Immune Suppressants
Showing 1–12 of 81 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
|---|---|---|---|---|---|
|
Tacrolimus Cp24 .5Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Tacrolimus Cp24 1Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Tacrolimus Cp24 5Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Azathioprine Tabs 100Mg (Generic) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Azathioprine Tabs 75Mg (Generic) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Azasan Tabs 100Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Imuran Tabs 50 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Azasan Tabs 75Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Nulojix Solr 250 Mg (Brand) |
Immune Suppressants |
MA |
Administered in Medical Office |
N/A |
|
|
Benlysta Solr 120 Mg (Brand) |
Immune Suppressants |
MA |
Administered in Medical Office |
N/A |
|
|
Benlysta Solr 400 Mg (Brand) |
Immune Suppressants |
MA |
Administered in Medical Office |
N/A |
|
|
Belimumab Soaj 200Mg/Ml (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Belimumab Sosy 200Mg/Ml (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Mycophenolate Mofetil Caps 250Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Mycophenolate Mofetil Tabs 500Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Sandimmune Caps 100 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Sandimmune Caps 25 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Gengraf Caps 100 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Neoral Caps 100 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Neoral Caps 25 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Gengraf Caps 25 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
No Brand Option Available |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
No Brand Option Available |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Gengraf Soln 100 Mg/Ml (Brand |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Neoral Soln 100 Mg/Ml (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Sandimmune Soln 50 Mg/Ml (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Gamifant Soln 10 Mg/2Ml (Brand) |
Immune Suppressants |
MA |
Administered in Medical Office |
N/A |
|
|
Gamifant Soln 50 Mg/10Ml (Brand) |
Immune Suppressants |
MA |
Administered in Medical Office |
N/A |
|
|
Tacrolimus Tb24 .75Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Tacrolimus Tb24 1Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Tacrolimus Tb24 4Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Zortress Tabs 0.25 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Zortress Tabs 0.5 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Zortress Tabs 0.75 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Zortress Tabs 1Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |