Enzymes

Showing 1–12 of 48 results

NAME	ALSO KNOW AS	DRUG CATEGORY	FORMULARY CATEGORY	WHAT WE COVER	COST SHARE
Agalsidase Beta Solr 35Mg (Generic)	Fabrazyme Solr 35 Mg (Brand)	Enzymes	MA	Administered in Medical Office	N/A
Agalsidase Beta Solr 5Mg (Generic)	Fabrazyme Solr 5 Mg (Brand)	Enzymes	MA	Administered in Medical Office	N/A
Aldurazyme Soln 2.9 Mg/5Ml (Brand)	Laronidase Soln 2.9Mg/5Ml (Generic)	Enzymes	2	Formulary Brand	$38
Alglucosidase Alfa Solr 50Mg (Generic)	Lumizyme Solr 50 Mg (Brand)	Enzymes	MA	Administered in Medical Office	N/A
Bronchitol Inhal Caps 40 Mg (Brand)	Mannitol Inhalation Caps 40Mg (Generic)	Enzymes	3	Non-Formulary Brand	$68
Cerdelga Caps 84 Mg (Brand)	Eliglustat Tartrate Caps 84Mg (Generic)	Enzymes	3	Non-Formulary Brand	$68
Creon Cpep 12000 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	2	Formulary Brand	$38
Creon Cpep 24000-76000 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	2	Formulary Brand	$38
Creon Cpep 3000-9500 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	2	Formulary Brand	$38
Creon Cpep 36000 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	2	Formulary Brand	$38
Creon Cpep 6000 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	2	Formulary Brand	$38
Docetaxel Soln 80Mg/4Ml (Generic)	Docetaxel (Non-Alcohol) Soln 80 Mg/4Ml (Brand)	Enzymes	MA	Administered in Medical Office	N/A
Elapegademase-Lvlr Soln 2.4Mg/1.5Ml (Generic)	Revcovi Soln 2.4 Mg/1.5Ml (Brand)	Enzymes	MA	Administered in Medical Office	N/A
Elosulfase Alfa Soln 5Mg/5Ml (Generic)	Vimizim Soln 5 Mg/5Ml (Brand)	Enzymes	MA	Administered in Medical Office	N/A
Idursulfase Soln 6Mg/3Ml (Generic)	Elaprase Soln 6 Mg/3Ml (Brand)	Enzymes	MA	Administered in Medical Office	N/A
Imiglucerase Solr 400Unit (Generic)	Cerezyme Solr 400 Unit (Brand)	Enzymes	MA	Administered in Medical Office	N/A
Miglustat Caps 100Mg (Generic)	Zavesca Caps 100 Mg (Brand)	Enzymes	1	Generic	$14
Naglazyme Soln 1 Mg/Ml (Brand)	Galsulfase Soln 1Mg/Ml (Generic)	Enzymes	3	Non-Formulary Brand	$68
Palynziq Sosy 2.5 Mg/0.5Ml (Brand)	Pegvaliase-Pqpz Sosy 2.5Mg/0.5Ml (Generic)	Enzymes	3	Non-Formulary Brand	$68
Pancreaze Cpep 10500 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	3	Non-Formulary Brand	$68
Pancreaze Cpep 16800 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	3	Non-Formulary Brand	$68
Pancreaze Cpep 21000 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	3	Non-Formulary Brand	$68
Pancreaze Cpep 2600 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	3	Non-Formulary Brand	$68
Pancreaze Cpep 4200 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	3	Non-Formulary Brand	$68
Pegademase Bovine Soln 250Unit/Ml (Generic)	Adagen Soln 250 Unit/Ml (Brand)	Enzymes	MA	Administered in Medical Office	N/A
Pertzye Cpep 16000 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	3	Non-Formulary Brand	$68
Pertzye Cpep 4000 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	3	Non-Formulary Brand	$68
Pertzye Cpep 8000 Unit (Brand)	Pancrelipase (Lipase-Protease-Amylase) Cpep (Generic)	Enzymes	3	Non-Formulary Brand	$68
Pulmozyme Soln 1 Mg/Ml (Brand)	Dornase Alfa Soln 1Mg/Ml (Generic)	Enzymes	3	Non-Formulary Brand	$68
Rasburicase Solr 1.5Mg (Generic)	Elitek Solr 1.5 Mg (Brand)	Enzymes	MA	Administered in Medical Office	N/A
Sebelipase Alfa Soln 20Mg/10Ml (Generic)	Kanuma Soln 20 Mg/10Ml (Brand)	Enzymes	MA	Administered in Medical Office	N/A
Strensiq Soln 18 Mg/0.45Ml (Brand)	Asfotase Alfa Soln 18Mg/0.45Ml (Generic)	Enzymes	3	Non-Formulary Brand	$68
Strensiq Soln 28 Mg/0.7Ml (Brand)	Asfotase Alfa Soln 28Mg/0.7Ml (Generic)	Enzymes	3	Non-Formulary Brand	$68
Strensiq Soln 40 Mg/Ml (Brand)	Asfotase Alfa Soln 40Mg/Ml (Generic)	Enzymes	3	Non-Formulary Brand	$68
Strensiq Soln 80 Mg/0.8Ml (Brand)	Asfotase Alfa Soln 80Mg/0.8Ml (Generic)	Enzymes	3	Non-Formulary Brand	$68

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