All *ANTIPSYCHOTICS/ANTIMANIC AGENTS*

Abilify TABLET 10 MG Oral
Abilify TABLET 10 MG Oral

ARIPiprazole

Tier: 3
PA Type: No Prior Authorization
ST: N
Abilify TABLET 15 MG Oral
Abilify TABLET 15 MG Oral

ARIPiprazole

Tier: 3
PA Type: No Prior Authorization
ST: N
Abilify Tablet 2 MG Oral
Abilify Tablet 2 MG Oral

ARIPiprazole

Tier: 3
PA Type: No Prior Authorization
ST: N
Abilify Tablet 20 MG Oral
Abilify Tablet 20 MG Oral

ARIPiprazole

Tier: 3
PA Type: No Prior Authorization
ST: N
Abilify Tablet 20 MG Oral
Abilify Tablet 20 MG Oral

ARIPiprazole

Tier: 3
PA Type: No Prior Authorization
ST: N
Abilify Tablet 30 MG Oral
Abilify Tablet 30 MG Oral

ARIPiprazole

Tier: 3
PA Type: No Prior Authorization
ST: N
Abilify Tablet 30 MG Oral
Abilify Tablet 30 MG Oral

ARIPiprazole

Tier: 3
PA Type: No Prior Authorization
ST: N
Abilify Tablet 5 MG Oral
Abilify Tablet 5 MG Oral

ARIPiprazole

Tier: 3
PA Type: No Prior Authorization
ST: N
Adasuve Aerosol Powder Breath Activated 10 MG Inhalation
Adasuve Aerosol Powder Breath Activated 10 MG Inhalation

Loxapine

Tier: 3
PA Type: No Prior Authorization
ST: N
Adasuve Aerosol Powder Breath Activated 10 MG Inhalation
Adasuve Aerosol Powder Breath Activated 10 MG Inhalation

Loxapine

Tier: 3
PA Type: No Prior Authorization
ST: N
Adasuve Aerosol Powder Breath Activated 10 MG Inhalation
Adasuve Aerosol Powder Breath Activated 10 MG Inhalation

Loxapine

Tier: 3
PA Type: No Prior Authorization
ST: N
Adasuve Aerosol Powder Breath Activated 10 MG Inhalation
Adasuve Aerosol Powder Breath Activated 10 MG Inhalation

Loxapine

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