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Your 2021 Formulary

Your 2021 FormularyEffective July 1, 2021 For the most current list of covered medications or if you have questions:Call the number on your member ID cardVisit your plan s website on your member ID card or log on to the OptumRx app to: Find a participating retail pharmacy by ZIP code Look up possible lower-cost medication alternatives Compare medication pricing and options2 Understanding your formularyWhat is a Formulary ?A Formulary is a list of prescribed medications or other pharmacy care products, services or supplies chosen for their safety, cost, and effectiveness. Medications are listed by categories or classes and are placed into cost levels known as tiers.

nitrofurantoin monohydrate macrocrystals Generic penicillin v potassium oral tablet Generic sulfamethoxazole-trimethoprim oral tablet Generic. 6 Drug Name Drug Tier Notes ELIQUIS Brand QL ELIQUIS DVT/PE STARTER PACK Brand QL …

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  Nitrofurantoin, Monohydrate, Nitrofurantoin monohydrate

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