Your doctor must complete and fax the prior authorization form for the specific medication to the Johns Hopkins HealthCare Pharmacy department at 410-424-4037. Pharmacy and Formulary. We are here to help you with your testing questions.. Use your account to view your electonic health record, email your care team, schedule appointments and view test results. Drugs subject to step therapy will be approved for first-time users only after they have tried one of the preferred agents on the DoD Uniform Formulary. Search health topics in theHealth Library. Privacy Policy. (7 days ago) The Uniformed Services Family Health Plan (USFHP) is a managed care program developed by the Department of Defense (DoD). Instead, contact the IT Help Desk at (410) 516-HELP. USFHP utilizes the TRICARE pharmacy formulary. Obtain your care at one of the clinics listed below, if possible. The, For over 125 years, Marylanders have counted on. US Family Health Plan Overview. Interested in joining our network? We're here to help. Johns Hopkins USFHP is backed by Johns Hopkins Hopkinsmedicine.org Category: Health Detail Health Pharmacy & Prescription Coverage Johns Hopkins US Health Patients choose a primary care physician who provides and coordinates care and referrals to specialists and hospitals. glycopyrrolate tablets glycopyrrolate oral solution (Cuvposa), Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, Prior Authorization & Other Exception Requests, Review the changes that will be made to the formulary, prior authorization form for the specific medication. Masks are required inside all of our care facilities. However, it's important to follow these guidelines: Obtain your care at one of the clinics listed below, if possible. Claims & Appeals . Registration is required for first-time users. You may search for the specialty medications covered under pharmacy benefit on the TRICARE Formulary. Submission. All other test strips will require prior authorization. Click to visit the USFHP COVID-19 Information Page. To pre-certify outpatient Physical Therapy/Occupational Therapy services, contact OrthoNet at (844) 356-4901. The full TRICARE benefit, including doctor visits, hospitalizations, and medications. If a provider determines that a step therapy requirement is not appropriate for a member, the Pharmacy Prior Authorization Form may be submitted for review. Johns Hopkins students, faculty, and staff who feel ill or are concerned about COVID-19 exposure should call the Johns Hopkins COVID-19 Call Center at 443-287-8500, seven days a week, between 7 a.m. and 7 p.m. You can also self-schedule a COVID test through your Hopkins MyChart. For urgent, short-term acute medications or for the first prescription of a newly prescribed medication, for 30 days or less, present your US Family Health Plan member ID card at a participating pharmacy. Claims Address. The US Family Health Plan requires beneficiaries to enroll and is offered through six participating non-profit plans in different regions of the country. Providers must provide medical justification for use of the higher quantity. All rights reserved. 1st Grade Stationary Engineer (Casual hours - 19/hrs per week - 7a.m.-3p.m.) Physical Therapy / Occupational Therapy. . For members who prefer to utilize a mail order program for maintenance medications, the Walgreens Pharmacy at Remington provides this service for Maryland Residents only. Generic drugs are chemically identical to their branded counterparts. 12/29/2021 USFHP has expanded its pharmacy network and added more pharmacies for . Contact our Provider Relations department at 888-895-4998 or 410-762-5385. Providers may supply any vaccine for any age group under the medical benefit as long as a scheduled vaccine is in line with the Advisory Committee on Immunization Practices (ACIP) recommendations. We're proud to rate in the 99th percentile for member satisfaction in . Your doctor can request a co-pay reduction on your behalf by completing and submitting a non-formulary co-pay reduction request form. Download a copy of the Pharmacy Prior-Authorization form, complete and fax the Prior Authorization form to the Johns Hopkins Healthcare Pharmacy department at 410-424-4037. document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); This field is for validation purposes and should be left unchanged. Specialty Medications are usually high-cost prescription medications used to treat complex chronic conditions. Maine. Call us at +966-013-870-1920. Members who live outside of Maryland may obtain home delivery from AllianceRx Walgreens Prime Pharmacy in Arizona. Two free dental cleanings and a . Treatment at urgent care clinics is covered by US Family Health Plan, and you don't need to obtain a referral from your PCP before receiving urgent care. Immediate response to inquiries, requests and/or issues. The TRICARE formulary and pharmaceutical management policies are developed by the Department of Defense Pharmacy and Therapeutics Committee. Brand-name drugs with a generic equivalent may be dispensed only if the prescriber submits a Brand Name Prior Authorization Request and approval is granted by the JHHC USFHP Pharmacy Review Department. You can call 1-800-74-USFHP (1-800-748-7347) to be routed to your specific site or call your US Family Health Plan Site directly to enroll: Johns Hopkins Medicine: 1-800-808-7347; Martin's Point Health Care: 1-888-241-4556; Brighton Marine Health Center: 1-800-818-8589; St. Vincent Catholic Medical Centers: 1 . We wouldnt want to do anything else, to be honest with you., 2022 Uniformed Services Family Health Plan. Visit the USFHP website Call (410) 955-8215, Fax (410) 955-1085. or e-mail us at [email protected]. In those cases, USFHP members will pay the brand name copayment. Found 2530 jobs at Johns Hopkins Medicine. Johns Hopkins USFHP utilizes the TRICARE pharmacy formulary. Once you begin using Home Delivery, you can order refills by phone using our automated systems or by going online. Review the latest formulary changes. New Hampshire. Providers can also search for lower cost alternative medications to a medication they are currently prescribing. Sign in now. Note: All products/benefit packages may not. In such a case, the beneficiary may receive the non-formulary medication at the formulary brand co-payment. prior authorization form for the specific medication, non-drug specific prior authorization form. Do NOT perform this step if you already have a JHED ID. Choose a provider who will get to know you and your family, with easy to schedule appointments and Johns Hopkins OnDemand Virtual Care: no-appointment after-hours telehealth. If you have copy of the previous approval letter, please fax it along with the Prior Authorization Form to USFHP Pharmacy Review department. Please keep in mind that specialist visits and hospital admissions, except for . Washington D.C. Parts of Pennsylvania, Virginia, Delaware and West Virginia. Doryx MPC. 1. ABA Prior Authorization Request Acknowledgement and Financial Responsibility Statement Care Management Services Request Medical Admission or Procedure Authorization Request (not for medical injectable requests) Doryx/Doxycycline Hyclate. Each of these tiers represents a cost share that USFHP members are responsible for paying. Use the TRICARE formulary search tool to find coverage and cost share details for a specific drug. Department of Art as Applied to Medicine. About. USFHP Retail Pharmacy Network Expands. In case the medication is not listed, providersmay use the non-drug specific prior authorization form. Prescriptions may be filled for up to a 90 day supply at any network pharmacy. In case the medication is not listed, providers may use the non-drug specific prior authorization form. Johns Hopkins Medicine. Specialty Medications - Pharmacy Benefit: These medications are self-administered and processed through the members pharmacy benefit. Non-preferred drugs are only prescribed if the preferred medication is ineffective or poorly tolerated. Quantity Limits information may be found on the TRICARE formulary tool. Want to find a doctor at one of our many locations? MyChart >> With MyChart , you can: See portions of your/your child's medical record, including some test results, scans and images Monitor health care provided View and pay bills Send secure messages to some members of the health care team Request prescription renewals. If you choose to provide us with personal information by sending an email, or by filling out a form with your personal information and submitting it through our Web site, we use that information to respond to your message and to help us provide you with information or material that you request. Canton, MA 02021-0495. 1st Grade Stationary Engineer- PRN. Plus extras like chiropractic care and discounts on acupuncture and eyewear. Johns Hopkins USFHP is proud to provide you, our military community, with comprehensive health care services. A Increase font size. For a list of drugs that require prior authorization, refer to theTRICARE Prior Authorization page. Pharmacy Services. A Reset font size. are vaccinating all eligible patients. Enter the last name, specialty or keyword for your search below. Glucose test strips - FreeStyle Lite and Precision Xtra strips are TRICARE preferred test strips. Treatment at urgent care clinics is covered by US Family Health Plan, and you don't need to obtain a referral from your PCP before receiving urgent care. US Family Health Plan. Non-Formulary Co-Pay Reduction Request form, Medical Injectable Prior Authorization Form, EHP/Priority Partners/Advantage MD patients, tretinoin 0.1%/benzoyl peroxide3% topical cream(Twyneo), Dihydroergotamine mesylate nasal spray (Trudhesa), Corticosteroids-Immune Modulators: High Potency, Clobetasol propionate 0.05% lotion metered dose pump (Impeklo), Calcipotriene/ betamethasone dipropionate 0.005% /0.064% topical cream (Wynzora), Pulmonary I Agents Inhaled Corticosteroids (ICS), Fluticasone propionate dry powder inhaler oral (ArmonAir Digihaler), Pulmonary I Agents ICS/Long-Acting Beta Agonists (LABA), Fluticasone propionate / salmeterol dry powder inhaler oral (AirDuo Digihaler), Calcipotriene 0.005% Betamethasone 0.064% Suspension (Taclonex, Generic), Halcinonide 0.1% topical solution (Halog), NSAIDs: celecoxib, diclofenac, indomethacin, meloxicam, naproxen, (also includes other NSAIDs), Pulmonary: Short Acting Beta-2 Agonists (SABA), ProAir Digihaler (albuterol dry powder inhaler), Talicia (omeprazole magnesium-amoxicillin-rifabutin), Methylphenidate ER sprinkle capsules (Adhansia XR), Halobetasol propionate 0.05% foam (Lexette brand), Diabetes Non- Insulin Drugs Biguanides Subclass, Metformin ER gastric retention 24 hours (Glumetza), Compounded medications of which at least one ingredient is a legend drug. mercury grand marquis hesitation on acceleration, 89 to 92 chevy geo tracker for sale northern california, the coming collapse of the united states 2022, longest work slot hackerrank solution in java. TRICARE is a registered trademark of the Department of Defense, Defense Health Agency. For more information on OrthoNet, visit their website at www.orthonet-online.com. View certain prescription medications removed from the TRICARE pharmacy benefit program. The Plan covers care at urgent-care or after-hours clinics, but be sure to let your PCP know that you've been there. Contact us or find a patient care location. If the requested drug also requires prior authorization, your doctor should submit a prior authorization request as well. Contact. Job Req: 460783. Job Req: 563363. The Uniformed Services Family Health Plan (USFHP) is a TRICARE Prime military health care option that provides benefits including routine doctor visits, specialty care, hospitalization, urgent and emergent care, preventative health care services, and prescription coverage. P.O. Providers may submit claims electronically by means of a variety of external clearinghouse sources. Use our Provider Directory for a list of participating infusion providers. Review the changes that will be made to the formulary. If you have any further questions about our plan, please feel free to contact us here. Download a copy of the Pharmacy Prior-Authorization form, complete and fax the Prior Authorization form to the Johns Hopkins Healthcare Pharmacy department at 410-424-4037. For maintenance medications used to treat ongoing, chronic illnesses, our plan requires that those medications be filled routinely by mail order. Drugs subject to step therapy will be approved for first-time users only after they have tried one of the preferred agents as covered in the TRICARE formulary. what happened to texas game warden cummings wife. Use the Prior Authorization form to request prior authorization for self-administered specialty medications. Johns Hopkins US Family Health Plan (USFHP) is a health care choice for eligible beneficiaries under . USFHP is sponsored by the Department of Defense. It is a tiered, open formulary, and includes generic drugs (Tier 1), preferred brand drugs (Tier 2), and non-preferred brand drugs (Tier 3). JHM's vision, "Together, we will deliver the promise of medicine," is supported by its mission to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care.. . The preferred prescribed medication is often a generic version that offers the best overall value in terms of safety, effectiveness, and cost. The Johns Hopkins USFHP Plan allows retail prescription processing at any Walgreens pharmacy in the United States (including those Rite Aid pharmacies that converted to Walgreens pharmacies). To initiate a prior-authorization, providers must complete and fax the prior authorization form for the specific medication to the Johns Hopkins HealthCare Pharmacy department at 410-424-4037. Access to local doctors and hospitals from a network of more than 26,000 providers, including Johns Hopkins physicians and specialists. Some medications require prior authorization before they can be dispensed. Please note: If another Health Plan or Tricare has previously approved a medication, USFHP will not have access to that information. Certain common vaccines such as Flu, Pneumonia and Shingles vaccines may be also be administered by Pharmacists at select Walgreens pharmacies. Step therapy involves prescribing a safe, clinically effective, and cost-effective medication as the first step in treating a medical condition. Providers. Step 1. Forms. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. Faculty authors in the humanities and social sciences are invited to apply for grants of up to $15,000 to support the publication of open-access digital monographs The first five recipients []. All rights reserved. To initiate a prior authorization, your doctor must complete and fax the prior authorization form for the specific medication to the Johns Hopkins HealthCare Pharmacy department at 410-424-4037. You can also find information about medications, including how to take them, possible side effects, and drug interactions. The provider can establish medical necessity by completing and submitting the Johns Hopkins Pharmacy Review departments Non-Formulary Co-Pay Reduction Request form. Johns Hopkins Libraries Announce Recipients of First TOME Monograph Subvention Grants, Invite Applications for 2022/23 Grants. The choice and flexibility in your health care you deserve Learn more about your plan's coverage , including medical, dental, and vision benefits; special services; your pharmacy and prescription drug coverage; how to take advantage . Note: A member who has filled a prescription for a step-therapy drug within 180 days prior to the implementation of step therapy, will not be affected by step-therapy requirements and will not be required to switch medications. If you want to learn more about our plan or to become a member, visit us here. Diethylpropion. Appeals Address. US Family Health Plan Northwest is a Department of Defense sponsored health plan offering the TRICARE Prime benefit to uniformed services beneficiaries in the Washington, Northern Idaho and Western Oregon service areas. 1-800-808-7347. Attend an Information Briefing by Field Service Representatives, who are Johns Hopkins USFHP members. Download our new Member Mobile App! Not a USFHP Member? With stories in Coronavirus (COVID-19), United States, Coronavirus (U.S.), Health, COVID-19 Vaccines, Vaccination, Public Health, Omicron Covid-19 Variant, Covid-19 Variants. Step Therapy: Step therapy involves prescribing a safe, clinically effective, and cost-effective medication as the first step in treating a medical condition. We do not give, share, sell, or transfer any personal information to a third party unless required by law. Click below for your choice of 26,000+ providers across the region. To ensure safety and effectiveness of compound drug claims and to manage cost, some compound medications when rejected at the pharmacy may require prior authorization. Please note: If another Health Plan or TRICAREhas previously approved a medication, USFHP will not have access to that information. It also explains any fees or co-pays. To enroll in Mail Order Pharmacy Benefits with MAXOR - "Click Here" To view your Enhanced . The TRICARE formulary and pharmaceutical management policies are developed by the Department of Defense Pharmacy and Therapeutics Committee. If your doctor can establish that you are not able to be treated with generic or preferred formulary brand medications, you can get non-formulary drugs at a network pharmacy, or through home delivery. Step 2. rheem tankless water heater not heating no error code, portfolio solar string lights not working, react horizontal scroll cards with arrows, impact of technology on automobile industry, toyota yaris stereo wiring diagram color codes, citizenship in society online merit badge, 2011 harley davidson street glide won t start, honda pioneer 1000 sub transmission oil change interval, JHM's vision, "Together, we will deliver the promise of medicine," is supported by its mission to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care.. Contact Us - USFHP Contact For media inquiries only, please email Debra Wada debra.wada@usfhp.com For General Inquiries, please call 1-800-748-7347, or e-mail us at alliance.admin@usfhp.com Contact a Health Care Customer Service Representative, click here. The USFHP Pharmacy Program provides outpatient coverage to beneficiaries for medications that are approved for marketing by the U.S. Food and Drug Administration (FDA) and that generally require prescriptions. These services are covered when they are provided or authorized by the Plan and your US Family Health Plan primary care provider (PCP). To determine if a drug requires prior authorization and view any applicable criteria, please search the TRICARE formulary tool. Also, the FDA requires that all drugs, including generic drugs be safe and effective. Log in to your HealthLINK account to view information on yourUSFHP patients. US Family Health Plan Service Area. You may find yourself in a situation that requires urgent, but not emergency, medical attention. In case the medication is not listed, your doctor may use the non-drug specific prior authorization form. Find more COVID-19 testing locations on Maryland.gov. JHM's vision, "Together, we will deliver the promise of medicine," is supported by its mission to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care.. When you visit any website, it may store or retrieve information on your browser, mostly in the form of cookies. Your doctor must complete and fax the prior authorization form for the specific medication to the Johns Hopkins HealthCare Pharmacy department at 410-424-4037. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. Dojolvi. Sign into MyChart Users can access MyChart or learn more about it here. Discover our growing collection of curated stories on . Johns hopkins medical center Juan R. Garca, Facial Prosthetics Clinic. The Johns Hopkins US Family Health Plan Serving military families for over 30 years The Uniformed Services Family Health Plan (USFHP) is a managed care program developed by the Department of Defense (DoD). Routine correspondence and communication. Our Summary of Benefits lets you see what the Plan covers at a glance. Category: Support Services (Services/Trades) Schedule: Night Shift. US Family Health Plan/TRICARE Attn: Claims Department P.O.x Bo 830479 Birmingham, AL 35283. JHM's vision, "Together, we will deliver the promise of medicine," is supported by its mission to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care.. . If you need urgent care over a weekend or holiday, or after your Primary Care Provider's (PCP) office is closed, it's appropriate to seek care at an urgent care clinic. The formulary is updated on a regular basis to include tier changes and utilization (UM) requirements. Plan Benefits. . Doxycycline Monohydrate 40mg IR/DR. Co-Payment Reduction for Non-Formulary Medications: A non-formulary medication may be eligible for co-pay reduction if the provider can establish that the beneficiary is unable to be treated with generic, or preferred brand formulary medications. Call your PCP on the next business day after you have received the urgent . 1830 E. Monument Street, Suite 7000, Baltimore, MD 21287. Contact Johns Hopkins USFHP | Johns Hopkins US Family Health Plan Contact Us We're here to help Whether you are interested in our plan and have questions, or you are a current member and need assistance, we are happy to help you in any way we can. Johns Hopkins USFHP utilizes the TRICARE pharmacy formulary. For all other inquires, please use the form below. Obtain your follow-up care from your PCP, not from the urgent care clinic. US Family Health Plan of Southern New England is a TRICARE Prime option funded by the Department of Defense. Phone: 410-955-1921. Drizalma Sprinkle. Support and counseling line for people experiencing domestic abuse. Although generic drugs are chemically identical to their branded counterparts, and are held to the same FDA standards for safety and performance as brand name drugs, they sell for 30-75 percent less. Close, Attend an Information Briefing by Field Service Representatives, who are. To request a prior authorization for applicable compounded drugs, use the Compounded Drug prior authorization form. Notice of Privacy Practices(Patients & Health Plan Members). world grant humanitarian financial assistance program facebook. Maryland. Request. The provider must provide clinical documentation to support the request and demonstrate that an FDA approved commercially-available product is not clinically appropriate for the member. However, it's important to follow these guidelines: We prefer that you receive urgent care at these clinics: My wife and my son love the health plan, love the doctors. The new electronic medical record system is being installed at different times and locations across, Ranked #4 in the Nation and #1 in Maryland. Care is provided through large local civilian health care networks of primary care physicians, hospitals and affiliated specialists. Coronavirus Disease 2019 (COVID-19) To schedule a COVID-19 test or vaccine appointment, please sign in or create an account to the right. Providers can view the cost share for a medication using the TRICARE pharmacy formulary. Review the changes that will be made to the formulary. To determine if a drug requires Step Therapy and view any applicable criteria, please search the TRICARE formulary tool. the billionaire39s accidental bride full movie, on it laptop simulate a tcp syn flood attack using hping3 and analyze the packets with wireshark, solubility of salt in water at different temperatures, dax count specific characters in a string, how to switch rows and columns in power bi table visual, third conditional exercises with answers pdf, convert number to words javascript w3schools, unreal engine the sdk for windows is not installed properly, why is there no barcode on my ticketmaster tickets in apple wallet, guppedantha manasu serial today episode hotstar, love between fairy and devil novel updates, a nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease, could not connect to redis at connection refused, veeam waiting for backup infrastructure resources availability, fslogix set outlook cached mode on successful container attach, pioneer ts f1634r 65 200w 2 way speakers review, pure mathematics 2 and 3 sue pemberton pdf free download, python code to flowchart converter online free, given a positive integer n the program must print the odd integers from 1 to n inclusive of 1 and n, nursing care plan for intestinal obstruction pdf, unable to attach or mount volumes timed out waiting for the condition aks, the arctic because it is so cold can be considered a environment, schuylkill county tax claim repository list, clinical words to use in progress notes pdf, harry potter fanfiction harry mentally disabled snape, wheeler avenue baptist church live streaming today live. Some medications require prior authorization from our plan before they can be dispensed by your pharmacist. US FAMILY HEALTH PLANS The US Family Health Plan is a contracted TRICARE program under which the TRICARE Prime benefit is offered to eligible military beneficiaries. If the requested drug also requires prior authorization, the prescriber should submit a Prior-Authorization form as well. Log in to your HealthLINK account to view information on your EHP/Priority Partners/Advantage MD patients. Find a doctor at The Johns Hopkins Hospital, Johns Hopkins Bayview Medical Center or Johns Hopkins Community Physicians. This information might be about you, your preferences or your device and is mostly used to make the site work as you expect it to. The Department of Defense Pharmacy and Therapeutics Committee has established quantity limits for certain medications. Attend a Briefing Find a Doctor Call the US Family Health Plan. Providers may supply these medications and bill the health plan for the medication and related administration using HCPCS Codes or J codes. This is your access point to hundreds of Johns Hopkins web applications and key information about your Johns Hopkins community. Specialty medications may also have side effects that require pharmacist and/or provider monitoring. Get in touch Potential Members 800-801-9322 Current Members 800-808-7347 Our location This helps us ensure that your prescriptions are medically necessary. The Food and Drug Administration (FDA) requires generic drugs to have the same quality, strength, purity, and stability as brand name drugs. To obtain your prescriptions by Home Delivery, please call the pharmacy at 1.877.880.7007. . Log in to MyChart. US Family Health Plan provides immediate access to required forms and documents to assist our providers in expediting claims processing. Welcome to my.jh. The formulary lists all of the prescription drugs that are covered under the TRICARE benefit. Johns Hopkins Medicine Maryland, Washington, DC, Delaware, Virginia, and parts of West Virginia and Pennsylvania Martin's Point Health Care Serving Maine, New Hampshire, Vermont, Upstate and Western New York and Pennsylvania. If you or your provider have a copy of the previous approval letter, please fax it along with the Prior Authorization Form to USFHP. This site includes general plan information, current news and updates specific to the USFHP provider network. To request prior authorization, submit the Medical Injectable Prior Authorization Form along with clinical supporting documentation via fax to 410-424-2801. The TRICARE formulary is a tiered, open formulary and includes generic drugs (Tier 1), preferred brand drugs (Tier 2), and non-preferred brand drugs (Tier 3). Diflorasone Diacetate 0.05% Ointment. In case the medication is not listed, your doctor may use the non-drug specific prior authorization form. Members may also receive the FreeStyle Libre 2 and Dexcom G6 and all other CGMs under the Johns Hopkins USFHP medical benefit from a, budesonide delayed release capsules (Entocort EC, generics), pasireotide (Signifor LAR medical benefit), Betamethasone/propylene glycol 0.05% lotion, Clobetasol propionate/emollient 0.05 % (emulsion) foam, Clobetasol propionate 0.05% solution, lotion, gel, foam, spray, and shampoo, Vitamin D analog (calcipotriene 0.005% cream, ointment or solution) with a high potency topical corticosteroid (clobetasol propionate 0.05% ointment, cream, solution and gel, Fluocinonide 0.05% cream, gel, and solution, Calcipotriene 0.005% / betamethasone 0.064% foam (Enstilar) [Nonformulary], Budesonide ER tablets (Entocort EC, generics, Dexamethasone generics 0.5, 0.75, 1, 1.5, 2, 4, 6 mg tabs, Fluticasone furoate (Arnuity Ellipta) [non formulary], Budesonide (Pulmicort Flexhaler) [non formulary], Mometasone (Asmanex Twisthaler [non formulary], Fluticasone/vilanterol (Breo Ellipta) [non formulary], Mometasone/formoterol (Dulera) [non formulary], Budesonide/formoterol (Symbicort) [non formulary], Fluticasone/salmeterol (AirDuo Respiclick) [non formulary], Metoclopramide oral tablet (Reglan generics), Metoclopramide oral solution (Reglan, generics), Metoclopramide orally disintegrating tablet (Reglan ODT), Calcipotriene 0.005%-betamethasone 0.064% foam (Enstilar) [Nonformulary], Calcipotriene 0.005% ointment, cream, solution, Betamethasone propylene glycol 0.05% cream, Clobetasol propionate 0.05% cream and ointment, Clobetasol propionate/emollient 0.05% cream, Clindamycin phosphate 1% gel, cream, lotion, and solution, Clindamycin/ benzoyl peroxide 1.2% -5% gel, Tazarotene 0.1% cream tretinoin 0.025%, 0.05%, and 0.1% cream, Dihydropyridine calcium channel blockers: amlodipine, felodipine, nifedipine, isradipine PLUS, NSAIDs: celecoxib, diclofenac, ibuprofen, meloxicam, naproxen, (also includes other NSAIDs), Zipsor liquid-filled capsules (diclofenac potassium), H2 blockers: famotidine, ranitidine, cimetidine, nizatidine PLUS, Flector, generics (diclofenac 1.3% patch), Oral NSAIDs: celecoxib, diclofenac, indomethacin, meloxicam, naproxen, (also includes other NSAIDs), Albuterol MDI (Proventil HFA) [Nonformulary], Albuterol MDI (Ventolin HFA) [Nonformulary], Levalbuterol MDI (Xopenex HFA) [Nonformulary], Clindamycin/benzoyl peroxide 1.2% -5% gel (Duac, generics), Clindamycin/benzoyl peroxide 1% -5% gel (Benzaclin, generics), Clindamycin/benzoyl peroxide 1% -5% gel kit (Duac CS Kit), Omeprazole PLUS amoxicillin PLUS rifabutin (given separately), Omeprazole PLUS clarithromycin PLUS amoxicillin, Bismuth subsalicylate OTC PLUS metronidazole PLUS tetracycline PLUS PPI, Insulin lispro (Humalog or authorized generic lispro), Insulin glulisine (Apidra) [nonformulary], Glycopyrrolate/formoterol (Bevespi Aerosphere) [nonformulary], Sumatriptan nasal spray (Imitrex, generics), Vardenafil oral disintegrating tablet (ODT) (Staxyn and generics), Methylphenidate ER (Aptensio XR sprinkle capsule) for patients with swallowing difficulties, Methylphenidate ER oral suspension (Quillivant XR suspension) for patients with swallowing difficulties, Methylphenidate ER osmotic controlled release oral delivery system (OROS) (Concerta, generics), Methylphenidate long-acting (Ritalin LA, generics), Methylphenidate controlled delivery (CD) (Metadate CD, generics), Dexmethylphenidate ER (Focalin XR, generics), Mixed amphetamine salts ER (Adderall XR, generics), Clobetasol propionate 0.025% cream (Impoyz), Diflorasone diacetate/emollient 0.05% cream (Apexicon-E), Betamethasone/propylene glycol 0.05% cream, Betamethasone dipropionate 0.05% ointment, Betamethasone/propylene glycol 0.05% ointment, Clobetasol propionate 0.05% shampoo/ cleanser (kit) (Clodan kit), Halobetasol propionate 0.05% lotion (Ultravate), Halobetasol propionate 0.05% foam (authorized generic for Lexette) (see Feb 2019 for brand Lexette recommendation), Betamethasone propylene glycol 0.05% lotion, Clobetasol propionate/emollient 0.05 % emulsion foam, Clobetasol propionate/emollient 0.05% emulsion foam, PPIs: omeprazole, pantoprazole, esomeprazole, rabeprazole PLUS.
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