drug tier list 2019 stromectol

0000015992 00000 n @�X��(�9i���l��"�d�Vh%��}����qa3*9����ˀ�B�f�d+��8%�f�s2�Q1�K�R��&�tb��v�G�:]�� ܇�*:gTL�VjIok�i�8�M �Po% hQ�x#�zB�멋+�5�]����! Members are encouraged to show this list to their physicians and pharmacists. This Prescription Drug List (PDL) is accurate as of July 2018 and is … 0000027342 00000 n 0 Your prescription benefit comes with a drug list, which is also called a formulary. 5229 0 obj <>/Filter/FlateDecode/ID[<54B28578CFBA47C1B0A32CC431DF127E><46FA1EE0D5E3FA409B8CEFA70FFB099A>]/Index[5211 31]/Info 5210 0 R/Length 90/Prev 641117/Root 5212 0 R/Size 5242/Type/XRef/W[1 2 1]>>stream Includes. Tier 1: Preferred generic. 0000003879 00000 n trailer <<9BA0E86AC5F0421D8EFE03949A3148E1>]/Prev 523511/XRefStm 1740>> startxref 0 %%EOF 7905 0 obj <>stream endstream endobj 5212 0 obj <>/Metadata 174 0 R/Outlines 245 0 R/Pages 5202 0 R/StructTreeRoot 246 0 R/Type/Catalog/ViewerPreferences<>>> endobj 5213 0 obj <>/Font<>/ProcSet[/PDF/Text]>>/Rotate 0/StructParents 2/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 5214 0 obj <>stream This is a list of preferred drugs which includes brand drugs and a partial listing of generic drugs. The enclosed comprehensive drug list is up to date as of 8/1/2020. This list is made up of brand-name and generic prescription drugs approved by the U.S. Food & Drug … 2019 Tiered Prescription Drug List (PDL) ... $$$ Tier 3 Brand drugs that don't have a generic available. This PDL applies to members of our UnitedHealthcare, Neighborhood Health Plan, River Valley, All Savers and Oxford medical plans Blue Cross and Blue Shield October 2019 Multi-Tier Basic Drug List I Introduction Blue Cross and Blue Shield is pleased to present the 2019 Drug List. 0000007175 00000 n h�b```�E���B ��ea�(h`� ���F���F��9��;!W��F �+"/Y��Xx�2�qX�Al�^���LDxݙ]�H0[ó�ic�B���7K����'� [�j�* ��:s�ԙm�! 0000016523 00000 n 0000001740 00000 n �N��*@BDHp���]���(� h�bbd``b`+��* �f$�K@� �|���"����. 0000002201 00000 n The drug list may change from time to time as described in the plan document or other plan materials. 5211 0 obj <> endobj %PDF-1.4 %���� 0000012347 00000 n 0000006254 00000 n 0000008143 00000 n 0000002033 00000 n 5241 0 obj <>stream endstream endobj startxref �㖟� ��HaxEDB(�����Cy�U� �"��"g�� �v� ��q�{�$q����8~$�Dq��/�0q�8��O �3 �pp�pda�x�0c& 3 TIER 1 $ TIER 2 $$ INFECTIONS acyclovir adefovir** amoxicillin amoxicillin ER ... Stromectol Tamiflu (QL) Thalomid** (PA) Uretron D-S Vibramycin Medications are grouped by ... tier. 0000026979 00000 n ?�:��B�i�m T�~E`\'&���������4܋�2Q��DA����@�!z���JeEci��Ϊz�t�ꩤ�7�����P�����i�|�ei�b1�txӾ�Yki�9�j��?�9�y����Ϳ�5��Tü�e^��&�}~��F����6�CI�Q��K7mg�l�lE�:�f�l>����L��o��;_jf� �T�iF3[��EU���WtL'tN]р�diDc�PNM���fTSC-�i�^X��^�%ٸa@GU���W7��*�c����7x�M�b���γ�xSW�ą۷���*�O�U^X.4�)޹�β��������xo8��UU�{��mm����3ڲ�C7r�3KI�mV�^9.���o��P���e[~�:��UM��FI|[46�ͲH��w/��M�U(��2^lt�u6*�w5�j9&L�E���1���$��6b|?�v�|N2����������_��+_F��(�R��9ґ�=��yE1h uG2E��",t~�ڑ�1D���Mc5����Q��v��rN���9�(HM&�_Mp��4�0eaG���l�)l��Ml�ZSd̈́~ں"�C���vR[���ט��R�ߐ[�ʼ��4{�y��C:�D�'��P�#�� ��>]�{�@�(ky>���|�E��з)��5��Z�O�>�Z�_�u�W�{����7D6[��nD��@KN��� � Α�ִ�U��=�����;dê���(�l(ޤ(^�튏���RZo*Y��/� 0000024448 00000 n changes that will be effective 01/01/2019. 0000010237 00000 n ... DRUG TIER 30-Day Supply 90-Day Supply Tier 0 $0.00 $0.00 Tier 1 $0.00 $0.00 Tier 2 $20.00 $55.00 0000003651 00000 n 0000011328 00000 n 0000017168 00000 n 0000005182 00000 n 0000000896 00000 n �P:Ds� T^�����A&2Z40)��u I3 �(�&�2�1A$��l @2�I��ô�)���� 4H �,8��0�2}�t 7876 0 obj <> endobj xref 7876 30 0000000016 00000 n Most generic drugs are followed by a reference brand drug in (parentheses). Most generic drugs. 0000004545 00000 n SourceRx 1.0 Six Tier Prescription Drug List, October 2019 I Introduction The attached SourceRx 1.0 Six Tier Prescription Drug List shows covered drugs for a broad range of diseases. A drug list, or formulary, is a list of prescription drugs covered by your plan. 0000018138 00000 n �+��|��L�H'�$M��FU��� ����qv`�``�R���8��AF q� �ׁ�0���r����o XԹ The next anticipated update will be Jan. 1, 2020. ... For the most recent list of drugs requiring prior authorization, You can purchase some drugs in these categories at a discount through participating pharmacies. Stromectol Tamiflu (QL) Thalomid** (PA) Uretron D-S Vibramycin Medications are grouped by ... Drug List as of March 1, 2019.1 All of these medications are approved by the U.S. Food and Drug Administration ... Cigna Value 4-Tier Prescription Drug List TIER 1 $ TIER 2 $$ TIER 3 $$$ BLOOD THINNERS/ANTI-CLOTTING aspirin-dipyridamole ER Tier 2:. 0000002626 00000 n Last Updated: December 1, 2019 SG-DMHC Select 4 Tier Drug List.

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