Mg40118c 1199 2h10 seiu pdl bifold_v4

MG40118C 1199 2H10 SEIU PDL BiFold_v4 5/6/10 12:26 PM Page a 1199SEIU
Preferred Drug List
Please take this guide
with you the next time
you visit your doctor.
2010 Medco Health Solutions, Inc. All rights reserved.
Medco is a registered trademark of Medco Health Solutions, Inc.
If you have questions about your prescription drug benefit,
visit www.medco.com or call Medco Member Services at (800) 818-6720.
For questions about your 1199SEIU benefits, call the 1199SEIU Benefit Funds’ Member Services representatives at (646) 473-9200.
Medco manages your prescription drug benefit for the 1199SEIU Benefit Funds.
MG40118C 1199 2H10 SEIU PDL BiFold_v4 5/6/10 12:26 PM Page 1 This Preferred Drug List includes classes of widely used drugs that are preferred by the 1199SEIU BenefitFunds. These medications have been carefully selected to provide safety and value. If you receive anygeneric drug or preferred brand, you will have no out-of-pocket expense (except for GNY Benefit Fundand Rochester-area members, who may have small co-payments for certain brand-name drugs).
However, if you get a nonpreferred brand when a preferred drug is available, you will be responsible forthe difference in cost between the preferred and nonpreferred drugs. (Please note that this list is subjectto change.) Section II provides a listing of nonpreferred brands and their possible preferred alternatives.
SAFETY CONSIDERATION SYMBOLS
Here is a quick guide that explains our safety symbols. These symbols appear next to certain
medications.
A dose lower than the manufacturer’s guidelines is often recommended for people 65 and older. Use by people 65 and older is associated with increased risk; safer alternatives may be available. Ifused, the dosage should generally be lowered.
Weigh the risk of birth defects and other adverse outcomes.
PRESCRIPTION PROGRAM CONSIDERATION SYMBOLS
For more information, please call Medco: (800) 753-2851.
[PA] This symbol next to a drug name indicates that this medication is subject to the Prior [ST] This symbol next to a drug name indicates that this medication is subject to the Step Therapy [QD] This symbol next to a drug name indicates that this medication is subject to the Quantity Duration OTHER SYMBOLS:[AC] This symbol next to a drug name indicates that this specialty medication must be obtained through Accredo. Please call Accredo: (800) 803-2523.
Shaded areas indicate the most recent additions to the Preferred Drug List.
Drugs Not Covered by the 1199SEIU Benefit Funds
All Over-the-Counter drugs (except diabetic supplies) Please refer to your Summary Plan Description for a complete list of excluded drugs. Information was in effect at the time of printing and may be subject to change.
For the most up-to-date 1199SEIU Benefit Funds Preferred Drug List go to www.1199SEIUBenefits.org.
MG40118C 1199 2H10 SEIU PDL BiFold_v4 5/6/10 12:26 PM Page 2 SECTION I: THERAPEUTIC DRUG CATEGORIES
ANTICONVULSANTS (EFFECTIVE 7-1-10)
ANTI-INFECTIVES (Antibiotics)
Oral Penicillins
Oral Cephalosporins
Oral Quinolones
Oral Erythromycins and other
Oral Tetracyclines
Macrolides
erythromycin ethylsuccinate/sulfisoxazole acetyl ANTIPARKINSONISM AGENTS (EFFECTIVE 1-1-10)
ANTIVERTIGO & ANTIEMETIC DRUGS (EFFECTIVE 4-1-10)
Key: G = Preferred generic medication.
This symbol next to a drug name indicates that this medication is subject tothe Prior Authorization Program.
This symbol next to a drug name indicates that this medication is subject to = A dose lower than the manufacturer’s guidelines is often recommended for This symbol next to a drug name indicates that this medication is subject to ▲ = Use by people 65 and older is associated with increased risk; safer alternatives may be available. If used, the dosage should generally be lowered.
This symbol indicates that this specialty medication must be obtained = Weigh risk of birth defects or other adverse outcomes.
through Accredo. Please call: (800) 501-7210.
MG40118C 1199 2H10 SEIU PDL BiFold_v4 5/6/10 12:26 PM Page 3 BENIGN PROSTATE HYPERPLASIA (BPH) THERAPY
BIOTECHNOLOGY DRUGS (EFFECTIVE 7-1-10)
Factor VIII - Recombinant Drugs
P
CARDIOVASCULAR (Blood Pressure/Heart/Cholesterol)
Beta Blockers
ACE Inhibitors
propranolol HCl capsule, sustained Angiotensin II Blockers
Calcium Channel Blockers
Long Acting Nitrates (Topical)
Antilipidemics - Statin Drugs
(EFFECTIVE 7-1-10)
Antiplatelet Agents
(EFFECTIVE 7-1-10)
Other Antilipidemics
Dihydropyridines Calcium
Channel Blocker
Select Combination
Antihypertensives
DRUGS TO TREAT OVERACTIVE BLADDER (EFFECTIVE 1-1-10)
Key: G = Preferred generic medication.
This symbol next to a drug name indicates that this medication is subject tothe Prior Authorization Program.
This symbol next to a drug name indicates that this medication is subject to = A dose lower than the manufacturer’s guidelines is often recommended for This symbol next to a drug name indicates that this medication is subject to ▲ = Use by people 65 and older is associated with increased risk; safer alternatives may be available. If used, the dosage should generally be lowered.
This symbol indicates that this specialty medication must be obtained = Weigh risk of birth defects or other adverse outcomes.
through Accredo. Please call: (800) 501-7210.
MG40118C 1199 2H10 SEIU PDL BiFold_v4 5/6/10 12:26 PM Page 4 ENDOCRINE (Diabetes/Hormones/Contraceptives)
Insulin Therapy
Blood Glucose Test Strips
Estrogen Agents (oral/vaginal)
(EFFECTIVE 1-1-09)
Oral Hypoglycemic Agents
EVISED – EFFECTIVE 4-1-10)
Blood Glucose Monitoring
Androgen Replacement Agents
EVISED – EFFECTIVE 10-1-09)
Contraceptive Agents
(EFFECTIVE 10-1-09)
Estrogen Patches (EFFECTIVE 7-1-09)
G I (Ulcer)
Ulcer Drugs
GROWTH HORMONES (REVISED – EFFECTIVE 7-1-10)
IMMUNOGLOBULIN AGENTS (INJECTABLES) (EFFECTIVE 5-1-09)
INTERFERONS (EFFECTIVE 10-1-09)
Hepatitis C Agents
Key: G = Preferred generic medication.
This symbol next to a drug name indicates that this medication is subject tothe Prior Authorization Program.
This symbol next to a drug name indicates that this medication is subject to = A dose lower than the manufacturer’s guidelines is often recommended for This symbol next to a drug name indicates that this medication is subject to ▲ = Use by people 65 and older is associated with increased risk; safer alternatives may be available. If used, the dosage should generally be lowered.
This symbol indicates that this specialty medication must be obtained = Weigh risk of birth defects or other adverse outcomes.
through Accredo. Please call: (800) 501-7210.
MG40118C 1199 2H10 SEIU PDL BiFold_v4 5/6/10 12:26 PM Page 5 MISCELLANEOUS GASTROINTESTINAL AGENTS (EFFECTIVE 7-1-10)
Ulcerative Colitis Agents
MISCELLANEOUS RHEUMATOLOGICAL AGENTS (EFFECTIVE 7-1-10)
Rheumatoid Arthritis Agents
(Injectables)
MUSCLE RELAXANTS (EFFECTIVE 10-1-09)
NARCOTIC ANALGESICS (Pain Relievers)
Narcotics
Miscellaneous Analgesic
Therapy (EFFECTIVE 1-1-09)
NON-NARCOTIC ANALGESICS (Pain Relievers)
Migraine/Headache Therapy
(EFFECTIVE 1-1-09)
Osteoarthritis Agents
(Injectable) (EFFECTIVE 7-1-09)
NSAID COX-2 Inhibitors
Key: G = Preferred generic medication.
This symbol next to a drug name indicates that this medication is subject tothe Prior Authorization Program.
This symbol next to a drug name indicates that this medication is subject to = A dose lower than the manufacturer’s guidelines is often recommended for This symbol next to a drug name indicates that this medication is subject to ▲ = Use by people 65 and older is associated with increased risk; safer alternatives may be available. If used, the dosage should generally be lowered.
This symbol indicates that this specialty medication must be obtained = Weigh risk of birth defects or other adverse outcomes.
through Accredo. Please call: (800) 501-7210.
MG40118C 1199 2H10 SEIU PDL BiFold_v4 5/6/10 12:26 PM Page 6 OPHTHALMICS (Eye Preparations)
Ophthalmic-Steroids
Ophthalmic Carbonic Anhdyrase
FFECTIVE 1-1-10)
Inhibitors (EFFECTIVE 1-1-10)
Ophthalmic Beta-Blockers
Miscellaneous Ophthalmics
(EFFECTIVE 1-1-10)
(EFFECTIVE 1-1-09)
Miscellaneous Glaucoma Agents
Antibiotic-Ophthalmics
(EFFECTIVE 1-1-09)
(EFFECTIVE 5-1-09)
OSTEOPOROSIS/PAGET’S DISEASE
OTICS (Ear Preparations) (EFFECTIVE 4-1-10)
PSYCHOTHERAPEUTICS (Anxiety/Depression)
Hypnotic Agents
Anxiolytics
Miscellaneous Antidepressants
SSRI Antidepressants
Attention Deficit Hyperactivity
Disorder (EFFECTIVE 5-1-09)
Antipsychotics
Key: G = Preferred generic medication.
This symbol next to a drug name indicates that this medication is subject tothe Prior Authorization Program.
This symbol next to a drug name indicates that this medication is subject to = A dose lower than the manufacturer’s guidelines is often recommended for This symbol next to a drug name indicates that this medication is subject to ▲ = Use by people 65 and older is associated with increased risk; safer alternatives may be available. If used, the dosage should generally be lowered.
This symbol indicates that this specialty medication must be obtained = Weigh risk of birth defects or other adverse outcomes.
through Accredo. Please call: (800) 501-7210.
MG40118C 1199 2H10 SEIU PDL BiFold_v4 5/6/10 12:26 PM Page 7 RESPIRATORY (Allergy/Asthma/COPD)
Beta Agonist Inhalers
PDATED 5-1-09)
Nasal Corticosteroids
Miscellaneous Pulmonary Agents
(EFFECTIVE 1-1-09)
Inhaled Corticosteroid Therapy
(EFFECTIVE 1-1-09)
TOPICAL ACNE THERAPY (EFFECTIVE 1-1-09)
TOPICAL ANTIFUNGALS
TOPICAL ANTIVIRAL THERAPY (EFFECTIVE 1-1-09)
TOPICAL CORTICOSTEROIDS (Topical Skin Products)
Low Potency
High Potency
Very High Potency
Medium Potency
VITAMINS — All generics are preferred (Most commonly used listed below) (EFFECTIVE 1-1-09)
Prenatal Vitamin Therapy
Vitamin B Therapy
Multivitamin Therapy
Iron Supplement Therapy
Key: G = Preferred generic medication.
This symbol next to a drug name indicates that this medication is subject tothe Prior Authorization Program.
This symbol next to a drug name indicates that this medication is subject to = A dose lower than the manufacturer’s guidelines is often recommended for This symbol next to a drug name indicates that this medication is subject to ▲ = Use by people 65 and older is associated with increased risk; safer alternatives may be available. If used, the dosage should generally be lowered.
This symbol indicates that this specialty medication must be obtained = Weigh risk of birth defects or other adverse outcomes.
through Accredo. Please call: (800) 501-7210.
MG40118C 1199 2H10 SEIU PDL BiFold_v4 5/6/10 12:26 PM Page 8 If your prescribed drug is in the “non-preferred” column, ask your doctor if she or he can prescribe oneof the alternatives listed.
SECTION II: NONPREFERRED DRUGS AND THEIR POSSIBLE PREFERRED ALTERNATIVES
Nonpreferred Product
Possible Preferred Alternatives
Nonpreferred Product
Possible Preferred Alternatives
clozapine (generic), risperidone (generic), Geodon® Flovent HFA® (GlaxoSmithKline), Flovent Diskus® (Pfizer), Seroquel® (AstraZeneca), Zyprexa® (Lilly) (GlaxoSmithKline), Pulmicort Respules® (AstraZeneca),Qvar® (IVAX) clindamycin (generic) + benzoyl peroxide (generic) omeprazole (generic), Nexium® (AstraZeneca) flunisolide (generic), fluticasone propionate (generic), Boniva® (Roche), alendronate 35mg (generic), alendronate losartan potassium (generic), Micardis® (BIPI) Boniva® (Roche), alendronate 5mg (generic), alendronate losartan/HCTZ (generic), Micardis HCT® (BIPI) clindamycin phosphate (generic), benzoyl peroxide lovastatin (generic), niacin (generic), simvastatin (generic), pravastatin (generic), Lipitor® (Pfizer),Niaspan ER® (Abbott) betaxolol (generic), carteolol (generic), timolol (generic), Flovent HFA® (GlaxoSmithKline), Flovent Diskus® levobunolol (generic), metipranolol (generic) (GlaxoSmithKline), Pulmicort Respules® (AstraZeneca),Qvar® (IVAX) betaxolol (generic), carteolol (generic), timolol (generic),levobunolol (generic), metipranolol (generic) Flovent HFA® (GlaxoSmithKline), Flovent Diskus®(GlaxoSmithKline), Pulmicort Respules® (AstraZeneca), fluocinolone acetonide solution, non oral (generic) chloral hydrate (generic), temazepam (generic), triazolam(generic) acebutolol HCl (generic), atenolol HCl (generic), metoprolol tartrate (generic), metoprolol succinate estradiol (generic), Estraderm (Novartis),Vivelle amlodipine besylate (generic), Lipitor® (Pfizer) ondansetron (generic), granisetron (generic), Emend® amlodipine besylate (generic), nifedipine ER (generic) fluorometholone (generic), prednisolone (generic) diltiazem HCl capsule, sustained release 24 hr (generic) lovastatin (generic), simvastatin (generic), pravastatin Gamunex® (Talecris Biotherapeutics),Vivaglobin® (ZLB acebutolol HCl (generic), atenolol tablet (generic), zolpidem (generic), temazepam (generic), triazolam metoprolol tartrate tablet (generic), propranolol HCl tablet (generic), propranolol HCl capsule, sustained action24 hr (generic), timolol maleate tablet (generic) sumatriptan (generic), Maxalt (Merck), Relpax (Pfizer) cefpodoxime (generic), cefaclor (generic), cefuroxime fenofibrate (generic), gemfibrozil (generic) Folbain Plus (generic),Vitaplex (generic), Folbic (generic), ondansetron (generic), granisetron (generic), Emend® Folbain Plus (generic),Vitaplex (generic), Folbic (generic),Folbee (generic), Renal Caps (generic) mesalamine (generic),Asacol® (Procter & Gamble),Pentasa® ( Shire US) Foltrin (generic), Ferrex 150 Forte (generic), HematogenForte (generic), Ferotrinsic (generic), Poly-Iron 150 Forte diclofenac (generic), misoprostol (generic), Celebrex® Foltrin (generic), Ferrex 150 Forte (generic), Hematogen Flovent HFA® (GlaxoSmithKline), Flovent Diskus® Forte (generic), Ferotrinsic (generic), Poly-Iron 150 Forte (GlaxoSmithKline), Pulmicort Respules® (AstraZeneca), Foltrin (generic), Ferrex 150 Forte (generic), Hematogen losartan potassium (generic), Micardis® (BIPI) Forte (generic), Ferotrinsic (generic), Poly-Iron 150 Forte losartan/HCTZ (generic), Micardis HCT® (BIPI) amoxicillin trihydrate/potassium clavulanate (generic) neomycin/polymyxin/HC (generic), ofloxacin (generic) losartan/HCTZ (generic), Micardis HCT® (BIPI) neomycin/polymyxin/HC (generic), ofloxacin (generic) losartan potassium (generic), Micardis® (BIPI) finasteride (generic), tamsulosin (generic) sumatriptan (generic), Maxalt® (Merck), Relpax® (Pfizer) erythromycin ointment (generic), ciprofloxacin drops desoximetasone cream (generic), fluocinolone acetonide (generic), tobramycin sulfate drops (generic),Vigamox cream (generic), hydrocortisone valerate cream (generic), neomycin/polymyxin/HC (generic), ofloxacin (generic) *Branded generics have the same co-payment as regular generics.
MG40118C 1199 2H10 SEIU PDL BiFold_v4 5/6/10 12:26 PM Page 9 Nonpreferred Product
Possible Preferred Alternatives
Nonpreferred Product
Possible Preferred Alternatives
econazole nitrate (generic), ketoconazole (generic), betamethasone valerate cream (generic), desoximetasone cream (generic), fluocinolone acetonide cream (generic),hydrocortisone valerate cream (generic), triamcinolone amlodipine (generic), benazepril (generic), ciprofloxacin (generic), Avelox® (Schering) neomycin/polymyxin/HC (generic), ofloxacin (generic) clozapine (generic), risperidone (generic), Geodon®(Pfizer), Seroquel® (AstraZeneca), Zyprexa® (Lilly) Therobec Plus (generic),Vitaplex Plus (generic),VitaconPlus (generic), Formula B Plus (generic),Vita Forte Accu-Chek® (Roche), Ascensia® (Bayer), Breeze2® verapamil HCl tablet, sustained action (generic) simvastatin (generic), Lipitor® (Pfizer) methylphenidate ER (generic), Concerta® (McNeil Androderm® (Watson Pharmaceuticals),Androgel® fluocinolone acetonide solution, non oral (generic) desonide (generic), alclometasone (generic), Gamunex® (Talecris Biotherapeutics),Vivaglobin® (ZLB flavoxate( generic), oxybutynin (generic), oxybutynin ER naproxen (generic), etodolac (generic), ibuprofen flavoxate( generic), oxybutynin (generic), oxybutynin ER tretinoin (generic), Azelex® (Allergan), Finacea® (Bayer) losartan potassium (generic), Micardis® (BIPI) dexmethylphenidate (generic), methylphenidate ER losartan/HCTZ (generic), Micardis HCT® (BIPI) sulfasalazine (generic), balsalazide (generic),Asacol® (Procter & Gamble), Pentasa® ( Shire US) Accu-Chek® (Roche), Ascensia® (Bayer), Breeze2® clindamycin phosphate (generic), benzoyl peroxide sumatriptan (generic), Maxalt (Merck), Relpax (Pfizer) Gammagard® Liquid Gamunex® (Talecris Biotherapeutics),Vivaglobin® (ZLB Accu-Chek® (Roche), Ascensia® (Bayer), Breeze2® Gamunex® (Talecris Biotherapeutics),Vivaglobin® (ZLBBehring LLC) Prenatal Plus (generic), OB-Natal Plus (generic), PNV-DHA (generic),Taron-Prex Prenatal (generic), Pruet DHA oxybutynin (generic), oxybutynin ER (generic) Norditropin® (Nov Nordisk),Tev-Tropin® (Gate amlodipine besylate (generic), nifedipine ER (generic) desoximetasone cream (generic), fluocinonide cream venlafaxine HCl (generic), citalopram HBr (generic), fluoxetine HCl (generic), paroxetine HCl (generic), Norditropin® (Nov Nordisk),Tev-Tropin® (Gate sertraline HCl (generic), Cymbalta® (Eli Lilly) methylphenidate (generic), methylphenidate ER (generic),Concerta® (Janssen) flavoxate( generic), oxybutynin (generic),oxybutynin ER (generic),Vesicare® (GlaxoSmithKline) risperidone (generic), Seroquel® (AstraZeneca), Zyprexa® tretinoin (generic), benzoyl peroxide (generic) econazole nitrate (generic), ketoconazole (generic), ciprofloxacin drops (generic),Vigamox® (Alcon) betaxolol (generic), carteolol (generic), timolol (generic), levobunolol (generic), metipranolol (generic) estradiol patch (generic), Estraderm® (Novartis),Vivelle® omeprazole (generic), Nexium® (AstraZeneca) (Barr-branded generic*), Microgestin Fe®(Watson-branded generic*) Hyalgan® (Sanofi Pharm), Synvisc® (Genzyme), lovastatin (generic), simvastatin (generic), pravastatin (generic), Lipitor® (Pfizer) hydromorphone (generic), morphine ER (generic), lovastatin (generic), simvastatin (generic), pravastatin (generic), Lipitor® (Pfizer) *Branded generics have the same co-payment as regular generics.
MG40118C 1199 2H10 SEIU PDL BiFold_v4 5/6/10 12:26 PM Page 10 Nonpreferred Product
Possible Preferred Alternatives
Nonpreferred Product
Possible Preferred Alternatives
ciprofloxacin (generic), ofloxacin (generic),Avelox® acebutolol HCl (generic), atenolol (generic), metoprolol Prenatal Plus (generic), OB-Natal Plus (generic), citalopram solution (generic), fluoxetine HCl solution PNV-DHA (generic),Taron-Prex Prenatal (generic), citalopram (generic), fluoxetine HCl (generic), paroxetine Gamunex® (Talecris Biotherapeutics),Vivaglobin® (ZLB balsalazide (generic),Asacol® (Procter & Gamble), flunisolide (generic), fluticasone propionate (generic), lovastatin (generic), pravastatin( generic), simvastatin Norditropin® (Nov Nordisk),Tev-Tropin® (Gate Accu-Chek® (Roche), Ascensia® (Bayer), Breeze2® cefaclor (generic), cefuroxime axetil (generic), Accu-Chek® (Roche), Ascensia® (Bayer), Breeze2® cefdinir (generic), cefpodoxime (generic) fluorometholone (generic), prednisolone (generic) fenofibrate (generic), Niaspan ER® (Abbott) morphine sulfate ER (generic), Oxycontin® (Purdue temazepam (generic), triazolam (generic), zolpidem TriNessa® (Watson),Tri-Sprintec® (Barr) Hyalgan® (Sanofi Pharm), Synvisc® (Genzyme), trandolapril HCl (generic), benazepril HCl (generic), enalapril maleate (generic), lisinopril (generic), quinapril econazole nitrate (generic), ketoconazole (generic), oxybutynin (generic), oxybutynin ER (generic) fluorometholone (generic), prednisolone (generic) desoximetasone cream (generic),fluocinolone acetonide cream (generic), estradiol (generic), estropipate (generic), Cenestin(Barr/Duramed), Enjuvia (Barr/Duramed) hydrocortisone valerate cream (generic),triamcinolone acetonide cream (generic) estradiol (generic), Estraderm (Novartis),Vivelle(Novartis),Vivelle-Dot (Novartis) carbidopa/levadopa (generic), carbidopa/levadopa ER(generic) econazole nitrate (generic), ketoconazole (generic),nystatin (generic) Folbain Plus (generic),Vitaplex (generic), Folbic (generic), etodolac (generic), ibuprofen (generic), naproxen etodolac (generic), ibuprofen (generic), indomethacin(generic), naproxen (generic), sulindac (generic) pramopexole (generic), Mirapex® 0.75mg (BoehringerIngelheim) econazole nitrate (generic), ketoconazole (generic), metformin (generic),+ Prandin® (Novo Nordisk) Accu-Chek® (Roche), Ascensia® (Bayer), Breeze2® etodolac (generic), ibuprofen (generic), indomethacin (generic), naproxen (generic), sulindac (generic) Accu-Chek® (Roche), Ascensia® (Bayer), Breeze2® flunisolide (generic), fluticasone propionate (generic), estradiol (generic), Cenestin® (Barr/Duramed), Enjuvia® flunisolide (generic), fluticasone propionate (generic), Prenatal Plus (generic), OB-Natal Plus (generic), PNV-DHA (generic),Taron-Prex Prenatal (generic), Foltrin (generic), Ferrex 150 Forte (generic), Hematogen Forte (generic), Ferotrinsic (generic), Accu-Chek® (Roche), Ascensia® (Bayer), Breeze2® venlafaxine HCl (generic), citalopram HBR (generic), ciprofloxacin (generic), ofloxacin (generic),Avelox® fluoxetine HCL (generic), paroxetine HCl (generic), sertraline HCl (generic), Cymbalta® (Eli Lilly) Therobec Plus (generic),Vitaplex Plus (generic),VitaconPlus (generic), Formula B Plus (generic),Vita Forte Norditropin® (NovoNordisk),Tev-Tropin® (Gate Pharmaceuticals) *Branded generics have the same co-payment as regular generics.
MG40118C 1199 2H10 SEIU PDL BiFold_v4 5/6/10 12:26 PM Page 11 Nonpreferred Product
Possible Preferred Alternatives
Nonpreferred Product
Possible Preferred Alternatives
Flovent HFA® (GlaxoSmithKline), Flovent Diskus® tretinoin (generic),Azelex® (Allergan), Finacea® (Bayer) (GlaxoSmithKline), Pulmicort Respules® (AstraZeneca), losartan potassium (generic), Micardis® (BIPI) losartan/HCTZ (generic), Micardis HCT® (BIPI) ciprofloxacin drops (generic),Vigamox® (Alcon) ciprofloxacin (generic), ofloxacin (generic),Avelox® Foltrin (generic), Ferrex 150 Forte (generic), HematogenForte (generic), Ferotrinsic (generic), Poly-Iron 150 Forte Androderm® (Watson Pharmaceuticals),Androgel® losartan potassium (generic), Micardis® (BIPI) flunisolide (generic), fluticasone propionate (generic), losartan/HCTZ (generic), Micardis HCT® (BIPI) fluocinolone acetonide solution, non oral (generic) sodium sulfacetamide 10% and sulfur 5% (generic) sodium sulfacetamide 10% and sulfur 5% (generic) sodium sulfacetamide 10% and sulfur 5% (generic) sumatriptan (generic), naproxen (generic) temazepam (generic), triazolam (generic), divalproex (generic), lamotrigine (generic), levetiracetam(generic), topiramate (generic), Gabitril® (Cephalon) Norditropin® (NovoNordisk),Tev-Tropin® (Gate benazepril HCl (generic), enalapril (generic), fosinopril (generic), lisinopril (generic), quinapril (generic), flavoxate( generic), oxybutynin (generic), oxybutynin ER doxazosin (generic), terazosin (generic), tamsulosin ondansetron (generic), granisetron (generic), Emend® cloxapine (generic), risperidone (generic), Seroquel® amlodipine (generic) + losarten (generic) or Micardis® clobetasol propionate (generic), betamethasone dp augmented (generic), diflorasone diacetate (generic) chloral hydrate (generic), temazepam (generic), triazolam cefaclor suspension (generic), cefdinir (generic), Prenatal Plus (generic), OB-Natal Plus (generic), PNV-DHA (generic),Taron-Prex Prenatal (generic),Pruet DHA (generic) flunisolide (generic), fluticasone propionate (generic),Nasonex® (Schering) Norditropin® (NovoNordisk),Tev-Tropin® (GatePharmaceuticals) simvastatin (generic) + Niaspan ER® (Abbott) Prenatal Plus (generic), OB-Natal Plus (generic),PNV-DHA (generic),Taron-Prex Prenatal (generic), carbidopa/levadopa (generic) + Comtan® (Novartis) etodolac (generic), ibuprofen (generic), naproxen Androderm® (Watson Pharmaceuticals),Testim® simvastatin (generic), Zetia® (Merck-Schering Plough), Therobec Plus (generic),Vitaplex Plus (generic),Vitacon Plus (generic), Formula B Plus (generic),Vita Forte(generic) Therobec Plus (generic),Vitaplex Plus (generic),Vitacon Plus (generic), Formula B Plus (generic),Vita Forte Therobec Plus (generic),Vitaplex Plus (generic),VitaconPlus (generic), Formula B Plus (generic),Vita Forte ciprofloxacin HCl (generic), Avelox® (Schering) omeprazole (generic), Nexium® (AstraZeneca) Hyalgan® (Sanofi Pharm), Synvisc® (Genzyme), clindamycin phosphate (generic), tretinoin (generic) cefuroxime axetil (generic), cefdinir (generic) Accu-Chek® (Roche), Ascensia® (Bayer), Breeze2®(Bayer), Contour® (Bayer) sumatriptan (generic), Maxalt® (Merck), Relpax® (Pfizer) alclometasone dipropionate (generic), fluocinoloneacetonide (generic), hydrocortisone (generic) Advair HFA® (GlaxoSmithKline), Advair Diskus®(GlaxoSmithKline) fluoxetine HCl (generic), Zyprexa® (Eli Lilly) ciprofloxacin drops (generic),Vigamox® (Alcon) *Branded generics have the same co-payment as regular generics.

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