All *VASOPRESSORS*

Adrenalin Solution 1 MG/ML Injection
Adrenalin Solution 1 MG/ML Injection

EPINEPHrine (Anaphylaxis)

Tier: 3
PA Type: No Prior Authorization
ST: N
Adrenalin Solution 1 MG/ML Injection
Adrenalin Solution 1 MG/ML Injection

EPINEPHrine (Anaphylaxis)

Tier: 3
PA Type: No Prior Authorization
ST: N
Adrenalin Solution 30 MG/30ML Injection
Adrenalin Solution 30 MG/30ML Injection

EPINEPHrine (Anaphylaxis)

Tier: 3
PA Type: No Prior Authorization
ST: N
Adrenalin Solution 30 MG/30ML Injection
Adrenalin Solution 30 MG/30ML Injection

EPINEPHrine (Anaphylaxis)

Tier: 3
PA Type: No Prior Authorization
ST: N
Adrenalin Solution 30 MG/30ML Injection
Adrenalin Solution 30 MG/30ML Injection

EPINEPHrine (Anaphylaxis)

Tier: 3
PA Type: No Prior Authorization
ST: N
Adyphren Amp II Kit 1 MG/ML Injection
Adyphren Amp II Kit 1 MG/ML Injection

EPINEPHrine

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adyphren Amp Kit 1 MG/ML Injection
Adyphren Amp Kit 1 MG/ML Injection

EPINEPHrine

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adyphren II Kit 1 MG/ML Injection
Adyphren II Kit 1 MG/ML Injection

EPINEPHrine

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Adyphren Kit 1 MG/ML Injection
Adyphren Kit 1 MG/ML Injection

EPINEPHrine

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Akovaz Solution 50 MG/ML Intravenous
Akovaz Solution 50 MG/ML Intravenous

ePHEDrine Sulfate

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Akovaz Solution 50 MG/ML Intravenous
Akovaz Solution 50 MG/ML Intravenous

ePHEDrine Sulfate

Tier: Non-Formulary
PA Type: No Prior Authorization
ST: N
Auvi-Q Solution Auto-Injector 0.1 MG/0.1ML Injection
Auvi-Q Solution Auto-Injector 0.1 MG/0.1ML Injection

EPINEPHrine

Tier: 3
PA Type: No Prior Authorization
ST: N