PA = Prior Authorization is required; QL = Quantity limits apply; ST = Step Therapy applies; 
RD = Specialty Drug, please refer to Specialty Pharmacy Program section for additional information;
OTC = Over-the-counter Product, may be covered if a prescription is written, and it is filled at a retail or mailorder pharmacy

Medications written in all CAPITAL letters are Brand names.
Medications written in all lower case letters are available generically. The brand name is listed in parenthesis for reference only.


H
HALFAN
halobetasol propionate cream/oint 0.05% (Ultravate)
haloperidol (Haldol)
haloperidol decanoate
heparin
HEPSERA, RD
HEXALEN, RD 
HIVID
HMS
homatropine (Isopto Homatropine)
HUMALOG
HUMALOG 50/50
HUMALOG 75/25
HUMIRA, GI/Dermatologists/Rheumatologists only, PA, RD 
HUMULIN 50/50, OTC
HUMULIN 70/30, OTC
HUMULIN L, OTC
HUMULIN N, OTC
HUMULIN R, OTC
HUMULIN U, OTC
hyaluronate topical gel (Hylira, Bionect)
HYCAMTIN, RD
hydralazine (Apresoline)
hydralazine/hydrochlorothiazide (Apresazide)
hydrochlorothiazide (Hydrodiuril)
hydrocodone/acetaminophen 10/325 tabs/solution (Norco)
hydrocodone/acetaminophen 10/500 (Lortab)
hydrocodone/acetaminophen 10/650 (Lorcet)
hydrocodone/acetaminophen 10/660 (Vicodin HP)
hydrocodone/acetaminophen 2.5/500 (Vicodin)
hydrocodone/acetaminophen 5/325 (Norco)
hydrocodone/acetaminophen 5/500 (Vicodin)
hydrocodone/acetaminophen 7.5/325 (Norco)
hydrocodone/acetaminophen 7.5/500 (Lortab)
hydrocodone/acetaminophen 7.5/650 (Lorcet Plus)
hydrocodone/acetaminophen 7.5/750 (Vicodin ES) 
hydrocodone/ibuprofen (Reprexain, Ibudone)
hydrocortisone butyrate 0.1% cream/oint/soln (Locoid)
hydrocortisone cream/oint/lotion, 2.5% (Hytone, Anusol HC, Lacticare HC)
hydrocortisone enema/suppositories (Cortenema, Anusol HC)
hydrocortisone tablets (Cortef) 
hydrocortisone valerate cream/oint, 0.2% (Westcort)
hydrocortisone/aloe 2% (Nuzon)
hydrocortisone/lidocaine 2%/2% (Peranex HC)
hydrocortisone/pramoxine cream (Pramosone, Analpram HC)
hydrocortisone/pramoxine/chloroxylenol (Cortamox otic)
hydromorphone (Dilaudid)
hydroxychloroquine (Plaquenil)
hydroxyurea (Hydrea)
hydroxyzine hcl (Atarax)
hydroxyzine pamoate (Vistaril)
hyoscyamine (Levsin, Levsin SL)
hyoscyamine extended-release (Levsinex, Levbid, Symax Duotab)
HYZAAR, ST


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