All *ANTIDEPRESSANTS*

Amitriptyline HCl Tablet 10 MG Oral
Amitriptyline HCl Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amitriptyline HCl Tablet 10 MG Oral
Amitriptyline HCl Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amitriptyline HCl Tablet 10 MG Oral
Amitriptyline HCl Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amitriptyline HCl Tablet 10 MG Oral
Amitriptyline HCl Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amitriptyline HCl Tablet 10 MG Oral
Amitriptyline HCl Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amitriptyline HCl Tablet 10 MG Oral
Amitriptyline HCl Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amitriptyline HCl Tablet 10 MG Oral
Amitriptyline HCl Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amitriptyline HCl Tablet 10 MG Oral
Amitriptyline HCl Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amitriptyline HCl Tablet 10 MG Oral
Amitriptyline HCl Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amitriptyline HCl Tablet 10 MG Oral
Amitriptyline HCl Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amitriptyline HCl Tablet 10 MG Oral
Amitriptyline HCl Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Amitriptyline HCl Tablet 10 MG Oral
Amitriptyline HCl Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N