| Document Date: 2015-04-29 12:03:39
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City Washington / / Company LifeWise Assurance Company / / IndustryTerm levonorgestrel-releasing intrauterine device / cysteamine ophthalmic solutions / / Position RT / / Product Hydroxyprogesterone caproate / polyethylene glycol / Chorionic Gonadotropin / Abraxane / Octreotide Acetate / Torisel / Leuprolide Acetate / fluocinolone acetonide / Carbidopa and Levodopa / Enteral Suspension / Sucralfate / Lupron Depot / Intron A / Gonal-F / Tev-Tropin / Supprelin LA / Somatuline Depot / norethindrone acetate / Ribavirin / Revatio / Complex High Molecular Weight Hyaluronan Injection / / ProvinceOrState Oregon / / Technology Alpha / Ado / /
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Mandatory Specialty Drug List Drug Name Generic Name Abraxane