Programs: Maryland Medical Assistance Program (MA)



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glimepiride

Amaryl

0

Unkn

N

d03864

151

7/27/2006

glipizide

Glucotrol

0

Antidiabetic

N

d00246

92

12/1/2003

haloperidol

Haldol

0

Antipsychotic

N

d00027

76

5/5/2000

hydralazine

(generic only)

0

Antihypertensive

N

d00132

138

2/28/2006

hydrochlorothiazide

hydrochlorothiazide

0

Antihypertensive

N

d00253

146

2/28/2006

hydroxyurea

Droxia

1

Anti-retroviral NRTI

N

d01373

36

7/14/2000

hydroxyzine

Atarax

0

Antianxiety

N

d00907

75

5/5/2000

imiquimod

Aldara Cream

0

Immune Response Modifier

N

d04125

44

7/14/2000

indapamide

indapamide

0

Antihypertensive

N

d00260

147

2/28/2006

indinavir

Crixivan

1

Protease Inhibitor

N

d03985

26

7/14/2000

insulin glargine

Lantus

0

Antidiabetic

N

d04538

124

2/28/2006

insulin lispro

Humalog

0

Antidiabetic

N

d04373

121

2/28/2006

insulin NPH

Humulin N

0

Antidiabetic

N

d04370

123

2/28/2006

interferon alpha-2A

Roferon-A

0

Neoplasm

N

d01369

11

5/1/1992

interferon alpha-2B

Intron-A

0

Neoplasm

N

d01369

104

6/1/1992

isoniazid

Nydrazid, INH

0

Mycobacterial

N

d00101

12

5/1/1992

isoniazid-rifampin

Rifamate

0

Mycobacterial

N

d03508

105

6/1/1992

itraconazole

Sporanox

0

Antifungal

N

d00102

62

7/14/2000

ketoconazole

Nizoral

0

Antifungal

N

d00103

13

5/1/1992

lamivudine

Epivir, 3TC

1

Anti-retroviral NRTI

N

d03858

27

7/14/2000

lamotrigine

Lamictal

0

Unkn

N

d03809

152

7/27/2006

leucovorin

Leucovorin

0

PCP Prophylaxis

N

d00275

14

5/1/1992

levetiracetam

Keppra

0

Anticonvulsant

N

d04499

111

8/1/2004

levonorgestrel 0.75 mg

Plan B

0

Contraceptive

N

d03242

144

2/28/2006

lisinopril

(generic only)

0

Antihypertensive

N

d00732

127

2/28/2006

lithium carbonate

Lithium Carbonate

0

Antimanic

N

d00061

112

8/1/2004

loperamide

Imodium

0

Antidiarrheal

N

d01025

54

2/1/1999

lopinavir-ritonavir

Kaletra

2

Protease Inhibitor

N

d04717

78




maraviroc

selzentry

0

CCR-5 coreceptor antagonist

Y







9/04/2007

medroxyprogesterone

(generic only)

0

Contraceptive

N

d00284

143

2/28/2006

megestrol acetate

Megace

0

Wasting

N

d01348

20

6/15/1993

metformin HCL

Glucophage

0

Antidiabetic

N

d03807

94

12/1/2003

metoclopramide

Reglan

0

Unkn

N

d00298

153

7/27/2006

metoprolol

(generic only)

0

Antihypertensive

N

d00134

130

2/28/2006

metronidazole

Flagyl, Metryl, Protostat

0

Antibiotics

N

d03208

97

12/1/2003

miconazole

Monistat

0

Antifungal

N

d00155

55

2/1/1999

mirtazapine

Remeron

0

Antidepressant

N

d04025

113

8/1/2004

nandrolone

injection & patches

0

Wasting

N

d00568

42

7/14/2000

nelfinavir

Viracept

1

Protease Inhibitor

N

d04118

32

7/14/2000

nevirapine

Viramune

1

Anti-retroviral NNRTI

N

d04029

30

7/14/2000

nifedipine

(generic only)

0

Antihypertensive

N

d00051

135

2/28/2006

norethindrone

Errin

0

Contraceptive

N

d00555

142

2/28/2006

nortriptyline

Pamelor, Aventyl

0

Antidepressant

N

d00144

40

7/14/2000

nystatin

Mycostatin

0

Antifungal

N

d01233

59

7/14/2000

octreotide

Sandostatin

0

Antidiarrheal

N

d00370

56

2/1/1999

olanzapine

Zyprexa

0

Antipsychotic

N

d04050

63

5/5/2000

oxandrolone

Oxandrin

0

Wasting

Y

d00566

46

7/14/2000

oxymetholone

Anadrol-50

0

Wasting

N

d04295

61

7/14/2000

paromomycin

Humatin

0

Antibiotics

N

d01104

67

7/14/2000

paroxetine

Paxil

0

Antidepressant

N

d03157

70

5/5/2000

peginterferon alfa 2a

Pegasys

0

HepCVirus

Y

d04821

93

12/1/2003

peginterferon alfa 2b

Peg-Intron

0

HepCVirus

Y

d04746

87

3/1/2003

pentamidine

Pentam, NebuPent

0

PCP Prophylaxis

N

d00030

02

1/1/1992

perphenazine

Trilafon

0

Antipsychotic

N

d00855

114

8/1/2004

polymyxin B-trimethoprim sulfate

Polytrim

0

Antibiotics

N

d03529

115

8/1/2004

pravastatin

Pravachol

0

Antilipemic Agent

N

d00348

68

5/5/2000

primaquine phosphate

Primaquine

0

Antibiotics

N

d00351

98

12/1/2003

prochlorperazine

Compazine

0

Antiemetic

N

d00355

60

7/14/2000

propranolol

(generic only)

0

Antihypertensive

N

d00032

131

2/28/2006

pyrazinamide

Rifater

0

Mycobacterial

N

d00117

15

5/1/1992

pyrimethamine

Daraprim, Fansidar

0

Toxoplasmosis

N

d00364

16

5/1/1992

quetiapine

Seroquel

0

Antipsychotic

N

d04220

120

2/28/2006

Raltegravir

Isentress

0

Integrase inhibitor

N







10/15/2007

regular insulin

Humulin R

0

Antidiabetic

N

d04374

122

2/28/2006

ribavirin

Rebetol, Copegus

0

HepCVirus

Y

d00085

88

3/1/2003

rifabutin

Mycobutin

0

Mycobacterial

N

d01097

23

6/15/1993

rifampin

Rifadin, Rimactane

0

Mycobacterial

N

d00047

17

5/1/1992

risperidone

Risperdal

0

Antipsychotic



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