Cathartics And Laxatives

Showing 1–12 of 18 results

NAME	ALSO KNOW AS	DRUG CATEGORY	FORMULARY CATEGORY	WHAT WE COVER	COST SHARE
Clenpiq Soln 10-3.5-12 Mg-Gm -Gm/160Ml (Brand)	Sodium Picosulfate-Magnesium Oxide-Anhydrous Citric Acid Soln (Generic)	Cathartics And Laxatives	3	Non-Formulary Brand	$68
Colyte With Flavor Packs Solr 240 Gm (Brand)	Peg 3350-Kcl-Sod Bicarb-Sod Chloride-Sod Sulfate Solr (Generic)	Cathartics And Laxatives	3	Non-Formulary Brand	$68
Gavilyte-C Solr 240 Gm (Brand)	Peg 3350-Kcl-Sod Bicarb-Sod Chloride-Sod Sulfate Solr (Generic)	Cathartics And Laxatives	3	Non-Formulary Brand	$68
Golytely Solr 227.1 Gm (Brand)	Peg 3350-Kcl-Sod Bicarb-Sod Chloride-Sod Sulfate Solr (Generic)	Cathartics And Laxatives	3	Non-Formulary Brand	$68
Golytely Solr 236 Gm (Brand)	Peg 3350-Kcl-Sod Bicarb-Sod Chloride-Sod Sulfate Solr (Generic)	Cathartics And Laxatives	3	Non-Formulary Brand	$68
Moviprep Solr 100 Gm (Brand)	Peg 3350-Kcl-Nacl-Na Sulfate-Na Ascorbate-Ascorbic Acid Solr (Generic)	Cathartics And Laxatives	3	Non-Formulary Brand	$68
Nulytely With Flavor Packs Solr 420 Gm (Brand)	Peg 3350-Potassium Chloride-Sod Bicarbonate-Sod Chloride Solr (Generic)	Cathartics And Laxatives	3	Non-Formulary Brand	$68
Osmoprep Tabs 1.102-0.398 Gm (Brand)	Sodium Phosphate Monobasic-Sodium Phosphate Dibasic Tabs (Generic)	Cathartics And Laxatives	3	Non-Formulary Brand	$68
Peg 3350-Kcl-Sod Bicarb-Sod Chloride-Sod Sulfate Solr (Generic)	Peg-3350/Electrolytes Solr 236 Gm (Brand)	Cathartics And Laxatives	1	Generic	$14
Peg 3350-Kcl-Sod Bicarb-Sod Chloride-Sod Sulfate Solr (Generic)	Peg 3350/Electrolytes Solr 240 Gm	Cathartics And Laxatives	1	Generic	$14
Peg 3350-Kcl-Sod Bicarb-Sod Chloride-Sod Sulfate Solr (Generic)	Gavilyte-G Solr 236 Gm (Brand)	Cathartics And Laxatives	1	Generic	$14
Peg 3350-Potassium Chloride-Sod Bicarbonate-Sod Chloride Solr (Generic)	Gavilyte-N With Flavor Pack Solr 420 Gm	Cathartics And Laxatives	1	Generic	$14
Peg 3350-Potassium Chloride-Sod Bicarbonate-Sod Chloride Solr (Generic)	Trilyte Solr 420 Gm	Cathartics And Laxatives	1	Generic	$14
Peg 3350-Potassium Chloride-Sod Bicarbonate-Sod Chloride Solr (Generic)	Peg 3350-Kcl-Na Bicarb-Nacl Solr 420 Gm	Cathartics And Laxatives	1	Generic	$14
Plenvu Solr 140 Gm (Brand)	Peg 3350-Kcl-Nacl-Na Sulfate-Na Ascorbate-Ascorbic Acid Solr (Generic)	Cathartics And Laxatives	3	Non-Formulary Brand	$68
Polyethylene Glycol 3350 Powd (Generic)	Polyethylene Glycol 3350 Powd (Brand)	Cathartics And Laxatives	MA	Administered in Medical Office	N/A
Prepopik Pack 10-3.5-12 Mg-Gm-Gm (Brand)	Sodium Picosulfate-Magnesium Oxide-Anhydrous Citric Acid Pack (Generic)	Cathartics And Laxatives	3	Non-Formulary Brand	$68
Suprep Bowel Prep Kit Soln 17.5-3.13-1.6 Gm/177Ml (Brand)	Sodium Sulfate-Potassium Sulfate-Magnesium Sulfate Soln (Generic)	Cathartics And Laxatives	3	Non-Formulary Brand	$68