All *ANTIPSYCHOTICS/ANTIMANIC AGENTS*

ZyPREXA Zydis TABLET DISPERSIBLE 15 MG ORAL
ZyPREXA Zydis TABLET DISPERSIBLE 15 MG ORAL

OLANZapine

Tier: 3
PA Type: No Prior Authorization
ST: N
ZyPREXA Zydis Tablet Dispersible 20 MG Oral
ZyPREXA Zydis Tablet Dispersible 20 MG Oral

OLANZapine

Tier: 3
PA Type: No Prior Authorization
ST: N
ZyPREXA Zydis Tablet Dispersible 20 MG Oral
ZyPREXA Zydis Tablet Dispersible 20 MG Oral

OLANZapine

Tier: 3
PA Type: No Prior Authorization
ST: N
ZyPREXA Zydis Tablet Dispersible 5 MG Oral
ZyPREXA Zydis Tablet Dispersible 5 MG Oral

OLANZapine

Tier: 3
PA Type: No Prior Authorization
ST: N
ZyPREXA Zydis Tablet Dispersible 5 MG Oral
ZyPREXA Zydis Tablet Dispersible 5 MG Oral

OLANZapine

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