Adderall Tablet 10 MG Oral
Amphetamine-Dextroamphetamine
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adderall Tablet 12.5 MG Oral
Amphetamine-Dextroamphetamine
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adderall Tablet 15 MG Oral
Amphetamine-Dextroamphetamine
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adderall TABLET 20 MG ORAL
Amphetamine-Dextroamphetamine
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adderall Tablet 30 MG Oral
Amphetamine-Dextroamphetamine
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adderall Tablet 5 MG Oral
Amphetamine-Dextroamphetamine
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adderall Tablet 7.5 MG Oral
Amphetamine-Dextroamphetamine
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adderall XR Capsule Extended Release 24 Hour 10 MG Oral
Amphetamine-Dextroamphet ER
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adderall XR CAPSULE EXTENDED RELEASE 24 HOUR 15 MG Oral
Amphetamine-Dextroamphet ER
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adderall XR Capsule Extended Release 24 Hour 20 MG Oral
Amphetamine-Dextroamphet ER
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N