2022 Lycoming Tioga MA Kit

T1 = Tier 1 T2 = Tier 2 T3 = Tier 3 T4 = Tier 4 T5 = Tier 5 M meclizine oral tablet 12.5 mg, 25 mg T2 T2 meloxicam oral tablet T2 T1 memantine oral tablet T3 T2 metformin oral tablet T1 T1 metformin oral tablet extended release 24 hr (generic Glucophage XR) T1 T1 methocarbamol oral tablet T2 T2 methotrexate sodium oral tablet T3 T1 methylprednisolone oral tablets, dose pack T2 T2 metoprolol succinate oral tablet extended release 24 hr T2 T2 metoprolol tartrate oral tablet 100 mg, 25 mg, 50 mg T1 T1 metronidazole oral capsule T4 T4 metronidazole oral tablet T2 T2 metronidazole topical cream T4 T3 metronidazole topical gel 0.75 % T4 T3 metronidazole vaginal gel T4 T3 montelukast oral tablet T2 T2 mupirocin topical ointment T2 T2 MYRBETRIQ ORAL TABLET EXTENDED RELEASE 24 HR T3 T3 N naproxen oral tablet T2 T1 nifedipine oral tablet extended release T2 T2 nifedipine oral tablet extended release 24hr T2 T2 nitroglycerin sublingual tablet T2 T2 nitroglycerin transdermal patch 24 hour T2 T2 nitroglycerin translingual spray, non-aerosol T4 T4 nortriptyline oral capsule T2 T2 nystatin oral tablet T3 T2 nystatin topical cream T2 T2 nystatin topical ointment T2 T2 nystatin topical powder T3 T2 O olanzapine oral tablet T3 T2 olmesartan oral tablet T2 T2 omeprazole oral capsule, delayed release (dr/ec) T2 T1 oseltamivir oral capsule T3 T3 oxybutynin chloride oral tablet T2 T1 oxybutynin chloride oral tablet extended release 24hr T2 T2 OZEMPIC SUBCUTANEOUS PEN INJECTOR T3 T2 P pantoprazole oral tablet, delayed release (dr/ec) T2 T1 paroxetine hcl oral tablet T2 T2 penicillin v potassium oral tablet T2 T2 pioglitazone oral tablet T1 T1 potassium chloride oral capsule, extended release T2 T2 potassium chloride oral tablet extended release T2 T2 potassium chloride oral tablet, er particles/crystals 10 meq, 20 meq T2 T2 pravastatin oral tablet T1 T1 prednisolone acetate ophthalmic (eye) drops,suspension T2 T2 prednisone oral tablet T2 T1 Drug List 17