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ACNE AGENTS, TOPICAL - ctdssmap.com

ACNE AGENTS, TOPICAL ANGIOTENSIN MODULATOR COMBINATIONSANTICONVULSANTS, CONT.(STEP THERAPY CATEGORY)AMLODIPINE / BENAZEPRIL (ORAL)ETHOSUXIMIDE SOLUTION (ORAL)(DX CODE REQUIRED - DIFFERIN and EPIDUO)AMLODIPINE / OLMESARTAN (ORAL)GABITRIL TABLET (ORAL)AZELEX 20% CREAM ( TOPICAL )AMLODIPINE / VALSARTAN (ORAL)LAMOTRIGINE CHEW DISPERS TAB (not ODT) (ORAL)CLINDAMYCIN PHOS 1% PLEGET ( TOPICAL )AMLODIPINE / VALSARTAN / HCTZ (ORAL)LAMOTRIGINE STARTER PACK (not ODT) (ORAL)CLINDAMYCIN PHOS 1% SOLUTION ( TOPICAL )LAMOTRIGINE TABLET (IR) (not ER) (ORAL)CLINDAMYCIN-BENZOYL PEROXIDE 1-5% PUMP ( TOPICAL )ANTHELMINTICSLEVETIRACETAM SOLUTION, IR TABLET (not ER) (ORAL)DIFFERIN CREAM ( TOPICAL ) (DX CODE REQ.)

acne agents, topical ‡ angiotensin modulator combinations anticonvulsants, cont. (step therapy category) amlodipine / benazepril (oral) lamotrigine tablet (ir) (not er) (oral) (dx code required - differin and epiduo) amlodipine / olmesartan (oral) levetiracetam solution, ir tablet (not er) (oral) azelex 20% cream (topical) amlodipine / valsartan (oral) oxcarbazepine suspension, tablet (oral)

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