Nappi Name Action Status Rules
893409 A-LENNON AMOXYCILLIN SUSP. CEF Acute - no application Price limitation. Limited to 100ml & 3 fills per 3 months
893398 A-LENNON DICLOFENAC 100mg. SUPPS. CEF Acute - no application Price limitation & limited to 2 fills per year
893390 A-LENNON DICLOFENAC 25mg. TABLETS CEF Acute - no application Price limitation, limited to 21 tablets & 4 fills per year. Doctor to apply telephonically for longterm use.
893391 A-LENNON DICLOFENAC 50mg. TABLETS CEF Acute - no application Price limitation, limited to 21 tablets & 4 fills per year. Doctor to apply telephonically for longterm use.
893402 A-LENNON DOXYCYCLINE HCL CAPSULES CEF Acute - no application Price limitation & limited to 7 capsules
899147 A-LENNON ERYTHROMYCIN ES CAPSULES CEF Acute - no application Price limitation. Limited to 20 tablets & 3 fills per 3 months
703391 A-LENNON FLUOXETINE CAPSULES CEF Chronic - no application Price limitation on all SSRI's & limited to 60/month. Preferred product is fluoxetine generic.
893650 A-LENNON NIFEDIPINE CAPSULES CEF Reject/Chronic Step, Price & quantity limitation : Rejected as monotherapy for hypertension. Chronic as third line agent in hypertension after a diuretic/ beta-blocker/ACE-inhibitor.
893657 A-LENNON NIFEDIPINE CAPSULES CEF Reject/Chronic Step, Price & quantity limitation : Rejected as monotherapy for hypertension. Chronic as third line agent in hypertension after a diuretic/ beta-blocker/ACE-inhibitor.
893374 A-LENNON PHENOXYMETHYLPEN Allow Acute - no application Price limitation - limited to 20 tablets & 3 fills per 3 months
893382 A-LENNON PHENOXYMETHYLPEN Allow Acute - no application Price limitation - limited to 100ml & 3 fills per 3 months
700966 A-LENNON PHENOXYMETHYLPEN SUSP Allow Acute - no application Price limitation - limited to 100ml & 3 fills per 3 months
701874 ALERTONIC Excl Excluded Excluded, registered tonics/stimulants
844136 ALETRIS-HEEL E Excluded Excluded - Patent homeopathic medicine.
864692 ALEVE 220mg. Tablets Allow Acute - no application Price limitation, limited to 20 tablets & 4 fills per year.
811777 ALEXAN 100 20mg./ml. x5ml.vial Inject. CEF-Apply 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)
811785 ALEXAN 500 50mg./ml. x10ml.vial Inject. CEF-Apply 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)
703636 ALFANATIVE-INTERFERON 0,5 Excl Excluded Excluded - betaferon & immunemodulators.
703633 ALFANATIVE-INTERFERON 1ML Excl Excluded Excluded - betaferon & immunemodulators.
705833 ALIMTA 500 mg Excl Excluded Excluded - not on the reimbursed protocol - unacceptable benefit/cost ratio
816256 ALKAFIZZ Allow Acute - no application Price limitation.
704000 ALKAFIZZ ECONOPACK EFFERV Allow Acute - no application Price limitation & limited to 4 fills per year
887251 ALKALA N 150G Allow Acute - no application Price limitation & limited to 4 fills per year
701811 ALKALA T E Excluded Excluded - Patent homeopathic medicine.
728349 ALKALITE D Allow Acute - no application Price limitation & limited to 6 fills per year
701998 ALKERAN 2mg. Tablets CEF-Apply 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)
797774 ALKERAN 50mg. Inject. CEF-Apply 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)
852767 ALK-SPEC SPEC REQ MAINT Non-F Excluded Excluded - Immunoglobulins
868493 ALL CLEAR COMPLEXION CREA Excl Excluded Excluded - Moisturizers
853518 ALL MAN (VITALITY) Excl Excluded Excluded - Patent medicine
896660 ALL OMEGA Excl Excluded Excluded - Evening Primrose Oil
853496 ALL WOMAN (VITALITY) Excl Excluded Excluded - Patent medicine
702048 ALLBEE WITH C Excl Excluded Excluded - Patent medicine
703313 ALLECET 1mg./ml. ml. Soln. SYRUP CEF Acute - no application Price limitation. Limited to 150ml and 3 fills per year
703315 ALLECET 10mg. TABLETS CEF Acute - no application Price limitation. Limited to 10 tablets & 3 fills per year
702145 ALLERGEX 2mg./5ml. ml. ELIXIR CEF Acute - no application Price limitation. Limited to 100ml & 3 fills per year
702072 ALLERGEX 4mg. TABLETS CEF Acute - no application Price limitation. Limited to 30 tablets & 3 fills per year
702080 ALLERGIN CEF Acute - no application Price limitation & limited to 4 fills per year
849081 ALLERGIN ANIMALS E Excluded Excluded - Patent homeopathic medicine.
849103 ALLERGIN CIGARETTE E Excluded Excluded - Patent homeopathic medicine.
849111 ALLERGIN DAIRY PRODUCTS E Excluded Excluded - Patent homeopathic medicine.
816000 ALLERGIN DUST E Excluded Excluded - Patent homeopathic medicine.
849138 ALLERGIN FOODS E Excluded Excluded - Patent homeopathic medicine.
849146 ALLERGIN FRUITS E Excluded Excluded - Patent homeopathic medicine.
849154 ALLERGIN GRAINS E Excluded Excluded - Patent homeopathic medicine.
842907 ALLERGIN GRASS E Excluded Excluded - Patent homeopathic medicine.
820040 ALLERGIN MIXED TABLETS EA TAB E Excluded Excluded - Patent homeopathic medicine.
842915 ALLERGIN POLLEN E Excluded Excluded - Patent homeopathic medicine.
849189 ALLERGIN VEGETABLES & LEG E Excluded Excluded - Patent homeopathic medicine.
892267 ALLERGOSTOP I TREATMENT Non-F Excluded Excluded - Immunoglobulins
401 - 450 of 9613 Medicine's

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