| Preferred |
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Preferred over all other drugs in the same therapeutic category. |
| Approved |
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Approved for reimbursement without any restrictions. |
| Prior Authorization |
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Reimbursement will be allowed only when the claim has been submitted to plan officials by a prescriber for review prior to the issuance of a prescription. |
| Non-Formulary |
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The Plan lists this drug as not on the formulary. Please click on the icon to review the Plan's Benefits/Policies regarding non formulary drugs. |
| Not Reimbursed |
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This drug is not reimbursed by the plan. |
| Not Listed |
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No information available for this drug. It may or may not be reimbursable. |
| Benefits/Policies |
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Click the icon to view the Plan's Benefits/Policies. |
| Generic Available |
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The symbol indicates that the drug name it appears after is available as a generic equivalent. Health insurance providers almost always require that a generic be used if it is available. |
| Notes or Restrictions |
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Click the icon to view the Plan's notes or restrictions. |