Central Nervous System Agents, Miscellaneous
Showing 1–12 of 67 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
|---|---|---|---|---|---|
|
Strattera Caps 100 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Strattera Caps 10 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Strattera Caps 18 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Strattera Caps 25 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Strattera Caps 40 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Strattera Caps 60 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Strattera Caps 80 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Deutetrabenazine Tabs 12Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Deutetrabenazine Tabs 6Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Deutetrabenazine Tabs 9Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Intuniv Tb24 1 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Intuniv Tb24 2 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Intuniv Tb24 3 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Intuniv Tb24 4 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Valbenazine Tosylate Caps 40Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Valbenazine Tosylate Caps 80Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Valbenazine Tosylate Cppk (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Guanfacine Hcl (Adhd) Tb24 1Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Guanfacine Hcl (Adhd) Tb24 2Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Guanfacine Hcl (Adhd) Tb24 3Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Guanfacine Hcl (Adhd) Tb24 4Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Namenda Xr Cp24 14 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Namenda Xr Cp24 21 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Namenda Xr Cp24 28 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Namenda Xr Cp24 7 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
No Brand Option Available |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Namenda Titration Pak Tabs 28 X 5 Mg & 21 X 10 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Namenda Tabs 10 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Namenda Tabs 5 Mg (Brand) |
Central Nervous System Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Memantine Hcl Tabs 10Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Memantine Hcl Tabs 5Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Memantine Hcl Tabs (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Memantine Hcl Cp24 14Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Memantine Hcl Cp24 21Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Memantine Hcl Cp24 28Mg (Generic) |
Central Nervous System Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |