Note Title
Not Available Through Mail Service
Definition
This medication is not available through the mail service pharmacy
- Home
- Provider Central Home
- Lookup a Medication
- Search Results
- Medication Details
Medication Lookup
The results below have been sorted using a 2-tier plan. For the most accurate search results, check your plan details and choose another tier plan from the drop-down menu near the search bar.
TRACLEER
THERAPEUTIC CLASS: Vasodilators
Select a strength to see details
62.5MG TABS
62.5MG TABS
Not Covered by a 3-Tier Plan
-
-
Note TitleRequires Specialty PharmacyDefinitionThis medication will only be covered through the pharmacy benefit when purchased through a specialty pharmacy that participates in our network. To find a specialty pharmacy, visit Specialty Network Pharmacy Contact Information in the Specialty Pharmacy section.
-
Note TitleExceptions To Non Covered MedicationsDefinitionYour doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.
125MG TABS
125MG TABS
Not Covered by a 3-Tier Plan
-
Note TitleNot Available Through Mail ServiceDefinitionThis medication is not available through the mail service pharmacy
-
Note TitleRequires Specialty PharmacyDefinitionThis medication will only be covered through the pharmacy benefit when purchased through a specialty pharmacy that participates in our network. To find a specialty pharmacy, visit Specialty Network Pharmacy Contact Information in the Specialty Pharmacy section.
-
Note TitleExceptions To Non Covered MedicationsDefinitionYour doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.
32MG TAB FOR ORAL SUSP
32MG TAB FOR ORAL SUSP
Covered by a 3-Tier Plan as a Tier 2 Medication
-
Note TitleNot Available Through Mail ServiceDefinitionThis medication is not available through the mail service pharmacy
-
Note TitleRequires Specialty PharmacyDefinitionThis medication will only be covered through the pharmacy benefit when purchased through a specialty pharmacy that participates in our network. To find a specialty pharmacy, visit Specialty Network Pharmacy Contact Information in the Specialty Pharmacy section.
Prior Authorization Forms
Massachusetts Standard Form for Hepatitis-C Medication Prior Authorization Requests
Massachusetts Standard Form for Medication Prior Authorization Requests
Massachusetts Standard Form for Synagis® Medication Prior Authorization Requests
Important Information
Affordable Care Act (ACA) Medication List
Medical Benefit Prior Authorization Medication List
Over-the-Counter Exclusion Medication List
Quality Care Dosing Guidelines
Learn About Your Pharmacy Program
Learn About Your Pharmacy Program
Affordable Care Act (ACA) Medication List
Cost-Share Assistance Program Medication List
Health Savings Account (HSA) Preventive Medication List
Lower-Cost, Brand-Name Insulins Medication List
Medical Benefit Prior Authorization Medication List
No-Cost Generic Medications List
Over-the-Counter Exclusion Medication List
Specialty Pharmacy
Specialty Pharmacy Medication List
5-Tier Specialty Pharmacy Medication List
6-Tier Specialty Pharmacy Medication List
Alternatives to Opioids
For Federal Employee Program Members
Eligible Medicare Members
Covered Alternative Medications