View Document Preview and Link Document Date: 2010-12-03 12:25:59 Open Document File Size: 409,44 KB Share Result on Facebook
Company COGNEX / EXELON / / Event FDA Phase / / IndustryTerm requested non-preferred product / chemical entities / generic equivalent products / treatment of nausea and vomiting associated with cancer / / MedicalCondition fibromyalgia / injury / cancer / seizure disorder / unnecessary breakthrough pain / seizure / vomiting / AIDS / strain / nausea / tinea capitis / chronic pain therapy / MS / fibromyalgia diagnosis / Acne / post-herpetic neuralgia / / MedicalTreatment chemotherapy / / Organization BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC DRUG CLASS PREFERRED AGENTS NON-PREFERRED AGENTS EFFECTIVE / BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC PREFERRED AGENTS DRUG CLASS ANTICOAGULANTS / BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC PREFERRED AGENTS NON-PREFERRED AGENTS DRUG CLASS ANALGESICS / BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC DRUG CLASS PREFERRED AGENTS / BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC PREFERRED AGENTS DRUG CLASS ACNE AGENTS / / Person EQUETRO (carbamazepine) EPITOL / / Product GRIS-PEG / topiramate / DEPAKOTE ER / LOVENOX / SARAFEM / acetaminophen / DARVON / PRINZIDE / LUVOX / itraconazole / DURAGESIC / ANZEMET / EMLA / NEURONTIN / EVOCLIN / DIFLUCAN / escitalopram / promethazine / VICOPROFEN / ZESTRIL / EFFEXOR XR / ERTACZO / AZOR / TOFRANIL / ANDROGEL / MENTAX / TYLENOL / CYMBALTA / ciclopirox / OPANA / zonisamide / WELLBUTRIN XL / TALWIN NX / clonazepam / ethosuximide / PEXEVA / erythromycin / KYTRIL / tretinoin / KLONOPIN / BENZACLIN / CAPOTEN / RAZADYNE ER / KADIAN / losartan / rivastigmine / UNIVASC / FENTORA / NAFTIN / KLARON / diazepam / fluoxetine / phenytoin / telmisartan / LIDODERM / ZOFRAN / VOLTAREN / DEPAKENE / KEPPRA / CELEXA / lisinopril / ZOFRAN ODT / DUAC / ibuprofen / PERCOCET / LOTENSIN HCT / ANCOBON / PRINIVIL / TEKTURNA HCT / lamotrigine / DILANTIN / AKNE-MYCIN / TESTIM / ROXICET / gabapentin / GABITRIL / quinapril / VASERETIC / lidocaine / REMERON / sulfacetamide sodium / ACEON / PEGANONE / VFEND / LOPROX / PAXIL / CEREBYX / FRAGMIN / fentanyl / MAVIK / captopril / ALTACE / EXELON / AVITA / trandolapril / HYZAAR / DARVOCET / ARICEPT / NIZORAL / LAMICTAL / DEMEROL / VENLAFAXINE / LOTREL / V TABLET / clindamycin phosphate / EFFEXOR / granisetron / mirtazapine / WELLBUTRIN SR / AVINZA / ZESTORETIC / EMEND / CARBATROL / SPORANOX / valsartan / TAZORAC / irbesartan / primidone / ULTRAM / BENZAMYCIN PAK / FIORINAL / PHENYTEK / MYSOLINE / COGNEX / clotrimazole / DESYREL / CLEOCIN / ARIXTRA / ZONEGRAN / LOTENSIN / FIORICET / ULTRAM ER / carbamazepine / MYCELEX / ZOLOFT / CESAMET / ACTIQ / TARKA / PROZAC / RAZADYNE / VASOTEC / CELONTIN / RETIN-A / TOPAMAX / TEVETEN / EXFORGE / ANDRODERM / divalproex / ACZONE / EXELDERM / VICODIN / MARINOL / ATACAND / fluconazole / MONOPRIL / LUVOX CR / dapsone / PAXIL CR / AVAPRO / WELLBUTRIN / ORAMORPH SR / LORTAB / sodium sulfacetamide / EMSAM / naloxone / AZELEX / MYCOSTATIN / DIOVAN / MS CONTIN / CAPOZIDE / OPANA ER / LEXXEL / ramipril / COMBUNOX / TEGRETOL / ZYDONE / ACCUPRIL / DIASTAT / EQUETRO / LEXAPRO / COZAAR / NOXAFIL / PERCODAN / xylocaine / ACCURETIC / FELBATOL / ULTRACET / ZIANA / PRISTIQ / INNOHEP / testosterone / BENICAR / NAMENDA / butalbital / valproic acid / griseofulvin / UNIRETIC / donepezil / ARICEPT ODT / nystatin / ketoconazole / oxcarbazepine / LYRICA / DIFFERIN / SYNERA / GRIFULVIN / TRILEPTAL / felodipine / MICARDIS / LAMISIL / TEKTURNA / OXYCONTIN / hydrocortisone / FLECTOR / ZARONTIN / TALACEN / DEPAKOTE / EPITOL / ondansetron / AVALIDE / DILAUDID / unless / / Region WEST VIRGINIA / / Technology chemotherapy / / URL http / SocialTag 
BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC PREFERRED AGENTS