Lista de medicamentos con receta Standard de 4 niveles de Cigna Healthcare Los medicamentos de especialidad están cubiertos en el Nivel 4 (la lista está en las páginas 17-20).
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VARIOS (cont.) POCKET CHAMBER (QL) PROCARE SPACER WITH CHILD MASK (QL) RITEFLO (QL) SPACE CHAMBER (QL) SPACE CHAMBER- MEDIUM MASK (QL) VORTEX (QL) VORTEX VHC FROG MASK (QL) NUTRITIVOS/ALIMENTICIOS
INFECCIONES (cont.)
metronidazole tablet, vaginal gel nitrofurantoin oseltamivir (QL) posaconazole suspension, tablet praziquantel sulfamethoxazole suspension, tablet valacyclovir vandazole ACCU-CHEK FASTCLIX LANCET DRUM ACCU-CHEK SOFTCLIX DROPLET LANCET KETONE TEST STRIP KETOSTIX REAGENT MICROLET ONETOUCH LANCET POGO AUTOMATIC TEST CARTRIDGE PRECISION XTRA sodium chloride SOFT TOUCH LANCET TRUEPLUS KETONE TEST STRIP
XOFLUZA (QL) ZITHROMAX PACKET, SUSPENSION, TABLET ZITHROMAX TRI- PAK ZYVOX SUSPENSION, TABLET (PA)
INFERTILIDAD
CRINONE^ ENDOMETRIN^ VARIOS ACE AEROSOL CLOUD
ludent fluoride+^ multivitamin with fluoride+ sodium fluoride chewable tablet, drops+^ tri-vitamin with fluoride+ vitamin d2 1.25 mg (50,000 unit)^ vitamins a,c,d and fluoride+
FLORIVA CHEW- ABLE TABLET+ LOKELMA
ACCRUFER^ AURYXIA (QL) DRISDOL^ EFFER-K OB COMPLETE CAPLET^ PHOSLYRA
ADDYI^ (PA, QL) NUEDEXTA (QL) VEOZAH (QL)
ENHANCER (QL) AEROCHAMBER (QL) AEROCHAMBER MV (QL) AEROCHAMBER PLUS FLOW-VU (QL) AEROCHAMBER Z-STAT PLUS (QL) AEROTRACH PLUS (QL) AEROVENT PLUS (QL) BREATHRITE (QL) CLEVER CHOICE HOLDING CHAMBER (QL) COMPACT SPACE CHAMBER (QL) EASIVENT (QL) FLEXICHAMBER (QL) MICROCHAMBER (QL) MICROSPACER (QL) OPTICHAMBER DIAMOND (QL)
mvc-fluoride+ NEEVODHA^ OB COMPLETE SOFTGEL, TABLET POLY-VI-FLOR WITH IRON+ POLY-VI-FLOR+ PRENATE CHEWABLE^ PRENATE DHA PRENATE ELITE PRENATE ENHANCE PRENATE ESSENTIAL^ PRENATE MINI PRENATE PIXIE PRENATE RESTORE PRIMACARE QUFLORA PEDIATRIC 0.25 MG/ML DROPS, 0.5 MG/ ML DROPS, 1 MG CHEWABLE TABLET+ TRI-VI-FLOR+ VELPHORO VELTASSA
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