Antivirals
Showing 1–12 of 250 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
|---|---|---|---|---|---|
|
Retrovir Syrp 50 Mg/5Ml (Brand) |
Antivirals |
1 |
Generic |
$14 |
|
|
No Brand Option Available |
Antivirals |
1 |
Generic |
$14 |
|
|
Acyclovir Caps 200Mg (Generic) |
Antivirals |
3 |
Non-Formulary Brand |
$68 |
|
|
Acyclovir Susp 200Mg/5Ml (Generic) |
Antivirals |
3 |
Non-Formulary Brand |
$68 |
|
|
Acyclovir Tabs 800Mg (Generic) |
Antivirals |
3 |
Non-Formulary Brand |
$68 |