Ammonia Detoxicants
Showing 13–15 of 15 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
|---|---|---|---|---|---|
|
Sodium Phenylbutyrate Powd 3Gm/Tsp (Generic) |
Ammonia Detoxicants |
3 |
Non-Formulary Brand |
$68 |
|
|
Sodium Phenylbutyrate Tabs 500Mg (Generic) |
Ammonia Detoxicants |
3 |
Non-Formulary Brand |
$68 |
|
|
Carglumic Acid Tabs 200Mg (Generic) |
Ammonia Detoxicants |
3 |
Non-Formulary Brand |
$68 |
|
|
Carbaglu Tabs 200Mg (Brand) |
Ammonia Detoxicants |
1 |
Generic |
$14 |
|
|
Lactulose Soln 10Gm/15Ml (Generic) |
Ammonia Detoxicants |
3 |
Non-Formulary Brand |
$68 |
|
|
Lactulose (Encephalopathy) Soln 10Gm/15Ml (Generic) |
Ammonia Detoxicants |
3 |
Non-Formulary Brand |
$68 |
|
|
Lactulose Pack 10Gm (Generic) |
Ammonia Detoxicants |
3 |
Non-Formulary Brand |
$68 |
|
|
Lactulose Pack 20Gm (Generic) |
Ammonia Detoxicants |
3 |
Non-Formulary Brand |
$68 |
|
|
Generlac Soln 10 Gm/15Ml (Brand) |
Ammonia Detoxicants |
1 |
Generic |
$14 |
|
|
Kristalose Pack 10 Gm (Brand) |
Ammonia Detoxicants |
1 |
Generic |
$14 |
|
|
Constulose Soln 10 Gm/15Ml (Brand) |
Ammonia Detoxicants |
1 |
Generic |
$14 |
|
|
Acetohydroxamic Acid Tabs 250Mg (Generic) |
Ammonia Detoxicants |
3 |
Non-Formulary Brand |
$68 |
|
|
Glycerol Phenylbutyrate Liqd 1.1Gm/Ml (Generic) |
Ammonia Detoxicants |
3 |
Non-Formulary Brand |
$68 |
|
|
Buphenyl Powd 3 Gm/Tsp (Brand) |
Ammonia Detoxicants |
1 |
Generic |
$14 |
|
|
Buphenyl Tabs 500 Mg (Brand) |
Ammonia Detoxicants |
1 |
Generic |
$14 |