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

IN CONTROL PEN NEEDLE6MM 31G. ............. 61IN CONTROL PEN NEEDLE8MM 31G. ............. 61IN CONTROL PEN NEEDLE12MM 29G ............ 61INCONTROL PEN NEEDLES4MM 32G. ............. 61INCONTROL SUPER THINLANCETS. ............. 61INCONTROL ULTRA THINLANCETS. ............. 61INCRELEX .............. 44indapamide .............. 36indomethacin capsule, -capsulesustained action, -injection 77INFANRIX ............... 49INFERGEN 9 MCG/0.3 MLVIAL. .................. 50INFERGEN 15 MCG/0.5 MLVIAL. .................. 50INFINITY CONTROL SOLNHIGH ................. 61INFINITY CONTROL SOLNLOW .................. 61INFINITY CONTROL SOLNNORMAL . . . . . . . . . . . . . . 61INFLUENZA A (H1N1)2009 .................. 49INJECT EASE 28GLANCETS. ............. 61INJECT EASE 30GLANCETS. ............. 61INJECT-EASE SYR NDLINTRODUCER ......... 61INJEX 30 AMPULE ....... 61INLYTA. ................. 17INSULIN 1/2 ML SYRINGE 61INSULIN 1 ML SYRINGE. . 61INSULIN 3/10 MLSYRINGE. ............. 61INSULIN SYR 1/2 ML BULKPACK ................. 61INSULIN SYRIN 0.3 ML29GX1/2 .............. 61INSULIN SYRIN 0.3 ML30GX1/2 .............. 61INSULIN SYRIN 0.3 ML30GX5/16 ............. 61INSULIN SYRIN 0.3 ML31GX5/16 ............. 61INSULIN SYRIN 0.5 ML28GX1/2 .............. 61INSULIN SYRIN 0.5 ML29GX1/2 .............. 61INSULIN SYRIN 0.5 ML30GX1/2 .............. 61INSULIN SYRIN 0.5 ML30GX5/16 ............. 61INSULIN SYRIN 0.5 ML31GX5/16 ............. 61INSULIN SYRIN 1 ML29GX1/2 .............. 62INSULIN SYRINGE 0.3 ML 62INSULIN SYRINGE 0.5 ML 62INSULIN SYRINGE 1 ML. . 62INSULIN SYRINGE 1 ML28GX1/2 .............. 62INSULIN SYRINGE 1 ML29GX1/2 .............. 62INSULIN SYRINGE 1 ML30GX1/2 .............. 62INSULIN SYRINGE 1 ML30GX5/16 ............. 62INSULIN SYRINGE 1 ML31GX5/16 ............. 62INSULIN SYRINGE 1 ML-HARD PK .............. 62INSULIN SYRINGE 30GX1 MLSYR................... 62INSULIN SYRINGE U100 0.5ML. ................... 62INSULIN SYRINGE U100 1ML. ................... 62INSULIN SYRINGE U1001ML. .................. 62INSULIN U100-1 MLSYRINGE. ............. 62INSUMED SYR 0.3 ML31GX5/16 ............. 62INSUPEN 29G ULTRAFINNEEDLE. .............. 62INSUPEN 30G ULTRAFINNEEDLE. .............. 62INSUPEN 31G ULTRAFINNEEDLE. .............. 62INSUPEN 32G 4MM PENNEEDLE. .............. 62INSUPEN 32G 6MM PENNEEDLE. .............. 62INSUPEN 32G 8MM PENNEEDLE. .............. 62INTELENCE 25 MG TABLET 8INTELENCE 100 MG TABLET,-200 MG TABLET ........ 8INTRON A 3 MILLION UNIT/MLPEN, -6 MILLION UNIT/MLVL, -10 MILLION UNIT PEN,-10 MILLION UNIT/ML, -10MILLION UNITS VIAL. ... 50INTRON A 5 MILLION UNIT/ML PEN, -18 MILLION UNITSVIAL, -50 MILLION UNITSVIAL. .................. 50introvale ................. 84INTUNIV ................ 29INVACARE 30G LANCETS 62INVANZ VIAL ............ 10INVEGA. ................ 21INVEGA SUSTENNA 39 MGPREF SYR, -78 MG PREFSYR................... 21INVEGA SUSTENNA 117 MGPREF SY, -156 MG PREF SY,-234 MG PREF SY ...... 21INVIRASE CAPSULE. ...... 8INVIRASE TABLET. ........ 8IPOL. ................... 49ipratropium 0.03% spray ... 41ipratropium 0.06% spray ... 41ipratropium-albuterol. ...... 94ipratropium bromide nebs .. 94irbesartan. ............... 31irbesartanhydrochlorothiazide...... 35IRESSA ................. 17irinotecan hcl. ............ 17ISENTRESS .............. 8isoditrate ................ 34iso gentamicin. ............ 7isonarif ................... 9110