Adrenals

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NAME
ALSO KNOW AS
DRUG CATEGORY
FORMULARY CATEGORY
WHAT WE COVER
COST SHARE
Alkindi Sprinkle Caps 0.5Mg (Brand)

Hydrocortisone Sprinkle Caps 0.5Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Alkindi Sprinkle Caps 1Mg (Brand)

Hydrocortisone Sprinkle Caps 1Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Alkindi Sprinkle Caps 2Mg (Brand)

Hydrocortisone Sprinkle Caps 2Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Alkindi Sprinkle Caps 5Mg (Brand)

Hydrocortisone Sprinkle Caps 5Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Breo Ellipta Aepb 100-25 Mcg/Inh (Brand)

Fluticasone Furoate-Vilanterol Aepb (Generic)
Adrenals
3
Non-Formulary Brand
$68
Breo Ellipta Aepb 200-25 Mcg/Inh (Brand)

Fluticasone Furoate-Vilanterol Aepb (Generic)
Adrenals
3
Non-Formulary Brand
$68
Budesonide Cpep 3Mg (Generic)

Entocort Ec Cpep 3 Mg (Brand)
Adrenals
1
Generic
$14
Budesonide Tb24 9Mg (Generic)

Uceris Tb24 9 Mg (Brand)
Adrenals
1
Generic
$14
Cortef Tabs 10 Mg (Brand)

Hydrocortisone Tabs 10Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Cortef Tabs 20 Mg (Brand)

Hydrocortisone Tabs 20Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Cortef Tabs 5 Mg (Brand)

Hydrocortisone Tabs 5Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Cortisone Acetate Tabs 25Mg (Generic)

No Brand Option Available
Adrenals
1
Generic
$14
Decadron Tabs 6 Mg (Brand)

Dexamethasone Tabs 6Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Dexamethasone Conc 1Mg/Ml (Generic)

No Brand Option Available
Adrenals
1
Generic
$14
Dexamethasone Elix .5Mg/5Ml (Generic)

No Brand Option Available
Adrenals
1
Generic
$14
Dexamethasone Tabs .5Mg (Generic)

No Brand Option Available
Adrenals
1
Generic
$14
Dexamethasone Tabs .75Mg (Generic)

No Brand Option Available
Adrenals
1
Generic
$14
Dexamethasone Tabs 1.5Mg (Generic)

No Brand Option Available
Adrenals
1
Generic
$14
Dexamethasone Tabs 1Mg (Generic)

No Brand Option Available
Adrenals
1
Generic
$14
Dexamethasone Tabs 2Mg (Generic)

No Brand Option Available
Adrenals
1
Generic
$14
Dexamethasone Tabs 4Mg (Generic)

Decadron Tabs 4 Mg (Brand)
Adrenals
1
Generic
$14
Dexamethasone Tabs 6Mg (Generic)

Decadron Tabs 6 Mg (Brand)
Adrenals
1
Generic
$14
Dexamethasone Tbpk 1.5Mg (21) (Generic)

Taperdex 6-Day Tbpk 1.5 Mg (21) (Brand)
Adrenals
1
Generic
$14
Dexamethasone Tbpk 1.5Mg (35) (Generic)

No Brand Option Available
Adrenals
1
Generic
$14
Dexamethasone Tbpk 1.5Mg (51) (Generic)

Dexpak 13 Day Tbpk 1.5 Mg (51) (Brand)
Adrenals
1
Generic
$14
Dexpak 13 Day Tbpk 1.5 Mg (51) (Brand)

Dexamethasone Tbpk 1.5Mg (51) (Generic)
Adrenals
3
Non-Formulary Brand
$68
Emflaza Susp 22.75 Mg/Ml (Brand)

Deflazacort Susp 22.75Mg/Ml (Generic)
Adrenals
3
Non-Formulary Brand
$68
Emflaza Tabs 18 Mg (Brand)

Deflazacort Tabs 18Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Emflaza Tabs 30 Mg (Brand)

Deflazacort Tabs 30Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Emflaza Tabs 36 Mg (Brand)

Deflazacort Tabs 36Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Emflaza Tabs 6 Mg (Brand)

Deflazacort Tabs 6Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Entocort Ec Cpep 3 Mg (Brand)

Budesonide Cpep 3Mg (Generic)
Adrenals
3
Non-Formulary Brand
$68
Fludrocortisone Acetate Tabs .1Mg (Generic)

No Brand Option Available
Adrenals
1
Generic
$14
Hydrocortisone Sod Succinate Solr 1000Mg (Generic)

Solu-Cortef Solr 1000 Mg (Brand)
Adrenals
MA
Administered in Medical Office
N/A
Hydrocortisone Sod Succinate Solr 100Mg (Generic)

Solu-Cortef Solr 100 Mg (Brand)
Adrenals
MA
Administered in Medical Office
N/A
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