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

na thiosul/sod nit/amyl nit (DIAGNOSTIC PRODUCTS)

NABI-HB (IMMUNOLOGICALS AND VACCINES)

nabumetone (NON-STEROIDAL ANTIINFLAMMATORY AGENTS)

NABUMETONE (Requires trial of 2 first line NSAIDs within 6 months) (NON-STEROIDAL ANTIINFLAMMATORY AGENTS)

nadolol (BETA-ADRENERGIC ANTAGONIST DRUGS)

nadolol-bendroflumethiazide (OTHER ANTIHYPERTENSIVES)

nafarelin (SPECIALIZED OB/GYN DRUGS)

NAFCILL IN DEXTROSE (PENICILLINS)

nafcillin (PENICILLINS)

nafcillin sodium (PENICILLINS)

naftifine (OTHER TOPICAL ANTIFUNGALS)

NAFTIN (OTHER TOPICAL ANTIFUNGALS)

nalbuphine (ANALGESICS)

nalbuphine hcl (ANALGESICS)

NALDEX (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

NALEX A 12 (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

NALEX AC (ANTITUSSIVE AND EXPECTORANT DRUGS)

NALEX-A (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

NALFON (Requires trial of OTC NSAID) (NON-STEROIDAL ANTIINFLAMMATORY AGENTS)

NALLPEN (PENICILLINS)

NALLPEN IN DEXTROSE (PENICILLINS)

NALLPEN-ISO-OSMOTIC DEXTROSE (PENICILLINS)

naloxone (OTHER CNS/AUTONOMIC DRUGS)

naloxone hcl (OTHER CNS/AUTONOMIC DRUGS)

naltrexone (OTHER CNS/AUTONOMIC DRUGS)

naltrexone hcl (OTHER CNS/AUTONOMIC DRUGS)

NAMENDA (ANTIDEMENTIA DRUGS)

NAPRELAN (NON-STEROIDAL ANTIINFLAMMATORY AGENTS)

NAPROSYN (Requires trial of OTC NSAID) (NON-STEROIDAL ANTIINFLAMMATORY AGENTS)

NAPROXEN (NON-STEROIDAL ANTIINFLAMMATORY AGENTS)

NAPROXEN (Requires trial of OTC NSAID) (NON-STEROIDAL ANTIINFLAMMATORY AGENTS)

NAPROXEN SODIUM (NON-STEROIDAL ANTIINFLAMMATORY AGENTS)

NAPROXEN SODIUM (Requires trial of OTC NSAID) (NON-STEROIDAL ANTIINFLAMMATORY AGENTS)

NARDIL (MAO INHIBITORS)

NARIZ (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

NASACORT AQ (DRUGS AFFECTING THE NOSE)

NASCOBAL (THERAPEUTIC VITAMINS & MINERALS)

NASOFED (DECONGESTANTS)

NASOHIST (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

NASOHIST DM (ANTITUSSIVE AND EXPECTORANT DRUGS)

NASONEX (QLL = 3/Rx) (DRUGS AFFECTING THE NOSE)

NASOP (DECONGESTANTS)

NASOP (ANTITUSSIVE AND EXPECTORANT DRUGS)

NASOP 12 (ANTITUSSIVE AND EXPECTORANT DRUGS)

NATACHEW (PRENATAL VITAMINS)

NATACYN (OTHER OPHTHALMIC DRUGS)

NATAFORT (PRENATAL VITAMINS)

NATALVIT (PRENATAL VITAMINS)

nateglinide (ORAL HYPOGLYCEMICS & COMBOS)

NATELLE C (PRENATAL VITAMINS)

NATELLE PLUS (PRENATAL VITAMINS)

NATELLE PREFER (PRENATAL VITAMINS)

NATELLE-EZ (PRENATAL VITAMINS)

NATURE-THROID (THYROID SUPPLEMENTS)

NATURETIN-5 (THIAZIDE AND RELATED DRUGS)

NAVANE (ANTIPSYCHOTIC DRUGS)

NAVELBINE (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

NEBCIN IN DEXTROSE (AMINOGLYCOSIDES)

nebulizer/supplies (MEDICAL (MISCELLANEOUS) SUPPLIES)

NEBUPENT (PAR) (OTHER ANTIINFECTIVE DRUGS)

necon (CONTRACEPTIVES)

nedocromil (OTHER OPHTHALMIC DRUGS)

NEEVO (PRENATAL VITAMINS)

NEEVO DHA (PRENATAL VITAMINS)

nefazodone (OTHER ANTIDEPRESSANTS)

nefazodone hcl (OTHER ANTIDEPRESSANTS)

nelfinavir mesylate (ANTIRETROVIRALS & PROTEASE INH)

NEMBUTAL SODIUM (SEDATIVE/HYPNOTIC DRUGS)

NEO DM (ANTITUSSIVE AND EXPECTORANT DRUGS)

NEO-FRADIN (AMINOGLYCOSIDES)

NEO-SYNEPHRINE (OTHER CARDIOVASCULAR DRUGS)

NEOBENZ MICRO (ANTIACNE DRUGS)

NEOBENZ MICRO SD (ANTIACNE DRUGS)

neocidin (OPHTHALMIC TOPICAL ANTIBACTERIAL DRUGS)

neomycin (AMINOGLYCOSIDES)

neomycin sulfate (AMINOGLYCOSIDES)

neomycin sulfate/colist sul/hc (DRUGS AFFECTING THE EAR)

neomycin sulfate/polymyxin/hc (DRUGS AFFECTING THE EAR)

neomycin sulfate/polymyxin/hc (OPHTHALMIC ANTIINFECTIVE/CORTICOSTEROIDS)

neomycin-bacitracin-poly-hc (OPHTHALMIC ANTIINFECTIVE/CORTICOSTEROIDS)

neomycin-bacitracin-polymyxin (OPHTHALMIC TOPICAL ANTIBACTERIAL DRUGS)

neomycin-polymyxin-dexameth (OPHTHALMIC ANTIINFECTIVE/CORTICOSTEROIDS)

neomycin-polymyxin-gramicidin (OPHTHALMIC TOPICAL ANTIBACTERIAL DRUGS)

neomycin-polymyxin-hc (DRUGS AFFECTING THE EAR)

neomycin-polymyxin-hc (OPHTHALMIC ANTIINFECTIVE/CORTICOSTEROIDS)

neomycin/bacitracin/poly/hc (OPHTHALMIC ANTIINFECTIVE/CORTICOSTEROIDS)

neomycin/bacitracin/polymyxin (OPHTHALMIC TOPICAL ANTIBACTERIAL DRUGS)

neomycin/colist sul/hc/thonz (DRUGS AFFECTING THE EAR)

neomycin/gramicidin/polymyxin (OPHTHALMIC TOPICAL ANTIBACTERIAL DRUGS)

neomycin/polymyxin/dexameth (OPHTHALMIC ANTIINFECTIVE/CORTICOSTEROIDS)

NEORAL (PAR) (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

NEOSALUS (TOPICAL DERMATOLOGICAL DRUGS)

NEOSPORIN (OPHTHALMIC TOPICAL ANTIBACTERIAL DRUGS)

NEOSPORIN G.U. IRRIGANT (OTHER GENITOURINARY PRODUCTS)

neostigmine bromide (OTHER CNS/AUTONOMIC DRUGS)

neostigmine methylsulfate (OTHER CNS/AUTONOMIC DRUGS)

NEOTIC (DRUGS AFFECTING THE EAR)

NEOTUSS-D (ANTITUSSIVE AND EXPECTORANT DRUGS)

NEPHPLEX RX (VITAMINS & MINERALS & RELATED PRODUCTS)

NEPHRO-VITE RX (VITAMINS & MINERALS & RELATED PRODUCTS)

NEPHROCAPS (VITAMINS & MINERALS & RELATED PRODUCTS)

NEPHRON FA (VITAMINS & MINERALS & RELATED PRODUCTS)

nervidox (THERAPEUTIC VITAMINS & MINERALS)

NERVIDOX 6 (INJECTABLE VITAMINS)

NESACAINE (LOCAL ANESTHETICS)

NESACAINE-MPF (LOCAL ANESTHETICS)

NEULASTA (MYELOID STIMULANTS)

NEUMEGA (INTERLEUKINS)

NEUPOGEN (PAR) (MYELOID STIMULANTS)

neurin bc (INJECTABLE VITAMINS)

neurin-12 (THERAPEUTIC VITAMINS & MINERALS)

NEURIN-SL (VITAMINS & MINERALS & RELATED PRODUCTS)

NEURONTIN (OTHER ANTICONVULSANTS)

NEUTRAGARD ADVANCED (FLUORIDE PRODUCTS)

NEUTRAHIST (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

NEUTRAHIST PDX (ANTITUSSIVE AND EXPECTORANT DRUGS)

NEVANAC (OTHER OPHTHALMIC DRUGS)

nevirapine (ANTIRETROVIRALS & PROTEASE INH)

NEXAVAR (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

NEXIUM (Requires trial of H2 and OTC omeprazole) (PROTON PUMP INHIBITORS)

NEXT CHOICE (CONTRACEPTIVES)

niacin (HYPOLIPOPROTEINEMICS)

NIACOR (HYPOLIPOPROTEINEMICS)

NIASPAN (HYPOLIPOPROTEINEMICS)

nicardipine (CALCIUM ANTAGONISTS)

nicardipine hcl (CALCIUM ANTAGONISTS)

NICOTINAMIDE (VITAMINS & MINERALS & RELATED PRODUCTS)

NICOTROL (SMOKING CESSATION PRODUCTS)

NICOTROL NS (SMOKING CESSATION PRODUCTS)

nifediac cc (CALCIUM ANTAGONISTS)

nifedical xl (CALCIUM ANTAGONISTS)

nifedipine (CALCIUM ANTAGONISTS)

nifedipine er (CALCIUM ANTAGONISTS)

NIFEREX GOLD (VITAMINS & MINERALS & RELATED PRODUCTS)

NIFEREX-150 FORTE (VITAMINS & MINERALS & RELATED PRODUCTS)

NILANDRON (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

nilutamide (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

nimodipine (CALCIUM ANTAGONISTS)

NIMOTOP (PAR) (CALCIUM ANTAGONISTS)

NIPENT (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

NIRAVAM (ANXIOLYTICS)

NISOLDIPINE (CALCIUM ANTAGONISTS)

nitazoxanide (OTHER ANTIINFECTIVE DRUGS)

nitisinone (MISCELLANEOUS DRUGS)

nitro-bid (NITRATES)

NITRO-DUR (NITRATES)

nitro-time (NITRATES)

nitrofurantoin (URINARY ANTIINFECTIVES)

nitrofurantoin macrocrystal (URINARY ANTIINFECTIVES)

nitrofurantoin mono-macro (URINARY ANTIINFECTIVES)

nitrofurantoin/nitrofuran mac (URINARY ANTIINFECTIVES)

nitroglycerin (NITRATES)

nitroglycerin patch (NITRATES)

NITROLINGUAL (NITRATES)

NITROSTAT (NITRATES)

NIZATIDINE (ANTIULCER DRUGS)

NIZORAL (OTHER TOPICAL ANTIFUNGALS)

NOHIST (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

NOHIST DMX (ANTITUSSIVE AND EXPECTORANT DRUGS)

NOHIST-EXT (ANTIHISTAMINES)

NOHIST-PDX (ANTITUSSIVE AND EXPECTORANT DRUGS)

NOHIST-PE (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

NOHIST-PLUS (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

NOHIST-PLUS JR (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

non insulin syringes/needles (MEDICAL (MISCELLANEOUS) SUPPLIES)

NOR-Q-D (PROGESTIN DRUGS)

nora-be (PROGESTIN DRUGS)

NORCO (CLASS III NARCOTICS)

NORDETTE-28 (CONTRACEPTIVES)

NORDIPEN 15 (DIABETIC SUPPLIES)

NORDIPEN 5 (DIABETIC SUPPLIES)

NORDITROPIN (PAR) (GROWTH HORMONES AND RELATED DRUGS)

NORDITROPIN NORDIFLEX (GROWTH HORMONES AND RELATED DRUGS)

NOREL SR (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

noreth a-et estra/fe fumarate (CONTRACEPTIVES)

norethindrone (PROGESTIN DRUGS)

norethindrone a-e estradiol (CONTRACEPTIVES)

norethindrone acetate (PROGESTIN DRUGS)

norethindrone-ethin estradiol (CONTRACEPTIVES)

norethindrone-mestranol (CONTRACEPTIVES)

NORFLEX (CNS MUSCLE RELAXANTS)

norgestimate-ethinyl estradiol (CONTRACEPTIVES)

norgestrel-ethiny estra (CONTRACEPTIVES)

norgestrel-ethinyl estradiol (CONTRACEPTIVES)

NORINYL 1+35 (CONTRACEPTIVES)

NORINYL 1+50 (CONTRACEPTIVES)

NORITATE (ANTIACNE DRUGS)

NORM-JECT (DIABETIC SUPPLIES)

normal saline (ELECTROLYTES, IRRIGATING SOLUTIONS, ETC.)

normal saline flush (ELECTROLYTES, IRRIGATING SOLUTIONS, ETC.)

NORMOSOL-M AND DEXTROSE (ELECTROLYTES, IRRIGATING SOLUTIONS, ETC.)

NOROXIN (QUINOLONES)

NORPACE (CLASS 1A)

NORPACE CR (CLASS 1A)

NORPRAMIN (SECONDARY AMINES)

nortrel (CONTRACEPTIVES)

nortriptyline (SECONDARY AMINES)

nortriptyline hcl (SECONDARY AMINES)

NORTUSS-EX (ANTITUSSIVE AND EXPECTORANT DRUGS)

NORVASC (CALCIUM ANTAGONISTS)

NORVIR (ANTIRETROVIRALS & PROTEASE INH)

NOTUSS AC (ANTITUSSIVE AND EXPECTORANT DRUGS)

NOTUSS DC (ANTITUSSIVE AND EXPECTORANT DRUGS)

NOTUSS-PE (ANTITUSSIVE AND EXPECTORANT DRUGS)

NOVACORT (TOPICAL CORTICOSTEROID DRUGS)

NOVAGESIC (ANALGESICS)

NOVAHISTINE DH (ANTITUSSIVE AND EXPECTORANT DRUGS)

NOVANATAL (PRENATAL VITAMINS)

NOVANTRONE (ANTINEOPLASTIC/IMMUNOSUPPRESSANT DRUGS)

novarel (SPECIALIZED OB/GYN DRUGS)

NOVOCAIN (LOCAL ANESTHETICS)

NOVOFINE (DIABETIC SUPPLIES)

NOVOFINE 32 (DIABETIC SUPPLIES)

NOVOFINE AUTOCOVER (DIABETIC SUPPLIES)

NOVOLIN 70-30 (INSULIN)

NOVOLIN 70-30 INNOLET (INSULIN)

NOVOLIN N (INSULIN)

NOVOLIN N INNOLET (INSULIN)

NOVOLIN R (INSULIN)

NOVOLOG (INSULIN)

NOVOLOG MIX 70-30 (INSULIN)

NOVOSEVEN (HEMOSTATICS)

NOXAFIL (ORAL ANTIFUNGAL DRUGS)

nu-derm (TOPICAL DERMATOLOGICAL DRUGS)

NU-DERM SUNFADER (TOPICAL DERMATOLOGICAL DRUGS)

NUCORT (TOPICAL CORTICOSTEROID DRUGS)

NUCYNTA (CLASS II NARCOTICS)

nufol (VITAMINS & MINERALS & RELATED PRODUCTS)

NULEV (ANTISPASMODICS/DRUGS AFFECT GI MOTILITY)

NULYTELY WITH FLAVOR PACKS (OTHER GI DRUGS)

NUMOISYN (DRUGS AFFECTING THE THROAT AND MOUTH)

NUMONYL (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

NUMONYL DX (ANTITUSSIVE AND EXPECTORANT DRUGS)

NUMONYL PEDIATRIC (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

NUOX (ANTIACNE DRUGS)

nuquin hp (TOPICAL DERMATOLOGICAL DRUGS)

NUTRESTORE (VITAMINS & MINERALS & RELATED PRODUCTS)

NUTRICAP (VITAMINS & MINERALS & RELATED PRODUCTS)

NUTRIDOX (TETRACYCLINES)

nutriject (INJECTABLE VITAMINS)

NUTROPIN (PAR) (GROWTH HORMONES AND RELATED DRUGS)

NUTROPIN AQ (GROWTH HORMONES AND RELATED DRUGS)

NUTROPIN AQ (PAR) (GROWTH HORMONES AND RELATED DRUGS)

NUVARING (CONTRACEPTIVES)

NUVIGIL (PAR) (Restriced to Neurology) (CNS STIMULANT DRUGS)

NUZON (TOPICAL CORTICOSTEROID DRUGS)

NY-TANNIC (ANTIHISTAMINE/DECONGESTANT COMBINATIONS)

nyamyc (OTHER TOPICAL ANTIFUNGALS)

NYDAMAX (ANTIACNE DRUGS)

nystatin (ORAL ANTIFUNGAL DRUGS)

NYSTATIN (ORAL ANTIFUNGAL DRUGS)

nystatin (VAGINAL ANTIFUNGALS)

nystatin (OTHER TOPICAL ANTIFUNGALS)

nystatin-triamcinolone (TOPICAL ANTIFUNGAL-CORTICOSTEROID COMB.)

nystatin/triamcinolone (TOPICAL ANTIFUNGAL-CORTICOSTEROID COMB.)

nystop (OTHER TOPICAL ANTIFUNGALS)

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