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Rods – Prescription Drugs

Rods – Prescription Drugs
· Allergy medication,93-029
· Benefits excluded
     –medication dispensed by physician,78-11681-057
     –medication experimental in nature,81-50484-12388-445
     –medically reasonable and necessary,88-09988-25688-29393-090CA-07211-0065
     –obesity treatment, 78-10478-29688-293
     –medications dispensed in a hospital (including take home drugs), 11-012611-0137
     –infertility, 16-0001

· Benefits Provided , CA-130

· Copay and Deductibles:, CA-130

· Dosage limits-override02-006 
· Estrogens/progestogens88-20288-44516-0001
· Formulary drug program with surcharge98-01398-01402-002CA-05693-098CA-07207-0050, CA-130 
· Generic vs. brand name,93-07993-098CA-072 
· Human growth hormone84-041
· Infant formula78-12678-22784-408
· Liquid nutrient,88-10388-313
    Medically necessary, 16-0001
· Non-prescription drugs/ over the counter81-02181-56184-09884-50284-50411-0137
· Payment of initial prescriptions,78-013
· Pregnancy /ovulation assisting medication93-026
· Refills beyond the initial six month prescription88-099
· Transdermal nicotine patches,88-578
· ViagraCA-05598-024CA-097