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2021 Drug Formulary 1

Details: Drugs covered on our Dental Formulary are available when prescribed by a dental Formulary are listed with a “DF” on the formulary. Drugs without a “DF” will not be covered when written by a dental provider. OTC Sedative/Hypnotic Medications Sedative/hypnotic medications are limited for all prescribers except sleep specialists to 14

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2021 Comprehensive Formulary (List of Covered Drugs)

Details: A formulary is a list of covered drugs selected by our plan in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatmen t program. Our plan will generally cover the drugs listed in ourormul f ary as long as the drug is medically necessary, the

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› Url: https://fm.formularynavigator.com/FBO/67/08_GS_Core_MAPD_CompForm_21392.pdf Go Now

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Essential Drug List

Details: ” is the complete list of drugs preferred for use and eligible for coverage under a health plan product, and includes all drugs covered under the outpatient prescription drug benefit of the health plan product. Formulary is also known as a prescription drug list. “ Generic drug

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• Get more: Md medicaid drug formulary 2021Go Now

Comprehensive Formulary (List of Covered Drugs)

Details: drugs from our formulary, or add prior authorization, quantity limits and/or step therapy restrictions on a drug or move a drug to a higher cost -sharing tier, we must notify affected members of the change at least 30 days before the change becomes effective, or at the time the member requests a

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PRESCRIPTION DRUG FORMULARY

Details: What are generic drugs? Our plan covers both brand name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient as the brand name drug. Generally, generic drugs cost less than brand name drugs. Are there any restrictions on my coverage? Some covered drugs may have additional requirements or limits on

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› Url: https://fm.formularynavigator.com/FBO/126/2021_Medicare_Formulary.pdf Go Now

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Comprehensive Formulary (List of Covered Drugs)

Details: The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category “Cardiovascular.” If you know what your drug is used for, look

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› Url: https://fm.formularynavigator.com/FBO/67/11_6T_Core_MAPD_Comp_Form_22379.pdf Go Now

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Select Drug List

Details: o Tier 4 drugs have the highest cost share and usually include specialty brand and generic drugs. They may cost more than drugs on lower tiers that are used to treat the same condition. Tier 4 may also include drugs recently approved by the FDA or specialty drugs used to treat serious, long-term health conditions and that may need special handling.

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› Url: https://fm.formularynavigator.com/FBO/143/2022_Select_4_Tier_CT_SG_Split_.pdf Go Now

• Get more: Dmap formulary 2021Go Now

National Drug List

Details: The drugs on the list are reviewed through our Pharmacy and Therapeutics (P&T) process. In this process, a group of independent doctors, pharmacists, and healthcare professionals decides which drugs we include. The group meets regularly to review …

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› Url: https://fm.formularynavigator.com/FBO/143/2022_Select_3_Tier_NY_EBS_IND.pdf Go Now

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Tufts Medicare Preferred HMO 2022 Formulary (List of

Details: drugs from our formulary, add prior authorization, quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must notify affected members of the change at least 30 days before the change becomes effective, or at the time the member requests a

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› Url: https://fm.formularynavigator.com/FBO/36/2022_MA_HMO_Formulary.pdf Go Now

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3 Tier Drug Formulary

Details: The drugs on this Drug Formulary are grouped by the type of therapeutic class the drugs fall into. These classes of drugs are also grouped with plain language descriptions for the medical conditions for which these drugs aim to treat. For example, drugs used to treat high blood pressure are listed under “Antihypertensives” and

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› Url: https://fm.formularynavigator.com/FBO/221/Avera_Health_Plans_3_Tier_Formulary_Output_2020.pdf Go Now

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2022 Drug Formulary 1

Details: LDD – Limited Distribution Drugs MM – 90-day supply PV – Preventive OTC – Over-the-Counter PA – Prior Authorization Required QL – Quantity Limits Apply SP – Specialty Pharmacy ST – Step Therapy SUD – Substance Use Disorder. met. Compounds which cost more than $200 will

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National Drug List

Details: ” is the complete list of drugs preferred for use and eligible for coverage under a health plan product, and includes all drugs covered under the outpatient prescription drug benefit of the health plan product. Formulary is also known as a prescription drug list. “ Generic drug

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› Url: https://fm.formularynavigator.com/FBO/143/National_Drug_List_4_Tier_ABC.pdf Go Now

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Select 4 Tier Drug List

Details: and generic prescription drugs approved by the U.S. Food & Drug Administration (FDA). The following is a list of plan names to which this formulary may apply. Additional plans may be applicable.

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Tufts Medicare Preferred HMO Group Retiree 2021 Formulary

Details: The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category Cardiovascular Agents.

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› Url: https://fm.formularynavigator.com/FBO/36/2021_EG_formulary_final.pdf Go Now

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2022 Comprehensive Formulary

Details: What are generic drugs? Highmark Wholecare Medicare Assured Diamond and Highmark Wholecare Medicare Assured Ruby cover both brand name drugs and generic drugs. A generic drug is approved by the FDA as having the same active ingredient as the brand name drug. Generally, generic drugs cost less than brand name drugs.

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› Url: https://fm.formularynavigator.com/FBO/77/2022_BS_Medicare_Formulary_PDF.pdf Go Now

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Tufts Medicare Preferred PDP Group Retiree 2021 Formulary

Details: The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category Cardiovascular Agents.

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Select 4 Tier Drug List

Details: ” is a group of prescription drugs that corresponds to a specified cost sharing tier in the health plan’s prescription drug coverage. The tier in which a prescription drug is placed determines the enrollee’s portion of the cost for the drug.

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2021 Commercial Formulary

Details: Generic drugs are prescription drugs that have the same active ingredients as brand drugs and are prescribed for the same reasons. When the patent expires on a brand name drug, the FDA permits new manufacturers to produce an equivalent of the brand name drug and …

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2021 Formulary List of Covered Drugs

Details: The drugs in this formulary are grouped into categories. Categories depend on the type of medical conditions that they are used to treat. Alphabetical listing The Index provides an alphabetical list of all of the drugs included in this document. What are generic drugs? Our plan covers both brand name drugs and generic drugs.

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Select Drug List

Details: o Tier 4 drugs have the highest cost share and usually include specialty brand and generic drugs. They may cost more than drugs on lower tiers that are used to treat the same condition. Tier 4 may also include drugs recently approved by the FDA or specialty drugs used to treat serious, long-term health conditions and that may need special handling.

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2021 Formulary List of Covered Drugs

Details: The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. If you know what your drug is used for, look for the category name in the list that begins on page 1. Then, look under

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› Url: https://fm.formularynavigator.com/FBO/125/Choice_2021_Formulary.pdf Go Now

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List of covered drugs

Details: The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category, “Cardiovascular Agents”. If you know what your drug is used for, look for the category name in the list

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PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION …

Details: The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category, “Cardiovascular Agents.” If you

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› Url: https://fm.formularynavigator.com/FBO/197/2022_5TC_Drug_List.pdf Go Now

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Tufts Medicare Preferred HMO Group Retiree 2022 Formulary

Details: drugs from our formulary, add prior authorization, quantity limits and/or step therapy restrictions on a drug, or move a drug to a higher cost-sharing tier, we must notify affected members of the change at least 30 days before the change becomes effective, or at the time the member requests a

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› Url: https://fm.formularynavigator.com/FBO/36/2022_MA_EG_Formulary.pdf Go Now

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2021 Formulary List of Covered Drugs

Details: The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. If you know what your drug is used for, look for the category name in the list that begins on page 1. Then, look under

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Medicaid-Approved Preferred Drug List

Details: 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 * : 599 CHIP benefits (Pregnant Women) AL: Age Limit Restrictions . DO: Dose Optimization Program . GR: Gender Restriction . OTC: Over the counter medication available with a

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› Url: https://fm.formularynavigator.com/FBO/4/Nebraska_Medicaid_PDL_English.pdf Go Now

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Plan for your best health

Details: Specialty prescription drugs typically include higher-cost drugs that require special handling, special storage or monitoring. These types of drugs may include, but are not limited to, drugs that are injected, infused, inhaled or taken by mouth. You’re covered for all …

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Step Therapy Medications

Details: Step Therapy Medications Step therapy is a limitation that requires you to try preferred medications before the plan will pay for another medication for the same medical condition that the doctor may have originally prescribed.

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Pharmacy Benefit Dimensions Prescription Drug Plan PDP

Details: The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category, “Cardiovascular Agents”. If you know what your drug is used

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› Url: https://fm.formularynavigator.com/FBO/43/2021_PDP_LMHF_Formulary_.pdf Go Now

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National Drug List

Details: The drugs are listed in alphabetical order based on the name of their drug class, also called therapeutic class. You can search the PDF drug list by: o Drug name, using Ctrl + F on your keyboard, then type in the name of the drug you’re looking for.

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› Url: https://fm.formularynavigator.com/FBO/143/National_Drug_List_5_Tier_IGX.pdf Go Now

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National Drug List

Details: The drugs are listed in alphabetical order based on the name of their drug class, also called therapeutic class. You can search the PDF drug list by: o Drug name, using Ctrl + F on your keyboard, then type in the name of the drug you’re looking for.

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› Url: https://fm.formularynavigator.com/FBO/143/National_Drug_List_3_Tier_IGX.pdf Go Now

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Buckeye Health Plan – MyCare Ohio (Medicare-Medicaid Plan

Details: This document is called the List of Covered Drugs (also known as the Drug List). It tells you which prescription drugs and over-the-counter drugs and items are covered by Buckeye Health Plan ‒ MyCare Ohio. The Drug List also tells you if there are any special rules or restrictions on any drugs covered by Buckeye Health Plan ‒ MyCare Ohio.

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HEALTH NET CAL MEDICONNECT PLAN (MEDICARE …

Details: The drugs on the Drug List are the drugs covered by Health Net Cal MediConnect. The drugs are available at pharmacies within our ne twork. A pharmacy is in our network if we have an agreement with them to work with us and provide you services. We refer to these pharmacies as “network

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Qualified Health Plans 2 Drug Formulary for HMOs and PPOs

Details: Specialty drugs are biologics or prescription drugs that require close monitoring for safety and efficacy. For this reason we contract with Pharmacy Advantage, a specialty pharmacy, from whom you can obtain specialty drugs. Specialty drugs require prior authorization and Pharmacy Advantage can help you and your doctor submit a request.

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Keystone 65 Rx HMO/HMO-POS

Details: Drugs that require step therapy are listed in this document. • Quantity Limits (QL): For certain drugs, our plan limits the amount of the drug that our plan will cover. Drugs that have quantity limits are listed in the Keystone 65 Rx and Personal Choice 65 Rx Formulary (List of Covered Drugs).

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Keystone 65 Rx Personal Choice 65SM Rx 2022 Formulary

Details: The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category, “Cardiovascular Agents.” If you know what your drug is used for, look for the category name in the list

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2019 Comprehensive Formulary (List of Covered Drugs)

Details: The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category, “Cardiovascular Drugs”. If you know what your drug is used

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PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION …

Details: The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category, “Cardiovascular Agents.” If you

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Virginia Premier Individual Plans Comprehensive Formulary

Details: drugs. The term “covered drugs” means all prescription drugs that are covered on our plan’s formulary. For certain kinds of drugs, you can use the plan’s network mail-order services. Generally, the drugs provided through mail order are drugs that you take on a regular basis, for …

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Commercial Metal 5-Tier Formulary (List of Covered Drugs)

Details: Generic drugs are prescription drugs that have the same active ingredients as brand-name drugs and are prescribed for the same reasons. When the patent expires on a brand-name drug, the FDA permits new manufacturers to produce an equivalent of the brand-name drug and make it …

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Superior HealthPlan STAR+PLUS Medicare-Medicaid Plan …

Details: prescription drugs and over-the-counter drugs and items are covered by Superior HealthPlan STAR+PLUS Medicare-Medicaid Plan (MMP). The Drug List also tells you if there are any special rules or restrictions on any drugs covered by Superior STAR+PLUS MMP. Key terms and their definitions appear in the last chapter of the Member Handbook. Updated

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Keystone 65 Rx Personal Choice 65SM Rx 2021 Formulary

Details: The drugs in this formulary are grouped into categories depending on the type of medical conditions that they are used to treat. For example, drugs used to treat a heart condition are listed under the category, “Cardiovascular Agents.” If you know what your drug is used for, look for the category name in the list

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