2022 Preventive Medications And Your Plan
2022 Preventive medications and your planEffective January 1, 2022Managing your health with preventive medicationsYour pharmacy benefit plan includes special coverage for preventive medications.The drugs on your plan’s preventive medications list do not have a deductible. This means you’ll payyour copayment/coinsurance or nothing at all, depending on your plan.To check the cost of any medication, call the number on your member ID card, visit your plan’swebsite on your member ID card, or log on to the OptumRx app.Potential savings with generic medicationsTo get the most from your benefits, ask your doctor if a generic medication is right for you. Genericsnormally cost less than brand medications, and the Food and Drug Administration (FDA) requiresthem to be just as safe and effective.A list of covered preventive medications begins on the next page.Medications are listed by therapeutic category. Where differences are noted between this list andyour benefit plan documents, the benefit plan documents will rule.For questions on injectable preventive medications administered by your doctor or healthcareprovider, please call the number on your ID card.5434/110121
2022 Premium HDHP Preventive Medication ListDrug NameNotesAnti-Addiction / Substance Abuse Treatment AgentsAPO-VARENICLINE ORAL TABLET bupropion hcl er (smoking det) oral tablet extended release 12 hour NICOTROL INHALATION INHALER NICOTROL NS NASAL SOLUTIONAnticoagulants ARIXTRA SUBCUTANEOUS SOLUTIONSPELIQUIS DVT/PE STARTER PACK ORAL TABLET THERAPYPACKELIQUIS ORAL TABLETenoxaparin sodium injection solutionSPenoxaparin sodium subcutaneous solutionSPfondaparinux sodium subcutaneous solutionSPFRAGMIN SUBCUTANEOUS SOLUTIONSPheparin sodium (porcine) injection solutionheparin sodium (porcine) injection solution prefilled syringeheparin sodium (porcine) pf injection solutionjantoven oral tabletLOVENOX INJECTION SOLUTIONSPLOVENOX SUBCUTANEOUS SOLUTIONSPPRADAXA ORAL CAPSULESAVAYSA ORAL TABLETwarfarin sodium oral tabletXARELTO ORAL TABLETXARELTO STARTER PACK ORAL TABLET THERAPY PACKAntidepressantscitalopram hydrobromide oral solutioncitalopram hydrobromide oral tabletescitalopram oxalate oral solutionescitalopram oxalate oral tabletfluoxetine hcl oral capsulefluoxetine hcl oral capsule delayed releasefluoxetine hcl oral solutionfluoxetine hcl oral tabletfluvoxamine maleate er oral capsule extended release 24 hourBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.2
Drug NameNotesfluvoxamine maleate oral tabletolanzapine-fluoxetine hcl oral capsuleparoxetine hcl er oral tablet extended release 24 hourparoxetine hcl oral tabletPAXIL ORAL SUSPENSIONPEXEVA ORAL TABLETsertraline hcl oral concentratesertraline hcl oral tabletSYMBYAX ORAL CAPSULEAntineoplastics - Drugs for Canceranastrozole oral tabletAROMASIN ORAL TABLETexemestane oral tabletFARESTON ORAL TABLETFEMARA ORAL TABLETletrozole oral tabletSOLTAMOX ORAL SOLUTIONtamoxifen citrate oral tablettoremifene citrate oral tabletAntiplateletsaspirin-dipyridamole er oral capsule extended release 12 hourBRILINTA ORAL TABLETcilostazol oral tabletclopidogrel bisulfate oral tabletdipyridamole oral tabletDURLAZA ORAL CAPSULE EXTENDED RELEASE 24 HOUREFFIENT ORAL TABLETprasugrel hcl oral tabletZONTIVITY ORAL TABLETAntipsychotics - Drugs for Mood DisordersABILIFY MAINTENA INTRAMUSCULAR PREFILLED SYRINGE ABILIFY MAINTENA INTRAMUSCULAR SUSPENSIONRECONSTITUTED ER ABILIFY MYCITE MAINTENANCE KIT ORAL TABLETABILIFY MYCITE ORAL TABLETABILIFY MYCITE STARTER KIT ORAL TABLETBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.3
Drug NameNotesADASUVE INHALATION AEROSOL POWDER BREATHACTIVATEDaripiprazole oral solutionaripiprazole oral tabletaripiprazole oral tablet dispersibleARISTADA INITIO INTRAMUSCULAR PREFILLED SYRINGE ARISTADA INTRAMUSCULAR PREFILLED SYRINGE asenapine maleate sublingual tablet sublingualCAPLYTA ORAL CAPSULEchlorpromazine hcl oral concentratechlorpromazine hcl oral tabletclozapine oral tabletclozapine oral tablet dispersibleCLOZARIL ORAL TABLETFANAPT ORAL TABLETFANAPT TITRATION PACK ORAL TABLETfluphenazine hcl oral concentratefluphenazine hcl oral elixirfluphenazine hcl oral tabletGEODON INTRAMUSCULAR SOLUTION RECONSTITUTED GEODON ORAL CAPSULEhaloperidol lactate oral concentratehaloperidol oral tabletINVEGA ORAL TABLET EXTENDED RELEASE 24 HOURINVEGA SUSTENNA INTRAMUSCULAR SUSPENSIONPREFILLED SYRINGE INVEGA TRINZA INTRAMUSCULAR SUSPENSION PREFILLEDSYRINGE LATUDA ORAL TABLETloxapine succinate oral capsulemolindone hcl oral tabletNUPLAZID ORAL CAPSULENUPLAZID ORAL TABLETolanzapine intramuscular solution reconstituted olanzapine oral tabletolanzapine oral tablet dispersiblepaliperidone er oral tablet extended release 24 hourBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.4
Drug NameNotesPERSERIS SUBCUTANEOUS PREFILLED SYRINGE quetiapine fumarate er oral tablet extended release 24 hourquetiapine fumarate oral tabletREXULTI ORAL TABLETRISPERDAL CONSTA INTRAMUSCULAR SUSPENSIONRECONSTITUTED ER risperidone oral solutionrisperidone oral tabletrisperidone oral tablet dispersiblethioridazine hcl oral tabletthiothixene oral capsuletrifluoperazine hcl oral tabletVERSACLOZ ORAL SUSPENSIONVRAYLAR ORAL CAPSULEVRAYLAR ORAL CAPSULE THERAPY PACKziprasidone hcl oral capsuleziprasidone mesylate intramuscular solution reconstituted ZYPREXA RELPREVV INTRAMUSCULAR SUSPENSIONRECONSTITUTED ZYPREXA ZYDIS ORAL TABLET DISPERSIBLEAntiviralsabacavir sulfate oral solutionabacavir sulfate oral tabletabacavir sulfate-lamivudine oral tabletabacavir-lamivudine-zidovudine oral tabletAPTIVUS ORAL CAPSULEatazanavir sulfate oral capsuleBIKTARVY ORAL TABLETCIMDUO ORAL TABLETCOMBIVIR ORAL TABLETCOMPLERA ORAL TABLETCRIXIVAN ORAL CAPSULEDELSTRIGO ORAL TABLETDOVATO ORAL TABLETEDURANT ORAL TABLETefavirenz oral capsuleBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.5
Drug NameNotesefavirenz oral tabletefavirenz-emtricitab-tenofovir oral tabletefavirenz-lamivudine-tenofovir oral tabletemtricitabine oral capsuleemtricitabine-tenofovir df oral tabletEMTRIVA ORAL CAPSULEEMTRIVA ORAL SOLUTIONEPIVIR ORAL SOLUTIONEPIVIR ORAL TABLETEPZICOM ORAL TABLETetravirine oral tabletEVOTAZ ORAL TABLETfosamprenavir calcium oral tabletFUZEON SUBCUTANEOUS SOLUTION RECONSTITUTEDGENVOYA ORAL TABLETINTELENCE ORAL TABLET 100 MG, 200 MGINTELENCE ORAL TABLET 25 MGINVIRASE ORAL TABLETISENTRESS HD ORAL TABLETISENTRESS ORAL PACKETISENTRESS ORAL TABLETISENTRESS ORAL TABLET CHEWABLEJULUCA ORAL TABLETKALETRA ORAL SOLUTIONKALETRA ORAL TABLETlamivudine oral solutionlamivudine oral tablet 150 mg, 300 mglamivudine-zidovudine oral tabletLEXIVA ORAL SUSPENSIONLEXIVA ORAL TABLETlopinavir-ritonavir oral solutionlopinavir-ritonavir oral tabletnevirapine er oral tablet extended release 24 hournevirapine oral suspensionnevirapine oral tabletNORVIR ORAL PACKETBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.6
Drug NameNotesNORVIR ORAL SOLUTIONNORVIR ORAL TABLETODEFSEY ORAL TABLETPIFELTRO ORAL TABLETPREZCOBIX ORAL TABLETPREZISTA ORAL SUSPENSIONPREZISTA ORAL TABLETRETROVIR ORAL CAPSULERETROVIR ORAL SYRUPREYATAZ ORAL CAPSULEREYATAZ ORAL PACKETritonavir oral tabletRUKOBIA ORAL TABLET EXTENDED RELEASE 12 HOURSELZENTRY ORAL SOLUTIONSELZENTRY ORAL TABLETstavudine oral capsuleSTRIBILD ORAL TABLETSUSTIVA ORAL CAPSULESUSTIVA ORAL TABLETSYMFI LO ORAL TABLETSYMFI ORAL TABLETSYMTUZA ORAL TABLETtenofovir disoproxil fumarate oral tabletTIVICAY ORAL TABLETTIVICAY PD ORAL TABLET SOLUBLETRIUMEQ ORAL TABLETTRIZIVIR ORAL TABLETTYBOST ORAL TABLETVIRACEPT ORAL TABLETVIRAMUNE ORAL SUSPENSION 50 MG/5MLVIRAMUNE XR ORAL TABLET EXTENDED RELEASE 24 HOURVIREAD ORAL POWDERVIREAD ORAL TABLET 150 MG, 200 MG, 250 MGVIREAD ORAL TABLET 300 MGZIAGEN ORAL SOLUTIONZIAGEN ORAL TABLETBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.7
Drug NameNoteszidovudine oral capsulezidovudine oral syrupzidovudine oral tabletCardiovascular Agents - Drugs for Heart and CirculationConditionsACCUPRIL ORAL TABLETACCURETIC ORAL TABLETacebutolol hcl oral capsuleALDACTAZIDE ORAL TABLETALDACTONE ORAL TABLETaliskiren fumarate oral tabletALTOPREV ORAL TABLET EXTENDED RELEASE 24 HOURamiloride hcl oral tabletamiloride-hydrochlorothiazide oral tabletAMLODIPINE BES SYRSPEND SF ORAL SUSPENSIONamlodipine besylate oral tabletamlodipine besylate-benazepril hcl oral capsuleamlodipine besylate-valsartan oral tabletamlodipine-atorvastatin oral tabletamlodipine-olmesartan oral tabletamlodipine-valsartan-hctz oral tabletANTARA ORAL CAPSULEATACAND HCT ORAL TABLETatenolol oral tabletATENOLOL SYRSPEND SF ORAL SUSPENSIONatenolol-chlorthalidone oral tabletatorvastatin calcium oral tabletAVALIDE ORAL TABLETbenazepril hcl oral tabletbenazepril-hydrochlorothiazide oral tabletBETAPACE AF ORAL TABLETBETAPACE ORAL TABLETbetaxolol hcl oral tabletBIDIL ORAL TABLETbisoprolol fumarate oral tabletbisoprolol-hydrochlorothiazide oral tabletBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.8
Drug NameNotesbumetanide oral tabletBUMEX ORAL TABLETCADUET ORAL TABLETCALAN SR ORAL TABLET EXTENDED RELEASEcandesartan cilexetil oral tabletcandesartan cilexetil-hctz oral tabletcaptopril oral tabletCARDIZEM CD ORAL CAPSULE EXTENDED RELEASE 24 HOURCARDIZEM LA ORAL TABLET EXTENDED RELEASE 24 HOUR120 MGCARDIZEM ORAL TABLETCARDURA ORAL TABLETCAROSPIR ORAL SUSPENSIONcartia xt oral capsule extended release 24 hourcarvedilol oral tabletcarvedilol phosphate er oral capsule extended release 24 hourchlorthalidone oral tabletcholestyramine light oral packetcholestyramine light oral powdercholestyramine oral packetcholestyramine oral powderclonidine hcl oral tabletclonidine transdermal patch weeklycolesevelam hcl oral packetcolesevelam hcl oral tabletcolestipol hcl oral granulescolestipol hcl oral packetcolestipol hcl oral tabletCORGARD ORAL TABLETDEMSER ORAL CAPSULEDIBENZYLINE ORAL CAPSULEdigitek oral tabletdigox oral tabletdigoxin oral solutiondigoxin oral tabletDILATRATE-SR ORAL CAPSULE EXTENDED RELEASE 40 MGBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.9
Drug NameNotesdiltiazem hcl er beads oral capsule extended release 24 hourdiltiazem hcl er coated beads oral capsule extended release 24 hourdiltiazem hcl er coated beads oral tablet extended release 24 hourdiltiazem hcl er oral capsule extended release 12 hourdiltiazem hcl er oral capsule extended release 24 hourdiltiazem hcl oral tabletdilt-xr oral capsule extended release 24 hourDIURIL ORAL SUSPENSIONdoxazosin mesylate oral tabletDUTOPROL ORAL TABLET EXTENDED RELEASE 24 HOURDYRENIUM ORAL CAPSULEEDARBI ORAL TABLETEDARBYCLOR ORAL TABLETEDECRIN ORAL TABLETenalapril maleate oral tabletenalapril-hydrochlorothiazide oral tabletEPANED ORAL SOLUTIONeplerenone oral tabletethacrynic acid oral tabletEZALLOR SPRINKLE ORAL CAPSULE SPRINKLEezetimibe oral tabletezetimibe-simvastatin oral tabletfelodipine er oral tablet extended release 24 hourfenofibrate micronized oral capsulefenofibrate oral capsulefenofibrate oral tabletfenofibric acid oral capsule delayed releasefenofibric acid oral tabletFENOGLIDE ORAL TABLETFIBRICOR ORAL TABLETFLOLIPID ORAL SUSPENSIONfluvastatin sodium er oral tablet extended release 24 hourfluvastatin sodium oral capsulefosinopril sodium oral tabletfosinopril sodium-hctz oral tabletfurosemide oral solutionBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.10
Drug NameNotesfurosemide oral tabletgemfibrozil oral tabletGONITRO SUBLINGUAL PACKETguanfacine hcl oral tabletHEMANGEOL ORAL SOLUTIONhydralazine hcl oral tablethydrochlorothiazide oral capsulehydrochlorothiazide oral tableticosapent ethyl oral capsuleindapamide oral tabletINSPRA ORAL TABLETirbesartan oral tabletirbesartan-hydrochlorothiazide oral tabletISORDIL TITRADOSE ORAL TABLETisosorbide dinitrate oral tabletisosorbide mononitrate er oral tablet extended release 24 hourisosorbide mononitrate oral tabletisradipine oral capsuleJUXTAPID ORAL CAPSULESPlabetalol hcl oral tabletLANOXIN ORAL TABLETLIPOFEN ORAL CAPSULElisinopril oral tabletlisinopril-hydrochlorothiazide oral tabletLOPID ORAL TABLETLOPRESSOR ORAL TABLETlosartan potassium oral tabletlosartan potassium-hctz oral tabletLOTENSIN HCT ORAL TABLETLOTENSIN ORAL TABLETlovastatin oral tabletmatzim la oral tablet extended release 24 hourMAXZIDE ORAL TABLETMAXZIDE-25 ORAL TABLETmethyldopa oral tabletmetolazone oral tabletBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.11
Drug NameNotesmetoprolol succinate er oral tablet extended release 24 hourmetoprolol tartrate oral tabletmetoprolol-hydrochlorothiazide oral tabletmetyrosine oral capsuleMINIPRESS ORAL CAPSULEminitran transdermal patch 24 hour 0.1 mg/hr, 0.2 mg/hr, 0.4 mg/hr,0.6 mg/hrminoxidil oral tabletmoexipril hcl oral tabletnadolol oral tabletNEXLETOL ORAL TABLETNEXLIZET ORAL TABLETniacin (antihyperlipidemic) oral tabletniacin er (antihyperlipidemic) oral tablet extended releaseniacor oral tabletnicardipine hcl oral capsulenifedipine er oral tablet extended release 24 hournifedipine er osmotic release oral tablet extended release 24 hournifedipine oral capsulenimodipine oral capsulenisoldipine er oral tablet extended release 24 hourNITRO-BID TRANSDERMAL OINTMENTNITRO-DUR TRANSDERMAL PATCH 24 HOURnitroglycerin sublingual tablet sublingualnitroglycerin transdermal patch 24 hournitroglycerin translingual solutionNITROLINGUAL TRANSLINGUAL SOLUTIONNITROMIST TRANSLINGUAL AEROSOL SOLUTIONNITRO-TIME ORAL CAPSULE EXTENDED RELEASENYMALIZE ORAL SOLUTIONolmesartan medoxomil oral tabletolmesartan medoxomil-hctz oral tabletolmesartan-amlodipine-hctz oral tabletOMEGA-3 RX COMPLETE ORAL THERAPY PACKomega-3-acid ethyl esters oral capsuleperindopril erbumine oral tabletBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.12
Drug NameNotesphenoxybenzamine hcl oral capsulepindolol oral tabletpravastatin sodium oral tabletprazosin hcl oral capsulePRESTALIA ORAL TABLETprevalite oral packetprevalite oral powderPROCARDIA XL ORAL TABLET EXTENDED RELEASE 24 HOURpropranolol hcl er oral capsule extended release 24 hourpropranolol hcl oral solutionpropranolol hcl oral tabletQBRELIS ORAL SOLUTIONquinapril hcl oral tabletquinapril-hydrochlorothiazide oral tabletramipril oral capsuleranolazine er oral tablet extended release 12 hourREPATHA PUSHTRONEX SYSTEM SUBCUTANEOUS SOLUTIONCARTRIDGEREPATHA SUBCUTANEOUS SOLUTION PREFILLED SYRINGEREPATHA SURECLICK SUBCUTANEOUS SOLUTION AUTOINJECTORrosuvastatin calcium oral tabletROSZET ORAL TABLETsimvastatin oral tabletsorine oral tabletsotalol hcl (af) oral tabletsotalol hcl oral tabletSOTYLIZE ORAL SOLUTIONspironolactone oral tabletspironolactone-hctz oral tabletSULAR ORAL TABLET EXTENDED RELEASE 24 HOURSURE RESULT O3D3 SYSTEM ORAL KITTARKA ORAL TABLET EXTENDED RELEASE 2-240 MGtaztia xt oral capsule extended release 24 hourTEKTURNA HCT ORAL TABLETTEKTURNA ORAL TABLETBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.13
Drug NameNotestelmisartan oral tablettelmisartan-amlodipine oral tablettelmisartan-hctz oral tabletTENORETIC 100 ORAL TABLETTENORETIC 50 ORAL TABLETtiadylt er oral capsule extended release 24 hourTIAZAC ORAL CAPSULE EXTENDED RELEASE 24 HOURtimolol maleate oral tablettorsemide oral tablettrandolapril oral tablettrandolapril-verapamil hcl er oral tablet extended releasetriamterene oral capsuletriamterene-hctz oral capsuletriamterene-hctz oral tabletTRILIPIX ORAL CAPSULE DELAYED RELEASETWYNSTA ORAL TABLET 40-10 MG, 40-5 MG, 80-10 MG, 80-5 MGvalsartan oral tabletvalsartan-hydrochlorothiazide oral tabletVASCEPA ORAL CAPSULEVASERETIC ORAL TABLETVASOTEC ORAL TABLETVECAMYL ORAL TABLETverapamil hcl er oral capsule extended release 24 hourverapamil hcl er oral tablet extended releaseverapamil hcl oral tabletVERELAN ORAL CAPSULE EXTENDED RELEASE 24 HOURVERELAN PM ORAL CAPSULE EXTENDED RELEASE 24 HOURZESTORETIC ORAL TABLETZIAC ORAL TABLETDiabetes - Antidiabetic Agentsacarbose oral tabletACTOPLUS MET ORAL TABLETACTOS ORAL TABLETAMARYL ORAL TABLETBYDUREON BCISE AUTOINJECTOR SUBCUTANEOUS AUTOINJECTORBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.14
Drug NameNotesBYETTA 10 MCG PENBYETTA 5 MCG PENCYCLOSET ORAL TABLETDUETACT ORAL TABLETFARXIGA ORAL TABLETglimepiride oral tabletglipizide er oral tablet extended release 24 hourglipizide oral tabletglipizide xl oral tablet extended release 24 hourglipizide-metformin hcl oral tabletGLUCOTROL XL ORAL TABLET EXTENDED RELEASE 24 HOURglyburide micronized oral tabletglyburide oral tabletglyburide-metformin oral tabletGLYNASE ORAL TABLETGLYXAMBI ORAL TABLETJANUMET ORAL TABLETJANUMET XR ORAL TABLET EXTENDED RELEASE 24 HOURJANUVIA ORAL TABLETJARDIANCE ORAL TABLETJENTADUETO ORAL TABLETJENTADUETO XR ORAL TABLET EXTENDED RELEASE 24 HOURmetformin hcl er oral tablet extended release 24 hourmetformin hcl oral solutionmetformin hcl oral tabletmiglitol oral tabletnateglinide oral tabletOZEMPIC SUBCUTANEOUS SOLUTION PEN-INJECTORpioglitazone hcl oral tabletpioglitazone hcl-glimepiride oral tabletpioglitazone hcl-metformin hcl oral tabletPRECOSE ORAL TABLETrepaglinide oral tabletRIOMET ORAL SOLUTIONRYBELSUS ORAL TABLETSOLIQUA SUBCUTANEOUS SOLUTION PEN-INJECTORBrand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.15
Drug NameNotesSYMLINPEN 120SYMLINPEN 60SYNJARDY ORAL TABLETSYNJARDY XR ORAL TABLET EXTENDED RELEASE 24 HOURtolbutamide oral tablet 500 mgTRADJENTA ORAL TABLETTRIJARDY XR ORAL TABLET EXTENDED RELEASE 24 HOURTRULICITY SUBCUTANEOUS SOLUTION PEN-INJECTORVICTOZAXIGDUO XR ORAL TABLET EXTENDED RELEASE 24 HOURXULTOPHY SUBCUTANEOUS SOLUTION PEN-INJECTORDiabetes - Glucose MonitoringCONTOUR MONITOR DEVICE DEVICE CONTOUR MONITOR KIT W/DEVICE KIT CONTOUR NEXT EZ KIT CONTOUR NEXT LINK KIT CONTOUR NEXT MONITOR KIT CONTOUR NEXT ONE KITDiabetes - Insulins AFREZZA INHALATION POWDER HUMALOG KWIKPEN SUBCUTANEOUS SOLUTION PENINJECTOR HUMALOG MIX 50/50 KWIKPEN HUMALOG MIX 50/50 VIAL SUBCUTANEOUS SUSPENSION HUMALOG MIX 75/25 KWIKPEN HUMALOG MIX 75/25 VIAL SUBCUTANEOUS SUSPENSION HUMALOG SUBCUTANEOUS SOLUTION HUMALOG SUBCUTANEOUS SOLUTION CARTRIDGE HUMALOG U-100 JUNIOR KWIKPEN SUBCUTANEOUSSOLUTION PEN-INJECTOR HUMULIN 70/30 KWIKPEN HUMULIN 70/30 VIAL SUBCUTANEOUS SUSPENSION HUMULIN N KWIKPEN HUMULIN N VIAL SUBCUTANEOUS SUSPENSION HUMULIN R U-500 KWIKPEN HUMULIN R U-500 VIAL SUBCUTANEOUS SOLUTION Brand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.16
Drug NameNotesHUMULIN R VIAL INJECTION SOLUTION LANTUS U-100 SOLOSTAR LANTUS U-100 VIAL SUBCUTANEOUS SOLUTION LYUMJEV KWIKPEN SUBCUTANEOUS SOLUTION PENINJECTOR LYUMJEV VIAL INJECTION SOLUTION TOUJEO MAX SOLOSTAR SUBCUTANEOUS SOLUTION PENINJECTOR TOUJEO SOLOSTAR SUBCUTANEOUS SOLUTION PENINJECTORElectrolytes / Minerals / Metals / Vitamins adc/f (0.5mg/ml) oral solution ATABEX EC ORAL TABLET DELAYED RELEASE ATABEX OB ORAL TABLET CITRANATAL B-CALM ORAL CITRANATAL BLOOM DHA ORAL CITRANATAL MEDLEY ORAL CAPSULE CITRANATAL RX ORAL TABLET C-NATE DHA ORAL CAPSULE COMPLETE NATAL DHA ORAL 29-1-200 & 250 MG COMPLETENATE ORAL TABLET CHEWABLE CO-NATAL FA ORAL TABLET CONCEPT DHA ORAL CAPSULE CONCEPT OB ORAL CAPSULE ELITE-OB ORAL TABLET FLORIVA ORAL LIQUID FLORIVA ORAL TABLET CHEWABLE FLORIVA PLUS ORAL SOLUTION FOLIVANE-OB ORAL CAPSULE 130-92.4-1 MG INATAL GT ORAL TABLET kosher prenatal plus iron oral tablet M-NATAL PLUS ORAL TABLET multi-vitamin/fluoride oral solution multivitamin/fluoride oral tablet chewable multi-vitamin/fluoride/iron oral solution MYNATAL ORAL CAPSULE MYNATAL PLUS ORAL TABLET Brand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.17
Drug NameNotesMYNATAL-Z ORAL TABLET NATALVIT ORAL TABLET NEONATAL 19 ORAL TABLET NEONATAL COMPLETE ORAL TABLET 27-1 MG NEONATAL PLUS ORAL TABLET NESTABS ORAL TABLET NIVA-PLUS ORAL TABLET OB COMPLETE ORAL TABLET OB COMPLETE/DHA ORAL CAPSULE OBSTETRIX DHA ORAL OBSTETRIX EC ORAL TABLET OBSTETRIX ONE ORAL CAPSULE O-CAL PRENATAL ORAL TABLET ONE VITE WOMENS PLUS ORAL TABLET ONEVITE ORAL TABLETpnv tabs 29-1 oral tablet pnv-dha oral capsule pnv-dha docusate oral capsule pnv-omega oral capsule pnv-select oral tablet POLY-VI-FLOR ORAL SUSPENSION POLY-VI-FLOR ORAL TABLET CHEWABLE POLY-VI-FLOR/IRON ORAL SUSPENSION POLY-VI-FLOR/IRON ORAL TABLET CHEWABLE PREMESISRX ORAL TABLET PRENA 1 TRUE ORAL PRENA1 ORAL TABLET CHEWABLE PRENA1 PEARL ORAL CAPSULE EXTENDED RELEASE PRENAISSANCE ORAL CAPSULE PRENAISSANCE PLUS ORAL CAPSULE PRENATABS RX ORAL TABLET prenatal 19 oral tablet 29-1 mg prenatal 19 oral tablet chewable prenatal oral tablet 27-1 mg prenatal plus iron oral tablet prenatal vitamin plus low iron oral tablet Brand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.18
Drug NameNotesPRENATAL-U ORAL CAPSULE PRENATE AM ORAL TABLET PRENATVITE PLUS ORAL TABLET PRENATVITE RX ORAL TABLET preplus oral tablet PRETAB ORAL TABLET PROVIDA OB ORAL CAPSULE QUFLORA FE PEDIATRIC ORAL LIQUID QUFLORA GUMMIES ORAL TABLET CHEWABLE QUFLORA PEDIATRIC ORAL SOLUTION QUFLORA PEDIATRIC ORAL TABLET CHEWABLE RELNATE DHA ORAL CAPSULE SELECT-OB ORAL TABLET CHEWABLE 29-1 MG SE-NATAL 19 ORAL TABLET SE-NATAL 19 ORAL TABLET CHEWABLE TARON-C DHA ORAL CAPSULE 53.5-38-1 MG TARON-PREX ORAL CAPSULE THRIVITE 19 ORAL TABLETTHRIVITE RX ORAL TABLET TRICARE ORAL TABLET TRICARE PRENATAL DHA ONE ORAL CAPSULE TRINATAL RX 1 ORAL TABLET TRINATE ORAL TABLET TRIVEEN-DUO DHA ORAL 29-1-200 & 400 MG TRI-VI-FLOR ORAL SUSPENSION TRI-VI-FLORO ORAL SUSPENSION tri-vite/fluoride oral solution UDAMIN SP ORAL TABLETVINATE DHA RF ORAL CAPSULE VINATE II ORAL TABLET VINATE ONE ORAL TABLET virt-c dha oral capsule virt-nate dha oral capsule virt-pn dha oral capsule virt-pn plus oral capsule VITAFOL STRIPS ORAL FILM Brand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.19
Drug NameNotesvitamins acd-fluoride oral solution VIVA DHA ORAL CAPSULE vp-pnv-dha oral capsule WESTAB PLUS ORAL TABLET ZATEAN-PN DHA ORAL CAPSULE ZATEAN-PN PLUS ORAL CAPSULEGastrointestinal Agents - Drugs for Acid Reflux and Ulcer ACIPHEX SPRINKLE ORAL CAPSULE SPRINKLE CARAFATE ORAL SUSPENSIONcimetidine hcl oral solution cimetidine oral tablet CYTOTEC ORAL TABLETDEXILANT ORAL CAPSULE DELAYED RELEASE esomeprazole magnesium oral capsule delayed release esomeprazole magnesium oral packet ESOMEPRAZOLE STRONTIUM ORAL CAPSULE DELAYEDRELEASE famotidine oral suspension reconstituted famotidine oral tablet 40 mg famotidine tablet 20 mg oral (rx) FIRST-LANSOPRAZOLE ORAL SUSPENSION FIRST-OMEPRAZOLE ORAL SUSPENSION lansoprazole oral capsule delayed release lansoprazole oral tablet delayed release dispersible misoprostol oral tabletNEXIUM ORAL PACKET nizatidine oral capsule nizatidine oral solution omeprazole oral capsule delayed releaseOMEPRAZOLE SYRSPEND SF ALKA ORAL SUSPENSION pantoprazole sodium oral packet pantoprazole sodium oral tablet delayed releasePEPCID ORAL TABLET PRILOSEC ORAL PACKET PROTONIX ORAL PACKET rabeprazole sodium oral tablet delayed release Brand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.20
Drug NameNotessucralfate oral suspensionsucralfate oral tabletGastrointestinal Agents - Drugs for Bowel, Intestine andStomach Conditionsamoxicill-clarithro-lansopraz oralHELIDAC THERAPY ORALOMECLAMOX-PAK ORALPYLERA ORAL CAPSULETALICIA ORAL CAPSULE DELAYED RELEASEHormonal Agents - Selective Estrogen Receptor ModifyingAgentsEVISTA ORAL TABLETOSPHENA ORAL TABLETraloxifene hcl oral tabletHormonal Agents - Sex Hormones and Birth ControlACTIVELLA ORAL TABLETafirmelle oral tablet ALORA TRANSDERMAL PATCH TWICE WEEKLYaltavera oral tablet alyacen 1/35 oral tablet alyacen 7/7/7 oral tablet amabelz oral tabletamethia oral tablet amethyst oral tablet ANGELIQ ORAL TABLETANNOVERA VAGINAL RING apri oral tablet aranelle oral tablet ashlyna oral tablet aubra eq oral tablet aubra oral tablet aurovela 1.5/30 oral tablet aurovela 1/20 oral tablet aurovela 24 fe oral tablet aurovela fe 1.5/30 oral tablet aurovela fe 1/20 oral tablet Brand-name medications are shown in UPPERCASE (for example, CELEXA) and generic medications inlowercase (for example, citalopram). : Refer to benefit plan documents to make sure listed medication is included in your benefit.SP: Oral and self-injectable Specialty medications may have limitations based on your plan benefit.21
Drug NameNotesaviane oral tablet ayuna oral tablet azurette oral tablet BALCOLTRA ORAL TABLET balziva oral tablet BIJUVA ORAL CAPSULEblisovi 24 fe oral tablet blisovi fe 1.5/30 oral tablet blisovi fe 1/20 oral tablet briellyn oral tablet camila oral tablet camrese lo oral tablet camrese oral tablet caziant oral tablet charlotte 24 fe oral tablet chewable chateal eq oral tablet chateal oral tablet CLIMARA PRO TRANSDERMAL PATCH WEEKLYCOMBIPATCH TRANSDERMAL PATCH TWICE WEEKLYCOVARYX HS ORAL TABLETCOVARYX ORAL TABLETcryselle-28 oral tablet cyclafem 1/35 oral tablet cyclafem 7/7/7 oral tablet cyred eq oral tablet cyr
CARDURA ORAL TABLET: CAROSPIR ORAL SUSPENSION. cartia xt oral capsule extended release 24 hour: carvedilol oral tablet. carvedilol phosphate er oral capsule extended release 24 hour: chlorthalidone oral tablet. cholestyramine light oral packet: cholestyramine light oral powder. cholestyramine oral packet: cholestyramine oral powder. clonidine .
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 .
Feb 19, 2022 · Miami-Dade County Daily Covid-19 Hospital Report Category 02/05/2022 02/06/2022 02/07/2022 02/08/2022 02/09/2022 02/10/2022 02/11/2022 02/12/2022 02/13/2022 02/14/2022 02/15/2022 02/16/2022 02/17/2022 02/18/2022 Beds Acute Care Beds Beds that may be converted to Acute Care Beds IC
forms of preventive medications administered by your healthcare provider, please call the number on the back of your membership card for more information. 2018 Preventive medication list . Forteo SP Fosamax Fosamax
For most BCBSAZ members, specialty copay tiers (A, B, C, or D) apply. Tier Description A Specialty Medications, Low Cost Share B Specialty Medications, Moderate Cost Share C Specialty Medications, Moderately High Cost Share D Specialty Medications, Highest Cost Share Plans may include specialty medications at varying cost share tiers. Questions?
The percentage of respondents' engagement in preventive behaviors was calculated by 3 mo separately and overall. Overall, engagement in preventive behaviors was relatively acceptable and more than 45% of participants always carried out all preventive behaviors (Table 2). Engagement in some preventive behaviors, such as wearing a face mask in .
Lesson One: Managing Your Medications Reading and Writing Practice Before You Read! In this lesson, you will read about Lena and Youssef's problems taking their medications. Activity One: Before you read, discuss the following questions with your classmates and teacher. 1. What kind of medications do you take regularly? Which of these are
Generic medications contain the same active ingredients (what makes the medication work) as brand-name medications, but they often cost less. Once the patent of a brand-name medication ends, the FDA can approve a generic version with the same active ingredients. These types of medications are known as generic medications.
1. Define cytotoxic and non-cytotoxic hazardous medications. 2. Recognize & prevent potential risks and conditions for exposure to potentially hazardous medications. 3. Determine appropriate precautions for safe handling of potentially cytotoxic and non-cytotoxic hazardous medications and as