Memantine HCl ER CAPSULE EXTENDED RELEASE 24 HOUR 21 NF 1 Formulary Enhancement N/A MG Oral Memantine HCl ER CAPSULE EXTENDED RELEASE 24 HOUR 28 NF 1 Formulary Enhancement N/A MG Oral Memantine HCl ER CAPSULE EXTENDED RELEASE 24 HOUR 7 NF 1 Formulary Enhancement N/A MG Oral Methotrexate Sodium SOLUTION 250 NF 1 + BD Formulary Enhancement N/A MG/10ML INJECTION Naloxone HCl Solution Cartridge 0.4 NF 1 Formulary Enhancement N/A MG/ML Injection Nitrofurantoin Macrocrystal CAPSULE 1 + PA1 1 Formulary Enhancement N/A 100 MG Oral Nitrofurantoin Macrocrystal CAPSULE 1 + PA1 1 Formulary Enhancement N/A 25 MG ORAL Nitrofurantoin Macrocrystal Capsule 50 1 + PA1 1 Formulary Enhancement N/A MG Oral Nitrofurantoin Monohyd Macro 1 + PA1 1 Formulary Enhancement N/A CAPSULE 100 MG Oral 1 + QL eletriptan 20 Relpax TABLET 20 MG Oral NF Formulary Update 9 mg, 1 + QL 9 1 + QL eletriptan 40 Relpax TABLET 40 MG Oral NF Formulary Update 9 mg, 1 + QL 9 sevelamer Renvela TABLET 800 MG Oral 1 NF Formulary Update carbonate 800 mg, 1
Memantine HCl ER CAPSULE EXTENDED RELEASE 24 HOUR 21 MG Oral NF 1 Formulary Enhancement N/A Memantine HCl ER CAPSULE EXTENDED RELEASE 24 HOUR 28 MG Oral NF 1 Formulary Enhancement N/A Memantine HCl ER CAPSULE EXTENDED RELEASE 24 HOUR 7 MG Oral NF 1 Formulary Enhancement N/A Methotrexate Sodium SOLUTION 250 MG/10ML INJECTION NF 1 + BD Formulary Enhancement N/A Naloxone HCl Solution Cartridge 0.4 MG/ML Injection NF 1 Formulary Enhancement N/A Nitrofurantoin Macrocrystal CAPSULE 100 MG Oral 1 + PA1 1 Formulary Enhancement N/A Nitrofurantoin Macrocrystal CAPSULE 25 MG ORAL 1 + PA1 1 Formulary Enhancement N/A Nitrofurantoin Macrocrystal Capsule 50 MG Oral 1 + PA1 1 Formulary Enhancement N/A Nitrofurantoin Monohyd Macro CAPSULE 100 MG Oral 1 + PA1 1 Formulary Enhancement N/A Relpax TABLET 20 MG Oral 1 + QL 9 NF Formulary Update eletriptan 20 mg, 1 + QL 9 Relpax TABLET 40 MG Oral 1 + QL 9 NF Formulary Update eletriptan 40 mg, 1 + QL 9 Renvela TABLET 800 MG Oral 1 NF Formulary Update sevelamer carbonate 800 mg, 1
AgeWell_1-Tier_2018_Addendum_Eff_090120181.docx