All *MISCELLANEOUS THERAPEUTIC CLASSES*

Azasan Tablet 100 MG Oral
Azasan Tablet 100 MG Oral

AzaTHIOprine

Tier: 3
PA Type: No Prior Authorization
ST: N
Azasan Tablet 75 MG Oral
Azasan Tablet 75 MG Oral

AzaTHIOprine

Tier: 3
PA Type: No Prior Authorization
ST: N
AzaTHIOprine Sodium Solution Reconstituted 100 MG Injection
AzaTHIOprine Sodium Solution Reconstituted 100 MG Injection

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

Tier: 1
PA Type: No Prior Authorization
ST: N
azaTHIOprine Tablet 50 MG Oral
azaTHIOprine Tablet 50 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
azaTHIOprine Tablet 50 MG Oral
azaTHIOprine Tablet 50 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
azaTHIOprine Tablet 50 MG Oral
azaTHIOprine Tablet 50 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
azaTHIOprine Tablet 50 MG Oral
azaTHIOprine Tablet 50 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
azaTHIOprine Tablet 50 MG Oral
azaTHIOprine Tablet 50 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
azaTHIOprine Tablet 50 MG Oral
azaTHIOprine Tablet 50 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
azaTHIOprine Tablet 50 MG Oral
azaTHIOprine Tablet 50 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N
azaTHIOprine Tablet 50 MG Oral
azaTHIOprine Tablet 50 MG Oral

Tier: 1
PA Type: No Prior Authorization
ST: N