Nappi Name Action Status Rules
859710 CLEXANE 3ML MULTIDOSE VIA INJECT. Non-F Reject Excluded, injections included in consultation fee
788767 CLEXANE 40mg. Syringe x0.4ml. Inject. Pref.Syr Non-F Reject Excluded, injections included in consultation fee
851140 CLEXANE 60mg. INJECT. PREF.SY Non-F Reject Excluded, injections included in consultation fee
851159 CLEXANE 80mg. Inject. Non-F Reject Excluded, injections included in consultation fee
824658 CLIMARA FORTE PATCHES CEF Chronic - no application Limited to 4 patches per fill.
824631 CLIMARA PATCHES CEF Chronic - no application Limited to 4 patches per fill.
818550 CLIMEN TABLETS CEF Chronic - no application Limited to 28 tablets per fill.
797847 CLINDAC 600mg./4ml. x4ml.amp INJECT. Excl Excluded Excluded, injections included in consultation fee
849960 CLINDAHEXAL 150mg. CAPSULES CEF Reject / Acute Step on first line & Price limitation. Limited to 20 & 3 fills per 3 months
701051 CLINDAMYCIN-FRESENIUS 4ML Excl Excluded Excluded, injections included in consultation fee
703536 CLINICA TISSUE OIL Excl Excluded Excluded - Moisturizers
703539 CLINICA VITAMIN E CREAM Excl Excluded Excluded - Moisturizers
831794 CLINISTIX Allow Reject / Chronic Step therapy: Allowed with insulin and oral diabetes tablets. Type 2 diabetes - limited to 150 per year on chronic
714682 CLINITEST 36'S REF Allow Reject / Chronic Step therapy: Allowed with insulin and oral diabetes tablets. Type 2 diabetes - limited to 150 per year on chronic
714739 CLINORIL 200mg. Tablets Allow Acute - no application Price limitation, limited to 20 tablets & 4 fills per year.
829544 CLOCKTOWER SALVE Excl Excluded Excluded - Moisturizers
878421 CLOMADERM CREAM Allow Acute - no application Price limitation & limited to 1 fill per year
700712 CLOMAX Allow Acute - no application Price limitation. Limited to 10 tablets & 3fills per year
700178 CLOMENT 100mg. TABLETS CEF Reject/ Chronic Price limitation. Step: Allowed as 2nd line to other conventional anti-psychotics. Specialist initiated
700176 CLOMENT 25mg. TABLETS CEF Reject/ Chronic Price limitation. Step: Allowed as 2nd line to other conventional anti-psychotics. Specialist initiated
714771 CLOMID 50mg. Tablets Excl Excluded Excluded - Infertility products
703381 CLOMIDEP Allow Chronic - no application Price limitation.
884980 CLOMIHEXAL Excl Excluded Excluded - Infertility products
714798 CLOMIN 10mg./5ml. ml. Syrup Allow Acute - no application Price limitation. Limited to 100ml & 3 fill per year
714828 CLOPAMON 10mg TABLETS Allow Acute - no application Price limitation. Limited to 20 tablets & 3 fills per year
714836 CLOPAMON 10mg./2ml. x2ml.amp INJECT. Excl Excluded Excluded, injections included in consultation fee
714844 CLOPAMON 5mg./5ml. ml. SYRUP CEF Acute - no application Price limitation. Limited to 100ml & 3 fills per year
789798 CLOPIXOL 10mg. TABLETS CEF Chronic - no application Price limitation.
796751 CLOPIXOL 2mg. TABLETS CEF Chronic - no application Price limitation.
786942 CLOPIXOL ACUPHASE 100mg. x2ml.amp INJECT. Excl Excluded Excluded, injections included in consultation fee
786934 CLOPIXOL ACUPHASE INJECT. Excl Excluded Excluded, injections included in consultation fee
786926 CLOPIXOL DEPOT 200mg./ml. x10ml. VIALS CEF Chronic - no application Only available through the pharmacy, all other providers rejected.
714852 CLOPIXOL DEPOT 200mg./ml. x1ml. INJECT. CEF Chronic - no application Only available through the pharmacy, all other providers rejected.
856886 CLORACEF MR Allow Reject / Acute Step on first line & Price limitation.
703544 CLORIX 150mg. Tablets Allow Chronic - no application Price limitation
703547 CLORIX 300mg. Tablets Allow Chronic - no application Price limitation
808857 CLOSCRIPT TOPICAL 10mg/g g. Cream Allow Acute - no application Price limitation & limited to 1 fill per year
831921 CLOSCRIPT VAGINAL CREAM CEF Acute - no application Price limitation. Limited to 1 unit & 3 fills per year
701081 CLOXACILLIN-FRESENIUS INJECTION Excl Excluded Excluded, injections included in consultation fee
701087 CLOXACILLIN-FRESENIUS INJECTION Excl Excluded Excluded, injections included in consultation fee
809616 CLOXAM 500mg. Capsules Allow Acute - no application Price limitation - limit to 28 capsules per fill & 3 fills per 3 months
809632 CLOXIN 250mg. CAPSULES Allow Acute - no application Price limitation - limited to 28 capsules per fill & 3 fills per 3 months
785571 CLOXIN 250mg. vials INJECT. Excl Excluded Excluded, injections included in consultation fee
809640 CLOXIN 500mg. Capsules Allow Acute - no application Price limitation - limited to 28 capsules per fill & 3 fills per 3 months
785598 CLOXIN 500mg. vials INJECT. Excl Excluded Excluded, injections included in consultation fee
714895 CLUSIVOL Excl Excluded Excluded - Patent medicine
714887 CLUSIVOL (ASST FLAV) Excl Excluded Excluded, unregistered vitamins.
787280 C-MOX 250 250mg. Capsules Allow Acute - no application Price limitation. Limited to 21 capsules per fill & 3 fills per 3 months
787299 C-MOX 500 500mg. Capsules Allow Acute - no application Price limitation. Limited to 21 capsules per fill & 3 fills per 3 months
810266 COAL TAR Non-F Reject/ PreAuth Motivations for special indications only will be considered.
2251 - 2300 of 9613 Medicine's

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