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2019 Commercial Formulary Drug Look Up Tool

A formulary is a list of drugs selected by FHCP in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. FHCP will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a FHCP network pharmacy, and other plan rules are followed.


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*ADHD/ANTI-NARCOLEPSY/ANTI-OBESITY/ANOREXIANTS**AMINOGLYCOSIDES**ANALGESICS - ANTI-INFLAMMATORY**ANALGESICS - NonNarcotic**ANALGESICS - OPIOID**ANDROGENS-ANABOLIC**ANORECTAL AGENTS**ANTHELMINTICS**ANTIANGINAL AGENTS**ANTIANXIETY AGENTS**ANTIARRHYTHMICS**ANTIASTHMATIC AND BRONCHODILATOR AGENTS**ANTICOAGULANTS**ANTICONVULSANTS**ANTIDEPRESSANTS**ANTIDIABETICS**ANTIDIARRHEALS**ANTIDOTES**ANTIEMETICS**ANTIFUNGALS**ANTIHISTAMINES**ANTIHYPERLIPIDEMICS**ANTIHYPERTENSIVES**ANTI-INFECTIVE AGENTS - MISC.**ANTIMALARIALS**ANTIMYASTHENIC/CHOLINERGIC AGENTS**ANTIMYCOBACTERIAL AGENTS**ANTINEOPLASTICS AND ADJUNCTIVE THERAPIES**ANTIPARKINSON AGENTS**ANTIPSYCHOTICS/ANTIMANIC AGENTS**ANTIVIRALS**ASSORTED CLASSES**BETA BLOCKERS**CALCIUM CHANNEL BLOCKERS**CARDIOTONICS**CARDIOVASCULAR AGENTS - MISC.**CEPHALOSPORINS**CONTRACEPTIVES**CORTICOSTEROIDS**COUGH/COLD/ALLERGY**DERMATOLOGICALS**DIAGNOSTIC PRODUCTS**DIGESTIVE AIDS**DIURETICS**ENDOCRINE AND METABOLIC AGENTS - MISC.**ESTROGENS**FLUOROQUINOLONES**GASTROINTESTINAL AGENTS - MISC.**GENITOURINARY AGENTS - MISCELLANEOUS**GOUT AGENTS**HEMATOLOGICAL AGENTS - MISC.**HEMATOPOIETIC AGENTS**HEMOSTATICS**HYPNOTICS/SEDATIVES/SLEEP DISORDER AGENTS**LAXATIVES**MACROLIDES**MEDICAL DEVICES AND SUPPLIES**MEDICAL DEVICES**MIGRAINE PRODUCTS**MINERALS & ELECTROLYTES**MISCELLANEOUS THERAPEUTIC CLASSES**MOUTH/THROAT/DENTAL AGENTS**MULTIVITAMINS**MUSCULOSKELETAL THERAPY AGENTS**NASAL AGENTS - SYSTEMIC AND TOPICAL**NEUROMUSCULAR AGENTS**OPHTHALMIC AGENTS**OTIC AGENTS**OXYTOCICS**PENICILLINS**PHARMACEUTICAL ADJUVANTS**PROGESTINS**PSYCHOTHERAPEUTIC AND NEUROLOGICAL AGENTS - MISC.**RESPIRATORY AGENTS - MISC.**TETRACYCLINES**THYROID AGENTS**ULCER DRUGS**URINARY ANTI-INFECTIVES**URINARY ANTISPASMODICS**VAGINAL PRODUCTS**VASOPRESSORS**VITAMINS*
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*The Affordable Care Act requires coverage of certain preventive medications without any patient cost-sharing to “ACA compliant” and “non-grandfathered” plans only. ACA compliant and “non-grandfathered” plan means any health plan available to subscribers created by FHCP on or after March 23, 2010. For more information call Member Services at 1-877-615-4022, 7 days a week, 8 am – 8 pm. TTY users should call TRS Relay 711.

Formulary Id: 14776
Formulary Effective Date: 01/01/2019
Updated:
01/2019
CMS Version:
1

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