Showing the top 100 results that matched your search. Please narrow your search.
- ACETAZOLAMID CAP 500MG ER
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - ACETAZOLAMID INJ 500MG
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - ACETAZOLAMID TAB 125MG
Classification: Tier 3 (preferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - ACETAZOLAMID TAB 250MG
Classification: Tier 3 (preferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - ALISKIREN TAB 150MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- ALISKIREN TAB 300MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMILOR/HCTZ TAB 5-50
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - AMLOD/ATORVA TAB 10-10MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/ATORVA TAB 10-20MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/ATORVA TAB 10-40MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/ATORVA TAB 10-80MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/ATORVA TAB 2.5-10MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/ATORVA TAB 2.5-20MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/ATORVA TAB 2.5-40MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/ATORVA TAB 5-10MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/ATORVA TAB 5-20MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/ATORVA TAB 5-40MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/ATORVA TAB 5-80MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/BENAZP CAP 10-20MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/BENAZP CAP 10-40MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/BENAZP CAP 2.5-10MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/BENAZP CAP 5-10MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/BENAZP CAP 5-20MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/BENAZP CAP 5-40MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/OLMESA TAB 10-20MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/OLMESA TAB 10-40MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/OLMESA TAB 5-20MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/OLMESA TAB 5-40MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/VALSAR TAB /HCTZ
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/VALSAR TAB 10-160MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/VALSAR TAB 10-320MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/VALSAR TAB 5-160MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- AMLOD/VALSAR TAB 5-320MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- ATENOL/CHLOR TAB 100-25MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - ATENOL/CHLOR TAB 50-25MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - ATROPINE SUL INJ 0.05MG/1
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - ATROPINE SUL INJ 0.1MG/ML
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - ATROPINE SUL INJ 8MG/20ML
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - ATROPINE SUL INJ
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - BENAZEP/HCTZ TAB 10-12.5
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- BENAZEP/HCTZ TAB 20-12.5
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- BENAZEP/HCTZ TAB 20-25MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- BENAZEP/HCTZ TAB 5-6.25
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- BIDIL TAB
Classification: Tier 3 (preferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 180 per 30-days (* depending on package size)
- BISOPRL/HCTZ TAB 10/6.25
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 60 per 30-days (* depending on package size)
- BISOPRL/HCTZ TAB 2.5/6.25
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 60 per 30-days (* depending on package size)
- BISOPRL/HCTZ TAB 5-6.25MG
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 60 per 30-days (* depending on package size)
- CANDESA/HCTZ TAB 16-12.5
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- CANDESA/HCTZ TAB 32-12.5
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- CANDESA/HCTZ TAB 32-25MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- CORLANOR SOL 5MG/5ML
Classification: Tier 4 (nonpreferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 450 per 30-days (* depending on package size)
Prior Authorization: Prior Authorization
- CORLANOR TAB 5MG
Classification: Tier 4 (nonpreferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 60 per 30-days (* depending on package size)
Prior Authorization: Prior Authorization
- CORLANOR TAB 7.5MG
Classification: Tier 4 (nonpreferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 60 per 30-days (* depending on package size)
Prior Authorization: Prior Authorization
- DEMSER CAP 250MG
Classification: Tier 5 (specialty tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - DIGITEK TAB 0.125MG
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - DIGITEK TAB 0.25MG
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - DIGOX TAB 0.125MG
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - DIGOX TAB 0.25MG
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - DIGOXIN INJ 0.25/ML
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - DIGOXIN INJ 0.25MG/1
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - DIGOXIN SOL 50MCG/ML
Classification: Tier 3 (preferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - DIGOXIN TAB 0.0625MG
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - DIGOXIN TAB 0.125MG
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - DIGOXIN TAB 0.25MG
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - DOBUTAM/D5W INJ 1MG/ML
Classification: Tier 4 (nonpreferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherPrior Authorization: Part B vs. Part D Prior Authorization
- DOBUTAM/D5W INJ 2MG/ML
Classification: Tier 4 (nonpreferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherPrior Authorization: Part B vs. Part D Prior Authorization
- DOBUTAM/D5W INJ 4MG/ML
Classification: Tier 4 (nonpreferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherPrior Authorization: Part B vs. Part D Prior Authorization
- DOBUTAMINE INJ 250MG
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherPrior Authorization: Part B vs. Part D Prior Authorization
- EDARBYCLOR TAB 40-12.5
Classification: Tier 4 (nonpreferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- EDARBYCLOR TAB 40-25MG
Classification: Tier 4 (nonpreferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- ENALAPR/HCTZ TAB 10-25MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 60 per 30-days (* depending on package size)
- ENALAPR/HCTZ TAB 5-12.5MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- ENTRESTO TAB 24-26MG
Classification: Tier 3 (preferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 60 per 30-days (* depending on package size)
- ENTRESTO TAB 49-51MG
Classification: Tier 3 (preferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 60 per 30-days (* depending on package size)
- ENTRESTO TAB 97-103MG
Classification: Tier 3 (preferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 60 per 30-days (* depending on package size)
- FOSINOP/HCTZ TAB 10/12.5
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 120 per 30-days (* depending on package size)
- FOSINOP/HCTZ TAB 20/12.5
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 120 per 30-days (* depending on package size)
- IRBESAR/HCTZ TAB 150-12.5
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- IRBESAR/HCTZ TAB 300-12.5
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- ISOSO/HYDRAL TAB 20-37.5
Classification: Tier 3 (preferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 180 per 30-days (* depending on package size)
- LANOXIN TAB 0.0625MG
Classification: Tier 4 (nonpreferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - LANOXIN TAB 0.125MG
Classification: Tier 4 (nonpreferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - LANOXIN TAB 0.25MG
Classification: Tier 4 (nonpreferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - LANOXIN PED INJ 0.1MG/ML
Classification: Tier 4 (nonpreferred brand tier) brand drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - LISINOP/HCTZ TAB 10-12.5
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- LISINOP/HCTZ TAB 20-12.5
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 120 per 30-days (* depending on package size)
- LISINOP/HCTZ TAB 20-25MG
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 60 per 30-days (* depending on package size)
- LOSARTAN/HCT TAB 100-12.5
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- LOSARTAN/HCT TAB 100-25
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 30 per 30-days (* depending on package size)
- LOSARTAN/HCT TAB 50-12.5
Classification: Tier 1 (preferred generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherQuantity Limit: 60 per 30-days (* depending on package size)
- METOPRL/HCTZ TAB 100-25MG
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - METOPRL/HCTZ TAB 100-50MG
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - METOPRL/HCTZ TAB 50-25MG
Classification: Tier 2 (generic tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - METYROSINE CAP 250MG
Classification: Tier 5 (specialty tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, Other - MILRINONE INJ 10/10ML
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherPrior Authorization: Part B vs. Part D Prior Authorization
- MILRINONE INJ 1MG/ML
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherPrior Authorization: Part B vs. Part D Prior Authorization
- MILRINONE INJ 20/20ML
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherPrior Authorization: Part B vs. Part D Prior Authorization
- MILRINONE INJ 50/50ML
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherPrior Authorization: Part B vs. Part D Prior Authorization
- MILRINONE/D5 INJ 20/100ML
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherPrior Authorization: Part B vs. Part D Prior Authorization
- MILRINONE/D5 INJ 40/200ML
Classification: Tier 4 (nonpreferred brand tier) generic drug
Therapeutic Category: Cardiovascular Agents
Therapeutic Class: Cardiovascular Agents, OtherPrior Authorization: Part B vs. Part D Prior Authorization
Last updated 09/13/2022