...are not accepted. This also includes prescription renewals. The pharmacy can, however, accept a change or substitution to a non-controlled and Schedule 3, 4 and 5 prescriptions via telephone if the original prescription is located within the pharmacy.

...are honored up to 365 days from the date the prescription was written. Antibiotic prescriptions over 10 days old will be filled at the discretion of the pharmacy. Prescriptions for maintenance medications may be written for up to a 90 day supply with a maximum of 3 refills. All other non-controlled prescriptions may be written for up to 30 days supply with a maximum of 11 refills.

...Prescriptions for Schedule 3, 4 or 5 medications will be honored for 6 months from the date they were written with up to 5 refills. Prescriptions for Schedule 2 medications will be honored for 7 days from the date they were written. Providers are reminded to include their DEA number on all controlled prescriptions.

In accordance with the Health Insurance and Accountability Act of 1996, Department of Defense and Air Force Policy, a patient must possess a valid Military ID to pick up any prescription. A patient representative may pick up prescriptions. However, the patient representative must possess a valid photo identification, preferably a Military ID, possess the patient's Military ID card (a copy front and back may be substituted), and possess a signed statement authorizing the representative to act on patient's behalf for this purpose.

Blood Glucose Strips/Syringes
• Limit 600 strips/syringes per 90 days.

Bupropion/Wellbutrin [Zyban Policy]
• Wellbutrin SR is not to be used for tobacco cessation.

Fluconazole (Diflucan) SINGLE DOSE
• For vaginal yeast indication only; qty limit of 3 tablets per 90 days.

Granisetron (Kytril) 1mg Dispensing Policy
• Restricted to chemotherapy patients only.
• Max of 8 tablets per month.

Imitrex Autoinjector 2/ kit
• Qty limit 8 syringes per month

Imitrex Nasal Spray/Tablets
• Qty limit 6 doses per month
• 50mg, 54 tablets per 90 days • 100mg, 27 Tbs 90 days

Levitra Tablets Dispensing Policy
• Qty limit 6 doses per month

Prenatal Vitamin Dispensing Policy
• Limited to women of child-bearing age up to and including age 45.

Rizatriptan (Maxalt) Dispensing Policy
• 2nd line therapy after documented trial of Zomig failure.
• 12 tablets max per month.

Transplant and HIV
• Call our supply line at 456-6237 for details on eligibility criteria for nonformulary meds under the AF High Dollar Program.

Treximet
• Qty Limit 27 tablets per 90 days Zolmitriptan (Zomig)
• Quantity limits 12 tablets per month.