All *GENERAL ANESTHETICS*

Amidate Solution 2 MG/ML Intravenous
Amidate Solution 2 MG/ML Intravenous

Etomidate

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Amidate Solution 2 MG/ML Intravenous
Amidate Solution 2 MG/ML Intravenous

Etomidate

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Amidate Solution 2 MG/ML Intravenous
Amidate Solution 2 MG/ML Intravenous

Etomidate

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Amidate Solution 2 MG/ML Intravenous
Amidate Solution 2 MG/ML Intravenous

Etomidate

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Amidate Solution 2 MG/ML Intravenous
Amidate Solution 2 MG/ML Intravenous

Etomidate

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Amidate Solution 2 MG/ML Intravenous
Amidate Solution 2 MG/ML Intravenous

Etomidate

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Amidate Solution 2 MG/ML Intravenous
Amidate Solution 2 MG/ML Intravenous

Etomidate

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Amidate Solution 2 MG/ML Intravenous
Amidate Solution 2 MG/ML Intravenous

Etomidate

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Amidate Solution 2 MG/ML Intravenous
Amidate Solution 2 MG/ML Intravenous

Etomidate

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Anesthesia S/I-40 Kit 200 MG/20ML Intravenous
Anesthesia S/I-40 Kit 200 MG/20ML Intravenous

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
ANESTHESIA S/I-40A KIT 200 MG/20ML Intravenous
ANESTHESIA S/I-40A KIT 200 MG/20ML Intravenous

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Anesthesia S/I-40H KIT 200 MG/20ML Intravenous
Anesthesia S/I-40H KIT 200 MG/20ML Intravenous

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