All *ALTERNATIVE MEDICINES*

Alpha-Lipoic Acid Solution 25 MG/ML Injection
Alpha-Lipoic Acid Solution 25 MG/ML Injection

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Co-Veratrol Capsule 200-5-400-0.8 MG Oral
Co-Veratrol Capsule 200-5-400-0.8 MG Oral

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Coenzyme Q-10 Solution 20 MG/ML Injection
Coenzyme Q-10 Solution 20 MG/ML Injection

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
EC-RX DHEA Cream 10 % External
EC-RX DHEA Cream 10 % External

Prasterone (DHEA)

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
EC-RX DHEA Cream 10 % External
EC-RX DHEA Cream 10 % External

Prasterone (DHEA)

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
EC-RX DHEA Cream 4 % External
EC-RX DHEA Cream 4 % External

Prasterone (DHEA)

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
EC-RX DHEA Cream 4 % External
EC-RX DHEA Cream 4 % External

Prasterone (DHEA)

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
NeoKe RA Lipoic POWDER 800 MG/GM ORAL
NeoKe RA Lipoic POWDER 800 MG/GM ORAL

Alpha-Lipoic Acid

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N