All *OXYTOCICS*

Carboprost Tromethamine Solution 250 MCG/ML Intramuscular
Carboprost Tromethamine Solution 250 MCG/ML Intramuscular

Tier: 1
PA Type: No Prior Authorization
ST: N
Carboprost Tromethamine Solution 250 MCG/ML Intramuscular
Carboprost Tromethamine Solution 250 MCG/ML Intramuscular

Tier: 1
PA Type: No Prior Authorization
ST: N
Carboprost Tromethamine Solution 250 MCG/ML Intramuscular
Carboprost Tromethamine Solution 250 MCG/ML Intramuscular

Tier: 1
PA Type: No Prior Authorization
ST: N
Carboprost Tromethamine Solution 250 MCG/ML Intramuscular
Carboprost Tromethamine Solution 250 MCG/ML Intramuscular

Tier: 1
PA Type: No Prior Authorization
ST: N
Carboprost Tromethamine Solution 250 MCG/ML Intramuscular
Carboprost Tromethamine Solution 250 MCG/ML Intramuscular

Tier: 1
PA Type: No Prior Authorization
ST: N
Carboprost Tromethamine Solution 250 MCG/ML Intramuscular
Carboprost Tromethamine Solution 250 MCG/ML Intramuscular

Tier: 1
PA Type: No Prior Authorization
ST: N
Cervidil Insert 10 MG Vaginal
Cervidil Insert 10 MG Vaginal

Dinoprostone

Tier: 3
PA Type: No Prior Authorization
ST: N
Hemabate Solution 250 MCG/ML Intramuscular
Hemabate Solution 250 MCG/ML Intramuscular

Carboprost Tromethamine

Tier: 3
PA Type: No Prior Authorization
ST: N
Hemabate Solution 250 MCG/ML Intramuscular
Hemabate Solution 250 MCG/ML Intramuscular

Carboprost Tromethamine

Tier: 3
PA Type: No Prior Authorization
ST: N
Methergine Tablet 0.2 MG Oral
Methergine Tablet 0.2 MG Oral

Methylergonovine Maleate

Tier: 1
PA Type: No Prior Authorization
ST: N
Methergine Tablet 0.2 MG Oral
Methergine Tablet 0.2 MG Oral

Methylergonovine Maleate

Tier: 1
PA Type: No Prior Authorization
ST: N
Methylergonovine Maleate SOLUTION 0.2 MG/ML Injection
Methylergonovine Maleate SOLUTION 0.2 MG/ML Injection

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