Preventive drug list

Preventive
ANTICONVULSANTS
INJECTABLE DIABETES AGENTS
SL and chewable formulations are not TRANSDERMAL/TOPICAL
ANTIANGINAL AGENTS
Over-the-Counter (OTC) products do not require a prescription. Coverage may vary ORAL DIABETES AGENTS
CORONARY ARTERY DISEASE
ANTIHYPERLIPIDEMICS
CARDIOVASCULAR
CONDITIONS - OTHER
ORAL ANTIANGINAL AGENTS
COMBINATION
ANTIHYPERLIPIDEMICS
DIABETES
HEMATOLOGIC AGENTS
DIAGNOSTIC AGENTS
Some strengths or dosage forms may not be included in the Preventive Drug List. Please note: This list represents brand products in CAPS, branded generics in upper- and lowercase Italics, and generic products in lowercase italics. This Preventive Drug List is provided as a courtesy and CVS Caremark makes no representations regarding the suitability for your particular plan. The Preventive Drug List should be modified as necessary or desired by the plan sponsor with the advice of counsel, if appropriate.       ACE INHIBITOR/CALCIUM
CHANNEL BLOCKER
COMBINATIONS
BETA-BLOCKERS
HYPERTENSION
ACE INHIBITORS/ANGIOTENSIN II
RECEPTOR ANTAGONISTS
DIURETICS
spironolactone/hydrochlorothiazide OTHER ANTIHYPERTENSIVE
CALCIUM CHANNEL BLOCKERS
hydrochlorothiazide/reserpine/hydralazine Some strengths or dosage forms may not be included in the Preventive Drug List. Please note: This list represents brand products in CAPS, branded generics in upper- and lowercase Italics, and generic products in lowercase italics. This Preventive Drug List is provided as a courtesy and CVS Caremark makes no representations regarding the suitability for your particular plan. The Preventive Drug List should be modified as necessary or desired by the plan sponsor with the advice of counsel, if appropriate.       OSTEOPOROSIS
IMMUNIZING AGENTS
PREVENTIVE CARE SERVICES
AGENTS FOR CHEMICAL
DEPENDENCY
ANTI-OBESITY AGENTS
ANTIPSYCHOTICS
MENTAL HEALTH
ANTIDEPRESSANTS
Some strengths or dosage forms may not be included in the Preventive Drug List. Please note: This list represents brand products in CAPS, branded generics in upper- and lowercase Italics, and generic products in lowercase italics. This Preventive Drug List is provided as a courtesy and CVS Caremark makes no representations regarding the suitability for your particular plan. The Preventive Drug List should be modified as necessary or desired by the plan sponsor with the advice of counsel, if appropriate.       HEREDITARY ANGIOEDEMA
ANTICOAGULANTS
IMMUNOSUPPRESSIVE AGENTS
ANTICOAGULANTS/PLATELET
AGGREGATION INHIBITORS
SMOKING DETERRENTS
MULTIPLE SCLEROSIS AGENTS
VARIOUS CONDITIONS
ANTI-MALARIAL AGENTS
Over-the-Counter (OTC) products do not WOMEN'S HEALTH
require a prescription. Coverage may vary AROMATASE INHIBITORS
RESPIRATORY DISORDERS
PRENATAL VITAMINS
BECLOVENT BROVANA FLOVENT HFA FORADIL INTAL PERFOROMIST PULMICORT QVAR SEREVENT SINGULAIR SYMBICORT SYNAGIS XOLAIR ZYFLO CR Some strengths or dosage forms may not be included in the Preventive Drug List. Please note: This list represents brand products in CAPS, branded generics in upper- and lowercase Italics, and generic products in lowercase italics. This Preventive Drug List is provided as a courtesy and CVS Caremark makes no representations regarding the suitability for your particular plan. The Preventive Drug List should be modified as necessary or desired by the plan sponsor with the advice of counsel, if appropriate.       hydrochlorothiazide/reserpine/hydralazine. 3

Source: http://www.ovationdsc.com/files/Preventive%20Drug%20List%202009.pdf

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