Immune Suppressants
Showing 1–12 of 81 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
|---|---|---|---|---|---|
|
Azathioprine Tabs 50Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Voclosporin Caps 7.9 Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Cladribine (Multiple Sclerosis) Tbpk 10Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Cladribine (Multiple Sclerosis) Tbpk 10Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Cladribine (Multiple Sclerosis) Tbpk 10Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Cladribine (Multiple Sclerosis) Tbpk 10Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Cladribine (Multiple Sclerosis) Tbpk 10Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Cladribine (Multiple Sclerosis) Tbpk 10Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Cladribine (Multiple Sclerosis) Tbpk 10Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Cellcept Caps 250 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Cellcept Susr 200 Mg/Ml (Brand) |
Immune Suppressants |
MA |
Administered in Medical Office |
N/A |
|
|
Mycophenolate Mofetil Susr 200 Mg/Ml (Brand) |
Immune Suppressants |
MA |
Administered in Medical Office |
N/A |
|
|
Cellcept Tabs 500 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Myfortic Tbec 180 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Myfortic Tbec 360 Mg (Brand) |
Immune Suppressants |
1 |
Generic |
$14 |
|
|
Mycophenolate Sodium Tbec 180Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Mycophenolate Sodium Tbec 360Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Cyclosporine Modified (For Microemulsion) Caps 100Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Cyclosporine Modified (For Microemulsion) Caps 25Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Cyclosporine Modified (For Microemulsion) Soln 100Mg/Ml (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Tacrolimus Caps .5Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Tacrolimus Caps 1Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Tacrolimus Caps 5Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Tacrolimus Pack .2Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Tacrolimus Pack 1Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Tacrolimus Soln 5Mg/Ml (Generic) |
Immune Suppressants |
2 |
Formulary Brand |
$38 |
|
|
Sirolimus Soln 1Mg/Ml (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Sirolimus Tabs .5Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Sirolimus Tabs 1Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Sirolimus Tabs 2Mg (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
BELUMOSUDIL MESYLATE TABS 200 MG (Generic) |
Immune Suppressants |
3 |
Non-Formulary Brand |
$68 |
|
|
Cyclosporine Caps 100Mg (Generic) |
Immune Suppressants |
2 |
Formulary Brand |
$38 |
|
|
Cyclosporine Caps 25Mg (Generic) |
Immune Suppressants |
2 |
Formulary Brand |
$38 |
|
|
Cyclosporine Soln 100Mg/Ml (Generic) |
Immune Suppressants |
2 |
Formulary Brand |
$38 |
|
|
Cyclosporine Soln 50Mg/Ml (Generic) |
Immune Suppressants |
2 |
Formulary Brand |
$38 |