Antimycobacterials
Showing 1–12 of 22 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
---|---|---|---|---|---|
Capastat Sulfate Solr 1 Gm (Brand) |
Antimycobacterials |
MA |
Administered in Medical Office |
N/A |
|
No Brand Option Available |
Antimycobacterials |
1 |
Generic |
$14 |
|
No Brand Option Available |
Antimycobacterials |
1 |
Generic |
$14 |
|
No Brand Option Available |
Antimycobacterials |
1 |
Generic |
$14 |
|
Myambutol Tabs 400 Mg (Brand) |
Antimycobacterials |
1 |
Generic |
$14 |
|
No Brand Option Available |
Antimycobacterials |
1 |
Generic |
$14 |
|
No Brand Option Available |
Antimycobacterials |
1 |
Generic |
$14 |
|
No Brand Option Available |
Antimycobacterials |
1 |
Generic |
$14 |
|
Ethambutol Hcl Tabs 400Mg (Generic) |
Antimycobacterials |
3 |
Non-Formulary Brand |
$68 |
|
Rifabutin Caps 150Mg (Generic) |
Antimycobacterials |
3 |
Non-Formulary Brand |
$68 |
|
Aminosalicylic Acid Pack 4Gm (Generic) |
Antimycobacterials |
3 |
Non-Formulary Brand |
$68 |
|
Rifapentine Tabs 150Mg (Generic) |
Antimycobacterials |
3 |
Non-Formulary Brand |
$68 |
|
No Brand Option Available |
Antimycobacterials |
1 |
Generic |
$14 |
|
Mycobutin Caps 150 Mg (Brand) |
Antimycobacterials |
1 |
Generic |
$14 |
|
Rifampin Caps 150Mg (Generic) |
Antimycobacterials |
3 |
Non-Formulary Brand |
$68 |
|
Isoniazid & Rifampin Caps (Generic) |
Antimycobacterials |
3 |
Non-Formulary Brand |
$68 |
|
Rifadin Caps 150 Mg (Brand) |
Antimycobacterials |
1 |
Generic |
$14 |
|
No Brand Option Available |
Antimycobacterials |
1 |
Generic |
$14 |
|
No Brand Option Available |
Antimycobacterials |
1 |
Generic |
$14 |
|
Isoniazid-Rifampin W/ Pyrazinamide Tabs (Generic) |
Antimycobacterials |
3 |
Non-Formulary Brand |
$68 |
|
Bedaquiline Fumarate Tabs 100Mg (Generic) |
Antimycobacterials |
3 |
Non-Formulary Brand |
$68 |
|
Ethionamide Tabs 250Mg (Generic) |
Antimycobacterials |
3 |
Non-Formulary Brand |
$68 |