Respiratory Agents, Miscellaneous
Showing 13–24 of 48 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
---|---|---|---|---|---|
Prolastin-C Soln 1000 Mg/20Ml (Brand) |
Respiratory Agents, Miscellaneous |
MA |
Administered in Medical Office |
N/A |
|
Glassia Soln 1000 Mg/50Ml (Brand) |
Respiratory Agents, Miscellaneous |
MA |
Administered in Medical Office |
N/A |
|
Aralast Np Solr 1000 Mg (Brand) |
Respiratory Agents, Miscellaneous |
MA |
Administered in Medical Office |
N/A |
|
Prolastin-C Solr 1000 Mg (Brand) |
Respiratory Agents, Miscellaneous |
MA |
Administered in Medical Office |
N/A |
|
Zemaira Solr 1000 Mg (Brand) |
Respiratory Agents, Miscellaneous |
MA |
Administered in Medical Office |
N/A |
|
Aralast Np Solr 500 Mg (Brand) |
Respiratory Agents, Miscellaneous |
MA |
Administered in Medical Office |
N/A |
|
Ciclesonide Aers 160Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
2 |
Formulary Brand |
$38 |
|
Ciclesonide Aers 80Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
2 |
Formulary Brand |
$38 |
|
Fluticasone Propionate (Inhalation) Aepb 113Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Fluticasone Propionate (Inhalation) Aepb 232Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Fluticasone Propionate (Inhalation) Aepb 55Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Fluticasone Furoate (Inhalation) Aepb 100Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Fluticasone Furoate (Inhalation) Aepb 200Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Fluticasone Furoate (Inhalation) Aepb 50Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Mometasone Furoate (Inhalation) Aepb 220Mcg/Inh (Generic) |
Respiratory Agents, Miscellaneous |
2 |
Formulary Brand |
$38 |
|
Mometasone Furoate (Inhalation) Aepb 110Mcg/Inh (Generic) |
Respiratory Agents, Miscellaneous |
2 |
Formulary Brand |
$38 |
|
Mometasone Furoate (Inhalation) Aepb 220Mcg/Inh (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Mometasone Furoate (Inhalation) Aepb 220Mcg/Inh (Generic) |
Respiratory Agents, Miscellaneous |
2 |
Formulary Brand |
$38 |
|
Mometasone Furoate (Inhalation) Aero 100Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
2 |
Formulary Brand |
$38 |
|
Mometasone Furoate (Inhalation) Aero 200Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
2 |
Formulary Brand |
$38 |
|
Budesonide-Glycopyrrolate-Formoterol Fumarate Aero 160-9-4.8 Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Pulmicort Susp 0.25 Mg/2Ml (Brand) |
Respiratory Agents, Miscellaneous |
1 |
Generic |
$14 |
|
Pulmicort Susp 0.5 Mg/2Ml (Brand) |
Respiratory Agents, Miscellaneous |
1 |
Generic |
$14 |
|
Pulmicort Susp 1 Mg/2Ml (Brand) |
Respiratory Agents, Miscellaneous |
1 |
Generic |
$14 |
|
Roflumilast Tabs 250Mcg (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Roflumilast Tabs 500Mcg (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Mometasone Furoate-Formoterol Fumarate Dihydrate Aero (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Mometasone Furoate-Formoterol Fumarate Dihydrate Aero (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Fluticasone Propionate (Inhalation) Aepb 100Mcg/Blist (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Fluticasone Propionate (Inhalation) Aepb 250Mcg/Blist (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Fluticasone Propionate (Inhalation) Aepb 50Mcg/Blist (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Fluticasone Propionate Hfa Aero 110Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
2 |
Formulary Brand |
$38 |
|
Fluticasone Propionate Hfa Aero 220Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
Fluticasone Propionate Hfa Aero 44Mcg/Act (Generic) |
Respiratory Agents, Miscellaneous |
2 |
Formulary Brand |
$38 |
|
Xolair Solr 150 Mg (Brand) |
Respiratory Agents, Miscellaneous |
MA |
Administered in Medical Office |
N/A |