Abaneu-SL Tablet Sublingual 600-600 MCG Sublingual
Cyanocobalamin-Methylcobalamin
Tier: 1
PA Type: No Prior Authorization
ST: N
Adakveo Solution 100 MG/10ML Intravenous
Crizanlizumab-tmca
Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Airavite Tablet 2.5-25-1 MG Oral
Folic Acid-Vit B6-Vit B12
Tier: 1
PA Type: No Prior Authorization
ST: N
Animi-3 Capsule 1 MG Oral
FA-B6-B12-D-Omega 3-Phytoster
Tier: 3
PA Type: No Prior Authorization
ST: N
Animi-3/Vitamin D Capsule 1 MG Oral
FA-B6-B12-D-Omega 3-Phytoster
Tier: 3
PA Type: No Prior Authorization
ST: N
Aranesp (Albumin Free) SOLUTION 100 MCG/ML INJECTION
Darbepoetin Alfa
Tier: Non-Formulary
PA Type: PA Applies
PA Group: Aranesp
Aranesp (Albumin Free) SOLUTION 100 MCG/ML INJECTION
Darbepoetin Alfa
Tier: Non-Formulary
PA Type: PA Applies
PA Group: Aranesp
Aranesp (Albumin Free) SOLUTION 200 MCG/ML INJECTION
Darbepoetin Alfa
Tier: Non-Formulary
PA Type: PA Applies
PA Group: Aranesp