Anti-Infectives
Showing 25–36 of 39 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
---|---|---|---|---|---|
Moxifloxacin Hcl (Ophth) Soln .5% (Generic) |
Anti-Infectives |
3 |
Non-Formulary Brand |
$68 |
|
Trifluridine Soln 1% (Generic) |
Anti-Infectives |
3 |
Non-Formulary Brand |
$68 |
|
Ganciclovir Ophthalmic Gel .15% (Generic) |
Anti-Infectives |
3 |
Non-Formulary Brand |
$68 |
|
Gatifloxacin (Ophth) Soln .5% (Generic) |
Anti-Infectives |
3 |
Non-Formulary Brand |
$68 |