Antimycobacterials

Showing 1–12 of 22 results

Filters Sort 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