Please consult your Benefit Booklet under Preventive Services or call Member Service if you have questions about your coverage for these drugs.
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- Job Jayson Clarke
- 6 years ago
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1 ACA Drug List Preventative Medications and Preferred Contraceptives In accordance with the Affordable Care Act (ACA) requirements for preventive services, most plans cover preventative care medicines and contraceptives in full. If your plan offers ACA benefits, all prescribed FDA approved contraceptive methods from the Kaiser Permanente formulary list will be covered in full when obtained in-network. For plans with out-of-network (OON) benefits, contraceptives will be subject to the OON cost-share. Please consult your Benefit Booklet under Preventive Services or call Member Service if you have questions about your coverage for these drugs. If you request coverage for a non-preferred contraceptive, we will contact your provider to recommend a preferred generic or therapeutically equivalent product. If you and your provider determine that the preferred contraceptive(s) would be medically inappropriate, your provider must request a contraceptive waiver. If waiver is completed, the requested non-preferred contraceptive will be covered in full. Below is the list of the preventative medications covered in full. Applies to: All Non-Medicare, non-grandfathered Kaiser Permanente plans CONTRACEPTIVES AFTERA ALTAVERA ALYACEN 1/35 ALYACEN 7/7/7 AMETHIA AMETHIA LO AMETHYST APRI ARANELLE ASHLYNA AUBRA AVIANE AZURETTE BALZIVA BEKYREE LEVONORGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG NORETHINDRONE & ETHINYL ESTRADIOL TAB 1 MG-35 MCG NORETHINDRONE-ETH ESTRADIOL TAB / /1-35 MG-MCG LEVONORG-ETH EST TAB MG(84) & ETH EST TAB 0.01MG(7) LEVONORG-ETH EST TAB MG(84) & ETH EST TAB 0.01MG(7) LEVONORGESTREL-ETHINYL ESTRADIOL (CONTINUOUS) TAB MCG DESOGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG NORETHINDRONE-ETH ESTRADIOL TAB /1-35/ MG-MCG LEVONORG-ETH EST TAB MG(84) & ETH EST TAB 0.01MG(7) DESOGEST-ETH ESTRAD & ETH ESTRAD TAB /0.01 MG(21/5) NORETHINDRONE & ETHINYL ESTRADIOL TAB 0.4 MG-35 MCG DESOGEST-ETH ESTRAD & ETH ESTRAD TAB /0.01 MG(21/5) BLISOVI 24 FE NORETHINDRONE ACE-ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG (24) BLISOVI FE 1.5/30 BLISOVI FE 1/20 BRIELLYN NORETHINDRONE ACE & ETHINYL ESTRADIOL-FE TAB 1.5 MG-30 MCG NORETHINDRONE ACE & ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG NORETHINDRONE & ETHINYL ESTRADIOL TAB 0.4 MG-35 MCG
2 CONTRACEPTIVES CAMILA CAMRESE LEVONORG-ETH EST TAB MG(84) & ETH EST TAB 0.01MG(7) CAMRESE LO LEVONORG-ETH EST TAB MG(84) & ETH EST TAB 0.01MG(7) CAYA *DIAPHRAGM ARC-SPRING*** CAZIANT DESOGEST-ETHIN EST TAB / / MG-MG CESIA DESOGEST-ETHIN EST TAB / / MG-MG CHATEAL LEVONORGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG CRYSELLE-28 NORGESTREL & ETHINYL ESTRADIOL TAB 0.3 MG-30 MCG CYCLAFEM 1/35 NORETHINDRONE & ETHINYL ESTRADIOL TAB 1 MG-35 MCG CYCLAFEM 7/7/7 NORETHINDRONE-ETH ESTRADIOL TAB / /1-35 MG-MCG CYRED DESOGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG DASETTA 1/35 NORETHINDRONE & ETHINYL ESTRADIOL TAB 1 MG-35 MCG DASETTA 7/7/7 NORETHINDRONE-ETH ESTRADIOL TAB / /1-35 MG-MCG DAYSEE LEVONORG-ETH EST TAB MG(84) & ETH EST TAB 0.01MG(7) DEBLITANE DEPO-SQ PROV INJ 104 MEDROXYPROGESTERONE ACETATE SUSP PREF SYR 104 MG/0.65ML DESOGESTREL/ETHINYL ESTRADIOL DESOGEST-ETH ESTRAD & ETH ESTRAD TAB /0.01 MG(21/5) DESOGESTREL/ETHINYL ESTRADIOL DESOGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG DROSPIRENONE/ETHINYL ESTRADIOL DROSPIRENONE-ETHINYL ESTRADIOL TAB MG DROSPIRENONE/ETHINYL ESTRADIOL DROSPIRENONE-ETHINYL ESTRADIOL TAB MG ECONTRA EZ ELINEST NORGESTREL & ETHINYL ESTRADIOL TAB 0.3 MG-30 MCG ELLA ULIPRISTAL ACETATE TAB 30 MG EMOQUETTE DESOGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG ENCARE NONOXYNOL-9 VAGINAL SUPPOS 100 MG ENPRESSE-28 LEVONORGESTREL-ETH ESTRA TAB / / MG-MCG ENSKYCE DESOGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG ERRIN ESTARYLLA NORGESTIMATE & ETHINYL ESTRADIOL TAB 0.25 MG-35 MCG FALLBACK SOLO FALMINA FAYOSIM TAB LEVONOR-ETH EST TAB /0.025/0.03 MG Ð EST 0.01 MG FC FEMALE CONDOM *CONDOMS - FEMALE*** FC2 FEMALE CONDOM *CONDOMS - FEMALE*** FEMCAP CERVICAL CAP 22 MM FEMCAP CERVICAL CAP 26 MM FEMCAP CERVICAL CAP 30 MM GIANVI DROSPIRENONE-ETHINYL ESTRADIOL TAB MG GILDAGIA NORETHINDRONE & ETHINYL ESTRADIOL TAB 0.4 MG-35 MCG
3 CONTRACEPTIVES GILDESS 1.5/30 GILDESS 1/20 NORETHINDRONE ACE & ETHINYL ESTRADIOL TAB 1.5 MG-30 MCG NORETHINDRONE ACE & ETHINYL ESTRADIOL TAB 1 MG-20 MCG GILDESS 24 FE NORETHINDRONE ACE-ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG (24) GILDESS FE 1.5/30 GILDESS FE 1/20 HEATHER INTROVALE NORETHINDRONE ACE & ETHINYL ESTRADIOL-FE TAB 1.5 MG-30 MCG NORETHINDRONE ACE & ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG LEVONORGESTREL & ETHINYL ESTRADIOL (91-DAY) TAB MG ISIBLOOM TAB DESOGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG JENCYCLA JOLESSA JOLIVETTE JULEBER JUNEL 1.5/30 JUNEL 1/20 JUNEL FE 1.5/30 JUNEL FE 1/20 LEVONORGESTREL & ETHINYL ESTRADIOL (91-DAY) TAB MG DESOGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG NORETHINDRONE ACE & ETHINYL ESTRADIOL TAB 1.5 MG-30 MCG NORETHINDRONE ACE & ETHINYL ESTRADIOL TAB 1 MG-20 MCG NORETHINDRONE ACE & ETHINYL ESTRADIOL-FE TAB 1.5 MG-30 MCG NORETHINDRONE ACE & ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG JUNEL FE 24 NORETHINDRONE ACE-ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG (24) KAITLIB FE KARIVA KELNOR 1/35 KIMIDESS KURVELO KYLEENA LARIN 1.5/30 LARIN 1/20 NORETHINDRONE & ETHINYL ESTRADIOL-FE CHEW TAB 0.8 MG-25 MCG DESOGEST-ETH ESTRAD & ETH ESTRAD TAB /0.01 MG(21/5) ETHYNODIOL DIACETATE & ETHINYL ESTRADIOL TAB 1 MG-35 MCG DESOGEST-ETH ESTRAD & ETH ESTRAD TAB /0.01 MG(21/5) LEVONORGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG PROGESTIN CONTRACEPTIVES - IUD** NORETHINDRONE ACE & ETHINYL ESTRADIOL TAB 1.5 MG-30 MCG NORETHINDRONE ACE & ETHINYL ESTRADIOL TAB 1 MG-20 MCG LARIN 24 FE NORETHINDRONE ACE-ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG (24) LARIN FE 1.5/30 LARIN FE 1/20 LAYOLIS FE LEENA LESSINA LEVONEST LEVONORGESTREL LEVONORGESTREL AND ETHINYL ESTRADIOL LEVONORGESTREL AND ETHINYL ESTRADIOL LEVONORGESTREL/ETHINYL ESTRADIOL LEVONORGESTREL/ETHINYL ESTRADIOL NORETHINDRONE ACE & ETHINYL ESTRADIOL-FE TAB 1.5 MG-30 MCG NORETHINDRONE ACE & ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG NORETHINDRONE & ETHINYL ESTRADIOL-FE CHEW TAB 0.8 MG-25 MCG NORETHINDRONE-ETH ESTRADIOL TAB /1-35/ MG-MCG LEVONORGESTREL-ETH ESTRA TAB / / MG-MCG LEVONORG-ETH EST TAB MG(84) & ETH EST TAB 0.01MG(7) LEVONORGESTREL-ETHINYL ESTRADIOL (CONTINUOUS) TAB MCG LEVONORGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG LEVONORGESTREL & ETHINYL ESTRADIOL (91-DAY) TAB MG
4 CONTRACEPTIVES LEVONORGESTREL/ETHINYL ESTRADIOL LEVONORGESTREL/ETHINYL ESTRADIOL LEVONORGESTREL/ETHINYL ESTRADIOL LEVONORGESTREL/ETHINYL ESTRADIOL LEVORA 0.15/30-28 LILETTA LEVONORG-ETH EST TAB MG(84) & ETH EST TAB 0.01MG(7) LEVONORGESTREL-ETH ESTRA TAB / / MG-MCG LEVONORGESTREL-ETHINYL ESTRADIOL TAB MCG LEVONORGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG LEVONORGESTREL RELEASING IUD 18.6 MCG/DAY (52 MG TOTAL) LO LOESTRIN TAB NORETHIN-ETH ESTRADIOL-FE TAB 1 MG-10 MCG (24)/10 MCG (2) LOMEDIA 24 FE NORETHINDRONE ACE-ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG (24) LORYNA LOW-OGESTREL LUTERA LYZA MARLISSA MEDROXYPROGESTERONE ACETATE DROSPIRENONE-ETHINYL ESTRADIOL TAB MG NORGESTREL & ETHINYL ESTRADIOL TAB 0.3 MG-30 MCG LEVONORGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG MEDROXYPROGESTERONE ACETATE IM SUSP 150 MG/ML MIBELAS 24 CHW FE NORETHINDRONE ACE-ETH ESTRADIOL-FE CHEW TAB 1 MG-20 MCG (24) MICROGESTIN 1.5/30 MICROGESTIN 1/20 NORETHINDRONE ACE & ETHINYL ESTRADIOL TAB 1.5 MG-30 MCG NORETHINDRONE ACE & ETHINYL ESTRADIOL TAB 1 MG-20 MCG MICROGESTIN 24 FE NORETHINDRONE ACE-ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG (24) MICROGESTIN FE MICROGESTIN FE 1.5/30 MIRENA MONO-LINYAH MONONESSA MY WAY MYZILRA NATAZIA NECON 0.5/35-28 NECON 1/35 NECON 1/50-28 NORETHINDRONE ACE & ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG NORETHINDRONE ACE & ETHINYL ESTRADIOL-FE TAB 1.5 MG-30 MCG LEVONORGESTREL RELEASING IUD 20 MCG/DAY (52 MG TOTAL) NORGESTIMATE & ETHINYL ESTRADIOL TAB 0.25 MG-35 MCG NORGESTIMATE & ETHINYL ESTRADIOL TAB 0.25 MG-35 MCG LEVONORGESTREL-ETH ESTRA TAB / / MG-MCG ESTRADIOL VALERATE-DIENOGEST TAB 3 MG /2-2 MG/2-3 MG/1 MG NORETHINDRONE & ETHINYL ESTRADIOL TAB 0.5 MG-35 MCG NORETHINDRONE & ETHINYL ESTRADIOL TAB 1 MG-35 MCG NORETHINDRONE & MESTRANOL TAB 1 MG-50 MCG NECON 10/11-28 NORETHINDRONE-ETH ESTRADIOL TAB /1-35 MG-MCG (10/11) NECON 7/7/7 NORETHINDRONE-ETH ESTRADIOL TAB / /1-35 MG-MCG NEXPLANON IMP 68MG ETONOGESTREL SUBDERMAL IMPLANT 68 MG NEXT CHOICE ONE DOSE NIKKI NORA-BE NORETHINDRONE NORETHINDRONE & ETHINYL ESTRADIOL FERROUS FUMARATE NORETHINDRONE ACETATE/ETHINYL DROSPIRENONE-ETHINYL ESTRADIOL TAB MG NORETHINDRONE & ETHINYL ESTRADIOL-FE CHEW TAB 0.8 MG-25 MCG NORETHINDRONE ACE & ETHINYL ESTRADIOL TAB 1 MG-20 MCG
5 CONTRACEPTIVES ESTRADIOL NORETHINDRONE ACETATE/ETHINYL ESTRADIOL/FERROUS FUMARATE NORETHINDRONE ACE & ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG NORETHINDRONE ACETATE/ETHINYL ESTRADIOL/FERROUS FUMARATE NORETHINDRONE ACE-ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG (24) NORGESTIMATE/ETHINYL ESTRADIOL NORGESTIMATE/ETHINYL ESTRADIOL NORGESTIMATE/ETHINYL ESTRADIOL NORINYL 1+50 NORGESTIMATE-ETH ESTRAD TAB / / MG-MCG NORGESTIMATE & ETHINYL ESTRADIOL TAB 0.25 MG-35 MCG NORGESTIMATE-ETH ESTRAD TAB / / MG-MCG NORETHINDRONE & MESTRANOL TAB 1 MG-50 MCG NORLYDA TAB 0.35MG NORTREL 0.5/35 (28) NORTREL 1/35 NORTREL 7/7/7 NUVARING OCELLA OGESTREL OMNIFLEX DIAPHRAGM OPCICON ONE-STEP NORETHINDRONE & ETHINYL ESTRADIOL TAB 0.5 MG-35 MCG NORETHINDRONE & ETHINYL ESTRADIOL TAB 1 MG-35 MCG NORETHINDRONE-ETH ESTRADIOL TAB / /1-35 MG-MCG ETONOGESTREL-ETHINYL ESTRADIOL VA RING MG/24HR DROSPIRENONE-ETHINYL ESTRADIOL TAB MG NORGESTREL & ETHINYL ESTRADIOL TAB 0.5 MG-50 MCG *DIAPHRAGMS*** OPTIONS CONCEPTROL VAGINAL CONTRACEPTIVE NONOXYNOL-9 GEL 4% OPTIONS GYNOL II VAGINAL CONTRACEPTIVE NONOXYNOL-9 GEL 3% OPTION 2 ORSYTHIA PARAGARD INTRAUTERINE COPPER CONTRACEPTIVE T380A PHILITH PIMTREA PIRMELLA 1/35 PIRMELLA 7/7/7 PLAN B ONE-STEP PORTIA-28 PRENTIF CAVITY-RIM CERVICAL CAP PRENTIF CAVITY-RIM CERVICAL CAP PRENTIF CAVITY-RIM CERVICAL CAP PRENTIF CAVITY-RIM CERVICAL CAP PREVIFEM QUASENSE RECLIPSEN *COPPER IUD** NORETHINDRONE & ETHINYL ESTRADIOL TAB 0.4 MG-35 MCG DESOGEST-ETH ESTRAD & ETH ESTRAD TAB /0.01 MG(21/5) NORETHINDRONE & ETHINYL ESTRADIOL TAB 1 MG-35 MCG NORETHINDRONE-ETH ESTRADIOL TAB / /1-35 MG-MCG LEVONORGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG CERVICAL CAP 22 MM CERVICAL CAP 25 MM CERVICAL CAP 28 MM CERVICAL CAP 31 MM NORGESTIMATE & ETHINYL ESTRADIOL TAB 0.25 MG-35 MCG LEVONORGESTREL & ETHINYL ESTRADIOL (91-DAY) TAB MG DESOGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG RIVELSA TAB LEVONOR-ETH EST TAB /0.025/0.03 MG Ð EST 0.01 MG
6 CONTRACEPTIVES SAFYRAL TAB DROSPIRENONE-ETHINYL ESTRAD-LEVOMEFOLATE TAB MG SETLAKIN LEVONORGESTREL & ETHINYL ESTRADIOL (91-DAY) TAB MG SHAROBEL SHUR-SEAL NONOXYNOL-9 GEL 2% SKYLA LEVONORGESTREL RELEASING IUD 14 MCG/DAY (13.5 MG TOTAL) SOLIA DESOGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG SPRINTEC 28 NORGESTIMATE & ETHINYL ESTRADIOL TAB 0.25 MG-35 MCG SRONYX SYEDA DROSPIRENONE-ETHINYL ESTRADIOL TAB MG TAKE ACTION TARINA FE 1/20 NORETHINDRONE ACE & ETHINYL ESTRADIOL-FE TAB 1 MG-20 MCG TAYTULLA CAP NORETHINDRONE ACE-ETHINYL ESTRADIOL-FE CAP 1 MG-20 MCG (24) TILIA FE NORETHINDRONE AC-ETHINYL ESTRAD-FE TAB 1-20/1-30/1-35 MG-MCG TODAY SPONGE NONOXYNOL-9 VAGINAL SPONGE 1000 MG TRI-ESTARYLLA NORGESTIMATE-ETH ESTRAD TAB / / MG-MCG TRI FEMYNOR TAB NORGESTIMATE-ETH ESTRAD TAB / / MG-MCG TRI-LEGEST FE NORETHINDRONE AC-ETHINYL ESTRAD-FE TAB 1-20/1-30/1-35 MG-MCG TRI-LINYAH NORGESTIMATE-ETH ESTRAD TAB / / MG-MCG TRI-LO-ESTARYLLA NORGESTIMATE-ETH ESTRAD TAB / / MG-MCG TRI-LO-MARZIA NORGESTIMATE-ETH ESTRAD TAB / / MG-MCG TRI-LO-SPRINTEC NORGESTIMATE-ETH ESTRAD TAB / / MG-MCG TRINESSA NORGESTIMATE-ETH ESTRAD TAB / / MG-MCG TRINESSA LO NORGESTIMATE-ETH ESTRAD TAB / / MG-MCG TRI-PREVIFEM NORGESTIMATE-ETH ESTRAD TAB / / MG-MCG TRI-SPRINTEC NORGESTIMATE-ETH ESTRAD TAB / / MG-MCG TRIVORA-28 LEVONORGESTREL-ETH ESTRA TAB / / MG-MCG VCF VAGINAL CONTRACEPTIVE FOAM NONOXYNOL-9 FOAM 12.5% VELIVET DESOGEST-ETHIN EST TAB / / MG-MG VESTURA DROSPIRENONE-ETHINYL ESTRADIOL TAB MG VIENVA VIORELE DESOGEST-ETH ESTRAD & ETH ESTRAD TAB /0.01 MG(21/5) VYFEMLA NORETHINDRONE & ETHINYL ESTRADIOL TAB 0.4 MG-35 MCG WERA NORETHINDRONE & ETHINYL ESTRADIOL TAB 0.5 MG-35 MCG WIDE-SEAL SILICONE DIAPHRAGM KIT 60 DIAPHRAGM WIDE SEAL 60 MM WIDE-SEAL SILICONE DIAPHRAGM KIT 65 DIAPHRAGM WIDE SEAL 65 MM WIDE-SEAL SILICONE DIAPHRAGM KIT 70 DIAPHRAGM WIDE SEAL 70 MM WIDE-SEAL SILICONE DIAPHRAGM KIT 75 DIAPHRAGM WIDE SEAL 75 MM WIDE-SEAL SILICONE DIAPHRAGM KIT 80 DIAPHRAGM WIDE SEAL 80 MM WIDE-SEAL SILICONE DIAPHRAGM KIT 85 DIAPHRAGM WIDE SEAL 85 MM
7 CONTRACEPTIVES WIDE-SEAL SILICONE DIAPHRAGM KIT 90 WIDE-SEAL SILICONE DIAPHRAGM KIT 95 WYMZYA FE XULANE ZARAH ZENCHENT ZENCHENT FE ZOVIA 1/35E ZOVIA 1/50E AFTERA ALTAVERA ALYACEN 1/35 ALYACEN 7/7/7 AMETHIA DIAPHRAGM WIDE SEAL 90 MM DIAPHRAGM WIDE SEAL 95 MM NORETHINDRONE & ETHINYL ESTRADIOL-FE CHEW TAB 0.4 MG-35 MCG NORELGESTROMIN-ETHINYL ESTRADIOL TD PTWK MCG/24HR DROSPIRENONE-ETHINYL ESTRADIOL TAB MG NORETHINDRONE & ETHINYL ESTRADIOL TAB 0.4 MG-35 MCG NORETHINDRONE & ETHINYL ESTRADIOL-FE CHEW TAB 0.4 MG-35 MCG ETHYNODIOL DIACETATE & ETHINYL ESTRADIOL TAB 1 MG-35 MCG ETHYNODIOL DIACETATE & ETHINYL ESTRADIOL TAB 1 MG-50 MCG LEVONORGESTREL & ETHINYL ESTRADIOL TAB 0.15 MG-30 MCG NORETHINDRONE & ETHINYL ESTRADIOL TAB 1 MG-35 MCG NORETHINDRONE-ETH ESTRADIOL TAB / /1-35 MG-MCG LEVONORG-ETH EST TAB MG(84) & ETH EST TAB 0.01MG(7) FLUORIDE PRODUCTS FLUOR-A-DAY FLUORIDE FLUORIDE FLUORIDE FLUORITAB FLUORITAB FLUORITAB FLUORITAB FLURA-DROPS FLURA-DROPS KARIDIUM LOZI-FLUR LUDENT LUDENT LUDENT NAFRINSE NAFRINSE DROPS SODIUM FLUORIDE SOLN MG/DROP F (0.275 MG/DROP NAF) SODIUM FLUORIDE CHEW TAB 0.25 MG F (FROM 0.55 MG NAF) SODIUM FLUORIDE CHEW TAB 0.5 MG F (FROM 1.1 MG NAF) SODIUM FLUORIDE CHEW TAB 1 MG F (FROM 2.2 MG NAF) SODIUM FLUORIDE CHEW TAB 1 MG F (FROM 2.2 MG NAF) SODIUM FLUORIDE CHEW TAB 0.5 MG F (FROM 1.1 MG NAF) SODIUM FLUORIDE CHEW TAB 0.25 MG F (FROM 0.55 MG NAF) SODIUM FLUORIDE SOLN MG/DROP F (0.275 MG/DROP NAF) SODIUM FLUORIDE SOLN 0.25 MG/DROP F (FROM 0.55 MG/DROP NAF) SODIUM FLUORIDE SOLN MG/DROP F (0.275 MG/DROP NAF) SODIUM FLUORIDE SOLN MG/DROP F (0.275 MG/DROP NAF) SODIUM FLUORIDE LOZENGE 1 MG F (FROM 2.2 MG NAF) SODIUM FLUORIDE CHEW TAB 0.25 MG F (FROM 0.55 MG NAF) SODIUM FLUORIDE CHEW TAB 0.5 MG F (FROM 1.1 MG NAF) SODIUM FLUORIDE CHEW TAB 1 MG F (FROM 2.2 MG NAF) SODIUM FLUORIDE CHEW TAB 1 MG F (FROM 2.2 MG NAF) SODIUM FLUORIDE SOLN MG/DROP F (0.275 MG/DROP NAF) SODIUM FLUORIDE SODIUM FLUORIDE SODIUM FLUORIDE SODIUM FLUORIDE SODIUM FLUORIDE SODIUM FLUORIDE TAB 0.5 MG F (FROM 1.1 MG NAF) SODIUM FLUORIDE SOLN 0.5 MG/ML F (FROM 1.1 MG/ML NAF) SODIUM FLUORIDE CHEW TAB 0.25 MG F (FROM 0.55 MG NAF) SODIUM FLUORIDE CHEW TAB 0.5 MG F (FROM 1.1 MG NAF) SODIUM FLUORIDE CHEW TAB 1 MG F (FROM 2.2 MG NAF)
8 BREAST CANCER PREVENTION TAMOXIFEN CITRATE TAMOXIFEN CITRATE TAMOXIFEN CITRATE TAB 20 MG (BASE EQUIVALENT) TAMOXIFEN CITRATE TAB 10 MG (BASE EQUIVALENT) TOBACCO CESSATION BUPROBAN BUPROPION HCL (SMOKING DETERRENT) TAB SR 12HR 150 MG BUPROPION HCL SR CHANTIX CHANTIX CHANTIX CONTINUING MONTH PAK CHANTIX STARTING MONTH PAK COMMIT COMMIT GOODSENSE NICOTINE GUM NICODERM CQ NICODERM CQ NICODERM CQ NICORELIEF NICORELIEF NICORETTE NICORETTE NICORETTE NICORETTE NICORETTE MINI NICORETTE MINI NICORETTE STARTER KIT NICORETTE STARTER KIT NICOTINE NICOTINE NICOTINE NICOTINE NICOTINE NICOTINE NICOTINE NICOTINE MINI LOZENGE NICOTINE POLACRILEX NICOTINE POLACRILEX BUPROPION HCL (SMOKING DETERRENT) TAB SR 12HR 150 MG VARENICLINE TARTRATE TAB 0.5 MG (BASE EQUIV) VARENICLINE TARTRATE TAB 1 MG (BASE EQUIV) VARENICLINE TARTRATE TAB 1 MG (BASE EQUIV) VARENICLINE TARTRATE TAB 0.5 MG X 11 & TAB 1 MG X 42 PACK NICOTINE POLACRILEX LOZENGE 2 MG NICOTINE POLACRILEX LOZENGE 4 MG NICOTINE TD PATCH 24HR 21 MG/24HR NICOTINE TD PATCH 24HR 14 MG/24HR NICOTINE TD PATCH 24HR 7 MG/24HR NICOTINE POLACRILEX GUM 2 MG NICOTINE POLACRILEX GUM 2 MG NICOTINE POLACRILEX LOZENGE 2 MG NICOTINE POLACRILEX LOZENGE 4 MG NICOTINE POLACRILEX LOZENGE 2 MG NICOTINE POLACRILEX LOZENGE 4 MG NICOTINE POLACRILEX GUM 2 MG NICOTINE TD PATCH 24HR 21 MG/24HR NICOTINE TD PATCH 24HR 7 MG/24HR NICOTINE TD PATCH 24HR 14 MG/24HR NICOTINE POLACRILEX LOZENGE 2 MG NICOTINE POLACRILEX LOZENGE 4 MG NICOTINE POLACRILEX GUM 2 MG NICOTINE POLACRILEX LOZENGE 4 MG NICOTINE POLACRILEX GUM 2 MG NICOTINE POLACRILEX LOZENGE 2 MG
9 TOBACCO CESSATION NICOTINE POLACRILEX NICOTINE POLACRILEX NICOTINE POLACRILEX REFILL NICOTINE POLACRILEX REFILL NICOTINE POLACRILEX STARTER KIT NICOTINE POLACRILEX STARTER KIT NICOTINE STEP 1 NICOTINE STEP 2 NICOTINE STEP 3 NICOTINE TRANSDERMAL SYSTEM NICOTINE TRANSDERMAL SYSTEM NICOTINE TRANSDERMAL SYSTEM NICOTINE TRANSDERMAL SYSTEM NICOTINE TRANSDERMAL SYSTEM STEP 2 NICOTROL INHALER NICOTROL NS THRIVE THRIVE NICOTINE POLACRILEX LOZENGE 4 MG NICOTINE POLACRILEX GUM 2 MG NICOTINE POLACRILEX GUM 2 MG NICOTINE TD PATCH 24HR 21 MG/24HR NICOTINE TD PATCH 24HR 14 MG/24HR NICOTINE TD PATCH 24HR 7 MG/24HR NICOTINE TD PATCH 24HR 7 MG/24HR NICOTINE TD PATCH 24HR 14 MG/24HR NICOTINE TD PATCH 24HR 21 MG/24HR NICOTINE TD PATCH 24 HR KIT MG/24HR NICOTINE TD PATCH 24HR 14 MG/24HR NICOTINE INHALER SYSTEM 10 MG (4 MG DELIVERED) NICOTINE NASAL SPRAY 10 MG/ML (0.5 MG/SPRAY) NICOTINE POLACRILEX GUM 2 MG FOLIC ACID PRODUCTS CLASSIC PRENATAL ENFAMIL EXPECTA FOLIC ACID FOLIC ACID FOLIC ACID FOLIC ACID GOODSENSE PRENATAL VITAMINS HEALTHY MAMA BE WELL ROUNDED MISSION PRENATAL MISSION PRENATAL HP MULTI PRENATAL ONE A DAY WOMENS PRENATAL/DHA ONE A DAY WOMENS PRENATAL1 ONE-A-DAY WOMENS PRENATAL PA PRENATAL FORMULA PERRY PRENATAL PRENATAL PRENATAL *PRENATAL VIT W/ FE FUMARATE-FA TAB MG*** *PRENATAL W/FE FUM-FA TAB MG & DHA CAP 200 MG PACK* FOLIC ACID TAB 1 MG FOLIC ACID TAB 800 MCG FOLIC ACID TAB 400 MCG FOLIC ACID INJ 5 MG/ML *PRENATAL VIT W/ FE FUMARATE-FA TAB MG*** *PRENAT W/FEBISGLY-FA TAB MG & OMEGA 3 CAP DR 450 MG* *PRENATAL VIT W/ FE GLUCONATE-FA TAB MG*** *PRENATAL VIT W/ FE GLUCONATE-FA TAB MG*** *PRENATAL VIT W/ FE FUMARATE-FA TAB MG*** *PRENAT W/ FE FUM-FA TAB MG & OMEGA 3 CAP 223 MG PAK* *PRENATAL VIT W/ FE CARBONYL-FA-OMEGA 3 CAP MG*** *PRENAT W/ FE FUM-FA TAB MG & OMEGA 3 CAP 440 MG PAK* *PRENATAL VIT W/ SEL-FE FUMARATE-FA TAB MG*** *PRENATAL VIT W/ FE FUMARATE-FA CAP MG*** *PRENATAL VIT W/ FE FUMARATE-FA TAB MG*** *PRENATAL VIT W/ FE FUMARATE-FA TAB MG***
10 FOLIC ACID PRODUCTS PRENATAL PRENATAL AND IRON PRENATAL COMPLETE PRENATAL FORMULA PRENATAL FORMULA PRE-NATAL FORMULA PRENATAL FORTE PRENATAL LOW IRON PRENATAL MULTI + DHA PRENATAL MULTI +DHA PRENATAL MULTIVITAMIN + DHA PRENATAL ONE DAILY PRENATAL PLUS DHA PRENATAL VITAMIN PRENATAL VITAMINS PRENATAL VITAMINS PRENATAL/OMEGA-3/FOLIC ACID/IRON RIGHT STEP PRENATAL STUART ONE STUART PRENATAL YOUR LIFE MULTI PRENATAL *PRENATAL MULTIVITAMINS & MINERALS W/IRON & FA TAB 0.8 MG*** *PRENATAL MULTIVITAMINS & MINERALS W/IRON & FA TAB 0.8 MG*** *PRENATAL VIT W/ FE FUMARATE-FA TAB MG*** *PRENATAL VIT W/ FE FUMARATE-FA TAB MG*** *PRENATAL VIT W/ FE FUM-FA-OMEGA 3 CAP MG*** *PRENATAL MULTIVITAMINS & MINERALS W/IRON & FA TAB 0.8 MG*** *PRENATAL MULTIVITAMINS & MINERALS W/IRON & FA TAB 0.8 MG*** *PRENATAL VIT W/ FE FUMARATE-FA TAB MG*** *PRENATAL MV & MIN W/FE FUM-FA-DHA CAP MG*** *PRENATAL VIT W/ FE FUM-FA-OMEGA 3 CAP MG*** *PRENATAL W/FE FUM-FA TAB MG & DHA CAP 200 MG PACK* *PRENATAL VIT W/ FE FUMARATE-FA TAB MG*** *PRENATAL MV & MIN W/FE CARBONYL-FA-DHA TAB MG*** *PRENATAL VIT W/ FE FUMARATE-FA TAB MG*** *PRENATAL VIT W/ FE FUMARATE-FA TAB MG*** *PRENATAL MULTIVITAMINS & MINERALS W/IRON & FA TAB 0.8 MG*** *PRENATAL VIT W/ FE FUM-FA-FISH OIL CAP MG*** *PRENATAL VIT W/ FE FUMARATE-FA TAB MG*** *PRENATAL MV & MIN W/FE CARBONYL-FA-DHA CAP MG** *PRENATAL VIT W/ FE FUMARATE-FA TAB MG*** *PRENATAL VIT W/ FE FUM-FA-FISH OIL CAP MG*** IRON PRODUCTS ELITE IRON FERROUS BISGLYCINATE CHELATE TAB 15 MG (ELEMENTAL IRON) EQ SLOW-RELEASE IRON EQL IRON SUPPLEMENT THERAPY EQL IRON SUPPLEMENT THERAPY EQL SLOW RELEASE IRON FE ASPARTATE FE GLUCONATE FE TABS FEMIRON FERATE FERGON FER-IN-SOL FER-IRON FEROSUL FERRETTS FERROUS SULFATE DRIED TAB CR 45 MG (FE EQUIVALENT) FERROUS SULFATE DRIED TAB 200 MG (65 MG ELEMENTAL FE) FERROUS SULFATE TAB 325 MG (65 MG ELEMENTAL FE) FERROUS SULFATE DRIED TAB CR 160 MG (50 MG FE EQUIVALENT) FERROUS ASPARTATE TAB 112 MG (18 MG ELEMENTAL FE) FERROUS GLUCONATE TAB 325 MG (36 MG ELEMENTAL FE) FERROUS SULFATE TAB EC 325 MG (65 MG FE EQUIVALENT) FERROUS FUMARATE TAB 63 MG (20 MG ELEMENTAL FE) FERROUS GLUCONATE TAB 240 MG (27 MG ELEMENTAL FE) FERROUS GLUCONATE TAB 240 MG (27 MG ELEMENTAL FE) FERROUS SULFATE SOLN 75 MG/ML (15 MG/ML ELEMENTAL FE) FERROUS SULFATE SOLN 75 MG/ML (15 MG/ML ELEMENTAL FE) FERROUS SULFATE ELIXIR 220 MG/5ML (44 MG/5ML ELEMENTAL FE) FERROUS FUMARATE TAB 325 MG (106 MG ELEMENTAL FE)
11 IRON PRODUCTS FERRETTS IPS FERRIMIN 150 FERRO-BOB FERROCITE FERRO-SEQUELS FERROUS DROPS FERROUS FUMARATE FERROUS FUMARATE FERROUS FUMARATE 324 FERROUS GLUCONATE FERROUS GLUCONATE FERROUS GLUCONATE FERROUS GLUCONATE FERROUS GLUCONATE FERROUS SULFATE FERROUS SULFATE FERROUS SULFATE FERROUS SULFATE FERROUS SULFATE FERROUS SULFATE FERROUS SULFATE FERROUS SULFATE FERROUSUL HIGH POTENCY IRON IRON IRON IRON IRON IRON IRON SLOW RELEASE IRON SUPPLEMENT IRON SUPPLEMENT CHILDRENS MYKIDZ IRON 10 PROFERRIN ES SLOW FE SLOW IRON SLOW RELEASE IRON SLOW RELEASE IRON SLOW RELEASE IRON IRON SUCCINYL-PROTEIN COMPLEX SOLN 40MG/15ML (ELEMENT FE EQ) FERROUS FUMARATE TAB 150 MG (FE EQUIVALENT) FERROUS SULFATE TAB 325 MG (65 MG ELEMENTAL FE) FERROUS FUMARATE TAB 325 MG (106 MG ELEMENTAL FE) FERROUS FUMARATE TAB CR 50 MG (FE EQUIVALENT) FERROUS SULFATE SOLN 75 MG/ML (15 MG/ML ELEMENTAL FE) FERROUS FUMARATE TAB 90 MG (29.5 MG ELEMENTAL FE) FERROUS FUMARATE TAB 29 MG (FE EQUIVALENT) FERROUS FUMARATE TAB 325 MG (106 MG ELEMENTAL FE) FERROUS GLUCONATE TAB 324 MG (38 MG ELEMENTAL IRON) FERROUS GLUCONATE TAB 324 MG (37.5 MG ELEMENTAL IRON) FERROUS GLUCONATE TAB 240 MG (27 MG ELEMENTAL FE) FERROUS GLUCONATE TAB 225 MG (27 MG FE EQUIVALENT) FERROUS GLUCONATE TAB 325 MG (36 MG ELEMENTAL FE) FERROUS SULFATE SYRUP 300 MG/5ML (60 MG/5ML ELEMENTAL FE) FERROUS SULFATE TAB 325 MG (65 MG ELEMENTAL FE) FERROUS SULFATE TAB EC 325 MG (65 MG FE EQUIVALENT) FERROUS SULFATE TAB CR 140 MG (45 MG FE EQUIVALENT) FERROUS SULFATE TAB EC 324 MG (65 MG FE EQUIVALENT) FERROUS SULFATE ELIXIR 220 MG/5ML (44 MG/5ML ELEMENTAL FE) FERROUS SULFATE TAB 27 MG (ELEMENTAL FE) FERROUS SULFATE SOLN 75 MG/ML (15 MG/ML ELEMENTAL FE) FERROUS SULFATE TAB 325 MG (65 MG ELEMENTAL FE) FERROUS SULFATE TAB 134 MG (27 MG ELEMENTAL FE) FERROUS SULFATE TAB 90 MG (18 MG ELEMENTAL FE) FERROUS SULFATE TAB 325 MG (65 MG ELEMENTAL FE) FERROUS GLUCONATE TAB 240 MG (27 MG ELEMENTAL FE) FERROUS SULFATE TAB CR 142 MG (45 MG FE EQUIVALENT) FERROUS SULFATE TAB 28 MG (ELEMENTAL FE) FERROUS SULFATE DRIED TAB CR 45 MG (FE EQUIVALENT) FERROUS SULFATE TAB 325 MG (65 MG ELEMENTAL FE) FERROUS SULFATE SOLN 75 MG/ML (15 MG/ML ELEMENTAL FE) IRON SUSP 15 MG/1.5ML IRON HEME POLYPEPTIDE TAB 12 MG (ELEMENTAL FE EQUIV) FERROUS SULFATE DRIED TAB CR 160 MG (50 MG FE EQUIVALENT) FERROUS SULFATE DRIED TAB CR 160 MG (50 MG FE EQUIVALENT) FERROUS SULFATE DRIED TAB CR 160 MG (50 MG FE EQUIVALENT) FERROUS SULFATE TAB CR 50 MG (ELEMENTAL FE) FERROUS SULFATE TAB CR 47.5 MG (ELEMENTAL FE)
12 IRON PRODUCTS SLOW RELEASE IRON SLOW-RELEASE IRON FERROUS SULFATE DRIED TAB CR 45 MG (FE EQUIVALENT) FERROUS SULFATE DRIED TAB CR 45 MG (FE EQUIVALENT) ASPIRIN ADULT ASPIRIN EC LOW STRENGTH ASPIR-81 ASPIRIN ASPIRIN ASPIRIN ASPIRIN ASPIRIN 81 ASPIRIN 81 LOW DOSE ASPIRIN ADULT LOW DOSE ASPIRIN ADULT LOW STRENGTH ASPIRIN ADULT LOW STRENGTH ASPIRIN CHILDRENS ASPIRIN EC ASPIRIN EC ASPIRIN EC LOW DOSE ASPIRIN ENTERIC COATED ADULT LOW STRENGTH ASPIRIN LOW DOSE ASPIRIN LOW DOSE ASPIRIN LOW DOSE ASPIRIN LOW STRENGTH ASPIR-LOW ASPIRTAB CHILDRENS ASPIRIN CHILDRENS ASPIRIN LOW STRENGTH ECOTRIN LOW STRENGTH ECOTRIN REGULAR STRENGTH ECPIRIN ENTERIC COATED ASPIRIN NORWICH ASPIRIN ST JOSEPH ADULT ST JOSEPH ADULT ANALGESICLOW DOSE BITE SIZE ST JOSEPH ASPIRIN ST JOSEPH ASPIRIN ASPIRIN TAB 325 MG ASPIRIN TAB DELAYED RELEASE 325 MG ASPIRIN TAB DELAYED RELEASE 325 MG ASPIRIN TAB 81 MG ASPIRIN TAB DELAYED RELEASE 325 MG ASPIRIN TAB DELAYED RELEASE 325 MG ASPIRIN TAB DELAYED RELEASE 325 MG ASPIRIN TAB DELAYED RELEASE 325 MG ASPIRIN TAB 325 MG ASPIRIN CHEW TAB 75 MG ASPIRIN CHEW TAB 75 MG
13 VITAMIN D PRODUCTS VITAMIN D-3 VITAMIN D VITAMIN D-3 VITAMIN D-400 VITAMIN D VITAMIN D-3 CHOLECALCIFEROL TAB 5000 UNIT CHOLECALCIFEROL TAB 5000 UNIT CHOLECALCIFEROL TAB 400 UNIT CHOLECALCIFEROL TAB 400 UNIT CHOLECALCIFEROL TAB 400 UNIT CHOLECALCIFEROL TAB 400 UNIT CHOLECALCIFEROL TAB 3000 UNIT CHOLECALCIFEROL TAB 2000 UNIT CHOLECALCIFEROL TAB 2000 UNIT CHOLECALCIFEROL TAB 2000 UNIT SUPER STRENGTH VITAMIN D VITAMIN D-1000 VITAMIN D-1000 MAXIMUM STRENGTH VITAMIN D-3 VITAMIN D VITAMIN D 400 ADULT GUMMIES MAXIMUM STRENGTH VITAMIN D 400 VITAMIN D VITAMIN D CHOLECALCIFEROL TAB 2000 UNIT CHOLECALCIFEROL TAB 1000 UNIT CHOLECALCIFEROL TAB 1000 UNIT CHOLECALCIFEROL TAB 1000 UNIT CHOLECALCIFEROL TAB 1000 UNIT CHOLECALCIFEROL TAB 1000 UNIT CHOLECALCIFEROL SPRAY 1000 UNIT/SPRAY CHOLECALCIFEROL ORAL LIQUID 400 UNIT/ML CHOLECALCIFEROL ORAL LIQUID 400 UNIT/ML CHOLECALCIFEROL ORAL LIQUID 1200 UNIT/15ML CHOLECALCIFEROL DROPS 5000 UNIT/ML (1000 UNIT/0.2ML) CHOLECALCIFEROL CHEW TAB 5000 UNIT CHOLECALCIFEROL CHEW TAB 400 UNIT CHOLECALCIFEROL CHEW TAB 400 UNIT CHOLECALCIFEROL CHEW TAB 2000 UNIT CHOLECALCIFEROL CHEW TAB 1000 UNIT CHOLECALCIFEROL CHEW TAB 1000 UNIT CHOLECALCIFEROL CAP UNIT CHOLECALCIFEROL CAP 5000 UNIT CHOLECALCIFEROL CAP 5000 UNIT CHOLECALCIFEROL CAP 400 UNIT CHOLECALCIFEROL CAP 400 UNIT CHOLECALCIFEROL CAP 400 UNIT CHOLECALCIFEROL CAP 2000 UNIT CHOLECALCIFEROL CAP 2000 UNIT CHOLECALCIFEROL CAP UNIT CHOLECALCIFEROL CAP 1000 UNIT
14 VITAMIN D PRODUCTS VITAMIN D HIGH POTENCY VITAMIN D-3 HIGH POTENCY CHOLECALCIFEROL CAP 1000 UNIT CHOLECALCIFEROL CAP 1000 UNIT CHOLECALCIFEROL CAP 1000 UNIT CHOLECALCIFEROL CAP 1000 UNIT BOWEL PREPARATION ALOPHEN TAB 5MG EC BISACODYL TAB 5MG EC CARTERS TAB 5MG EC CITROMA SOL CHERRY MAGNESIUM CITRATE SOLN CITROMA SOL LEMON MAGNESIUM CITRATE SOLN CLEARLAX POW CORRECT TAB 5MG EC CORRECTOL TAB 5MG EC CVS C-LAX TAB 5MG CVS PURELAX POW CVS PURELAX POW 3350 DUCODYL TAB 5MG EC DULCOLAX POW BALANCE EQ CLEARLAX POW EQL CLEARLAX POW EQL GENTLE TAB LAXATIVE EQL LAXATIVE TAB 5MG EC FEENAMINT TAB 5MG EC FEMININE LAX TAB 5MG EC GAVILAX POW GAVILYTE-C SOL PEG 3350-KCL-NA BICARB-NACL-NA SULFATE FOR SOLN 240 GM GAVILYTE-G SOL PEG 3350-KCL-NA BICARB-NACL-NA SULFATE FOR SOLN 236 GM GAVILYTE-N SOL FLAV PK PEG 3350-KCL-SOD BICARB-NACL FOR SOLN 420 GM GENTLE LAXAT TAB 5MG EC GENTLELAX POW GLYCOLAX POW 3350 NF GNP BISA-LAX TAB 5MG EC GNP CLEARLAX POW GNP LAXATIVE TAB 5MG EC HM CLEARLAX POW HM LAXATIVE TAB 5MG
15 BOWEL PREPARATION HM LAXATIVE TAB 5MG EC LAXACLEAR POW LAXATIVE TAB 5MG EC LAXATIVE POL POW GLYCOL MAG CITRATE SOL MAGNESIUM CITRATE SOLN MAG CITRATE SOL CHERRY MAGNESIUM CITRATE SOLN MAG CITRATE SOL GRAPE MAGNESIUM CITRATE SOLN MAG CITRATE SOL GRAPE MAGNESIUM CITRATE SOLN MAG CITRATE SOL LEMON MAGNESIUM CITRATE SOLN NATURA-LAX POW 3350 NF PEG 3350 POW PEG 3350 SOL ELECTROL PEG 3350-KCL-NA BICARB-NACL-NA SULFATE FOR SOLN 240 GM PEG3350 POW PEG-3350 SOL ELECTROL PEG 3350-KCL-NA BICARB-NACL-NA SULFATE FOR SOLN 236 GM PEG-3350/KCL SOL /SODIUM PEG 3350-KCL-SOD BICARB-NACL FOR SOLN 420 GM PEGYLAX POW POLYETH GLYC POW 3350 NF POWDERLAX POW QC LAXATIVE TAB 5MG EC RA LAXATIVE POW RA LAXATIVE TAB 5MG EC SB BISACODYL TAB 5MG EC SM CLEARLAX POW SM GENTLE TAB LAXATIVE SM LAXATIVE TAB 5MG EC SMOOTH LAX POW STIM LAXAT TAB 5MG EC SW CLEARLAX POW TRILYTE SOL PEG 3350-KCL-SOD BICARB-NACL FOR SOLN 420 GM VERCOLATE TAB 5MG EC WOMANS LAXAT TAB 5MG EC WOMENS LAXAT TAB 5MG EC STATINS* ATORVASTATIN CALCIUM TAB 10 MG ATORVASTATIN CALCIUM TAB 20 MG FLUVASTATIN SODIUM CAP 20 MG ATORVASTATIN CALCIUM TAB 10 MG (BASE EQUIVALENT) ATORVASTATIN CALCIUM TAB 20 MG (BASE EQUIVALENT) FLUVASTATIN SODIUM CAP 20 MG
16 STATINS* FLUVASTATIN SODIUM CAP 40 MG LOVASTATIN TAB 20 MG LOVASTATIN TAB 10 MG LOVASTATIN TAB 40 MG PRAVASTATIN SODIUM TAB 10 MG PRAVASTATIN SODIUM TAB 20 MG PRAVASTATIN SODIUM TAB 40 MG PRAVASTATIN SODIUM TAB 80 MG ROSUVASTATIN CALCIUM TAB 5 MG ROSUVASTATIN CALCIUM TAB 10 MG SIMVASTATIN TAB 5 MG SIMVASTATIN TAB 10 MG SIMVASTATIN TAB 20 MG SIMVASTATIN TAB 40 MG FLUVASTATIN SODIUM CAP 40 MG LOVASTATIN TAB 20 MG LOVASTATIN TAB 10 MG LOVASTATIN TAB 40 MG PRAVASTATIN SODIUM TAB 10 MG PRAVASTATIN SODIUM TAB 20 MG PRAVASTATIN SODIUM TAB 40 MG PRAVASTATIN SODIUM TAB 80 MG ROSUVASTATIN CALCIUM TAB 5 MG ROSUVASTATIN CALCIUM TAB 10 MG SIMVASTATIN TAB 5 MG SIMVASTATIN TAB 10 MG SIMVASTATIN TAB 20 MG SIMVASTATIN TAB 40 MG *Age specific benefit only for members years old
Please consult your Benefit Booklet under Preventive Services or call Member Service if you have questions about your coverage for these drugs.
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