5-Tier Preferred Drug List - Health Plan of Nevada

Alphabetical IndexDrug Name PDL Section Drug Name PDL Sectionmethyldopa-HCTZ 3-Imethylergonovine 8-DMETHYLIN 4-EMETHYLIN ER 4-Emethylnaltrexone bromide 7-Hmethylphenidate 4-Emethylphenidate CR 4-Emethylphenidate SA 4-Emethylphenidate SR 4-Emethylprednisolone 6-Amethyltestosterone 6-Bmetipranolol ophth 11-Bmetoclopramide 7-Hmetoclopramide 14-Ametolazone 3-Jmetoprolol 3-Cmetoprolol succinate SR 3-Cmetoprolol/hctz 14-AMETOZOLV ODT 14-AMETROCREAM 5-BMETROGEL 5-BMETROGEL vaginal 8-CMETROLOTION 5-Bmetronidazole 1-Lmetronidazole CR 1-Lmetronidazole cream 5-Bmetronidazole gel 5-Bmetronidazole lotion 5-Bmetronidazole vaginal 8-Cmetronidazole-tetracycline-bismuth 7-CMEVACOR 3-Lmexiletine 3-EMEXITIL 3-EMIACALCIN 6-JMICARDIS 3-GMICARDIS HCT 3-Imiconazole nitrate 14-AMICONAZOLE NITRATE 14-Amiconazole-zinc oxide-white petroleum 1-GMicrogestin 6-DMicrogestin FE 6-DMICROZIDE 3-Jmidodrine 3-KMIDRIN 9-Emiglitol 6-Fmiglustat 7-GMIGRANAL 9-EMILIPRED DP PAK 6-Amilnacipran 4-GMINASTRIN 24 FE 14-AMINIPRESS 3-HMINITRAN 3-BMINOCIN 1-Dminocycline 1-Dminocycline 14-Aminoxidil 3-HMINTEZOL 1-Kmipomersen sodium 3-LmirabegronMIRAPEX8-B4-HMIRAPEX ER 14-AMIRCETTE 6-Dmirtazapine 4-Bmirtazapine soltabs 4-Bmisoprostol 7-Cmitotane 2-AMOBIC 9-Cmodafinil 4-EMODICON 6-DMODURETIC 3-Jmoexipril 3-Fmoexipril-HCTZ 3-Imometasone 5-Hmometasone 14-Amometasone inhaler 12-Emometasone nasal 12-Bmometasone-formoterol inhalers 12-DMOMEXIN KIT 14-AMONODOX 1-DMononessa 6-D715-Tier Drug Benefit Guide 08/01/13