All *CARDIOVASCULAR AGENTS - MISC.*

Viagra TABLET 25 MG Oral
Viagra TABLET 25 MG Oral

Sildenafil Citrate

Tier: 3
PA Type: No Prior Authorization
ST: N
Viagra Tablet 50 MG Oral
Viagra Tablet 50 MG Oral

Sildenafil Citrate

Tier: 3
PA Type: No Prior Authorization
ST: N
Viagra Tablet 50 MG Oral
Viagra Tablet 50 MG Oral

Sildenafil Citrate

Tier: 3
PA Type: No Prior Authorization
ST: N
Viagra Tablet 50 MG Oral
Viagra Tablet 50 MG Oral

Sildenafil Citrate

Tier: 3
PA Type: No Prior Authorization
ST: N
Viagra Tablet 50 MG Oral
Viagra Tablet 50 MG Oral

Sildenafil Citrate

Tier: 3
PA Type: No Prior Authorization
ST: N
Vyndamax Capsule 61 MG Oral
Vyndamax Capsule 61 MG Oral

Tafamidis

Tier: 4
PA Type: PA Applies
PA Group: Vyndaqel and Vyndamax
Vyndamax Capsule 61 MG Oral
Vyndamax Capsule 61 MG Oral

Tafamidis

Tier: 4
PA Type: PA Applies
PA Group: Vyndaqel and Vyndamax
Vyndaqel Capsule 20 MG Oral
Vyndaqel Capsule 20 MG Oral

Tafamidis Meglumine (Cardiac)

Tier: 4
PA Type: PA Applies
PA Group: Vyndaqel and Vyndamax
Vyndaqel Capsule 20 MG Oral
Vyndaqel Capsule 20 MG Oral

Tafamidis Meglumine (Cardiac)

Tier: 4
PA Type: PA Applies
PA Group: Vyndaqel and Vyndamax