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Apple Health Preferred Drug List DUR Board Meeting Donna Sullivan, PharmD Chief Pharmacy Officer February 20, 2019

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Page 1: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

Apple HealthPreferred Drug List

DUR Board Meeting

Donna Sullivan, PharmDChief Pharmacy Officer February 20, 2019

Page 2: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIBIOTICS

2

AMINOGLYCOSIDES - ORALPreferred Non-PreferredNEOMYCIN SULFATE NONEPAROMOMYCIN SULFATE

Page 3: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIBIOTICS

3

ANTI-INFECTIVE AGENTS - MISC - ORALPreferred Non-PreferredMETRONIDAZOLE TABS FLAGYLTINIDAZOLE METRONIDAZOLE CAPS

XIFAXAN TINDAMAX

Page 4: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIBIOTICS

4

ANTIMYCOBACTERIAL AGENTS - ORALPreferred Non-PreferredCYCLOSERINE RIFAMPIN MYAMBUTOLETHAMBUTOL HCL SIRTURO MYCOBUTIN

ISONIAZID TRECATOR PASERPRIFTIN RIFADINPYRAZINAMIDE RIFAMATERIFABUTIN RIFATER

Page 5: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIBIOTICS

5

FLUOROQUINOLONES - ORALPreferred Non-PreferredCIPROFLOXACIN AVELOX LEVAQUINLEVOFLOXACIN TABS

BAXDELALEVOFLOXACIN SOLN

CIPRO MOXIFLOXACIN HCLCIPROFLOXACIN ER OFLOXACIN

Page 6: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIBIOTICS

6

GLYCOPEPTIDES - ORALPreferred Non-PreferredFIRVANQ VANCOCIN HCLVANCOMYCIN HCL

Page 7: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIBIOTICS

7

LEPROSTATICS - ORALPreferred Non-PreferredDAPSONE NONE

Page 8: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIBIOTICS

8

LINCOSAMIDES - ORALPreferred Non-PreferredCLINDAMYCIN HCL CLEOCINCLINDAMYCIN PALMITATE HCL

Page 9: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIBIOTICS

9

MACROLIDES - ORALPreferred Non-PreferredAZITHROMYCIN CLARITHROMYCIN ER ERYPED 400CLARITHROMYCIN DIFICID ERYTHROCIN STEARATE

ERY-TAB E.E.S. 400 ERYTHROMYCIN BASE

ERYTHROMYCIN E.E.S. GRANULES PCEERYTHROMYCIN ETHYLSUCCINATE ERYPED 200 ZITHROMAX

Page 10: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIBIOTICS

10

OXAZOLIDINONES - ORALPreferred Non-PreferredLINEZOLID SIVEXTRO

ZYVOX

Page 11: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIBIOTICS

11

PENICILLINASE-RESISTANT PENICILLINS - ORALPreferred Non-PreferredDICLOXACILLIN SODIUM NONE

Page 12: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIDOTES AND SPECIFIC ANTAGONISTS

12

CHELATING AGENTSPreferred Non-PreferredEXJADE NONEFERRIPROX

JADENU

Page 13: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIFUNGALS

13

ORALPreferred Non-PreferredCLOTRIMAZOLE ANCOBON NOXAFILFLUCONAZOLE CRESEMBA ONMEL

GRISEOFULVIN DIFLUCAN SPORANOX

ITRACONAZOLE SOLN FLUCYTOSINE TOLSURAKETOCONAZOLE GRIS-PEG VFENDNYSTATIN ITRACONAZOLE CAPS VORICONAZOLETERBINAFINE HCL LAMISIL

Page 14: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ANTIPARASITICS

14

ANTIPROTOZOAL AGENTSPreferred Non-PreferredALINIA MEPRONATOVAQUONE

Page 15: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

15

ACNE PRODUCTS - ORALPreferred Non-PreferredAMNESTEEM ABSORICACLARAVIS

ISOTRETINOINMYORISANZENATANE

Page 16: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

16

AGENTS FOR EXTERNAL GENITAL AND PERIANAL WARTSPreferred Non-PreferredNONE VEREGEN*

*PA REQUIRED

Page 17: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

17

ANTINEOPLASTIC OR PREMALIGNANT LESION AGENTS - TOPICALPreferred Non-PreferredAMELUZ EFUDEXDICLOFENAC SODIUM CARAC

FLUOROURACIL 5% CREAM/SOLN FLUOROURACIL 0.5% CREAMLEVULAN KERASTICKPANRETINPICATOTARGRETINTOLAKVALCHLOR

Page 18: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

18

ANTIPSORIATICS - ORALPreferred Non-PreferredACITRETIN METHOXSALEN

OXSORALEN ULTRA

SORIATANE

Page 19: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

19

DERMATOLOGICS : ANTIPSORIATICS - TOPICALPreferred Non-PreferredCALCIPOTRIENE CALCITRIOLCALCITRENE DOVONEX

SORILUXTAZAROTENETAZORACVECTICAL

Page 20: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

20

ECZEMA AGENTSPreferred Non-PreferredNONE DUPIXENT*

*PA REQUIRED

Page 21: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

21

ENZYMES - TOPICALPreferred Non-PreferredNONE SANTYL*

*PA REQUIRED

Page 22: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

22

PHOSPHODIESTERASE 4 (PDE4) INHIBITORSPreferred Non-PreferredNONE EUCRISA*

*PA REQUIRED

Page 23: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

23

ROSACEA AGENTSPreferred Non-PreferredAZELAIC ACID DOXYCYCLINE NORITATEFINACEA METROCREAM ORACEA

METRONIDAZOLE METROGEL RHOFADE

ROSADAN METROLOTION ROSADAN KITMIRVASO SOOLANTRA

Page 24: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

24

TOPICAL STEROIDS - HIGH POTENCYPreferred

BETAMETHASONE VALERATE CREAM, OINTMENT

CALCIPOTRIENE/ BETAMETHASONE DIPROPIONATE

TRIAMCINOLONE ACETONIDE CREAM, LOTION, OINTMENT

TRIDERM

Page 25: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

25

TOPICAL STEROIDS - HIGH POTENCY CONTINUEDNon-Preferred

AMCINONIDE DERMASORB TAAPEXICON E DESOXIMETASONEAUGMENTED BETAMETHASONE DIPROPIONATE DIFLORASONE DIACETATEBETAMETHASONE DIPROPIONATE DIPROLENEBETAMETHASONE VALERATE DIPROLENE AFCAPEX ENSTILARCLODAN KIT FLUOCINOLONE ACETONIDEDERMA-SMOOTHE/FS BODY FLUOCINOLONE ACETONIDE BODYDERMA-SMOOTHE/FS SCALP FLUOCINOLONE ACETONIDE SCALP

Page 26: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

26

TOPICAL STEROIDS - HIGH POTENCY CONTINUEDNon-Preferred

FLUOCINONIDE SYNALARFLUOCINONIDE EMULSIFIED BASE SYNALAR CREAM KITFLUOCINONIDE EMULSIFIED BASE SYNALAR OINTMENT KITFLURANDRENOLIDE SYNALAR TSHALOG TACLONEXKENALOG TOPICORTLUXIQ TRIAMCINOLONE ACETONIDEPSORCON TRIANEXSERNIVO VANOS

Page 27: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

27

TOPICAL STEROIDS - MEDIUM POTENCYPreferred

FLUTICASONE PROPIONATE CREAM, OINTMENT

MOMETASONE FUROATE

Non-Preferred

CLOCORTOLONE PIVALATE /PUMP ELOCON LOCOIDCLODERM /PUMP FLUTICASONE PROPIONATE LOCOID LIPOCREAM

CUTIVATEHYDROCORTISONE BUTYRATE PANDEL

DERMASORB HCHYDROCORTISONE VALERATE PREDNICARBATE

Page 28: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

DERMATOLOGICS

28

TOPICAL STEROIDS - VERY HIGH POTENCYPreferred

CLOBETASOL PROPIONATE CREAM, GEL, OINTMENT, SOLUTION

HALOBETASOL PROPIONATE

Non-Preferred

BRYHALI CLODAN OLUXCLOBETASOL PROPIONATE FOAM, LIQUID, LOTION, SHAMPOO CORDRAN TEMOVATECLOBETASOL PROPIONATE EMOLLIENT CREAM, FOAM HALAC ULTRAVATECLOBEX LEXETTE

Page 29: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

29

ANDROGENS - OTHERPreferred Non-PreferredDANAZOL NONE

Page 30: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

30

BONE DENSITY REGULATORS - BISPHOSPHONATESPreferred Non-PreferredALENDRONATE SODIUM

ACTONELIBANDRONATE SODIUMSOLN

IBANDRONATE SODIUMTABS ATELVIA

PAMIDRONATE DISODIUM

ZOLEDRONIC ACID BINOSTO RECLAST

BONIVARISEDRONATE SODIUM/ DR

ETIDRONATE DISODIUM ZOMETAFOSAMAX

Page 31: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

31

BONE DENSITY REGULATORS - CALCITONINSPreferred Non-PreferredCALCITONIN SALMON MIACALCIN

Page 32: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

32

BONE DENSITY REGULATORS - SELECTIVE ESTROGEN RECEPTOR MODULATORS (SERMS)

Preferred Non-PreferredRALOXIFENE HYDROCHLORIDE EVISTA

Page 33: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

33

BONE DENSITY REGULATORS - RANK LIGAND INHIBITORSPreferred Non-PreferredPROLIA* NONEXGEVA*

*PA REQUIRED

Page 34: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

34

BONE DENSITY REGULATORS - PARATHYROID HORMONE DERIVATIVES

Preferred Non-PreferredFORTEO NATPARA

TYMLOS

Page 35: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

35

ESTROGEN / ANDROGEN COMBINATIONSPreferred Non-PreferredESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE

Page 36: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

36

ESTROGEN / PROGESTIN COMBINATIONSPreferred Non-PreferredAMABELZ JINTELI ACTIVELLAANGELIQ LOPREEZA FEMHRT LOW DOSE

CLIMARA PRO MIMVEY /LO PREFEST

COMBIPATCH

NORETHINDRONE ACETATE/ETHINYL ESTRADIOL

ESTRADIOL/ NORETHINDRONE ACETATE PREMPHASEFYAVOLV PREMPROJEVANTIQUE LO

Page 37: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

37

ESTROGEN / SELECTIVE ESTROGEN RECEPTOR MODULATOR COMBINATIONS

Preferred Non-PreferredDUAVEE* NONE

*PA REQUIRED

Page 38: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

38

ESTROGENS - INJECTABLEPreferred Non-PreferredDEPO-ESTRADIOL DELESTROGENESTRADIOL VALERATE PREMARIN

Page 39: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

39

ESTROGENS - ORALPreferred Non-PreferredESTRADIOL ESTRACEESTROPIPATE

MENESTPREMARIN

Page 40: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

40

ESTROGENS - TOPICALPreferred Non-PreferredESTRADIOL ALORA

CLIMARA

DIVIGELELESTRINEVAMISTMENOSTARMINIVELLEVIVELLE-DOT

Page 41: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

41

ESTROGENS - VAGINALPreferred Non-PreferredESTRADIOL ESTRACEESTRING FEMRING

PREMARIN VAGIFEMYUVAFEM

Page 42: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

42

METABOLIC MODIFIERS - PHENYLKETONURIA (PKU) AGENTSPreferred Non-Preferred

PALYNZIQ*

*PA REQUIRED

Page 43: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

43

METABOLIC MODIFIERS - TRIPEPTIDY PEPTIDASE 1 DEFICIENCY AGENTS

Preferred Non-PreferredBRINEURA*

*PA REQUIRED

Page 44: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

44

METABOLIC MODIFIERS - X-LINKED HYPOPHOSPHATEMIA (XLH) AGENTS

Preferred Non-PreferredCRYSVITA*

*PA REQUIRED

Page 45: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

45

THYROID AGENTS - ANTITHYROID AGENTSPreferred Non-PreferredMETHIMAZOLE TAPAZOLEPROPYLTHIOURACIL

Page 46: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

ENDOCRINE AND METABOLIC AGENTS

46

THYROID AGENTS - THYROID HORMONE - ORALPreferred Non-PreferredARMOUR THYROID CYTOMELLEVO-T SYNTHROID

LEVOTHYROXINE SODIUM THYROLARLEVOTHYROXINE/LIOTHYRONINE TIROSINTLEVOXYLLIOTHYRONINE SODIUMNP THYROIDUNITHROID

Page 47: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

MISCELLANEOUS THERAPEUTIC CLASSES

47

CHELATING AGENTSPreferred Non-PreferredCUPRIMINE SYPRINEDEPEN TITRATABS D-PENAMINE

TRIENTINE HYDROCHLORIDE

Page 48: Apple Health Preferred Drug List / ANDROGEN COMBINATIONS Preferred Non-Preferred ESTERIFIED ESTROGENS/METHYLTESTOSTERONE NONE ENDOCRINE AND METABOLIC AGENTS 36 ESTROGEN / PROGESTIN

MISCELLANEOUS THERAPEUTIC CLASSES

48

POTASSIUM REMOVING AGENTSPreferred Non-PreferredKIONEX LOKELMASODIUM POLYSTYRENE SULFONATE

SPSVELTASSA


EUROPROXIMA PRODUCT OVERVIEWeuroproxima.com/wp-content/uploads/EuroProxima-2020... · 2020. 3. 19. · 5081TRENBO Trenbolone 5081MTES Methyltestosterone 5131MPA MedroxyProgesterone

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Use of esterified palm acid oils with different acylglycerol … · 2015. 9. 17. · P-EL Esterified palm acid oil low in MAG and DAG P-EH Esterified palm acid oil high in MAG and

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India's Preferred Investment Destination India's Preferred Investment Destination

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Preferred Stock: Not Really Preferred or Stock - Edward … · Preferred Stock: Not Really Preferred or Stock ... company issues except common stock. So if it’s not preferred, and

Beyond Word2Vec: Using embeddings to chart out the ebb and … · Consulting Experience Preferred External Consulting Experience Preferred Preferred Experience MBA Preferred BA in

Estradiol Progesterone Target concentration: 0.1 mg/m ... · 1 of 21 T-PV2001-02-0102-M Estradiol Estriol Estrone 17- "-Methyltestosterone Progesterone Testosterone Method number:

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Preferred Searches

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Sulfate removal from aqueous solutions using esterified

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Louisiana Medicaid Preferred Drug List (PDL)/Non-Preferred ...ldh.la.gov/assets/HealthyLa/Pharmacy/PDL.pdf · LA Medicaid Preferred Drug List (PDL)/Non-Preferred Drug List (NPDL)

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PS2 - Purdue Universityjtfuller/HW2/PS2.pdfstandard, preferred, and ultra-preferred. Of the company's policyholders, 50% are standard, 40% are preferred, and 10% are ultra-preferred

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Turnover of Plasma Esterified Cholesterol in Normocho- lesterolemic … · 2014. 1. 30. · Jovnal of CHnical Irvestigation Vol. 46, o. 6, 1967 Turnover of Plasma Esterified Cholesterol

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