Nappi Name Action Status Rules
716294 CORTOGEN ACETATE 25mg. TABLETS CEF Acute - no application Price limitation & limited to 30 tablets per fill.
797405 CORYX Allow Acute - no application Price limitation & limited to 4 fills per year
827460 CORYX PAED Allow Acute - no application Price limitation & 4 fills per year
716413 COSALDON RETARD Excl Excluded Excluded, no exceptions.
716421 COSMEGEN Non-F Reject/ PreAuth Specialist initiated only. Pre Auth for Oncology benefits. Obtain application form by dialling Fax on Demand Service from fax machine (Form no. 2004)
860379 COSOPT EYE Allow Chronic - no application Price limitation. Limited to 1 unit per fill & 12 fills per year
716456 COTET 250mg. CAPSULES CEF Acute - no application Price limitation - limited to 60 capsules, 6 fills per year.
779881 COTRIM 240mg. ml. Susp. SUSP. CEF Acute - no application Price limitation.
425131 COTTON EAR BUDS Non-F Excluded Excluded - Non formulary item
425776 COTTON WOOL BALLS 1G 3'S Non-F Excluded Excluded - Non formulary item
425121 COTTON WOOL BALLS 1G STER Non-F Excluded Excluded - Non formulary item
425799 COTTON WOOL BALLS STERILE Non-F Excluded Excluded - Non formulary item
425124 COTTON WOOL ROLL 500G INT Non-F Excluded Excluded - Non formulary item
425123 COTTON WOOL ROLLS 50G INT Non-F Excluded Excluded - Non formulary item
716529 COUGHCOD JUNIOR 10mg./5ml. ml. Syrup Junior CEF Acute - no application Price limitation & limited to 4 fills per year
716510 COUGHCOD SENIOR 10mg./5ml. ml. Syrup Senior CEF Acute - no application Price limitation & limited to 4 fills per year
716588 COUNTERPAIN BALM Excl Excluded Excluded - Patent medicine
809314 COVAMET 12.5mg./5ml. ml. SYRUP CEF Acute - no application Price limitation & limited to 50ml per fill
809322 COVAMET 50mg. TABLETS CEF Acute - no application Price limitation & limited to 10 tablets.
716596 COVANCAINE EAR 20ML Allow Acute - no application Price limitation. Limited to 1 unit per fill & 2 fills per year
877719 COVAREX CREAM CEF Acute - no application Price limitation & limited to 1 fill per year
705915 COVERSYL 10mg. Tablets Allow Chronic - no application Price limitation & limited to 30 tablets per fill.
705914 COVERSYL 4mg. Tablets Allow Chronic - no application Price limitation & limited to 30 tablets per fill.
785121 COVERSYL 4mg. Tablets Allow Chronic - no application Price limitation & limited to 30 tablets per fill.
877549 COVERSYL PLUS 4mg.+1.25mg. Comb. TABLETS CEF Chronic- no application Price limitation & limited to 30 tablets per fill.
716618 COVITE Excl Excluded Excluded, registered tonics/stimulants
716685 COVOCHOL 40(200)mg vial+dil. Soln. Powder Allow Acute - no application Price limitation. Limited to 1 unit per fill & 12 fills per year
716693 COVOCORT 10mg. TABLETS CEF Acute - no application Price limitation & limited to 30 tablets per fill.
716634 COVOMYCIN 7.5ML DROPS EAR/EYE N Allow Acute - no application Price limitation. Limited to 1 unit per fill & 2 fills per year
716626 COVOMYCIN D 7.5ML DROPS EYE/EAR Allow Acute - no application Price limitation. Limited to 1 unit per fill & 2 fills per year
716642 COVOSAN 15ML EYE DROPS Allow Acute - no application Price limitation. Limited to 1 unit per fill & 2 fills per year
814423 COVOSPOR TOP 1% g. Cream CREAM CEF Acute - no application Price limitation & limited to 1 fill per year
832332 COVOSPOR VAG 1% g. Cream Allow Acute - no application Price limitation. Limited to 1 unit & 4 fills per year
716650 COVOSTET 15ML Allow Acute - no application Limited to 1 unit per fill & 12 fills per year
716669 COVOSULF 15ML Allow Acute - no application Price limitation. Limited to 1 unit per fill & 2 fills per year
716677 COVOTOP 15ML Allow Acute - no application Price limitation. Limited to 1 unit per fill & 2 fills per year
899070 COXFLAM 15mg. Tablets Allow Acute - no application Price limitation. Available on acute, limited to 10 tablets & 4 fills per year. Doctor to apply telephonically for long term use.
899066 COXFLAM 7.5mg. TABLETS CEF Acute - no application Price limitation. Available on acute, limited to 10 tablets & 4 fills per year. Doctor to apply telephonically for long term use.
818739 COZAAR 50mg. TABLETS CEF- Apply Reject/PreAuth Rejected - Only considered as alternative to ACEI for hypertension when the latter elicits cough
828181 COZAAR COMP 50(12.5)mg. TABLETS CEF- Apply Reject/PreAuth Rejected - Only considered as alternative to ACEI for hypertension when the latter elicits cough
716731 COZOLE 400(80)mg. Tablets Allow Acute - no application Price limitation.
793310 COZOLE Susp. SUSP. CEF Acute - no application Price limitation.
897929 CPL ALLIANCE ALPRAZOLAM Allow Acute - no application Price limitation & limited to 4 fills per year
897930 CPL ALLIANCE ALPRAZOLAM Allow Acute - no application Price limitation.
897880 CPL ALLIANCE CEPHALEXIN Allow Acute - no application Price limitation. Limited to 20 capsules & 3 fills per 3 months
897887 CPL ALLIANCE CEPHALEXIN Allow Acute - no application Price limitation. Limited to 20 capsules & 3 fills per 3 months
897892 CPL ALLIANCE CEPHALEXIN D Allow Acute - no application Price limitation.
700284 CPL ALLIANCE CIPROFLOXACI Allow Acute - no application Price limitation. Limited to 10 tablets.
700287 CPL ALLIANCE CIPROFLOXACI Allow Acute - no application Price limitation. Limited to 10 tablets.
897879 CPL ALLIANCE PIROXICAM CAPSULES CEF Acute - no application Price limitation, limited to 10 capsules & 4 fills per year. Doctor to apply telephonically for longterm use.
2451 - 2500 of 9613 Medicine's

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