Drug List - Z

Z
Drug Name Tier Restrictions
ZACLIR CLEANSING 2 Quantity limit, Step therapy
ZADITOR NC
ZAFIRKULAST 1
ZALEPLON CAP 5MG 1
ZANAFLEX CAP 6MG 3
ZANTAC NC
ZARELTO 3
ZAROXOLYN 3
ZEGERID 3 Prior authorization, Step therapy
ZELAPAR 2
ZEMPLAR CAP 2
ZENCHENT FE 1*
ZENPEP 2
ZEPATIER 2 Prior authorization
ZESTORETIC 3 Prior authorization
ZESTRIL 3 Prior authorization
ZETIA 3 Prior authorization
ZETONNA NC
ZIAGEN 3 Prior authorization
ZIANA 3 Quantity limit, Step therapy
ZIDOVUDINE 1
ZINC OXIDE NC Quantity limit
ZIOPTAN 3 Prior authorization
ZIPRASIDONE 1
ZIRGAN GEL 0.15% 3
ZITHROMAX 3 Travel
ZODERM 3 Quantity limit, Step therapy
ZOFRAN 3 Prior authorization, Step therapy
ZOLADEX IMP 3
ZOLENE HC 3
ZOLINZA TAB 3 Prior authorization, Quantity limit
ZOLMITRIPTAN 1 Quantity limit
ZOLOFT 3
ZOLPIDEM TARTRATE 1 Travel
ZOMIG 3 Quantity limit
ZONALON 3 Prior authorization, Quantity limit, Step therapy
ZONISAMIDE 1
ZORBTIVE 3 Prior authorization, Step therapy
ZOVIA 1*
ZOVIRAX 2 Quantity limit
ZUBSOLV 2
ZYFLO CR 2
ZYLET 3
ZYMAXID 3 Prior authorization
ZYPREXA 3 Prior authorization
ZYTIGA TAB 250MG 3 Prior Authorization
ZYVOX 3 Prior authorization