First Fill prescription drug list

These are the only drugs approved for use with the First Fill pharmacy benefit:

• Opioids (short-acting)
  Codeine/apap
  Hydrocodone apap 5-500 mg
  Morphine IR
  Oxycodone 5 mg
  Oxycodone/apap 5-325 mg
  Propoxyphene n/apap 100-650
  Tramadol
  
• NSAIDS & Acetaminophen
  Acetaminophen*
  Ibuprofen*
  Naproxen*
  
• Anti-infective agents
  Amoxicillin
  Cephalexin
  Ciprofloxacin
  Erythromycin
  Penicillin
  Tetracycline
  
• Skeletal muscle relaxants
  Cyclobenzeprene
  
• Dermatological products
  Silver sulfadiazine cream
  
• Sedatives
  Temazepam
  Zolpidem

*Over-the-counter and prescription strength medications are covered with a provider's prescription.