All *CARDIOVASCULAR AGENTS - MISC.*

Ablysinol Solution Intra-arterial
Ablysinol Solution Intra-arterial

Dehydrated Alcohol

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Ablysinol Solution Intra-arterial
Ablysinol Solution Intra-arterial

Dehydrated Alcohol

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adcirca Tablet 20 MG Oral
Adcirca Tablet 20 MG Oral

Tadalafil (PAH)

Tier: 4
PA Type: PA Applies
PA Group: PAH PDE5 Inhibitors
Adempas Tablet 0.5 MG Oral
Adempas Tablet 0.5 MG Oral

Riociguat

Tier: 4
PA Type: PA Applies
PA Group: Adempas
Adempas Tablet 0.5 MG Oral
Adempas Tablet 0.5 MG Oral

Riociguat

Tier: 4
PA Type: PA Applies
PA Group: Adempas
Adempas Tablet 0.5 MG Oral
Adempas Tablet 0.5 MG Oral

Riociguat

Tier: 4
PA Type: PA Applies
PA Group: Adempas
Adempas Tablet 1 MG Oral
Adempas Tablet 1 MG Oral

Riociguat

Tier: 4
PA Type: PA Applies
PA Group: Adempas
Adempas Tablet 1 MG Oral
Adempas Tablet 1 MG Oral

Riociguat

Tier: 4
PA Type: PA Applies
PA Group: Adempas
Adempas Tablet 1 MG Oral
Adempas Tablet 1 MG Oral

Riociguat

Tier: 4
PA Type: PA Applies
PA Group: Adempas
Adempas Tablet 1.5 MG Oral
Adempas Tablet 1.5 MG Oral

Riociguat

Tier: 4
PA Type: PA Applies
PA Group: Adempas
Adempas Tablet 1.5 MG Oral
Adempas Tablet 1.5 MG Oral

Riociguat

Tier: 4
PA Type: PA Applies
PA Group: Adempas
Adempas Tablet 1.5 MG Oral
Adempas Tablet 1.5 MG Oral

Riociguat

Tier: 4
PA Type: PA Applies
PA Group: Adempas