VDSM hooks. 51 UI Plugins Command Line Interface . 52 Web Admin user interface Extend oVirt Web Admin user interface. 53 Web Admin user interface. 54 Web Admin user interface . 55 Web Admin user interface. 56 Web Admin user .

Jul 01, 2021 · History of unacceptable/toxic side effects to preferred drug . Member’s condition is clinically stable; changing to a preferred drug might cause deterioration of the member’s condition. 2. The requested drug may be approved if both of the following are true: There has been a therapeutic failure of at least . two . preferred drugs

Select 4 Tier Drug List. Drug list — Four Tier Drug Plan . Your prescription benefit comes with a drug list, which is also called a formulary. This list is made up of brand-name and generic prescription drugs approved by the U.S. Food & Drug Administration (FDA). The following is a list

members What is the UMP Preferred Drug List? The Uniform Medical Plan (UMP) Preferred Drug List (PDL) offers a choice of prescription drugs that are safe, effective, and evidence-based. The list also provides value. By choosing

Cigna-HealthSpring Rx Secure-Xtra Preferred Pharmacies Other network pharmacies Tier 1: Preferred Generic 1 4 Tier 2: Non-Preferred Generic 4 10 Tier 3: Preferred Brand 20% 22% Tier 4: Non-Preferred Brand 35% 40% Tier 5: Specialty 33% 33% . Rev.

2 - DRUG LIST Updated 10/2018 Welcome to Humana-The Humana Drug List (also known as a formulary) is effective on January 1st unless otherwise specified. This is an all-inclusive list and may change throughout the year. What is the Drug List? The Drug List is a list of covered medicines s

COB 311 Business Admin & Management X American Quarter Horse Association . COB 5323 Health/Hlthcare Admin/Mgt X Lehijh Valley Health Network . COB 5323 Health/Hlthcare Admin/Mgt X Mountain View Hospital COB 5323 Health/Hlthcare Admin/Mgt X Oneill Healthcare COB 5323 Health/Hlthcare Admin/Mgt X Smith's Food & Drug