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J deere maint dl_2

The UnitedHealthcare Maintenance Drug List provides a list of drugs in various therapeutic classes mostfrequently used for chronic prescription drug therapy. This list does not define coverage. Benefit coverage isdetermined by the member’s pharmacy benefit plan. For questions regarding the member’s benefit plan, callthe number on the back of the member ID card.
Autonomic & CNS Drugs, Neurology & Medications on this list are available with a 90 or 100 day supply as defined by your benefit plan. Please see your Benefit Summary to confirm.
*Medications with this notation are subject to Quantity level limits (QLL). QLL limits can and will be changed and/or added through out the year. Please check myuhc.com or call the number on the back of your card for the most current drug information.
Quinidine Gluconate (quinidine gluconate) Cardizem, DilacorXR, Tiazac (Diltiazem HCl) Nitrostat, Nitro-Bid, Nitroquick, Nitrolingual Accupril (quinapril HCl/magnesium carbonate) Aldactone (spironolactone)Bumex (bumetanide) • Adrenergic Antagonists & Related Drugs Hydrodiuril, Microzide (hydrochlorothiazide) Medications on this list are available with a 90 or 100 day supply as defined by your benefit plan. Please see your Benefit Summary to confirm.
*Medications with this notation are subject to Quantity level limits (QLL). QLL limits can and will be changed and/or added through out the year. Please check myuhc.com or call the number on the back of your card for the most current drug information.
Accuretic (quinapril HCl/HCTZ)Aldoril (methyldopa/HCTZ) Orapred, Pediapred, Prelone (prednisolone) Mevacor (lovastatin)NiaspanNicor (niacin)Questran, Light (cholestyramine)Vytorin*Zetia*Zocor* Medications on this list are available with a 90 or 100 day supply as defined by your benefit plan. Please see your Benefit Summary to confirm.
*Medications with this notation are subject to Quantity level limits (QLL). QLL limits can and will be changed and/or added through out the year. Please check myuhc.com or call the number on the back of your card for the most current drug information.
Glyburide Micronized (Glyburide micronized) Accusure (insulin syringe)Insulin Syringe (insulin syringe) • Corticosteroids (see Endocrine Therapy) Actonel*Boniva*EvistaFosamax*Miacalcin Nasal Spray Medications on this list are available with a 90 or 100 day supply as defined by your benefit plan. Please see your Benefit Summary to confirm.
*Medications with this notation are subject to Quantity level limits (QLL). QLL limits can and will be changed and/or added through out the year. Please check myuhc.com or call the number on the back of your card for the most current drug information.
Alesse (levonorgestrel-ethinyl estradiol) Loestrin (norethindrone A-ethinyl estradiol) Nordette (levonorgestrel-ethinyl estradiol) OrthoTri-Cyclen (norgestimate-ethinyl estradiol) Ortho-Cyclen (norgestimate-ethinyl estradiol) Ortho-Novum (norethindrone-ethinyl estradiol)Orthocept (desogestrel-ethinyl estradiol)TriNorinyl (norethindrone-ethinyl estradiol)Triphasil (levonorgestrel-ethinyl estradiol)Yasmin Medications on this list are available with a 90 or 100 day supply as defined by your benefit plan. Please see your Benefit Summary to confirm.
*Medications with this notation are subject to Quantity level limits (QLL). QLL limits can and will be changed and/or added through out the year. Please check myuhc.com or call the number on the back of your card for the most current drug information.
• Genitourinary Smooth Muscle Relaxants Prenate Advance, Prenate GT (prenatal vitamins) K-Lyte (potassium bicarbonate/citric acid) KaletraNorvirRescriptorRetrovir (zidovudine)SustivaTrizivirVidexViraceptViramuneVireadZeritZiagen Medications on this list are available with a 90 or 100 day supply as defined by your benefit plan. Please see your Benefit Summary to confirm.
*Medications with this notation are subject to Quantity level limits (QLL). QLL limits can and will be changed and/or added through out the year. Please check myuhc.com or call the number on the back of your card for the most current drug information.

Source: http://www.deere.com/healthydirections/media/pdf/maint_drug_list.pdf

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