Transcription of Drugs that are Not Covered - Florida Blue
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Drugs that are Not Covered - Florida Blue
Drugs that are Not Covered * (Medicinas que no est n cubiertas*)Current (Corriente) 1/1/18 In addition to this list, newly marketed prescription medications may not be Covered until the Pharmacy & Therapeutics Committee has had an opportunity to review the medication, to determine whether the medication will be Covered and if so, which tier will apply based on safety, efficacy and the availability of other products within that class of medications. The current list of newly marketed Drugs can be found on our New to Market Drug list. *Please check member benefit documentation to determine inclusion in the Drugs Not Covered program.
Detrol tablets . Detrol LA capsules . dexamethasone 1.5 mg 6-day, 10-day, and 13-day blister packs . dexchlorpheniramine oral syrup (authorized generic for RyClora) Dexedrine Spansule . Dexilant capsules . DexPac 6-Day, 10-Day, and 13-Day blister packs . dextroamphetamine 15 mg, 20 mg and 30 mg tablets . diclofenac 1% topical gel . diclofenac 3 ...
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