Antidotes
Showing all 10 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
|---|---|---|---|---|---|
|
No Brand Option Available |
Antidotes |
1 |
Generic |
$14 |
|
|
No Brand Option Available |
Antidotes |
1 |
Generic |
$14 |
|
|
Voraxaze Solr 1000 Unit (Brand) |
Antidotes |
MA |
Administered in Medical Office |
N/A |
|
|
No Brand Option Available |
Antidotes |
1 |
Generic |
$14 |
|
|
No Brand Option Available |
Antidotes |
1 |
Generic |
$14 |
|
|
No Brand Option Available |
Antidotes |
1 |
Generic |
$14 |
|
|
No Brand Option Available |
Antidotes |
1 |
Generic |
$14 |
|
|
Khapzory Solr 175 Mg (Brand) |
Antidotes |
MA |
Administered in Medical Office |
N/A |
|
|
Khapzory Solr 300 Mg (Brand) |
Antidotes |
MA |
Administered in Medical Office |
N/A |
|
|
Uridine Triacetate (Emergency Treatment) Pack 10Gm (Generic) |
Antidotes |
3 |
Non-Formulary Brand |
$68 |