Skin And Mucous Membrane Agents, Miscellaneous
Showing 1–12 of 125 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
|---|---|---|---|---|---|
|
Adapalene Lotn .1% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Calcipotriene Crea .005% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Dupilumab Sosy 200Mg/1.14Ml (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Dupilumab Sosy 300Mg/2Ml (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Fluorouracil (Topical) Crea 5% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Pimecrolimus Crea 1% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Adapalene-Benzoyl Peroxide Gel (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Adapalene-Benzoyl Peroxide Gel (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Tazarotene (Acne) Foam .1% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Azelaic Acid Foam 15% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Azelaic Acid Gel 15% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Fluorouracil (Topical) Crea 1% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Carac Crea 0.5 % (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Efudex Crea 5 % (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
No Brand Option Available |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
No Brand Option Available |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Tildrakizumab-Asmn Sosy 100Mg/Ml (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Zyclara Pump Crea 3.75 % (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Aldara Crea 5 % (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Claravis Caps 10 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Absorica Caps 10 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Myorisan Caps 10 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Zenatane Caps 10 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Amnesteem Caps 10 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Claravis Caps 20 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Absorica Caps 20 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Myorisan Caps 20 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Zenatane Caps 20 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Amnesteem Caps 20 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Isotretinoin Caps 25Mg (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Absorica Caps 30 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Myorisan Caps 30 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Zenatane Caps 30 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Claravis Caps 30 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Isotretinoin Caps 35Mg (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |