Pharmacy: maintenance and mail order drugs

Drugs on this list may be ordered in up 90-days’ supply. Certain Mail Order incentives apply only to drugs on this list. ACETIC ACID/RICINOLEIC ACID/OXYQUINOLINE, VAGINAL BACITRACIN/POLYMYXIN B SULFATE, OPHTHALMIC BELLADONNA ALKALOIDS/PHENOBARBITAL, ORAL BENAZEPRIL HCL/HYDROCHLOROTHIAZIDE, ORAL ALBUTEROL SULFATE/IPRATROPIUM BROMIDE, INHALATION BETAMETHASONE DIPROPIONATE/PROPYLENE GLYCOL, TOPICAL BISOPROLOL FUMARATE/HYDROCHLOROTHIAZIDE, ORAL AMLODIPINE BESYLATE/BENAZEPRIL HCL, ORAL AMOXICILLIN TRIHYDRATE/POTASSIUM CLAVULANATE, ORAL CANDESARTAN CILEXETIL/HYDROCHLOROTHIAZIDE, ORAL Group Health Maintenance & Mail Order Drugs • August 2007 DESOGESTREL-ETHINYL ESTRADIOL/ETHINYL ESTRADIOL, ORAL CHOLINE SALICYLATE/MAGNESIUM SALICYLATE, ORAL DEXTROMETHORPHAN HBR/PROMETHAZINE HCL, ORAL CLIDINIUM BROMIDE/CHLORDIAZEPOXIDE, ORAL DIFLORASONE DIACETATE/EMOLLIENT, TOPICAL CLINDAMYCIN PHOSPHATE/BENZOYL PEROXIDE, TOPICAL DIOXYBENZONE/PADIMATE O/HYDROQUINONE, TOPICAL DIPHENOXYLATE HCL/ATROPINE SULFATE, ORAL CLOTRIMAZOLE/BETAMETHASONE DIPROPIONATE, TOPICAL CODEINE PHOS/ACETAMINOPHEN/CAFFEINE/BUTALBITAL, ORAL CODEINE PHOS/ASPIRIN/CAFFEINE/BUTALBITAL, ORAL CYANOCOBALAMIN/FOLIC ACID/PYRIDOXINE, ORAL ERGOTAMINE TARTRATE/BELLADONNA ALKALOIDS/PHENOBARBITAL, Group Health Maintenance & Mail Order Drugs • August 2007 ERYTHROMYCIN BASE/BENZOYL PEROXIDE, TOPICAL ERYTHROMYCIN BASE/ETHYL ALCOHOL, TOPICAL ERYTHROMYCIN ETHYLSUCCINATE/SULFISOXAZOLE ACETYL, ORAL FLUTICASONE PROPIONATE/SALMETEROL XINAFOATE, INHALATION FOLIC ACID/MULTIVITAMINS, THER W-MINERALS, ORAL ESTRADIOL/NORETHINDRONE ACETATE, TRANSDERMAL ESTROGENS, CONJUGATED/MEDROXYPROGESTERONE ACET, ORAL ETHINYL ESTRADIOL/NORELGESTROMIN, TRANSDERMAL GONADOTROPIN, CHORIONIC, HUMAN, INTRAMUSCULAR ETHINYL ESTRADIOL/NORETHINDRONE ACETATE, ORAL GUAIFENESIN/POTASSIUM GUAIACOLSULFONATE, ORAL GUAIFENESIN/PSEUDOEPHEDRINE HCL/CODEINE, ORAL HYALURONIC ACID, DL-E AC, GRAPE, DEIONIZED H2O, TOPICAL FERROUS FUMARATE/ASCORBIC ACID/B12-IF/FOLIC ACID, ORAL FERROUS FUMARATE/FE BISGLY/VIT C/VIT B12/FA/CA-THREONATE, HYDROCODONE POLISTRX/CHLORPHENIRAMINE POLISTIREX, ORAL HYDROCORTISONE ACETATE/PRAMOXINE HCL, RECTAL HYDROCORTISONE ACETATE/PRAMOXINE HCL, TOPICAL FLUOCINOLONE ACETONIDE/TRETINOIN/HYDROQUINONE, TOPICAL HC 2 %/ALOE POLYSACCH 1 %/IODOQUINOL 1 %, TOPICAL FLUORIDE ION/IRON/VITAMINS A, C, AND D, ORAL Group Health Maintenance & Mail Order Drugs • August 2007 LOSARTAN POTASSIUM/HYDROCHLOROTHIAZIDE, ORAL IRON FUMARATE & SUMAL/SUCC/C/FA1/B12/CA, ORAL ISOMETHEPTENE MUCATE/ACETAMINOPHEN/DICHLORALPHENAZONE, METHENAMINE/PH.SALIC/ME BLUE/BA/ATP/HYOS METHYLPHENIDATE HCL EXTENDED RELEASE, ORAL METHYLPHENIDATE TRANSDERMAL SYSTEM, TOPICAL METHYLTESTOSTERONE/ESTROGENS, ESTERIFIED, ORAL Group Health Maintenance & Mail Order Drugs • August 2007 OXYBENZONE/AVOBENZONE/OCTINOXATE/HYDROQUINONE, TOPICAL NEOMYCIN SULFATE/BACITRACIN ZINC/POLYMYXIN NEOMYCIN SULFATE/COLISTIN SULFATE/HYDROCORTISONE, OTIC NEOMYCIN SULFATE/POLYMYXIN B SULFATE/HYDROCORTISONE, OTIC NEOMYCIN/BACITRACIN/POLYMYXIN B/HYDROCORTISONE, TOPICAL NEOMYCIN/POLYMYXIN B SULFATE/DEXAMETHASONE, OPHTHALMIC NIACIN EXTENDED RELEASE, LOVASTATIN, ORAL PHENYLEPHRINE HCL/CODEINE/PROMETHAZINE, ORAL PHENYLEPHRINE HCL/PROMETHAZINE HCL, ORAL NORETHINDRONE A-E ESTRADIOL/FERROUS FUMARATE, ORAL POLYMYXIN B SULFATE/TRIMETHOPRIM, OPHTHALMIC NYSTATIN/TRIAMCINOLONE ACETONIDE, TOPICAL OLMESARTAN MEDOXOMIL/HYDROCHLOROTHIAZIDE, ORAL Group Health Maintenance & Mail Order Drugs • August 2007 PRENATAL VITAMINS/FERROUS FUMARATE/FOLIC ACID, ORAL SODIUM PHOSPHATE, MONOBASIC/POTASSIUM PHOSPHATE, SODIUM PROPIONATE/AMINO ACIDS/UREA, VAGINAL SODIUM SULFATE/SODIUM/SODIUM BICARBONATE/KCL/PEG'S, ORAL SODIUM/POTASSIUM/POTASSIUM CITRATE/SODIUM CITRATE/CIT AC, SPIRONOLACTONE/HYDROCHLOROTHIAZIDE, ORAL PSEUDOEPHEDRINE HCL/CETIRIZINE HCL, ORAL PSEUDOEPHEDRINE HCL/CHLORPHENIRAMINE MALEATE, ORAL SULFACETAMIDE SODIUM/PREDNISOLONE ACETATE, OPHTHALMIC PSEUDOEPHEDRINE HCL/FEXOFENADINE HCL, ORAL TETRACYCLINE HCL/BISMUTH SUBSALICYLATE/METRONIDAZOLE, ROSIGLITAZONE MALEATE, GLIMEPIRIDE, ORAL ROSIGLITAZONE MALEATE/METFORMIN HCL, ORAL TIMOLOL MALEATE/DORZOLAMIDE HCL, OPHTHALMIC TOBRAMYCIN SULFATE/DEXAMETHASONE, OPHTHALMIC Group Health Maintenance & Mail Order Drugs • August 2007 TOLAZAMIDE, ORAL TOLBUTAMIDE, ORAL TOLMETIN SODIUM, ORAL TOLTERODINE TARTRATE, ORAL TOPIRAMATE, ORAL TORSEMIDE, ORAL TRAMADOL HCL, ORAL TRAMADOL HCL/ACETAMINOPHEN, ORAL TRANDOLAPRIL, ORAL TRANDOLAPRIL, VERAPAMIL SR, ORAL TRANYLCYPROMINE SULFATE, ORAL TRAVOPROST, OPHTHALMIC TRAZODONE HCL, ORAL TRETINOIN, TOPICAL TRETINOIN MICROSPHERES, TOPICAL TRETINOIN/EMOLLIENT, TOPICAL TRETINOIN/MEQUINOL, TOPICAL TRIAMCINOLONE ACETONIDE, INHALATION TRIAMCINOLONE ACETONIDE, NASAL TRIAMCINOLONE ACETONIDE, TOPICAL TRIAMTERENE, ORAL TRIAMTERENE/HYDROCHLOROTHIAZIDE, ORAL TRIAZOLAM, ORAL TRIFLUOPERAZINE HCL, ORAL TRIFLURIDINE, OPHTHALMIC TRIHEXYPHENIDYL HCL, ORAL TRIMETHOBENZAMIDE HCL, ORAL TRIMETHOBENZAMIDE HCL/BENZOCAINE, RECTAL TRIMETHOPRIM, ORAL TRIMIPRAMINE MALEATE, ORAL URSODIOL, ORAL VALDECOXIB, ORAL VALPROATE SODIUM, ORAL VALPROIC ACID, ORAL VALSARTAN, ORAL VALSARTAN/HYDROCHLOROTHIAZIDE, ORAL VARDENAFIL HCL, ORAL VARENICLINE, ORAL VENLAFAXINE HCL, ORAL VERAPAMIL HCL, ORAL VITAMIN E, ORAL WARFARIN SODIUM, ORAL YOHIMBINE HCL, ORAL ZAFIRLUKAST, ORAL ZALCITABINE, ORAL ZALEPLON, ORAL ZINC SULFATE, ORAL ZIPRASIDONE, ORAL ZOLMITRIPTAN, NASAL ZOLMITRIPTAN, ORAL ZOLPIDEM TARTRATE, ORAL ZONISAMIDE, ORAL Group Health Maintenance & Mail Order Drugs • August 2007

Source: http://www.ghc.org/pharmacy/maintMailOrderDrugs.pdf