2022 Lycoming Tioga MA Kit

T1 = Tier 1 T2 = Tier 2 T3 = Tier 3 T4 = Tier 4 T5 = Tier 5 doxycycline hyclate oral tablet 100 mg, 20 mg T2 T2 doxycycline monohydrate oral capsule 100 mg, 50 mg T2 T2 doxycycline monohydrate oral tablet 100 mg, 50 mg, 75 mg T2 T2 duloxetine oral capsule, delayed release(dr/ec) 20 mg, 30 mg, 60 mg T3 T3 E ELIQUIS DVT-PE TREAT 30D START ORAL TABLETS, DOSE PACK T3 T3 ELIQUIS ORAL TABLET T3 T3 enalapril maleate oral tablet T1 T1 ENTRESTO ORAL TABLET T3 T3 escitalopram oxalate oral tablet T2 T2 esomeprazole magnesium oral capsule, delayed release (dr/ec) T4 T4 ezetimibe oral tablet T3 T3 F famotidine oral tablet 20 mg, 40 mg T2 T2 feno„brate micronized oral capsule 134 mg, 200 mg, 67 mg T3 T3 feno„brate nanocrystallized oral tablet 145 mg, 48 mg T3 T3 feno„brate oral tablet 160 mg, 54 mg T3 T3 „nasteride oral tablet 5 mg T2 T1 FLOVENT HFA AEROSOL INHALER T3 T3 uoxetine oral capsule T1 T1 citalopram oral tablet T1 T1 clobetasol scalp solution T3 T2 clobetasol topical cream T3 T2 clobetasol topical gel T4 T2 clobetasol topical ointment T3 T2 clobetasol-emollient topical cream T3 T3 clonazepam oral tablet T2 T2 clonidine hcl oral tablet T2 T2 clopidogrel oral tablet 75 mg T2 T1 cyclobenzaprine oral tablet 10 mg, 5 mg T2 T2 D diazepam oral tablet T2 T2 diclofenac sodium ophthalmic (eye) drops T2 T2 diclofenac sodium oral tablet, delayed release (dr/ec) 25 mg T4 T3 diclofenac sodium oral tablet, delayed release (dr/ec) 50 mg, 75 mg T2 T2 diclofenac sodium topical gel 1 % T3 T3 dicyclomine oral capsule T2 T2 dicyclomine oral tablet T2 T2 digoxin oral tablet T2 T2 diltiazem hcl oral capsule, extended release 24hr 120 mg, 180 mg, 240 mg, 300 mg T2 T2 divalproex oral tablet, delayed release (dr/ec) T2 T2 donepezil oral tablet 10 mg, 5 mg T2 T2 dorzolamide-timolol ophthalmic (eye) drops T2 T2 doxazosin oral tablet T2 T2 doxycycline hyclate oral capsule T2 T2 Drug List 15