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

PUB INSUL SYR 0.3 ML31GX5/16 ............. 67PUB INSUL SYR 0.5 ML30GX1/2 .............. 67PUB INSUL SYR 0.5 ML31GX5/16 ............. 67PUB LANCETS .......... 67PUBLIX 28G LANCET .... 68PUB PEN 8MM 31GNEEDLES ............. 67PUB PEN 12MM 29GNEEDLES ............. 67PUB PEN NEEDLE 6MM31G. .................. 67PULMOZYME. ........... 95PV INS SYRIN 1 ML29GX1/2 .............. 68PV INSULIN SYR 1 ML31GX5/16 ............. 68PV INSULIN SYRINGE 0.5ML. ................... 68PV INSULIN SYRINGE 1ML. ................... 68PV INSUL SYR 0.3 ML31GX5/16 ............. 68PV INSUL SYR 0.5 ML31GX5/16 ............. 68PV ISOPROPYL ALCOHOL70% WIPES ........... 68PV PEN NEEDLE 6MM31G. .................. 68PV PEN NEEDLES 8MM31G. .................. 68PV PEN NEEDLES 12MM29G. .................. 68PV ULTRA THIN 30GLANCETS. ............. 68PV UNIFINE PENTIPS31GX3/16 ............. 68PX PEN 8MM 31GNEEDLES ............. 68PYLERA. ................ 47pyrazinamide .............. 9pyridostigmine bromidetablet. ................. 29QQC ALCOHOL 70%SWABS ............... 68QC INSULIN SYR 1 ML31GX5/16 ............. 68QC INSULIN SYRINGE 0.3ML. ................... 68QC INSULIN SYRINGE 0.5ML. ................... 68QC INSULIN SYRINGE 1ML. ................... 68QC INSUL SYR 0.5 ML31GX5/16 ............. 68QC PEN NEEDLES 6MM31G. .................. 68QC PEN NEEDLES 8MM31G. .................. 68QC PEN NEEDLES 12MM29G. .................. 68QC SUPER THIN LANCET 68QC ULTRA THIN LANCET . 68QC UNIFINE PENTIP 6MM31G. .................. 68QC UNIFINE PENTIP 8MM31G. .................. 68QC UNIFINE PENTIP 12MM29G. .................. 68QC UNILET SUPER THIN 30GLANCT ................ 68QUADRAMET. ........... 18QUALAQUIN ............ 13quasense ................ 84quetiapine fumarate ....... 21QUICKTEK CONTROLSOLUTION ............ 68quinapril hcl .............. 31quinapril-hydrochlorothiazide 35quinidine gluconate injection 31quinidine gluconate tabletsustained action. ........ 31quinidine sulfate tablet, -tabletsustained action. ........ 31quinine sulfate 324mgcapsule ................ 13QVAR. .................. 94RRA ALCOHOL SWABS ... 68RABAVERT .............. 49RA E-ZJECT 28G LANCETS 68RA E-ZJECT COLOR 33GLANCETS. ............. 68RA E-ZJECT LANCETS .... 68RA INS SYR 0.5 ML29GX1/2 .............. 68RA INS SYR 0.5 ML30GX5/16 ............. 68RA INS SYR 1 ML 29GX1/2 68RA INS SYRINGE 1 ML30GX5/16 ............. 68RA ISOPROPYL ALCOHOL70% WIPES ........... 68ramipril .................. 31RANEXA ................ 35ranitidine hcl capsule, -tablet 46ranitidine hcl injection. ..... 46ranitidine syrup ........... 46RAPAMUNE 2 MG TABLET 18RAPAMUNE SOLUTION,-0.5 MG TABLET, -1 MGTABLET. ............... 18RA PEN NEEDLE31GX3/16 ............. 68RA PEN NEEDLE31GX5/16 ............. 68RAYOS ................. 42REALITY 1/2 ML SYRINGE 68REALITY 1 ML SYRINGE .. 68REALITY ALCOHOLSWABS ............... 68REALITY LANCETS ....... 68REALITY TRIGGERLANCETS. ............. 68REBIF 22 MCG/0.5 MLSYRINGE, -44 MCG/0.5 MLSYRINGE. ............. 50REBIF TITRATION PACK .. 50RECLAST ............... 45reclipsen ................ 84RECOMBIVAX HB ....... 49RECTIV ................. 47REFUAH PLUS CONTROLSOLUTION ............ 68REGRANEX . . . . . . . . . . . . . 39RELENZA . . . . . . . . . . . . . . . 11RELIAMED SAFETY SEALLANCETS. ............. 69120