Adenocard Solution 12 MG/4ML Intravenous
Tier: 3
PA Type: No Prior Authorization
ST: N
Adenocard Solution 6 MG/2ML Intravenous
Tier: 3
PA Type: No Prior Authorization
ST: N
Adenosine Solution 12 MG/4ML Intravenous
Tier: 1
PA Type: No Prior Authorization
ST: N
Adenosine Solution 12 MG/4ML Intravenous
Tier: 1
PA Type: No Prior Authorization
ST: N
Adenosine Solution 12 MG/4ML Intravenous
Tier: 1
PA Type: No Prior Authorization
ST: N
Adenosine Solution 12 MG/4ML Intravenous
Tier: 1
PA Type: No Prior Authorization
ST: N
Adenosine Solution 12 MG/4ML Intravenous
Tier: 1
PA Type: No Prior Authorization
ST: N
Adenosine Solution 12 MG/4ML Intravenous
Tier: 1
PA Type: No Prior Authorization
ST: N
Adenosine Solution 12 MG/4ML Intravenous
Tier: 1
PA Type: No Prior Authorization
ST: N
Adenosine Solution 6 MG/2ML Intravenous
Tier: 1
PA Type: No Prior Authorization
ST: N
Adenosine Solution 6 MG/2ML Intravenous
Tier: 1
PA Type: No Prior Authorization
ST: N
Adenosine Solution 6 MG/2ML Intravenous
Tier: 1
PA Type: No Prior Authorization
ST: N