Tier: 1
Prior Authorization: 0
Step Therapy:
Category: ANTICONVULSANTS
Sub Category: ANTICONVULSANTS – MISC.
NDC:
Tier: 1
Tier: 1
Prior Authorization: 0
Step Therapy:
Category: ANTICONVULSANTS
Sub Category: ANTICONVULSANTS – MISC.
NDC:
Tier: 1
This link will open in a new window. Do you wish to continue?