2022 Lycoming Tioga MA Kit

CAPITALIZED = BRAND NAME lowercase italics = generic drug Drug Name Formulary 1 Formulary 2 atenolol oral tablet T1 T1 atorvastatin oral tablet T1 T1 azelastine nasal aerosol, spray 137 mcg T2 T2 azelastine ophthalmic (eye) drops T3 T2 B baclofen oral tablet 10 mg, 20 mg T4 T3 benazepril oral tablet T1 T1 benztropine oral tablet T2 T2 bisoprolol fumarate oral tablet T2 T2 BREO ELLIPTA INHALATION BLISTERWITH DEVICE T3 T3 bumetanide oral tablet T4 T2 C calcitriol oral capsule T3 T3 carbidopa-levodopa oral tablet T2 T1 cartia xt oral capsule, extended release 24hr T2 T2 carvedilol oral tablet T1 T1 cefdinir oral capsule T2 T2 celecoxib oral capsule T4 T3 cephalexin oral capsule 250 mg, 500 mg T2 T2 chlorhexidine gluconate mucous membrane mouthwash T2 T2 chlorthalidone oral tablet 25 mg, 50 mg T2 T2 ciprooxacin hcl oral tablet 250 mg, 500 mg, 750 mg T2 T2 This is a partial list. This is not a complete list of the prescription drugs we cover. Drug Name Formulary 1 Formulary 2 ADVAIR DISKUS INHALATION BLISTERWITH DEVICE T2 T2 albuterol sulfate inhalation hfa aerosol inhaler 90 mcg/actuation (generic Proair and generic Proventil) T2 T2 alendronate oral tablet 35 mg, 70 mg T1 T1 allopurinol oral tablet T2 T1 alprazolam oral tablet T2 T2 amiodarone oral tablet 100 mg, 400 mg T4 T4 amiodarone oral tablet 200 mg T2 T2 amitriptyline oral tablet T2 T2 amlodipine oral tablet T1 T1 amlodipine-benazepril oral capsule T2 T2 amoxicillin oral capsule T2 T2 amoxicillin oral tablet T2 T2 amoxicillin-pot clavulanate oral suspension for reconstitution 200-28.5 mg/5 ml, 600-42.9 mg/5 ml T2 T2 amoxicillin-pot clavulanate oral tablet 250-125 mg T4 T4 amoxicillin-pot clavulanate oral tablet 500-125 mg, 875-125 mg T2 T2 anastrozole oral tablet T2 T2 ANORO ELLIPTA INHALATION BLISTERWITH DEVICE T3 T3 aripiprazole oral tablet T4 T3 A through Z 14