If diabetic benefit does not apply please refer to the following tier classifications glimepiride, glipizide, glipizide er, actos, avandia,glyset, prandin, actoplus met, avandamet, glipizide metformin, glyburide, glyburide metformin, precose, starlix avandaryl, fortamet metformin, metformin xr numerous generics ciprodex, floxin otic brands with generics equivalents pku formulas pa all branded enteral products pa no drugs listed at this time cromolyn sodium bacitracin, bac poly neo, ciprofloxacin, neosporin, ofloxacin, polysporin, erythro, gent, sodium sulfacetamide, tmp pol, tobra dexameth, dexa neo, fluorometholone, flurbiprofen, prednisolone trifluridine neomycin, neomycin polymixin, dexamethasone sodium phosphate solution carbachol, carteolol, dipivefrin, levobunolol, pilocarpine, timolol, timolol xe acular, acular pf, optivar, zaditor no drugs listed at this time alamast, alocril, alomide, alrex, emadine, livostin, patanol quixin vigamox and zymar tier 2 if prescribed by an ophthalmologist fml forte, ocufen, predforte, vexol, xibrom brands with generics equivalents hms, pred-g tobradex tier 2 if prescribed by an ophthalmologist azopt, betagan, betimol, betoptic, betoptic-s, cosopt, iopidine, ocupress, ocusert, optipranolol, pilopine gel, xalatan.
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