Drug List - K

K
Drug Name Tier Restrictions
K CITRATE SOL CITR ACD 1
K-EFFERVESCENT 1
K-TABS 1
KADIAN 3
KADIAN CAP 40MG ER 3
KALETRA 2
KAON-CL-10 1
KAPIDEX 3 Step therapy
KARIVA 1*
KAZANO 3 Step therapy
KELNOR TAB 1/35 1*
KENALOG INJ 2
KEPPRA 3
KERAFOAM 3 Prior authorization, Quantity limit
KERALAC 3 Prior authorization, Quantity limit
KERALYT 2 Quantity limit
KEROL EMU 3 Prior authorization, Quantity limit
KERYDIN NC
KETEK PAK 2
KETOCONAZOLE CREAM 1 Quantity limit
KETOCONAZOLE TAB 1
KETOPROFEN 1
KETOROLAC TROMETHAMINE 1 Quantity limit
KINERASE 2 Prior authorization, Quantity limit
KINERET 3 Prior authorization, Step therapy
KLARON 3 Prior authorization, Quantity limit, Step therapy
KLONOPIN 3 Prior authorization
KLONOPIN WAFERS 3 Prior authorization, Step therapy
KLOR-CON 1
KLOR-CON-8 1
KLOR-CON/EF 1
KOMBIGLYZE XR 3 Step therapy
KRISTALOSE PAK 3