All *ANALGESICS - ANTI-INFLAMMATORY*

Actemra ACTPen Solution Auto-Injector 162 MG/0.9ML Subcutaneous
Actemra ACTPen Solution Auto-Injector 162 MG/0.9ML Subcutaneous

Tocilizumab

Tier: 4
PA Type: PA Applies
PA Group: Actemra
Actemra SOLUTION 200 MG/10ML Intravenous
Actemra SOLUTION 200 MG/10ML Intravenous

Tocilizumab

Tier: 4
PA Type: PA Applies
PA Group: Actemra
Actemra SOLUTION 400 MG/20ML Intravenous
Actemra SOLUTION 400 MG/20ML Intravenous

Tocilizumab

Tier: 4
PA Type: PA Applies
PA Group: Actemra
Actemra SOLUTION 80 MG/4ML Intravenous
Actemra SOLUTION 80 MG/4ML Intravenous

Tocilizumab

Tier: 4
PA Type: PA Applies
PA Group: Actemra
Actemra Solution Prefilled Syringe 162 MG/0.9ML Subcutaneous
Actemra Solution Prefilled Syringe 162 MG/0.9ML Subcutaneous

Tocilizumab

Tier: 4
PA Type: PA Applies
PA Group: Actemra
Active Injection Ket-L KIT 30 & 1 MG/ML-% INJECTION
Active Injection Ket-L KIT 30 & 1 MG/ML-% INJECTION

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Active Injection Ketmarc-L KIT 30 & 0.25 & 1 MG/ML-%-% INJECTION
Active Injection Ketmarc-L KIT 30 & 0.25 & 1 MG/ML-%-% INJECTION

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Anaprox DS Tablet 550 MG Oral
Anaprox DS Tablet 550 MG Oral

Naproxen Sodium

Tier: 3
PA Type: No Prior Authorization
ST: N
Anaprox DS Tablet 550 MG Oral
Anaprox DS Tablet 550 MG Oral

Naproxen Sodium

Tier: 3
PA Type: No Prior Authorization
ST: N
Anjeso Injectable 30 MG/ML Intravenous
Anjeso Injectable 30 MG/ML Intravenous

Meloxicam

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Arava TABLET 10 MG ORAL
Arava TABLET 10 MG ORAL

Leflunomide

Tier: 3
PA Type: No Prior Authorization
ST: N
Arava TABLET 20 MG ORAL
Arava TABLET 20 MG ORAL

Leflunomide

Tier: 3
PA Type: No Prior Authorization
ST: N