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

acyclovir ointment ......... 11ADACEL ................ 48ADAGEN. ............... 40adapalene ............... 37ADCIRCA ............... 36adenosine injection. ....... 34adriamycin injection ....... 15adrucil .................. 15ADVAIR DISKUS ......... 94ADVAIR HFA. ............ 94ADVANCED TRAVEL LANCETS28G. .................. 52ADVANCE MICRO-DRAWCNTRL SOLN .......... 52ADVANCE MICRO-DRAWCONTRL SOLN ........ 52ADVANCE NORMALCONTROL SOLN. ...... 52ADVOCATE 26G LANCETS 52ADVOCATE 30G LANCETS 52ADVOCATE CONTROLSOLUTION HIGH. ...... 52ADVOCATE CONTROLSOLUTION LOW ....... 52ADVOCATE INS 0.3 ML30GX5/16 ............. 52ADVOCATE INS 0.3 ML31GX5/16 ............. 52ADVOCATE INS 0.5 ML30GX5/16 ............. 52ADVOCATE INS 0.5 ML31GX5/16 ............. 52ADVOCATE INS 1 ML31GX5/16 ............. 52ADVOCATE INS SYR 0.3ML29GX1/2 .............. 53ADVOCATE INS SYR 0.5ML29GX1/2 .............. 53ADVOCATE INS SYR 1 ML29GX1/2 .............. 53ADVOCATE INS SYR 1 ML30GX5/16 ............. 53ADVOCATE PEN NEEDLES5MM 31G. ............. 53ADVOCATE PEN NEEDLES8MM 31G. ............. 53ADVOCATE REDI-CODE+CTRL SOLN. ........... 53afeditab cr ............... 32AFINITOR ............... 15AFLURIA 2011-2012. ..... 48AFLURIA 2011-2012 (PF) . 48AGAMATRIX HIGH CONTROLSOLN . . . . . . . . . . . . . . . . . 53AGAMATRIX NORM-HICONTROL SOLN. ...... 53AGGRENOX ............ 78AIMSCO INS PEN NDL29GX1/2 .............. 53AIMSCO INS PEN NDL31GX3/16 ............. 53AIMSCO INS PEN NDL31GX5/16 ............. 53AIMSCO INS SYR 0.3 ML29GX1/2 .............. 53AIMSCO INS SYR 0.3 ML30GX5/16 ............. 53AIMSCO INS SYR 0.5 ML28GX1/2 .............. 53AIMSCO INS SYR 0.5 ML29GX1/2 .............. 53AIMSCO INS SYR 1 ML28GX1/2 .............. 53AIMSCO INS SYR 1 ML29GX1/2 .............. 53AIMSCO INS SYR 1 ML30GX5/16 ............. 53AIMSCO SYRING 0.3 ML31GX5/16 ............. 53AIMSCO SYRING 0.5 ML30GX5/16 ............. 53AIMSCO SYRING 0.5 ML31GX5/16 ............. 53AIMSCO ULTR-THIN II 28GLANCET ............... 53ak-con .................. 91akorn balanced salt. ....... 91ak-poly-bac .............. 91ALBENZA ................ 7albuterol sulfate nebs ...... 93albuterol sulfate syrup, -tablet,-tablet sustained action. .. 93alclometasone dipropionate. 38ALCOHOL 70% PADS .... 53ALCOHOL 70% PREPPADS ................. 53ALCOHOL 70% SWABS .. 53ALCOHOL PREP PADS ... 53ALCOHOL PREP PADS70%. .................. 53ALCOHOL PREP SWABS. 53ALCOHOL SWAB ........ 53ALCOHOL SWABS. ...... 53ALCOHOL WIPES ....... 53ALDURAZYME. .......... 44alendronate sodium 5 mg tablet,-10 mg tab, -40 mg tab. .. 44alendronate sodium 35 mg tab,-70 mg tab ............. 44alfentanil hydrochloride .... 24alfuzosin hcl. ............. 95ALIMTA ................. 15ALINIA .................. 10ALKERAN TABLET. ....... 15allopurinol sodium. ........ 77allopurinol tablet . . . . . . . . . . 77alprazolam er ............. 23alprazolam intensol ........ 23alprazolam odt. ........... 23alprazolam tablet. ......... 23alprazolam xr . . . . . . . . . . . . . 23alprostadil injection. ....... 35altafrin .................. 91altavera ................. 83ALTERNATE SITE 26GLANCETS. ............. 53ALTERNATE SITELANCETS. ............. 53alyacen. ................. 83amantadine .............. 11amcinonide .............. 38a-methapred ............. 42amethia ................. 83amethia lo ............... 83amethyst ................ 83amifostine ............... 15amikacin. ................. 7amiloride hcl tablet ........ 36amiloride-hydrochlorothiazide 36amino acids .............. 79aminocaproic acid injection,-syrup, -500 mg tab. ..... 4097