Table Of Content

VA Anthem Common Core Formulary Medicaid-Approved Preferred Drug List Effective December 1, 2018 Legend In each class, drugs are listed alphabetically by either brand name or generic name. Brand name drug: Uppercase in bold type Generic drug: Lowercase in plain type AL: Age Limit Restrictions DO: Dose Optimization Program GR: Gender Restriction OTC: Over the counter medication available with a prescription. (Prescribers please indicate OTC on the prescription) PA: Prior authorization is required. Prior authorization is the process of obtaining approval of benefits before certain prescriptions are filled. QL: Quantity limits; certain prescription medications have specific quantity limits per prescription or per month. SP: Specialty Pharmacy ST: Step therapy is required. You may need to use one medication before benefits for the use of another medication can be authorized. Drug Name Reference Notes ALTERNATIVE THERAPY ALTERNATIVE THERAPY e-400 c-500 and beta carotene oral tablet OTC Glucosamine-Chondroitin glucosamine su 2kcl-chondroit oral tablet OTC DS glucosamine-chondroitin complx oral OTC capsule kelp-lecithin-b6 oral tablet OTC lecithin-kelp-b6 (100-8.3) oral tablet OTC lecithin-kelp-b6 (400-20) oral tablet OTC lecithin-kelp-b6 oral capsule OTC super antioxidant oral capsule OTC ANALGESIC, ANTI-INFLAMMATORY OR ANTIPYRETIC ANALGESIC/ANTIPYRETICS, SALICYLATES adult low dose aspirin oral tablet,delayed OTC release (dr/ec) antacid and pain relief oral tablet, OTC effervescent back and body pain reliever oral tablet OTC butalbital-aspirin-caffeine oral capsule Fiorinal QL choline,magnesium salicylate oral liquid enteric coated aspirin oral tablet,delayed OTC release (dr/ec) lo-dose aspirin oral tablet,delayed release OTC (dr/ec) salsalate oral tablet Disalcid ANALGESICS, NARCOTICS acetaminophen-codeine oral solution 120 mg-12 mg /5 ml (5 ml), 120-12 mg/5 ml, QL 300 mg-30 mg /12.5 ml acetaminophen-codeine oral solution 240 mg-24 mg /10 ml (10 ml) acetaminophen-codeine oral tablet QL ascomp with codeine oral capsule PA; QL butalbital-acetaminop-caf-cod oral capsule QL BUTRANS TRANSDERMAL PATCH PA WEEKLY 2 Drug Name Reference Notes endocet oral tablet QL fentanyl transdermal patch 72 hour Duragesic QL hydrocodone-acetaminophen oral solution Hycet QL hydrocodone-acetaminophen oral tablet Lorcet (hydrocodone) QL hydrocodone-ibuprofen oral tablet QL hydromorphone oral tablet Dilaudid QL lorcet (hydrocodone) oral tablet QL lorcet hd oral tablet QL lorcet plus oral tablet QL morphine concentrate oral solution QL morphine oral solution QL morphine oral tablet QL morphine oral tablet extended release MS Contin QL oxycodone oral capsule QL oxycodone oral solution QL oxycodone oral tablet Roxicodone QL oxycodone-acetaminophen oral tablet Endocet QL tramadol oral tablet Ultram QL verdrocet oral tablet QL vicodin es oral tablet QL vicodin hp oral tablet QL vicodin oral tablet QL xylon 10 oral tablet QL ANALGESICS, NON-NARCOTIC acetaminophen oral liquid OTC acetaminophen oral tablet,disintegrating Children's Pain-Fever Relief OTC BUTALBITAL-ACETAMINOPHEN ORAL QL CAPSULE butalbital-acetaminophen oral tablet Tencon QL butalbital-acetaminophen-caff oral capsule Capacet QL butalbital-acetaminophen-caff oral tablet Esgic QL capacet oral capsule QL children's acetaminophen oral suspension OTC children's acetaminophen oral syringe OTC feverall rectal suppository OTC infant's non-aspirin oral drops OTC infant's non-aspirin oral drops,suspension OTC 3 Drug Name Reference Notes pre-menstrual relief oral tablet OTC premsyn pms oral tablet OTC tencon oral tablet QL ANTI-ARTHRITIC, FOLATE ANTAGONIST AGENTS methotrexate sodium oral tablet ANTI-INFLAMMATORY TUMOR NECROSIS FACTOR INHIBITOR ENBREL MINI SUBCUTANEOUS CARTRIDGE ENBREL SUBCUTANEOUS RECON AL SOLN ENBREL SUBCUTANEOUS SYRINGE AL ENBREL SURECLICK AL SUBCUTANEOUS PEN INJECTOR HUMIRA PEDIATRIC CROHN'S START AL SUBCUTANEOUS SYRINGE KIT HUMIRA PEN CROHN'S-UC-HS START AL SUBCUTANEOUS PEN INJECTOR KIT HUMIRA PEN PSORIASIS-UVEITIS AL SUBCUTANEOUS PEN INJECTOR KIT HUMIRA PEN SUBCUTANEOUS PEN AL INJECTOR KIT HUMIRA SUBCUTANEOUS SYRINGE AL KIT ANTI-INFLAMMATORY, PYRIMIDINE SYNTHESIS INHIBITOR leflunomide oral tablet Arava RIDAURA ORAL CAPSULE DISEASE MODIFYING ANTI- RHEUMATOID DRUGS (DMARD) DEPEN TITRATABS ORAL TABLET PA hydroxychloroquine oral tablet Plaquenil minocycline oral capsule minocycline oral tablet sulfasalazine oral tablet Azulfidine sulfasalazine oral tablet,delayed release Azulfidine EN-tabs (dr/ec) IMMUNOSUPRESSANTS azathioprine oral tablet Imuran 4 Drug Name Reference Notes cyclosporine modified oral capsule Gengraf cyclosporine modified oral solution Gengraf cyclosporine oral capsule Sandimmune gengraf oral capsule gengraf oral solution mycophenolate mofetil oral capsule CellCept mycophenolate mofetil oral suspension for CellCept reconstitution mycophenolate mofetil oral tablet CellCept SANDIMMUNE ORAL SOLUTION NSAIDS ALEVE ORAL CAPSULE OTC CHILDREN'S MOTRIN ORAL OTC SUSPENSION ibu oral tablet ibuprofen oral tablet IBU ibuprofen pm oral tablet OTC meloxicam oral tablet Mobic MIDOL (NAPROXEN) ORAL TABLET OTC MOTRIN IB ORAL TABLET OTC motrin pm oral tablet OTC naproxen oral tablet naproxen oral tablet,delayed release EC-Naprosyn (dr/ec) sulindac oral tablet ANESTHETICS LOCAL ANESTHETICS lidocaine hcl laryngotracheal solution LTA Pre-Attached QL lidocaine topical ointment QL ANORECTAL PREPARATIONS ANORECTAL AGENTS ANUSOL-HC TOPICAL CREAM WITH PERINEAL APPLICATOR hydrocortisone topical cream with perineal Anusol-HC applicator PROCTOCORT TOPICAL CREAM procto-med hc topical cream with perineal applicator 5 Drug Name Reference Notes proctosol hc topical cream with perineal applicator proctozone-hc topical cream with perineal applicator HEMORRHOIDAL PREPARATIONS hemorrhoid rectal ointment OTC hemorrhoidal (phenyleph-cocoa) rectal OTC suppository hemorrhoidal rectal suppository OTC lidocaine hcl-hydrocortison ac rectal cream ANTIDOTES AND OTHER REVERSAL AGENTS ANTIDOTES acetylcysteine solution CHELATING AGENTS deferoxamine injection recon soln Desferal DEPEN TITRATABS ORAL TABLET PA trientine oral capsule Syprine PA; QL MU-OPIOID RECEPTOR ANTAGONISTS, PERIPHERALLY- ACTING MOVANTIK ORAL TABLET AL NARCOTIC ANTAGONISTS naloxone injection solution naloxone injection syringe naltrexone oral tablet NARCAN NASAL SPRAY,NON- AEROSOL REVIA ORAL TABLET ANTI-INFECTIVE AGENTS ABSORBABLE SULFONAMIDES sulfamethoxazole-trimethoprim oral Sulfatrim suspension sulfamethoxazole-trimethoprim oral tablet Bactrim sulfatrim oral suspension trimethoprim oral tablet 6 Drug Name Reference Notes AMINOPENICILLINS amoxicillin oral capsule amoxicillin oral suspension for QL reconstitution amoxicillin oral tablet amoxicillin oral tablet,chewable amoxicillin-pot clavulanate oral Augmentin ES-600 suspension for reconstitution amoxicillin-pot clavulanate oral tablet 250- 125 mg amoxicillin-pot clavulanate oral tablet 500- Augmentin 125 mg amoxicillin-pot clavulanate oral tablet 875- Augmentin QL 125 mg amoxicillin-pot clavulanate oral tablet Augmentin XR QL extended release 12 hr amoxicillin-pot clavulanate oral QL tablet,chewable ampicillin oral capsule ANTHELMINTIC AGENTS - MACROCYCLIC LACTONES ivermectin oral tablet Stromectol ANTHELMINTICS ivermectin oral tablet Stromectol praziquantel oral tablet Biltricide reese's pinworm medicine oral suspension OTC ANTIBACTERIAL AGENTS, OTHER nitrofurantoin macrocrystal oral capsule Macrodantin nitrofurantoin monohyd/m-cryst oral Macrobid capsule ANTIFUNGAL ANTIBIOTICS fluconazole oral suspension for Diflucan reconstitution fluconazole oral tablet Diflucan griseofulvin microsize oral suspension nystatin oral powder nystatin oral tablet terbinafine hcl oral tablet voriconazole intravenous solution Vfend IV PA 7 Drug Name Reference Notes ANTI-INFECTIVE AGENTS, OTHER methenamine hippurate oral tablet Hiprex methenamine mandelate oral tablet ANTILEPROTIC - SULFONE AGENTS dapsone oral tablet ANTIMYCOBACTERIUM AGENTS ethambutol oral tablet Myambutol isoniazid oral solution isoniazid oral tablet PRIFTIN ORAL TABLET pyrazinamide oral tablet rifabutin oral capsule Mycobutin rifampin oral capsule Rifadin RIFATER ORAL TABLET ANTIPROTOZOAL ANTIBACTERIAL AGENTS metronidazole oral tablet Flagyl ANTIVIRALS, GENERAL acyclovir oral capsule Zovirax acyclovir oral suspension 200 mg/5 ml Zovirax acyclovir oral suspension 200 mg/5 ml (5 ml) acyclovir oral tablet Zovirax famciclovir oral tablet oseltamivir oral suspension for Tamiflu reconstitution RELENZA DISKHALER INHALATION BLISTER WITH DEVICE rimantadine oral tablet Flumadine TAMIFLU ORAL CAPSULE valacyclovir oral tablet Valtrex valganciclovir oral recon soln Valcyte valganciclovir oral tablet Valcyte ANTIVIRALS, HIV SPECIFIC abacavir oral solution Ziagen abacavir oral tablet Ziagen abacavir-lamivudine oral tablet Epzicom 8 Drug Name Reference Notes abacavir-lamivudine-zidovudine oral tablet Trizivir APTIVUS ORAL CAPSULE APTIVUS ORAL SOLUTION atazanavir oral capsule Reyataz BIKTARVY ORAL TABLET CIMDUO ORAL TABLET CRIXIVAN ORAL CAPSULE DESCOVY ORAL TABLET didanosine oral capsule,delayed Videx EC release(dr/ec) EDURANT ORAL TABLET EMTRIVA ORAL CAPSULE EMTRIVA ORAL SOLUTION EVOTAZ ORAL TABLET FUZEON SUBCUTANEOUS RECON PA SOLN GENVOYA ORAL TABLET INTELENCE ORAL TABLET ISENTRESS HD ORAL TABLET ISENTRESS ORAL POWDER IN PACKET ISENTRESS ORAL TABLET ISENTRESS ORAL TABLET,CHEWABLE JULUCA ORAL TABLET KALETRA ORAL TABLET lamivudine oral solution Epivir lamivudine oral tablet Epivir lamivudine-zidovudine oral tablet Combivir lopinavir-ritonavir oral solution Kaletra nevirapine oral suspension Viramune nevirapine oral tablet Viramune nevirapine oral tablet extended release 24 Viramune XR hr NORVIR ORAL CAPSULE NORVIR ORAL SOLUTION PREZCOBIX ORAL TABLET PREZISTA ORAL SUSPENSION 9 Drug Name Reference Notes PREZISTA ORAL TABLET RESCRIPTOR ORAL TABLET RESCRIPTOR ORAL TABLET, DISPERSIBLE RETROVIR INTRAVENOUS SOLUTION REYATAZ ORAL POWDER IN PACKET ritonavir oral tablet Norvir SELZENTRY ORAL SOLUTION SELZENTRY ORAL TABLET stavudine oral capsule Zerit STRIBILD ORAL TABLET tenofovir disoproxil fumarate oral tablet Viread PA; QL TIVICAY ORAL TABLET TRIUMEQ ORAL TABLET TROGARZO INTRAVENOUS SOLUTION TRUVADA ORAL TABLET VIDEX 2 GRAM PEDIATRIC ORAL RECON SOLN VIDEX 4 GRAM PEDIATRIC ORAL RECON SOLN VIRACEPT ORAL TABLET VIREAD ORAL POWDER PA; QL VIREAD ORAL TABLET PA; QL zidovudine oral capsule Retrovir zidovudine oral syrup Retrovir zidovudine oral tablet CEPHALOSPORIN ANTIBIOTICS cefaclor oral capsule cefadroxil oral capsule cefadroxil oral suspension for reconstitution cefadroxil oral tablet cefdinir oral capsule cefdinir oral suspension for reconstitution cefixime oral suspension for reconstitution Suprax cefprozil oral suspension for reconstitution cefprozil oral tablet 10

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Anthem HealthKeepers Plus is the managed care program offered by HealthKeepers, Inc., .. fever reducer an pain reliever oral suspension. OTC.
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Medicaid-Approved Preferred Drug List PDF

141 Pages·2017·3.79 MB·English
by  Formulary Manager
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VA Anthem Common Core Formulary Medicaid-Approved Preferred Drug List Effective December 1, 2018 Legend In each class, drugs are listed alphabetically by either brand name or generic name. Brand name drug: Uppercase in bold type Generic drug: Lowercase in plain type AL: Age Limit Restrictions DO: Dose Optimization Program GR: Gender Restriction OTC: Over the counter medication available with a prescription. (Prescribers please indicate OTC on the prescription) PA: Prior authorization is required. Prior authorization is the process of obtaining approval of benefits before certain prescriptions are filled. QL: Quantity limits; certain prescription medications have specific quantity limits per prescription or per month. SP: Specialty Pharmacy ST: Step therapy is required. You may need to use one medication before benefits for the use of another medication can be authorized. Drug Name Reference Notes ALTERNATIVE THERAPY ALTERNATIVE THERAPY e-400 c-500 and beta carotene oral tablet OTC Glucosamine-Chondroitin glucosamine su 2kcl-chondroit oral tablet OTC DS glucosamine-chondroitin complx oral OTC capsule kelp-lecithin-b6 oral tablet OTC lecithin-kelp-b6 (100-8.3) oral tablet OTC lecithin-kelp-b6 (400-20) oral tablet OTC lecithin-kelp-b6 oral capsule OTC super antioxidant oral capsule OTC ANALGESIC, ANTI-INFLAMMATORY OR ANTIPYRETIC ANALGESIC/ANTIPYRETICS, SALICYLATES adult low dose aspirin oral tablet,delayed OTC release (dr/ec) antacid and pain relief oral tablet, OTC effervescent back and body pain reliever oral tablet OTC butalbital-aspirin-caffeine oral capsule Fiorinal QL choline,magnesium salicylate oral liquid enteric coated aspirin oral tablet,delayed OTC release (dr/ec) lo-dose aspirin oral tablet,delayed release OTC (dr/ec) salsalate oral tablet Disalcid ANALGESICS, NARCOTICS acetaminophen-codeine oral solution 120 mg-12 mg /5 ml (5 ml), 120-12 mg/5 ml, QL 300 mg-30 mg /12.5 ml acetaminophen-codeine oral solution 240 mg-24 mg /10 ml (10 ml) acetaminophen-codeine oral tablet QL ascomp with codeine oral capsule PA; QL butalbital-acetaminop-caf-cod oral capsule QL BUTRANS TRANSDERMAL PATCH PA WEEKLY 2 Drug Name Reference Notes endocet oral tablet QL fentanyl transdermal patch 72 hour Duragesic QL hydrocodone-acetaminophen oral solution Hycet QL hydrocodone-acetaminophen oral tablet Lorcet (hydrocodone) QL hydrocodone-ibuprofen oral tablet QL hydromorphone oral tablet Dilaudid QL lorcet (hydrocodone) oral tablet QL lorcet hd oral tablet QL lorcet plus oral tablet QL morphine concentrate oral solution QL morphine oral solution QL morphine oral tablet QL morphine oral tablet extended release MS Contin QL oxycodone oral capsule QL oxycodone oral solution QL oxycodone oral tablet Roxicodone QL oxycodone-acetaminophen oral tablet Endocet QL tramadol oral tablet Ultram QL verdrocet oral tablet QL vicodin es oral tablet QL vicodin hp oral tablet QL vicodin oral tablet QL xylon 10 oral tablet QL ANALGESICS, NON-NARCOTIC acetaminophen oral liquid OTC acetaminophen oral tablet,disintegrating Children's Pain-Fever Relief OTC BUTALBITAL-ACETAMINOPHEN ORAL QL CAPSULE butalbital-acetaminophen oral tablet Tencon QL butalbital-acetaminophen-caff oral capsule Capacet QL butalbital-acetaminophen-caff oral tablet Esgic QL capacet oral capsule QL children's acetaminophen oral suspension OTC children's acetaminophen oral syringe OTC feverall rectal suppository OTC infant's non-aspirin oral drops OTC infant's non-aspirin oral drops,suspension OTC 3 Drug Name Reference Notes pre-menstrual relief oral tablet OTC premsyn pms oral tablet OTC tencon oral tablet QL ANTI-ARTHRITIC, FOLATE ANTAGONIST AGENTS methotrexate sodium oral tablet ANTI-INFLAMMATORY TUMOR NECROSIS FACTOR INHIBITOR ENBREL MINI SUBCUTANEOUS CARTRIDGE ENBREL SUBCUTANEOUS RECON AL SOLN ENBREL SUBCUTANEOUS SYRINGE AL ENBREL SURECLICK AL SUBCUTANEOUS PEN INJECTOR HUMIRA PEDIATRIC CROHN'S START AL SUBCUTANEOUS SYRINGE KIT HUMIRA PEN CROHN'S-UC-HS START AL SUBCUTANEOUS PEN INJECTOR KIT HUMIRA PEN PSORIASIS-UVEITIS AL SUBCUTANEOUS PEN INJECTOR KIT HUMIRA PEN SUBCUTANEOUS PEN AL INJECTOR KIT HUMIRA SUBCUTANEOUS SYRINGE AL KIT ANTI-INFLAMMATORY, PYRIMIDINE SYNTHESIS INHIBITOR leflunomide oral tablet Arava RIDAURA ORAL CAPSULE DISEASE MODIFYING ANTI- RHEUMATOID DRUGS (DMARD) DEPEN TITRATABS ORAL TABLET PA hydroxychloroquine oral tablet Plaquenil minocycline oral capsule minocycline oral tablet sulfasalazine oral tablet Azulfidine sulfasalazine oral tablet,delayed release Azulfidine EN-tabs (dr/ec) IMMUNOSUPRESSANTS azathioprine oral tablet Imuran 4 Drug Name Reference Notes cyclosporine modified oral capsule Gengraf cyclosporine modified oral solution Gengraf cyclosporine oral capsule Sandimmune gengraf oral capsule gengraf oral solution mycophenolate mofetil oral capsule CellCept mycophenolate mofetil oral suspension for CellCept reconstitution mycophenolate mofetil oral tablet CellCept SANDIMMUNE ORAL SOLUTION NSAIDS ALEVE ORAL CAPSULE OTC CHILDREN'S MOTRIN ORAL OTC SUSPENSION ibu oral tablet ibuprofen oral tablet IBU ibuprofen pm oral tablet OTC meloxicam oral tablet Mobic MIDOL (NAPROXEN) ORAL TABLET OTC MOTRIN IB ORAL TABLET OTC motrin pm oral tablet OTC naproxen oral tablet naproxen oral tablet,delayed release EC-Naprosyn (dr/ec) sulindac oral tablet ANESTHETICS LOCAL ANESTHETICS lidocaine hcl laryngotracheal solution LTA Pre-Attached QL lidocaine topical ointment QL ANORECTAL PREPARATIONS ANORECTAL AGENTS ANUSOL-HC TOPICAL CREAM WITH PERINEAL APPLICATOR hydrocortisone topical cream with perineal Anusol-HC applicator PROCTOCORT TOPICAL CREAM procto-med hc topical cream with perineal applicator 5 Drug Name Reference Notes proctosol hc topical cream with perineal applicator proctozone-hc topical cream with perineal applicator HEMORRHOIDAL PREPARATIONS hemorrhoid rectal ointment OTC hemorrhoidal (phenyleph-cocoa) rectal OTC suppository hemorrhoidal rectal suppository OTC lidocaine hcl-hydrocortison ac rectal cream ANTIDOTES AND OTHER REVERSAL AGENTS ANTIDOTES acetylcysteine solution CHELATING AGENTS deferoxamine injection recon soln Desferal DEPEN TITRATABS ORAL TABLET PA trientine oral capsule Syprine PA; QL MU-OPIOID RECEPTOR ANTAGONISTS, PERIPHERALLY- ACTING MOVANTIK ORAL TABLET AL NARCOTIC ANTAGONISTS naloxone injection solution naloxone injection syringe naltrexone oral tablet NARCAN NASAL SPRAY,NON- AEROSOL REVIA ORAL TABLET ANTI-INFECTIVE AGENTS ABSORBABLE SULFONAMIDES sulfamethoxazole-trimethoprim oral Sulfatrim suspension sulfamethoxazole-trimethoprim oral tablet Bactrim sulfatrim oral suspension trimethoprim oral tablet 6 Drug Name Reference Notes AMINOPENICILLINS amoxicillin oral capsule amoxicillin oral suspension for QL reconstitution amoxicillin oral tablet amoxicillin oral tablet,chewable amoxicillin-pot clavulanate oral Augmentin ES-600 suspension for reconstitution amoxicillin-pot clavulanate oral tablet 250- 125 mg amoxicillin-pot clavulanate oral tablet 500- Augmentin 125 mg amoxicillin-pot clavulanate oral tablet 875- Augmentin QL 125 mg amoxicillin-pot clavulanate oral tablet Augmentin XR QL extended release 12 hr amoxicillin-pot clavulanate oral QL tablet,chewable ampicillin oral capsule ANTHELMINTIC AGENTS - MACROCYCLIC LACTONES ivermectin oral tablet Stromectol ANTHELMINTICS ivermectin oral tablet Stromectol praziquantel oral tablet Biltricide reese's pinworm medicine oral suspension OTC ANTIBACTERIAL AGENTS, OTHER nitrofurantoin macrocrystal oral capsule Macrodantin nitrofurantoin monohyd/m-cryst oral Macrobid capsule ANTIFUNGAL ANTIBIOTICS fluconazole oral suspension for Diflucan reconstitution fluconazole oral tablet Diflucan griseofulvin microsize oral suspension nystatin oral powder nystatin oral tablet terbinafine hcl oral tablet voriconazole intravenous solution Vfend IV PA 7 Drug Name Reference Notes ANTI-INFECTIVE AGENTS, OTHER methenamine hippurate oral tablet Hiprex methenamine mandelate oral tablet ANTILEPROTIC - SULFONE AGENTS dapsone oral tablet ANTIMYCOBACTERIUM AGENTS ethambutol oral tablet Myambutol isoniazid oral solution isoniazid oral tablet PRIFTIN ORAL TABLET pyrazinamide oral tablet rifabutin oral capsule Mycobutin rifampin oral capsule Rifadin RIFATER ORAL TABLET ANTIPROTOZOAL ANTIBACTERIAL AGENTS metronidazole oral tablet Flagyl ANTIVIRALS, GENERAL acyclovir oral capsule Zovirax acyclovir oral suspension 200 mg/5 ml Zovirax acyclovir oral suspension 200 mg/5 ml (5 ml) acyclovir oral tablet Zovirax famciclovir oral tablet oseltamivir oral suspension for Tamiflu reconstitution RELENZA DISKHALER INHALATION BLISTER WITH DEVICE rimantadine oral tablet Flumadine TAMIFLU ORAL CAPSULE valacyclovir oral tablet Valtrex valganciclovir oral recon soln Valcyte valganciclovir oral tablet Valcyte ANTIVIRALS, HIV SPECIFIC abacavir oral solution Ziagen abacavir oral tablet Ziagen abacavir-lamivudine oral tablet Epzicom 8 Drug Name Reference Notes abacavir-lamivudine-zidovudine oral tablet Trizivir APTIVUS ORAL CAPSULE APTIVUS ORAL SOLUTION atazanavir oral capsule Reyataz BIKTARVY ORAL TABLET CIMDUO ORAL TABLET CRIXIVAN ORAL CAPSULE DESCOVY ORAL TABLET didanosine oral capsule,delayed Videx EC release(dr/ec) EDURANT ORAL TABLET EMTRIVA ORAL CAPSULE EMTRIVA ORAL SOLUTION EVOTAZ ORAL TABLET FUZEON SUBCUTANEOUS RECON PA SOLN GENVOYA ORAL TABLET INTELENCE ORAL TABLET ISENTRESS HD ORAL TABLET ISENTRESS ORAL POWDER IN PACKET ISENTRESS ORAL TABLET ISENTRESS ORAL TABLET,CHEWABLE JULUCA ORAL TABLET KALETRA ORAL TABLET lamivudine oral solution Epivir lamivudine oral tablet Epivir lamivudine-zidovudine oral tablet Combivir lopinavir-ritonavir oral solution Kaletra nevirapine oral suspension Viramune nevirapine oral tablet Viramune nevirapine oral tablet extended release 24 Viramune XR hr NORVIR ORAL CAPSULE NORVIR ORAL SOLUTION PREZCOBIX ORAL TABLET PREZISTA ORAL SUSPENSION 9 Drug Name Reference Notes PREZISTA ORAL TABLET RESCRIPTOR ORAL TABLET RESCRIPTOR ORAL TABLET, DISPERSIBLE RETROVIR INTRAVENOUS SOLUTION REYATAZ ORAL POWDER IN PACKET ritonavir oral tablet Norvir SELZENTRY ORAL SOLUTION SELZENTRY ORAL TABLET stavudine oral capsule Zerit STRIBILD ORAL TABLET tenofovir disoproxil fumarate oral tablet Viread PA; QL TIVICAY ORAL TABLET TRIUMEQ ORAL TABLET TROGARZO INTRAVENOUS SOLUTION TRUVADA ORAL TABLET VIDEX 2 GRAM PEDIATRIC ORAL RECON SOLN VIDEX 4 GRAM PEDIATRIC ORAL RECON SOLN VIRACEPT ORAL TABLET VIREAD ORAL POWDER PA; QL VIREAD ORAL TABLET PA; QL zidovudine oral capsule Retrovir zidovudine oral syrup Retrovir zidovudine oral tablet CEPHALOSPORIN ANTIBIOTICS cefaclor oral capsule cefadroxil oral capsule cefadroxil oral suspension for reconstitution cefadroxil oral tablet cefdinir oral capsule cefdinir oral suspension for reconstitution cefixime oral suspension for reconstitution Suprax cefprozil oral suspension for reconstitution cefprozil oral tablet 10

Description:
Anthem HealthKeepers Plus is the managed care program offered by HealthKeepers, Inc., .. fever reducer an pain reliever oral suspension. OTC.
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