Download 2010_DLC_Commerical_Grid_Rx3 Movement

HUMANA 2010 DRUG LIST CHANGES
Rx3 DRUG MOVEMENT
Rx3 Drug Movement - The drugs below will move from Level 1 to Level 2 effective January 1, 2010.
For copayment level information and possible lower cost alternatives, visit Humana.com.
DRUG NAME
LEVOTHROID TABLET
LEVOXYL TABLET
UNITHROID TABLET
Rx3 Drug Movement - The drugs below will move from Level 1 to Level 3 effective January 1, 2010.
For copayment level information and possible lower cost alternatives, visit Humana.com.
DRUG NAME
AYGESTIN TABLET
ESTRACE TABLET
ISOPTO HOMATROPINE DROPS
REPREXAIN TABLETS
Rx3 Drug Movement - The drugs below will move from Level 2 to Level 3 effective January 1, 2010.
For copayment level information and possible lower cost alternatives, visit Humana.com.
DRUG NAME
8-MOP CAPSULE
ACUFLEX CAPLET
ADVICOR TABLET
AHIST TABLET
ALBENZA TABLET
ALKERAN TABLET
ALOMIDE EYE DROPS
ANAFRANIL CAPSULE
ANCOBON CAPSULE
ATABEX PRENATAL TABLET
ATROVENT HFA INHALER
AVC CREAM
AZMACORT INHALER
BACTROBAN CREAM
BACTROBAN NASAL OINTMENT
BETOPTIC S EYE DROPS
BLEPHAMIDE EYE DROPS
BLEPHAMIDE EYE OINTMENT
BROMHIST PEDIATRIC DROPS
BRONTUSS SF SYRUP
CALAN TABLET
CAPOZIDE TABLET
CARBAPHEN 12 PED SUSPENSION
CARBAPHEN 12 SUSPENSION
CARBATUSS-CL LIQUID
CARDIZEM LA TABLET
CARMOL SCALP LOTION
CASODEX TABLET
CATAPRES-TTS PATCH
CEENU CAPSULE
CELLCEPT ORAL SUSPENSION
CELLCEPT CAPSULE
CELLCEPT TABLET
CELONTIN KAPSEAL
CENESTIN TABLET
CHEMET CAPSULE
CHROMAGEN CAPLET
CHROMAGEN FA CAPLET
CHROMAGEN FORTE CAPLET
GCAFLHH 07/08
CIPRO HC OTIC SUSPENSION
CLEOCIN VAGINAL OVULE
CLIMARA DAY PATCH
CLINDESSE VAGINAL CREAM
CLODERM CREAM
COMBIVENT INHALER
COMTAN TABLET
CORDRAN CM TAPE
CORTIFOAM AEROSOL
CORTISPORIN CREAM
CORTISPORIN EAR SOLUTION
CORTISPORIN EAR SUSPENSION
CORTISPORIN OINTMENT
CORTISPORIN-TC EAR SUSPENSION
COSOPT EYE DROPS
COUMADIN TABLET
CRINONE GEL
CUTIVATE LOTION
CYCLOGYL EYE DROPS
DARAPRIM TABLET
DARVON-N TABLET
DAYPRO CAPLET
DELTUSS DMX LIQUID
DEPEN TITRATAB
DERMA-SMOOTHE-FS BODY OIL
DERMA-SMOOTHE-FS SCALP OIL
DESPEC DM SYRUP
DEXPAK TABLET
DIASTAT PEDI SYSTEM
DIASTAT ACUDIAL
DIFFERIN CREAM
DIFFERIN GEL
DILANTIN CAPSULE
DILANTIN KAPSEAL
DILANTIN INFATAB
DIURIL ORAL SUSPENSION
DROXIA CAPSULE
DUETACT TABLET
DYRENIUM CAPSULE
Page 1 of 3
This list is subject to change.
Rx3 Drug Movement - The drugs below will move from Level 2 to Level 3 effective January 1, 2010.
For copayment level information and possible lower cost alternatives, visit Humana.com.
DRUG NAME
E.E.S. GRANULES
EDECRIN TABLET
ENCORA COMBO PACK
EPIFOAM FOAM
EPIVIR ORAL SOLUTION
EPIVIR TABLET
EPIVIR HBV TABLET
EPIVIR HBV SOLUTION
ERGOMAR SL TABLET
EURAX LOTION
EVAMIST SPRAY
EXELDERM CREAM
EXELDERM SOLUTION
FARESTON TABLET
FELBATOL TABLET
FELBATOL SUSPENSION
FEMHRT TABLET
FLOMAX SA CAPSULE
FOLGARD OS TABLET
FOLTRATE TABLET
FURADANTIN SUSPENSION
GILTUSS PED-C LIQUID
GYNAZOLE-1 CREAM
HALOG CREAM
HALOG OINTMENT
HYCET SOLUTION
INDOCIN SUSPENSION
INDOCIN SUPPOSITORY
INNOPRAN XL CAPSULE
INNOPRAN XL SA CAPSULE
IOPIDINE EYE DROPS
ISOPTO CARBACHOL DROPS
ISOPTO CARPINE EYE DROPS
J-MAX SYRUP
KADIAN SR CAPSULE
KENALOG AEROSOL SPRAY
LEVATOL TABLET
LEVOTHYROXINE TABLET
LIDODERM PATCH
LOCOID LOTION
LODOSYN TABLET
LODRANE D SUSPENSION
LUFYLLIN TABLET
LUSONAL LIQUID
MACRODANTIN CAPSULE
MALATHION LOTION
MATULANE CAPSULE
MAXIDEX EYE DROPS
MENOSTAR DAY PATCH
MESNEX TABLET
METANX TABLET
MINOCIN PELLETIZED CAPSULE
MOBAN TABLET
MYCOBUTIN CAPSULE
NARDIL TABLET
NATELLE C TABLET
GCAFLHH 07/08
NEBUPENT POWDER
NEOTUSS-D LIQUID
NIFEREX-150 FORTE CAPSULE
NILANDRON TABLET
NORINYL 1+35-28 TABLET
OMNIHIST II LA TABLET
OPTINATE COMBO PACK
ORAP TABLET
OVIDE LOTION
OXISTAT CREAM
OXISTAT LOTION
OXSORALEN LOTION
OXSORALEN-ULTRA CAPSULE
PANATUSS DXP LIQUID
PANATUSS DXP PEDIATRIC DROPS
PAXIL SUSPENSION
PCE DISPERTAB
PHISOHEX CLEANSER
PHOSLO GELCAP
PHOSPHOLINE IODIDE
PILOPINE HS EYE GEL
PLEXION CLEANSER
POLY-PRED EYE DROPS
PRAMOSONE CREAM
PRAMOSONE LOTION
PRAMOSONE OINTMENT
PRECARE CHEWABLE TABLET
PRECARE CONCEIVE TABLET
PRECARE PREMIER CAPLETS
PRECOSE TABLET
PRED MILD EYE DROPS
PRED-G EYE DROPS
PRED-G S.O.P. EYE OINTMENT
PRIMACARE ADVANTAGE COMBO PACK
PRIMACARE COMBO PACK
PRIMACARE ONE SOFTGEL
PROCHIEVE GEL
PROGLYCEM ORAL SUSPENSION
PROZAC SOLUTION
PULMICORT RESPULE
PYRIDIUM TABLET
QUESTRAN PACKET
RAZADYNE TABLET
RAZADYNE ORAL SOLUTION
RAZADYNE ER CAPSULE
REPLIVA TABLET
REPREXAIN TABLET
RIDAURA CAPSULE
RIFAMATE CAPSULE
RISPERDAL M TABLET
RYNATAN PEDIATRIC CHEWABLE TABLET
SANTYL OINTMENT
SECTRAL CAPSULE
SEMPREX-D CAPSULE
STIMATE NASAL SPRAY
STROMECTOL TABLET
Page 2 of 3
This list is subject to change.
Rx3 Drug Movement - The drugs below will move from Level 2 to Level 3 effective January 1, 2010.
For copayment level information and possible lower cost alternatives, visit Humana.com.
DRUG NAME
SUDAL-12 CHEWABLE TABLET
SULAR TABLET
SULFAMYLON CREAM
SULFAMYLON POWDER PACKET
SYNALGOS-DC CAPSULE
SYNTHROID TABLET
TASMAR TABLET
TENORETIC TABLET
THEO-24 SA CAPSULE
TILADE INHALER
TOBRADEX EYE DROPS
TOBRADEX EYE OINTMENT
TOBREX EYE OINTMENT
TRANSDERM-SCOP
TREXALL TABLET
TRI-NORINYL 28 TABLET
TRISPEC DMX LIQUID
GCAFLHH 07/08
TRISPEC DMX PEDIATRIC DROPS
TRUSOPT EYE DROPS
TARGRETIN GEL
TARGRETIN SOFTGEL
TRUVADA TABLET
TUSSI-12D TABLET
TUSSI-PRES LIQUID
TUSSI-PRES PEDIATRIC LIQUID
VALTREX CAPLET
VAZOBID SUSPENSION
VESANOID CAPSULE
VEXOL EYE DROPS
VIGAMOX EYE DROPS
VISTARIL CAPSULE
VISTARIL TABLET
ZERIT SOLUTION
ZYDONE TABLET
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This list is subject to change.