5-Tier Preferred Drug List - Health Plan of Nevada
5-Tier Preferred Drug List - Health Plan of Nevada
5-Tier Preferred Drug List - Health Plan of Nevada
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Alphabetical Index<strong>Drug</strong> Name PDL Section <strong>Drug</strong> Name PDL SectionKU-ZYME 7-GKU-ZYME-HP 7-GKWELL 5-GKYNAMRO 3-LKYTRIL 7-Flabetalol 3-CLAC-HYDRIN 14-Alacosamide 4-Glactic acid 14-Alactulose 7-ALAMICTAL 4-GLAMICTAL ODT 4-GLAMICTAL ODT KIT 4-GLAMICTAL STARTER KIT 4-GLAMICTAL XR 4-GLAMICTAL XR KIT 4-GLAMISIL 1-GLAMISIL GRANULE PACKET 1-Glamivudine 1-Ilamivudine (hepatitis) 7-Hlamivudine-zidovudine 1-Ilamotrigine 4-GLANOXIN 3-Alanreotide acetate 13-Glansoprazole 7-Elansoprazole-naproxen 9-Clanthanum 7-HLANTUS 6-Glapatinib ditosylate 2-ALARIAM 1-JLASIX 3-Jlatanoprost ophth 11-DLATUDA 4-DLAZANDA 9-Bleflunomide 9-Dlenalidomide 2-ALESCOL 3-LLESCOL XL 3-LLessina 6-DLETAIRIS 3-Hletrozole 2-ALEUCOVORIN CALCIUM 2-Aleucovorin calcium 2-ALEUKERAN 2-ALEUKINE 13-Cleuprolide acetate 13-Ilevalbuterol inhaler 12-Dlevalbuterol nebulizer 12-DLEVAQUIN 1-ELEVATOL 3-CLEVBID 7-CLEVEMIR 6-Glevetiracetam 4-GLEVLEN 6-DLEVLITE 6-Dlevobunolol ophth 11-Blevocarnitine 6-Jlevocetirizine 14-Alev<strong>of</strong>loxacin 1-Elev<strong>of</strong>loxacin ophth 11-ALevora 6-Dlevothroid 6-Ilevothyroxine 6-Ilevothyroxine 6-Ilevoxyl 6-ILEVSIN 7-CLEVSINEX 7-CLEXAPRO 4-BLEXIVA 1-ILEXXEL 3-ILIALDA 7-HLIBRAX 7-CLIBRIUM 4-ALIDEX 5-Hlidocaine 11-Jlidocaine (topical) 5-Ilidocaine ophth 11-Hlidocaine patch 5-Ilidocaine-hydrocortisone 5-Ilidocaine-prilocaine 5-I685-<strong>Tier</strong> <strong>Drug</strong> Benefit Guide 08/01/13
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