All *CALCIUM CHANNEL BLOCKERS*

Adalat CC Tablet Extended Release 24 Hour 30 MG Oral
Adalat CC Tablet Extended Release 24 Hour 30 MG Oral

NIFEdipine ER

Tier: 3
PA Type: No Prior Authorization
ST: N
Adalat CC Tablet Extended Release 24 Hour 30 MG Oral
Adalat CC Tablet Extended Release 24 Hour 30 MG Oral

NIFEdipine ER

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

NIFEdipine ER

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

NIFEdipine ER

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

NIFEdipine ER

Tier: 3
PA Type: No Prior Authorization
ST: N
Adalat CC Tablet Extended Release 24 Hour 90 MG Oral
Adalat CC Tablet Extended Release 24 Hour 90 MG Oral

NIFEdipine ER

Tier: 3
PA Type: No Prior Authorization
ST: N
Adalat CC Tablet Extended Release 24 Hour 90 MG Oral
Adalat CC Tablet Extended Release 24 Hour 90 MG Oral

NIFEdipine ER

Tier: 3
PA Type: No Prior Authorization
ST: N
Afeditab CR Tablet Extended Release 24 Hour 30 MG Oral
Afeditab CR Tablet Extended Release 24 Hour 30 MG Oral

NIFEdipine ER

Tier: 1
PA Type: No Prior Authorization
ST: N
Afeditab CR Tablet Extended Release 24 Hour 30 MG Oral
Afeditab CR Tablet Extended Release 24 Hour 30 MG Oral

NIFEdipine ER

Tier: 1
PA Type: No Prior Authorization
ST: N
Afeditab CR Tablet Extended Release 24 Hour 60 MG Oral
Afeditab CR Tablet Extended Release 24 Hour 60 MG Oral

NIFEdipine ER

Tier: 1
PA Type: No Prior Authorization
ST: N
Afeditab CR Tablet Extended Release 24 Hour 60 MG Oral
Afeditab CR Tablet Extended Release 24 Hour 60 MG Oral

NIFEdipine ER

Tier: 1
PA Type: No Prior Authorization
ST: N
AmLODIPine Bes+SyrSpend SF SUSPENSION 1 MG/ML Oral
AmLODIPine Bes+SyrSpend SF SUSPENSION 1 MG/ML Oral

AmLODIPine Besylate

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N