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This is not a complete list of drugs covered under your plan. Check your plan documents for coverage information. Your plan may not cover certain drugs to treat conditions such as infertility, erectile dysfunction, and weight loss. Drug products are identified by unique numerical product identifiers, called National Drug Codes (NDC), which identify the manufacturer, strength, dosage form, formulation and package size. This listing does not include certain  NDCs. To check coverage and copay information for a specific medicine, log into your member website. If you’re still not sure whether your plan benefits include coverage, call the toll-free number on the back of your ID card.
Drug Search: cequa ophthalmic solution 0.09 %
1 drug(s) found
To view other medications in a therapeutic class, click any class hyperlink in your search results.

Results

Brand Name
Generic Name		Therapeutic Class
Sub-Class		Dose/StrengthStatusNotes & Restrictions
Cequa Ophthalmic Solution 0.09 %
cyclosporine (pf)Ophthalmic - Drugs To Treat Eye Conditions
Dry Eye Disease		Ophthalmic - Drugs To Treat Eye Conditions
Dry Eye Disease		SOLUTION 0.09 %

Definition of Status

IconStatusDefinition
GG

Generics
PBPB

Preferred Brands
NPBNPB

Non-Preferred Brands
PSPPSP

Preferred Specialty
NPSPNPSP

Non-Preferred Specialty
NFNFFormulary Excluded
CECECopay Exception:  Available to some members at no cost with a prescription from your provider when obtained at an in-network pharmacy.  Certain limitations may apply. 

Definition of Restrictions

IconRestrictionDefinition
IBCIBCIndication Based Coverage
N8N8Drug Specific Coverage