Vaccines
Showing 25–36 of 39 results
NAME | ALSO KNOW AS | DRUG CATEGORY | FORMULARY CATEGORY | WHAT WE COVER | COST SHARE |
---|---|---|---|---|---|
Vaxchora Susr (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Pediarix Susp (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Infanrix Susp 25-58-10 (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Daptacel Susp 23-15-5 (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Acthib Solr (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Hiberix Solr 10 Mcg (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Pedvax Hib Susp 7.5 Mcg/0.5Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Twinrix Susy 720-20 Elu-Mcg/Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Havrix Susp 1440 El U/Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Vaqta Susp 25 Unit/0.5Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Vaqta Susp 50 Unit/Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Havrix Susp 720 El U/0.5Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Engerix-B Susp 10 Mcg/0.5Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Recombivax Hb Susp 10 Mcg/Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Engerix-B Susp 20 Mcg/Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Recombivax Hb Susp 40 Mcg/Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Recombivax Hb Susp 5 Mcg/0.5Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Heplisav-B Soln 20 Mcg/0.5Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Gardasil 9 Susp (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Gardasil 9 Susy (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Ixiaro Susp (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Proquad Susr (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
M-M-R Ii Solr (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Menveo Solr (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Menactra Inj (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Trumenba Susy (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Bexsero Susy (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Ipol Inj (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Rabavert Susr (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Imovax Rabies Inj 2.5 Unit/Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Rotavirus Vaccine, Live Oral Susr (Generic) |
Vaccines |
3 |
Non-Formulary Brand |
$68 |
|
Rotavirus Vaccine, Live Oral Pentavalent Soln (Generic) |
Vaccines |
3 |
Non-Formulary Brand |
$68 |
|
Boostrix Susp 5-2.5-18.5 Lf-Mcg/0.5 (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Adacel Susp 5-2-15.5 Lf-Mcg/0.5 (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |
|
Typhim Vi Soln 25 Mcg/0.5Ml (Brand) |
Vaccines |
MA |
Administered in Medical Office |
N/A |