All *ANTIHYPERLIPIDEMICS*

Altoprev Tablet Extended Release 24 Hour 20 MG Oral
Altoprev Tablet Extended Release 24 Hour 20 MG Oral

Lovastatin ER

Tier: 3
PA Type: No Prior Authorization
ST: N
Altoprev Tablet Extended Release 24 Hour 20 MG Oral
Altoprev Tablet Extended Release 24 Hour 20 MG Oral

Lovastatin ER

Tier: 3
PA Type: No Prior Authorization
ST: N
Altoprev Tablet Extended Release 24 Hour 40 MG Oral
Altoprev Tablet Extended Release 24 Hour 40 MG Oral

Lovastatin ER

Tier: 3
PA Type: No Prior Authorization
ST: N
Altoprev Tablet Extended Release 24 Hour 40 MG Oral
Altoprev Tablet Extended Release 24 Hour 40 MG Oral

Lovastatin ER

Tier: 3
PA Type: No Prior Authorization
ST: N
Altoprev Tablet Extended Release 24 Hour 60 MG Oral
Altoprev Tablet Extended Release 24 Hour 60 MG Oral

Lovastatin ER

Tier: 3
PA Type: No Prior Authorization
ST: N
Altoprev Tablet Extended Release 24 Hour 60 MG Oral
Altoprev Tablet Extended Release 24 Hour 60 MG Oral

Lovastatin ER

Tier: 3
PA Type: No Prior Authorization
ST: N
Antara CAPSULE 30 MG ORAL
Antara CAPSULE 30 MG ORAL

Fenofibrate Micronized

Tier: 3
PA Type: No Prior Authorization
ST: N
Antara CAPSULE 90 MG ORAL
Antara CAPSULE 90 MG ORAL

Fenofibrate Micronized

Tier: 3
PA Type: No Prior Authorization
ST: N
Atorvastatin Calcium Tablet 10 MG Oral
Atorvastatin Calcium Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Atorvastatin Calcium Tablet 10 MG Oral
Atorvastatin Calcium Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Atorvastatin Calcium Tablet 10 MG Oral
Atorvastatin Calcium Tablet 10 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
Atorvastatin Calcium Tablet 10 MG Oral
Atorvastatin Calcium Tablet 10 MG Oral

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