BLUE - Formulary
RED - Non Formulary

Table of Contents Index Policy Information

Formulary Index

Numbers A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

E-Z SPACER (BETA-2 ADRENERGIC DRUGS)

E-Z SPACER & MASK (MEDICAL (MISCELLANEOUS) SUPPLIES)

E-Z SPACER MASK (MEDICAL (MISCELLANEOUS) SUPPLIES)

E-Z SPACER PEDSPAK (MEDICAL (MISCELLANEOUS) SUPPLIES)

E-Z-CAT (DIAGNOSTIC PRODUCTS)

E-Z-HD (DIAGNOSTIC PRODUCTS)

E-Z-PAQUE (DIAGNOSTIC PRODUCTS)

E.E.S. 200 (ERYTHROMYCINS)

E.E.S. 400 (ERYTHROMYCINS)

EAR POPPER (MEDICAL (MISCELLANEOUS) SUPPLIES)

EASIVENT (MEDICAL (MISCELLANEOUS) SUPPLIES)

EASPRIN (SALICYLATES AND RELATED DRUGS)

EC-NAPROSYN (NON-STEROIDAL ANTIINFLAMMATORY AGENTS)

echothiophate iodide (ANTIGLAUCOMA DRUGS)

econazole (OTHER TOPICAL ANTIFUNGALS)

econazole nitrate (OTHER TOPICAL ANTIFUNGALS)

ED A-HIST (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

ED CHLORPED (ANTIHISTAMINES)

ED CHLORPED D (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

ED CYTE F (VITAMINS & MINERALS & RELATED PRODUCTS)

ED-A-HIST DM (ANTITUSSIVE AND EXPECTORANT DRUGS)

ED-BRON G (METHYL XANTHINE DRUGS)

ED-CHLOR-TAN (ANTIHISTAMINES)

ED-FLEX (CNS MUSCLE RELAXANTS)

EDECRIN (LOOP DIURETICS)

edetate, calcium disodium (DIAGNOSTIC PRODUCTS)

EDEX (PAR) (OTHER GENITOURINARY PRODUCTS)

EDGE OB (PRENATAL VITAMINS)

EDLUAR (SEDATIVE/HYPNOTIC DRUGS)

edrophonium (OTHER CNS/AUTONOMIC DRUGS)

edrophonium/atropine sulfate (OTHER CNS/AUTONOMIC DRUGS)

eemt (ESTROGEN DRUGS)

eemt h.s. (ESTROGEN DRUGS)

efavirenz (ANTIRETROVIRALS & PROTEASE INH)

effer-k (POTASSIUM SUPPLEMENTS)

EFFER-K (POTASSIUM SUPPLEMENTS)

EFFEXOR (37.5mg & 50mg not covered) (OTHER ANTIDEPRESSANTS)

EFFEXOR XR (OTHER ANTIDEPRESSANTS)

EFFIENT (ANTIPLATELET DRUGS)

EFUDEX (TOPICAL DERMATOLOGICAL DRUGS)

ELDEPRYL (OTHER ANTIPARKINSON DRUGS)

ELDERCAPS (VITAMINS & MINERALS & RELATED PRODUCTS)

ELDOPAQUE FORTE (TOPICAL DERMATOLOGICAL DRUGS)

ELDOQUIN FORTE (TOPICAL DERMATOLOGICAL DRUGS)

electrolyte solution/peg's (OTHER GI DRUGS)

electrolyte solutions (ELECTROLYTES, IRRIGATING SOLUTIONS, ETC.)

ELESTAT (OTHER OPHTHALMIC DRUGS)

ELESTRIN (ESTROGEN DRUGS)

ELETONE (TOPICAL DERMATOLOGICAL DRUGS)

ELIDEL (covered if prescribed by dermatologist) (TOPICAL DERMATOLOGICAL DRUGS)

ELIGARD (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

ELIMITE (SCABICIDES)

ELIPHOS (THERAPEUTIC VITAMINS & MINERALS)

ELITE OB DHA (PRENATAL VITAMINS)

ELITE-OB (PRENATAL VITAMINS)

ELIXOPHYLLIN (METHYL XANTHINE DRUGS)

ELMIRON (OTHER GENITOURINARY PRODUCTS)

ELOCON (TOPICAL CORTICOSTEROID DRUGS)

ELSPAR (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

EMADINE (OTHER OPHTHALMIC DRUGS)

EMBEDA (CLASS II NARCOTICS)

EMCYT (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

EMEND (ANTIVERTIGO AND ANTIEMETIC DRUGS)

EMEND (prescribing limited to oncology) (ANTIVERTIGO AND ANTIEMETIC DRUGS)

EMGEL (ANTIACNE DRUGS)

EMLA (TOPICAL ANESTHETICS)

emollient (TOPICAL DERMATOLOGICAL DRUGS)

EMSAM (MAO INHIBITORS)

emtricitabine (ANTIRETROVIRALS & PROTEASE INH)

emtricitabine/tenofovir (ANTIRETROVIRALS & PROTEASE INH)

EMTRIVA (ANTIRETROVIRALS & PROTEASE INH)

ENABLEX (ANTICHOLINERGIC ANTISPASMODICS)

enalapril (ANGIOTENSIN CONVERTING ENZYME INHIBITORS)

enalapril maleate (ANGIOTENSIN CONVERTING ENZYME INHIBITORS)

enalapril maleate-hctz (OTHER ANTIHYPERTENSIVES)

enalapril maleate/hctz (OTHER ANTIHYPERTENSIVES)

enalaprilat (ANGIOTENSIN CONVERTING ENZYME INHIBITORS)

ENBREL (PAR) (covered only if prescribed by rheumatologist) (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

ENCORA (VITAMINS & MINERALS & RELATED PRODUCTS)

ENDACOF AC (ANTITUSSIVE AND EXPECTORANT DRUGS)

ENDACOF-C (ANTITUSSIVE AND EXPECTORANT DRUGS)

ENDACOF-PD (ANTITUSSIVE AND EXPECTORANT DRUGS)

ENDAL CD (ANTITUSSIVE AND EXPECTORANT DRUGS)

ENDO-AVITENE (HEMOSTATICS)

endocet (CLASS II NARCOTICS)

ENDOCET (CLASS II NARCOTICS)

endodan (CLASS II NARCOTICS)

ENDOMETRIN (PROGESTIN DRUGS)

enfuvirtide (ANTIRETROVIRALS & PROTEASE INH)

ENGERIX-B (IMMUNOLOGICALS AND VACCINES)

ENJUVIA (ESTROGEN DRUGS)

ENLON (OTHER CNS/AUTONOMIC DRUGS)

ENLON-PLUS (OTHER CNS/AUTONOMIC DRUGS)

enoxaparin (INJECTABLE ANTICOAGULANTS)

enpresse (CONTRACEPTIVES)

entacapone (OTHER ANTIPARKINSON DRUGS)

entecavir (OTHER ANTIVIRAL DRUGS)

ENTEREG (OTHER GI DRUGS)

ENTERO VU (DIAGNOSTIC PRODUCTS)

ENTOCORT EC (OTHER GI DRUGS)

enulose (BLOOD DETOXICANTS)

ephedrine sulfate (BETA-2 ADRENERGIC DRUGS)

EPICERAM (TOPICAL DERMATOLOGICAL DRUGS)

epidrin (DRUGS TO PREVENT AND TREAT HEADACHES)

EPIDUO (ANTIACNE DRUGS)

EPIFOAM (TOPICAL CORTICOSTEROID DRUGS)

epinephrine (OTHER DRUGS FOR ASTHMA)

epinephrine hcl (OTHER DRUGS FOR ASTHMA)

EPIPEN (OTHER DRUGS FOR ASTHMA)

EPIPEN JR (OTHER DRUGS FOR ASTHMA)

EPIQUIN MICRO (TOPICAL DERMATOLOGICAL DRUGS)

epitol (CARBAMAZEPINES)

EPIVIR (ANTIRETROVIRALS & PROTEASE INH)

EPIVIR HBV (OTHER ANTIVIRAL DRUGS)

eplerenone (POTASSIUM SPARING DIURETICS)

epoetin alfa (ERYTHROID STIMULANTS)

EPOGEN (PAR) (ERYTHROID STIMULANTS)

epoprostenol na (OTHER VASODILATING DRUGS)

epoprostenol sodium (OTHER VASODILATING DRUGS)

EPZICOM (ANTIRETROVIRALS & PROTEASE INH)

EQUETRO (CARBAMAZEPINES)

ergocalciferol (THERAPEUTIC VITAMINS & MINERALS)

ERGOLOID MESYLATES (MISCELLANEOUS DRUGS)

ERGOMAR (DRUGS TO PREVENT AND TREAT HEADACHES)

ergotamine (DRUGS TO PREVENT AND TREAT HEADACHES)

ergotamine tartrate/caffeine (DRUGS TO PREVENT AND TREAT HEADACHES)

ergotamine-caffeine (DRUGS TO PREVENT AND TREAT HEADACHES)

ERGOTRATE (OXYTOCICS)

erlotinib hcl (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

errin (PROGESTIN DRUGS)

ERTACZO (OTHER TOPICAL ANTIFUNGALS)

ery (ANTIACNE DRUGS)

ERY-TAB (ERYTHROMYCINS)

ERYPED 200 (ERYTHROMYCINS)

ERYPED 400 (ERYTHROMYCINS)

ERYTHROCIN LACTOBIONATE (ERYTHROMYCINS)

erythrocin stearate (ERYTHROMYCINS)

erythromycin (ERYTHROMYCINS)

erythromycin (ANTIACNE DRUGS)

erythromycin (OPHTHALMIC TOPICAL ANTIBACTERIAL DRUGS)

erythromycin base (ERYTHROMYCINS)

erythromycin base (ANTIACNE DRUGS)

erythromycin base (OPHTHALMIC TOPICAL ANTIBACTERIAL DRUGS)

erythromycin base/benz per (ANTIACNE DRUGS)

erythromycin ethylsuccinate (ERYTHROMYCINS)

erythromycin lactobionate (ERYTHROMYCINS)

erythromycin stearate (ERYTHROMYCINS)

erythromycin-benzoyl peroxide (ANTIACNE DRUGS)

erythromycin-sulfisoxazole (SULFONAMIDES)

erythromycin/sulfisoxazole (SULFONAMIDES)

escitalopram oxalate (SELECTIVE SEROTONIN REUPTAKE INHIBITORS)

ESGIC (DRUGS TO PREVENT AND TREAT HEADACHES)

ESGIC-PLUS (DRUGS TO PREVENT AND TREAT HEADACHES)

ESKALITH (ANTIMANIA DRUGS)

essian (ESTROGEN DRUGS)

essian h.s. (ESTROGEN DRUGS)

ESTAZOLAM (SEDATIVE/HYPNOTIC DRUGS)

ESTRACE (ESTROGEN DRUGS)

ESTRADERM (ESTROGEN DRUGS)

estradiol (ESTROGEN DRUGS)

estradiol cypionate (ESTROGEN DRUGS)

estradiol valerate (ESTROGEN DRUGS)

estradiol-norethindrone acetat (ESTROGEN/PROGESTIN COMBINATIONS)

estradiol/noreth ac (ESTROGEN/PROGESTIN COMBINATIONS)

estramustine phosphate sodium (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

ESTRASORB (ESTROGEN DRUGS)

ESTRING (ESTROGEN DRUGS)

ESTROGEL (ESTROGEN DRUGS)

estrogen & methyltestosterone (ESTROGEN DRUGS)

estrogen/medroxyprogesterone (ESTROGEN/PROGESTIN COMBINATIONS)

estrogens,conjugated (ESTROGEN DRUGS)

estropipate (ESTROGEN DRUGS)

ESTROSTEP FE (CONTRACEPTIVES)

etanercept (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

eth estradiol/drospirenone (CONTRACEPTIVES)

ethacrynate sodium (LOOP DIURETICS)

ethambutol (ANTITUBERCULOSIS DRUGS)

ethambutol hcl (ANTITUBERCULOSIS DRUGS)

ETHEDENT (FLUORIDE PRODUCTS)

ethionamide (ANTITUBERCULOSIS DRUGS)

ethosuximide (SUCCINIMIDES)

ethotoin (HYDANTOINS)

ETHYL ACETATE (PHARMACEUTICAL NECESSITIES)

ETHYL ALCOHOL (MISCELLANEOUS DRUGS)

ETHYL CHLORIDE (TOPICAL ANESTHETICS)

ethynodiol diace-eth estradiol (CONTRACEPTIVES)

ETHYOL (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

etidronate (OTHER ENDOCRINE DRUGS)

etidronate disodium (OTHER ENDOCRINE DRUGS)

etodolac (NON-STEROIDAL ANTIINFLAMMATORY AGENTS)

ETODOLAC (requires trial of OTC NSAID) (NON-STEROIDAL ANTIINFLAMMATORY AGENTS)

etoposide (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

EUFLEXXA (OTHER DRUGS FOR ARTHRITIS)

EURAX (SCABICIDES)

EVAMIST (ESTROGEN DRUGS)

EVISTA (SELECTIVE ESTROGEN RECEPTOR MODULATOR)

EVISTA (PAR) (SELECTIVE ESTROGEN RECEPTOR MODULATOR)

EVOCLIN (ANTIACNE DRUGS)

EVOXAC (DRUGS AFFECTING THE THROAT AND MOUTH)

EXACTACAIN (TOPICAL ANESTHETICS)

EXALL (ANTITUSSIVE AND EXPECTORANT DRUGS)

EXECLEAR-C (ANTITUSSIVE AND EXPECTORANT DRUGS)

EXECLEAR-DM (ANTITUSSIVE AND EXPECTORANT DRUGS)

EXELDERM (OTHER TOPICAL ANTIFUNGALS)

EXELON (ANTIDEMENTIA DRUGS)

exemestane (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

exenatide (INCRETIN MIMETICS)

EXFORGE (OTHER ANTIHYPERTENSIVES)

EXFORGE HCT (OTHER ANTIHYPERTENSIVES)

EXJADE (DIAGNOSTIC PRODUCTS)

EXODERM (OTHER TOPICAL ANTIFUNGALS)

EXOTIC-HC (DRUGS AFFECTING THE EAR)

EXPECTUSS (ANTITUSSIVE AND EXPECTORANT DRUGS)

EXTINA (OTHER TOPICAL ANTIFUNGALS)

ezetimibe (HYPOLIPOPROTEINEMICS)

ezetimibe/simvastatin (HMG-COA COMBINATIONS)

Formulary Date: 10/21/2009 Update Date: 10/26/2009 V1.3.0