2013 Medicare HMO Blue ValueRx/PlusRx Formulary - Blue Cross ...

AURORA PEN NEEDLES12MM 29G ............ 54AURORA SUPER THINLANCET ............... 54AURORA THIN LANCETS . 54AUTODISC NORMALCONTROL SOLN. ...... 54AUTOJECT 2 INJECTIONDEVICE ............... 54AUTOPEN 1 TO 16 UNITS. 54AUTOPEN 1 TO 21 UNITS. 54AUTOPEN 2 TO 32 UNITS. 54AUTOPEN 2 TO 42 UNITS. 54AVANDAMET ............ 43AVANDIA 2 MG TABLET, -4 MGTABLET. ............... 43AVANDIA 8 MG TABLET. .. 43AVASTIN ................ 15aviane. .................. 83AVONEX ................ 50AVONEX ADMINISTRATIONPACK ................. 50AVONEX PEN ........... 50AXIRON ................ 83AZACTAM-ISO-OSMOT 1GM/50 ML. ............ 10AZACTAM-ISO-OSMOT 2GM/50 ML. ............ 10azathioprine sodium ....... 15azathioprine tablet. ........ 15azelastine hcl nasal drops/sprays ................. 41azelastine hcl ophth drops .. 91AZILECT . . . . . . . . . . . . . . . . 28azithromycin injection ...... 12azithromycin packet,-suspension, -tablet ...... 12aztreonam vial . . . . . . . . . . . . 10azurette ................. 83Bbaciim. .................. 10bacitracin injection ........ 10bacitracin oint ............ 91bacitracin-polymyxin ....... 91baclofen tablet ........... 76bacteriostatic saline vial, -0.9%syringe, -0.9% vial, -0.9% zrsyr .................... 79bacteriostatic water vial .... 79bal-care dha. ............. 86balsalazide disodium ...... 46balziva .................. 83BANZEL 400 MG TABLET . 27BANZEL ORAL SUSP, -200MG TABLET. ........... 27BARACLUDE SOLUTION . 11BARACLUDE TABLET. .... 11baycadron ............... 42BD 10 ML SYRINGE WITHNEEDLE. .............. 54BD AUTO INJECTOR ..... 54BD ECLIPSE 30GX1/2SYRINGE. ............. 54BD INSULIN SYR 0.3 ML28GX1/2 .............. 54BD INSULIN SYR 0.3 ML29GX1/2 .............. 54BD INSULIN SYR 0.3 ML30GX1/2 .............. 54BD INSULIN SYR 0.3ML31GX5/16 ............. 54BD INSULIN SYR 0.5 ML28GX1/2 .............. 54BD INSULIN SYR 0.5 ML29GX1/2 .............. 54BD INSULIN SYR 0.5 ML30GX1/2 .............. 54BD INSULIN SYR 0.5ML31GX5/16 ............. 54BD INSULIN SYR 1 ML25GX1 ................ 54BD INSULIN SYR 1 ML25GX5/8 .............. 54BD INSULIN SYR 1 ML26GX1/2 .............. 54BD INSULIN SYR 1 ML27GX5/8 .............. 54BD INSULIN SYR 1 ML28GX1/2 .............. 54BD INSULIN SYR 1 ML29GX1/2 .............. 54BD INSULIN SYR 1 ML30GX1/2 .............. 54BD INSULIN SYR 1 ML31GX5/16 ............. 54BD INSULIN SYR 1 ML31GX15/64 ............ 54BD INSULIN SYRINGE 1ML. ................... 54BD INSULIN U100-1 MLSYRNGE .............. 54B-D INSULIN U100 2 MLSYRNGE .............. 54B-D INSULIN U100-2 MLSYRNGE .............. 54B-D INSULIN U100-3/10 MLSYR................... 54BD INSULIN U100-3/10 MLSYR................... 54BD INSUL SYR 0.3 ML31GX15/64 ............ 54BD INSUL SYR 0.5 ML31GX15/64 ............ 54BD INTEGRA SYR 1 ML29GX1/2 .............. 54BD INTEGRA SYRINGE 1 ML25GX1 ................ 54BD LANCETS 30G ....... 55BD LANCETS 33G ....... 55BD LANCETSMICROTAINER . . . . . . . . . 55BD LANCETS MICROTAINER21G. .................. 55BD LANCETS MICROTAINER30G. .................. 55BD LUER-LOK SYRINGE 1ML. ................... 55BD LUER-LOK SYRINGE 1ML20GX1 ................ 55BD NEEDLES 26GX0.5 ... 55BD NEEDLES 27GX0.5 ... 55BD PEN INSULIN DEVICE. 55BD PEN MINI INSULINDEVICE ............... 55BD PEN NEEDLE 29GX1/2 55BD PEN NEEDLE29GX3/16 ............. 55BD PEN NEEDLE29GX5/16 ............. 55BD PEN NEEDLE30GX3/16 ............. 55BD PEN NEEDLE MINI31GX3/16 ............. 5599