Gonadotropins
Showing all 7 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
---|---|---|---|---|---|
Novarel Solr 10000 Unit (Brand) |
Gonadotropins |
1 |
Generic |
$14 |
|
Chorionic Gonadotropin Solr 10000Unit (Generic) |
Gonadotropins |
3 |
Non-Formulary Brand |
$68 |
|
Chorionic Gonadotropin Solr 5000Unit (Generic) |
Gonadotropins |
3 |
Non-Formulary Brand |
$68 |
|
Elagolix Sodium Tabs 150Mg (Generic) |
Gonadotropins |
3 |
Non-Formulary Brand |
$68 |
|
Elagolix Sodium Tabs 200Mg (Generic) |
Gonadotropins |
3 |
Non-Formulary Brand |
$68 |
|
Chorionic Gonadotropin Solr 10000Unit (Generic) |
Gonadotropins |
3 |
Non-Formulary Brand |
$68 |
|
Triptodur Srer 22.5 Mg (Brand) |
Gonadotropins |
MA |
Administered in Medical Office |
N/A |