Transcription of Presbyterian Centennial Care
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Presbyterian Centennial Care
MPC051617 1 9/1/2018 Presbyterian Centennial care PHP Centennial care Formulary/Preferred Drug Listing The Centennial care Preferred Drug List is subject to change. This list is in order by therapeutic class. To find a specific drug, use the search feature available in Adobe Acrobat Reader (keyboard shortcut: Ctrl+F). MPC051617 2 9/1/2018 Presbyterian Health Plan Centennial care CURRENT AS OF 9/1/2018 lowercase italics = Generic drugs UPPERCASE BOLD = Brand name drugs Tier Notes SP = Specialty Pharmacy Drug Name Tier Notes *ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANORE XIANTS* *ADHD AGENT - SELECTIVE ALPHA ADRENERGIC AGONISTS** guanfacine hcl er oral tablet extended release 24 hour 1 mg, 2 mg, 3 mg, 4 mg Covered QL (30 EA per 30 days) *ADHD AGENT - SELECTIVE NOREPINEPHRINE REUPTAKE INHIBITOR** atomoxetine hcl oral capsule 10 mg, 100 mg, 18 mg, 25 mg, 40 mg, 60 mg, 80 mg Covered ST.
MPC051617 1 9/1/2018 . Presbyterian Centennial Care. PHP Centennial Care Formulary/Preferred Drug Listing. The Centennial Care Preferred Drug List is subject to change.
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