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 |
|---|---|---|---|---|---|
|
Claravis Caps 40 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Absorica Caps 40 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Myorisan Caps 40 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Zenatane Caps 40 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Amnesteem Caps 40 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Tirbanibulin Ointment 1% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
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 |
|
|
Oxsoralen Ultra Caps 10 Mg (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Brimonidine Tartrate (Topical) Gel .33% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Doxycycline (Rosacea) Cpdr 40Mg (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Methoxsalen Rapid Caps 10Mg (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Ingenol Mebutate Gel .015% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Ingenol Mebutate Gel .05% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Elidel Crea 1 % (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
No Brand Option Available |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Tacrolimus (Topical) Oint .03% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Tacrolimus (Topical) Oint .1% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Nitroglycerin (Intra-Anal) Oint .4% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Becaplermin Gel .01% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Oxymetazoline Hcl (Topical) Crea 1% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Urea Crea 37.5% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
SALICYLIC ACID 6% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Collagenase Oint 250Unit/Gm (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
2 |
Formulary Brand |
$38 |
|
|
Brodalumab Sosy 210Mg/1.5Ml (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Risankizumab-Rzaa Pskt 75Mg/0.83Ml (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Acitretin Caps 10Mg (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Acitretin Caps 17.5Mg (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Acitretin Caps 25Mg (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Calcipotriene Foam .005% (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Ustekinumab Soln 45Mg/0.5Ml (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Ustekinumab Sosy 45Mg/0.5Ml (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Ustekinumab Sosy 90Mg/Ml (Generic) |
Skin And Mucous Membrane Agents, Miscellaneous |
3 |
Non-Formulary Brand |
$68 |
|
|
Protopic Oint 0.03 % (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |
|
|
Protopic Oint 0.1 % (Brand) |
Skin And Mucous Membrane Agents, Miscellaneous |
1 |
Generic |
$14 |