| Document Date: 2013-10-09 17:12:57
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Facility Idaho’s Pharmacy / / IndustryTerm search field / / MedicalCondition ADHD / QL QL QL QL QL QL QL QL Attention-Deficit/Hyperactivity Disorder / / Organization Food and Drug Administration / PA PA / Idaho’s Pharmacy and Therapeutics Committee / / Person XR RITALIN RITALIN LA RITALIN SR / / Position pharmacist / physician / / Product TENCON / FLAGYL / testosterone cypionate / HUMIRA / VOLTAREN-XR / TESTRED / vancomycin hcl / TALWIN / PENTAM / AVINZA / METHYLIN / dextroamphetamine sulfate / acetaminophen / RITALIN LA / morphine sulfate / meclofenamate sodium / CORTENEMA / DURAGESIC / ANAPROX DS / EC-NAPROSYN / BACTRIM DS / CONCERTA / trimethoprim / ADDERALL XR / FOCALIN / ULTRAM / leflunomide / sulindac / FIORINAL / DAYPRO / modafinil / naloxone hcl / VICOPROFEN / RIDAURA / DEXEDRINE / CLINORIL / FLAGYL ER / kanamycin sulfate / tolmetin sodium / NALFON / ANDROGEL / ULTRAM ER / FIORICET / SUBUTEX / TYLENOL / etodolac / Tier Requirements / meloxicam / nalbuphine / gentamicin / CATAFLAM / streptomycin sulfate / ACTIQ / OPANA / STRIANT / danazol / NORCO / BILTRICIDE / ESGIC-PLUS / TINDAMAX / ANDRODERM / erythromycin / paromomycin sulfate / NUVIGIL / PRIMSOL / DELATESTRYL / naproxen / PROCTOFOAM HC / NAPRELAN / AZACTAM / MOBIC / VICODIN / FELDENE / METHADOSE / neomycin sulfate / indomethacin / KADIAN / CORTIFOAM / levorphanol tartrate / FOCALIN XR / PONSTEL / FENTORA / NUBAIN / CELEBREX / LORTAB / naloxone / ORENCIA / SUBOXONE / oxaprozin / KINERET / DESOXYN / sulfisoxazole / fentanyl citrate / OPANA ER / diflunisal / NEBUPENT / tobramycin sulfate / NEO-FRADIN / ZYDONE / TOBI / DEPO-TESTOSTERONE / ENBREL / methyltestosterone / metronidazole / testosterone enanthate / ibuprofen / REPREXAIN / PERCOCET / hydrocortisone acetate / PERCODAN / amikacin sulfate / ADDERALL / ALBENZA / ULTRACET / TESTIM / VYVANSE / oxandrolone / NAPROSYN / butalbital / VICODIN ES / ROXICODONE / ARAVA / STRATTERA / DAYTRANA / STROMECTOL / ANADROL / PROCTOCORT / diclofenac sodium / SEDAPAP / BACTRIM / OXANDRIN / diclofenac potassium / fenoprofen calcium / INDOCIN / ketorolac tromethamine / TYLOX / XIFAXAN / gentamicin sulfate / METADATE ER / fentanyl / flurbiprofen / mebendazole / ARCALYST / butorphanol tartrate / ESGIC / piroxicam / OXYCONTIN / nabumetone / hydrocortisone / PROVIGIL / ANEXSIA / METADATE CD / ANAPROX / RITALIN / naproxen sodium / DEMEROL / DILAUDID / / ProvinceOrState Pennsylvania / Idaho / / Technology alpha / Antibodies / PDF / /
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Blue Cross of Idaho’s Multi-Tier Prescription Drug Formulary for Qualified Health Plans This document is a searchable PDF. On your keyboard press ALT+F (Command+F for Mac) and a search field will open. Type in the name