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

H-TRON PLUS (MEDICAL (MISCELLANEOUS) SUPPLIES)

haemophilus b vaccine (IMMUNOLOGICALS AND VACCINES)

haemophilus b-tet toxoid (IMMUNOLOGICALS AND VACCINES)

halcinonide (TOPICAL CORTICOSTEROID DRUGS)

HALCION (SEDATIVE/HYPNOTIC DRUGS)

HALDOL (ANTIPSYCHOTIC DRUGS)

HALDOL DECANOATE 100 (ANTIPSYCHOTIC DRUGS)

HALDOL DECANOATE 50 (ANTIPSYCHOTIC DRUGS)

HALFAN (PLASMODICIDES)

HALFLYTELY-BISACODYL (OTHER GI DRUGS)

halobetasol propionate (TOPICAL CORTICOSTEROID DRUGS)

HALOG (TOPICAL CORTICOSTEROID DRUGS)

haloperidol (ANTIPSYCHOTIC DRUGS)

haloperidol decanoate (ANTIPSYCHOTIC DRUGS)

haloperidol lactate (ANTIPSYCHOTIC DRUGS)

HALOTIN (OTHER TOPICAL ANTIFUNGALS)

HAVRIX (IMMUNOLOGICALS AND VACCINES)

hctz/amiloride (POTASSIUM SPARING DIURETICS)

hctz/bisoprolol fumarate (OTHER ANTIHYPERTENSIVES)

hctz/metoprolol (OTHER ANTIHYPERTENSIVES)

hctz/propranolol (OTHER ANTIHYPERTENSIVES)

hctz/triamterene (POTASSIUM SPARING DIURETICS)

hctz/valsartan (OTHER ANTIHYPERTENSIVES)

HDC DM (ANTITUSSIVE AND EXPECTORANT DRUGS)

HECTOROL (THERAPEUTIC VITAMINS & MINERALS)

HELIDAC (HELICOBACTER PYLORI DRUGS)

HELISTAT (HEMOSTATICS)

HELITENE (HEMOSTATICS)

HELIXATE FS (HEMOSTATICS)

HEMATINIC PLUS (VITAMINS & MINERALS & RELATED PRODUCTS)

HEMATINIC WITH FOLIC ACID (VITAMINS & MINERALS & RELATED PRODUCTS)

HEMATOGEN (VITAMINS & MINERALS & RELATED PRODUCTS)

HEMATOGEN FA (VITAMINS & MINERALS & RELATED PRODUCTS)

HEMATOGEN FORTE (VITAMINS & MINERALS & RELATED PRODUCTS)

HEMATRON (VITAMINS & MINERALS & RELATED PRODUCTS)

HEMATRON-AF (VITAMINS & MINERALS & RELATED PRODUCTS)

HEMAX (VITAMINS & MINERALS & RELATED PRODUCTS)

HEMOCYTE PLUS (VITAMINS & MINERALS & RELATED PRODUCTS)

HEMOCYTE-F (VITAMINS & MINERALS & RELATED PRODUCTS)

HEMOFIL M (HEMOSTATICS)

hemorrhoidal hc (OTHER GI DRUGS)

HEMRIL (OTHER GI DRUGS)

hep-lock (INJECTABLE ANTICOAGULANTS)

heparin flush (INJECTABLE ANTICOAGULANTS)

heparin lock (INJECTABLE ANTICOAGULANTS)

heparin lock flush (INJECTABLE ANTICOAGULANTS)

heparin sodium (INJECTABLE ANTICOAGULANTS)

heparin sodium in 0.45% nacl (INJECTABLE ANTICOAGULANTS)

heparin sodium in 0.9% nacl (INJECTABLE ANTICOAGULANTS)

heparin sodium in 5% dextrose (INJECTABLE ANTICOAGULANTS)

heparin sodium(porcine)/d5w (INJECTABLE ANTICOAGULANTS)

heparin sodium(porcine)/nacl (INJECTABLE ANTICOAGULANTS)

HEPATAMINE (ELECTROLYTES, IRRIGATING SOLUTIONS, ETC.)

hepatatis a virus vaccine (IMMUNOLOGICALS AND VACCINES)

hepatitis b immune globulin (IMMUNOLOGICALS AND VACCINES)

hepatitis b virus vaccine (IMMUNOLOGICALS AND VACCINES)

HEPSERA (OTHER ANTIVIRAL DRUGS)

herbal drugs (DRUGS AFFECTING THE THROAT AND MOUTH)

HERCEPTIN (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

hexachlorophene (TOPICAL ANTIBACTERIAL DRUGS)

HEXALEN (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

HIBTITER (IMMUNOLOGICALS AND VACCINES)

HIPREX (URINARY ANTIINFECTIVES)

HISTACOL DM (ANTITUSSIVE AND EXPECTORANT DRUGS)

HISTADE (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

histamine phosphate (DIAGNOSTIC PRODUCTS)

HISTATAB D (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

HISTATAB PH (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

HISTATROL INTRADERMAL (DIAGNOSTIC PRODUCTS)

HISTEX SR (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

homatropaire (OTHER OPHTHALMIC DRUGS)

homatropine hbr (OTHER OPHTHALMIC DRUGS)

homeopathic drugs (HOMEOPATHIC DRUGS)

HONEY BEE VENOM TREATMENT KIT (IMMUNOLOGICALS AND VACCINES)

HRT CREAM BASE WOMEN (PHARMACEUTICAL NECESSITIES)

HT-TUSS DM (ANTITUSSIVE AND EXPECTORANT DRUGS)

HUMALOG (INSULIN)

HUMALOG MIX 50-50 (INSULIN)

HUMALOG MIX 75-25 (INSULIN)

HUMAPEN LUXURA HD (DIABETIC SUPPLIES)

HUMAPEN MEMOIR (DIABETIC SUPPLIES)

HUMATE-P (HEMOSTATICS)

HUMATROPE (PAR) (GROWTH HORMONES AND RELATED DRUGS)

HUMIRA (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

HUMIRA (PAR) (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

HUMULIN 50-50 (INSULIN)

HUMULIN 70-30 (INSULIN)

HUMULIN N (INSULIN)

HUMULIN R (INSULIN)

HYALGAN (OTHER DRUGS FOR ARTHRITIS)

HYCAMTIN (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

HYCET (CLASS III NARCOTICS)

HYCODAN (syrup only) (ANTITUSSIVE AND EXPECTORANT DRUGS)

hyd/ht (ANTITUSSIVE AND EXPECTORANT DRUGS)

hydp/cpmp (ANTITUSSIVE AND EXPECTORANT DRUGS)

hydra-zide (OTHER ANTIHYPERTENSIVES)

hydralazine (VASODILATOR ANTIHYPERTENSIVES)

hydralazine hcl (VASODILATOR ANTIHYPERTENSIVES)

hydralazine/hctz (OTHER ANTIHYPERTENSIVES)

HYDREA (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

HYDRO (DRUGS AFFECTING THE EAR)

HYDRO 40 (TOPICAL DERMATOLOGICAL DRUGS)

HYDROCHLORIC ACID (PHARMACEUTICAL NECESSITIES)

hydrochlorothiazide (THIAZIDE AND RELATED DRUGS)

HYDROCHLOROTHIAZIDE (THIAZIDE AND RELATED DRUGS)

HYDROCODONE BIT-IBUPROFEN (CLASS III NARCOTICS)

hydrocodone bitartrate/apap (CLASS III NARCOTICS)

hydrocodone-acetaminophen (CLASS III NARCOTICS)

hydrocodone-homatropine (ANTITUSSIVE AND EXPECTORANT DRUGS)

hydrocortisone (TOPICAL CORTICOSTEROID DRUGS)

hydrocortisone (GLUCOCORTICOID DRUGS)

hydrocortisone (OTHER GI DRUGS)

HYDROCORTISONE ACETATE (TOPICAL CORTICOSTEROID DRUGS)

hydrocortisone acetate (OTHER GI DRUGS)

HYDROCORTISONE ACETATE (OTHER GI DRUGS)

HYDROCORTISONE BUTYRATE (TOPICAL CORTICOSTEROID DRUGS)

hydrocortisone sod succinate (GLUCOCORTICOID DRUGS)

hydrocortisone valerate (TOPICAL CORTICOSTEROID DRUGS)

hydrocortisone-iodoquinol (TOPICAL CORTICOSTEROID DRUGS)

hydrocortisone/mo/petrolatum (TOPICAL CORTICOSTEROID DRUGS)

hydrogesic (CLASS III NARCOTICS)

hydromet (ANTITUSSIVE AND EXPECTORANT DRUGS)

hydromorphone (CLASS II NARCOTICS)

hydromorphone hcl (CLASS II NARCOTICS)

hydroquinone (TOPICAL DERMATOLOGICAL DRUGS)

HYDROQUINONE (TOPICAL DERMATOLOGICAL DRUGS)

hydroquinone/sunscreens (TOPICAL DERMATOLOGICAL DRUGS)

hydroxocobalamin (THERAPEUTIC VITAMINS & MINERALS)

hydroxychloroquine (PLASMODICIDES)

hydroxychloroquine sulfate (PLASMODICIDES)

hydroxyurea (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

hydroxyzine hcl (ANTIPRURITIC DRUGS)

hydroxyzine pamoate (ANTIPRURITIC DRUGS)

HYLIRA (TOPICAL DERMATOLOGICAL DRUGS)

hymenoptera allergenic extract (IMMUNOLOGICALS AND VACCINES)

HYOMAX-DT (ANTISPASMODICS/DRUGS AFFECT GI MOTILITY)

hyomax-ft (ANTISPASMODICS/DRUGS AFFECT GI MOTILITY)

hyomax-sl (ANTISPASMODICS/DRUGS AFFECT GI MOTILITY)

hyomax-sr (ANTISPASMODICS/DRUGS AFFECT GI MOTILITY)

hyoscyamine (ANTISPASMODICS/DRUGS AFFECT GI MOTILITY)

hyoscyamine sulfate (ANTISPASMODICS/DRUGS AFFECT GI MOTILITY)

HYOSCYAMINE SULFATE (ANTISPASMODICS/DRUGS AFFECT GI MOTILITY)

hyosyne (ANTISPASMODICS/DRUGS AFFECT GI MOTILITY)

HYPAQUE SODIUM (DIAGNOSTIC PRODUCTS)

HYPER-SAL (OTHER DRUGS FOR ASTHMA)

hypercare (TOPICAL DERMATOLOGICAL DRUGS)

HYPERHEP B S-D (IMMUNOLOGICALS AND VACCINES)

HYPERRAB S-D (IMMUNOLOGICALS AND VACCINES)

HYPERRHO S-D (IMMUNOLOGICALS AND VACCINES)

HYPERSTAT I.V. (OTHER ANTIHYPERTENSIVES)

HYPERTET S-D (IMMUNOLOGICALS AND VACCINES)

HYTRIN (VASODILATOR ANTIHYPERTENSIVES)

HYZAAR (OTHER ANTIHYPERTENSIVES)

HYZAAR (requires trial of ACE Inhibitor) (OTHER ANTIHYPERTENSIVES)

Formulary Date: 10/07/2008 Update Date: 10/09/2008 V1.3.0