Acthar Gel 80 UNIT/ML Injection
Tier: 4
PA Type: PA Applies
PA Group: Acthar HP
Actonel TABLET 150 MG ORAL
Tier: 3
PA Type: No Prior Authorization
ST: N
Actonel TABLET 150 MG ORAL
Tier: 3
PA Type: No Prior Authorization
ST: N
Actonel Tablet 30 MG Oral
Tier: 3
PA Type: No Prior Authorization
ST: N
Actonel Tablet 35 MG Oral
Tier: 3
PA Type: No Prior Authorization
ST: N
Actonel Tablet 35 MG Oral
Tier: 3
PA Type: No Prior Authorization
ST: N
Actonel Tablet 5 MG Oral
Tier: 3
PA Type: No Prior Authorization
ST: N
Alendronate Sodium Solution 70 MG/75ML Oral
Tier: 1
PA Type: No Prior Authorization
ST: N
Alendronate Sodium Solution 70 MG/75ML Oral
Tier: 1
PA Type: No Prior Authorization
ST: N
Alendronate Sodium Tablet 10 MG Oral
Tier: 1
PA Type: No Prior Authorization
ST: N
Alendronate Sodium Tablet 10 MG Oral
Tier: 1
PA Type: No Prior Authorization
ST: N