| Section |
Status |
BlueTeq |
Name |
| 06.06.01 |
Formulary
|
 |
Abaloparatide |
| 10.01.03 |
Formulary
|
|
Abatacept Orencia® |
| 13.05.03 |
Formulary
|
|
Abrocitinib Cibinqo ® |
| 04.12 |
Formulary
|
|
Acoramidis Beyonttra® |
| 01.05.03 |
Formulary
|
|
Adalimumab |
| 10.01.03 |
Formulary
|
|
Adalimumab |
| 11.08.02 |
Formulary
|
|
Adalimumab |
| 13.05.03 |
Formulary
|
|
Adalimumab |
| 11.08.02 |
Formulary
|
|
Aflibercept |
| 11.08.02 |
Formulary
|
|
Aflibercept 8mg in 0.07ml inj |
| 08.02.03 |
Formulary
|
|
Alemtuzumab Lemtrada® |
| 02.12 |
Formulary
|
|
Alirocumab Praluent® |
| 13.05.01 |
Formulary
|
|
Alitretinoin Prescribe generically |
| 08.01 |
Formulary
|
|
Anhydrous sodium thiosulfate |
| 10.01.03 |
Formulary
|
|
Apremilast Otezla® |
| 13.05.03 |
Formulary
|
|
Apremilast Otezla® |
| 09.08.01 |
Formulary
|
|
Asfotase alfa Strensiq® |
| 10.02 |
Formulary
|
|
Ataluren Translarna ® |
| 08.02 |
Formulary
|
|
Atezolizumab Tecentriq® |
| 09.08.01 |
Formulary
|
|
Avalglucosidase alfa Nexviadyme ® |
| 09.01.04 |
Formulary
|
|
Avatrombopag Doptelet® |
| 10.01.03 |
Formulary
|
|
Baricitinib |
| 13.05.03 |
Formulary
|
|
Baricitinib |
| 05.01.09 |
Formulary
|
|
Bedaquiline |
| 10.01.03 |
Formulary
|
|
Belimumab Benlysta® |
| 08.02 |
Formulary
|
|
Belumosudil |
| 03.04.02 |
Formulary
|
|
Benralizumab Fasenra® |
| 03.04.03 |
Formulary
|
|
Berotralstat dihydrochloride Orladeyo® |
| 11.08.02 |
Formulary
|
|
Bevacizumab gamma |
| 10.01.03 |
Formulary
|
|
Bimekizumab Bimzelx® |
| 13.05.03 |
Formulary
|
|
Bimekizumab Bimzelx ® |
| 13.01 |
Formulary
|
|
Birch bark extract Filsuvez Gel® |
| 08.02 |
Formulary
|
|
Blinatumomab Blincyto® |
| 13.05.03 |
Formulary
|
|
Brodalumab Kyntheum® |
| 11.08.02 |
Formulary
|
|
Brolucizumab Beovu® |
| 05.03.03 |
Formulary
|
|
Bulevirtide HEPCLUDEX® |
| 06.06.02 |
Formulary
|
|
Burosumab Crysvita® |
| 05.03.01 |
Formulary
|
|
Cabotegravir Vocabria® |
| 09.01.04 |
Formulary
|
|
Caplacizumab Cablivi ® |
| 10.01.03 |
Formulary
|
|
Certolizumab Pegol Cimzia® |
| 13.05.03 |
Formulary
|
|
Certolizumab pegol Cimzia® |
| 09.01.03 |
Formulary
|
|
Crovalimab Piasky® |
| 09.01.03 |
Formulary
|
|
Danicopan |
| 09.01.03 |
Formulary
|
|
Deferasirox |
| 09.01.03 |
Formulary
|
|
Deferiprone |
| 05.01.09 |
Formulary
|
|
Delamanid |
| 09.01.03 |
Formulary
|
|
Desferrioxamine Mesilate |
| 13.05.03 |
Formulary
|
|
Deucravacitinib Sotyktu® |
| 11.04.01 |
Formulary
|
|
Dexamethasone intravitreal implant Ozurdex® |
| 13.03 |
Formulary
|
|
Difelikefalin Kapruvia® |
| 13.05.02 |
Formulary
|
|
Dimethyl Fumarate Skilarence® |
| 03.04.02 |
Formulary
|
|
Dupilumab Dupixent® |
| 13.05.03 |
Formulary
|
|
Dupilumab Dupixent® |
| 08.01.05 |
Formulary
|
|
Durvalumab |
| 09.08.01 |
Formulary
|
|
Eladocagene exuparvovec Upstaza® |
| 01.09.01 |
Formulary
|
|
Elafibranor |
| 05.03.03.02 |
Formulary
|
|
Elbasvir with grazoprevir Zepatier® |
| 09.01.04 |
Formulary
|
|
Eltrombopag Revolade® |
| 02.11 |
Formulary
|
|
Emicizumab Hemlibra® |
| 09.08.01 |
Formulary
|
|
Eplontersen Wainzua® |
| 04.07.04.02 |
Formulary
|
|
Eptinezumab Vyepti® |
| 04.07.04.02 |
Formulary
|
|
Erenumab Aimovig® |
| 10.01.03 |
Formulary
|
|
Etanercept |
| 13.05.03 |
Formulary
|
|
Etanercept |
| 02.12 |
Formulary
|
|
Evinacumab Evkeeza® |
| 02.12 |
Formulary
|
|
Evolocumab Repatha® |
| 09.01.03 |
Formulary
|
|
Exagamglogene autotemcel Casgevy® |
| 11.08.02 |
Formulary
|
|
Faricimab Vabysmo ® |
| 04.08.01 |
Formulary
|
|
Fenfluramine Fintepla® |
| 01.05.03 |
Formulary
|
|
Filgotinib |
| 10.01.03 |
Formulary
|
|
Filgotinib Jyseleca® |
| 11.04.01 |
Formulary
|
|
Fluocinolone intravitreal implant Iluvien® |
| 09.01.04 |
Formulary
|
|
Fostamatinib TAVLESSE ® |
| 05.03.01 |
Formulary
|
|
Fostemsavir Rukobia® |
| 04.07.04.02 |
Formulary
|
|
Fremanezumab Ajovy® |
| 08.01.05 |
Formulary
|
|
Fruquintinib Fruzaqla® |
| 04.07.04.02 |
Formulary
|
|
Galcanezumab Emgality® |
| 03.04.03 |
Formulary
|
|
Garadacimab Andembry® |
| 05.03.03.02 |
Formulary
|
|
Glecaprevir with pibrentasvir Maviret® |
| 01.05.03 |
Formulary
|
|
Golimumab |
| 10.01.03 |
Formulary
|
|
Golimumab Simponi® |
| 01.05.03 |
Formulary
|
|
Guselkumab Tremfya |
| 10.01.03 |
Formulary
|
|
Guselkumab Tremfya® |
| 13.05.03 |
Formulary
|
|
Guselkumab Tremfya® |
| 03.04.03 |
Formulary
|
|
Icatibant |
| 11.08 |
Formulary
|
|
Idebenone Raxone® |
| 01.05.03 |
Formulary
|
|
Infliximab |
| 08.01 |
Formulary
|
|
Infliximab |
| 10.01.03 |
Formulary
|
|
Infliximab |
| 13.05.03 |
Formulary
|
|
Infliximab |
| 06.01.01.03 |
Formulary
|
|
Insulin pumps |
| 09.01.03 |
Formulary
|
|
Iptacopan Fabhalta® |
| 03.07 |
Formulary
|
|
Ivacaftor–Tezacaftor–Elexacaftor Kaftrio® |
| 10.01.03 |
Formulary
|
|
Ixekizumab Taltz® |
| 13.05.02 |
Formulary
|
|
Ixekizumab Taltz® |
| 08.03.04.03 |
Formulary
|
|
Lanreotide |
| 13.05.03 |
Formulary
|
|
Lebrikizumab Ebglyss® |
| 05.03.03.02 |
Formulary
|
|
Ledipasvir and Sofosbuvir Harvoni® |
| 08.01.05 |
Formulary
|
|
Leniolisib phosphate Joenja® |
| 05.03.02.02 |
Formulary
|
|
Letermovir Prevymis® |
| 04.09.01 |
Formulary
|
|
Levodopa-Carbidopa- Entacapone Intestinal Gel (LECIG) |
| 04.09.01 |
Formulary
|
|
Levodopa-Carbidopa Intestinal Gel (LCIG) |
| 08.02.04 |
Formulary
|
|
Lisocabtagene maraleucel Breyanzi® |
| 03.07 |
Formulary
|
|
Lumacaftor–Ivacaftor Orkambi® |
| 09.01.04 |
Formulary
|
|
Lusutrombopag Mulpleo® |
| 05.03.02.02 |
Formulary
|
|
Maribavir Livtencity® |
| 02.11 |
Formulary
|
|
Marstacimab Hympavzi® |
| 03.04.02 |
Formulary
|
|
Mepolizumab |
| 10.02.02 |
Formulary
|
|
Mexiletine hydrochloride Namuscla ® |
| 01.05.03 |
Formulary
|
|
Mirikizumab |
| 13.05.03 |
Formulary
|
|
Nemolizumab Nemluvio® |
| 05.03.05 |
Formulary
|
|
Nirsevimab Beyfortus® |
| 10.02 |
Formulary
|
|
Nusinersen Spinraza® |
| 08.02.03 |
Formulary
|
|
Ocrelizumab Ocrevus® |
| 08.03.04.03 |
Formulary
|
|
Octreotide |
| 08.03.04.03 |
Formulary
|
|
Octreotide |
| 08.02.03 |
Formulary
|
|
Ofatumumab |
| 08.03.04.01 |
Formulary
|
|
Olaparib |
| 13.05.03 |
Formulary
|
|
Omalizumab |
| 10.02 |
Formulary
|
|
Onasemnogene abeparvovec Zolgensma® |
| 08.01.05 |
Formulary
|
|
Osimertinib Tagrisso® |
| 01.05.03 |
Formulary
|
|
Ozanimod |
| 08.02 |
Formulary
|
|
Ozanimod Zeposia® |
| 05.03.05 |
Formulary
|
|
Palivizumab Synagis® |
| 08.02.04 |
Formulary
|
|
Peginterferon Alfa Pegasys® |
| 06.05 |
Formulary
|
|
Pegvisomant |
| 05.01.09 |
Formulary
|
|
Pretomanid |
| 11.08.02 |
Formulary
|
|
Ranibizumab |
| 09.01.03 |
Formulary
|
|
Ravulizumab Ultomiris® |
| 03.04.02 |
Formulary
|
|
Reslizumab |
| 01.05.03 |
Formulary
|
|
Risankizumab Skyrizi® |
| 10.01.03 |
Formulary
|
|
Risankizumab Skyrizi® |
| 13.05.03 |
Formulary
|
|
Risankizumab Skyrizi® |
| 10.02 |
Formulary
|
|
Risdiplam Evrysdi® |
| 13.05.03 |
Formulary
|
|
Ritlecitinib Litfulo® |
| 08.02.03 |
Formulary
|
|
Rituximab |
| 09.01.03 |
Formulary
|
|
Rituximab |
| 09.01.04 |
Formulary
|
|
Rituximab |
| 10.01.03 |
Formulary
|
|
Rituximab Biosimilars avaliable |
| 09.01.04 |
Formulary
|
|
Romiplostim Nplate® |
| 08.02.04 |
Formulary
|
|
Ropeginterferon Alfa-2b Besremi® |
| 09.01.01 |
Formulary
|
|
Roxadustat Evrenzo® |
| 08.01.05 |
Formulary
|
|
Rucaparib Rubraca® |
| 08.02.02 |
Formulary
|
|
Ruxolitinib Jakavi® |
| 10.01.03 |
Formulary
|
|
Sarilumab Kevzara® |
| 10.01.03 |
Formulary
|
|
Secukinumab Cosentyx® |
| 13.05.03 |
Formulary
|
|
Secukinumab Cosentyx® |
| 05.03.03.02 |
Formulary
|
|
Sofosbuvir and Velpatasvir Epclusa®
|
| 05.03.03.02 |
Formulary
|
|
Sofosbuvir with Velpatasvir and Voxilaprevir Vosevi® |
| 04.04 |
Formulary
|
|
Solriamfetol hydrochloride Sunosi® |
| 06.05.01 |
Formulary
|
|
Somapacitan |
| 06.05.01 |
Formulary
|
|
Somatrogon Ngenla® |
| 08.02.02 |
Formulary
|
|
Sparsentan |
| 13.05.02 |
Formulary
|
|
Spesolimab Spevigo® |
| 04.12 |
Formulary
|
|
Tafamidis |
| 03.07 |
Formulary
|
|
Tezacaftor–Ivacaftor Symkevi® |
| 13.05.03 |
Formulary
|
|
Tildrakizumab Ilumetri® |
| 10.01.03 |
Formulary
|
|
Tocilizumab Biosimilars avaliable |
| 01.05.03 |
Formulary
|
|
Tofacitinib |
| 10.01.03 |
Formulary
|
|
Tofacitinib Xeljanz® |
| 06.05.02 |
Formulary
|
|
Tolvaptan |
| 13.05.03 |
Formulary
|
|
Tralokinumab Adtralza ® |
| 08.02.03 |
Formulary
|
|
Ublituximab Briumvi® |
| 01.05.03 |
Formulary
|
|
Upadacitinib Rinvoq ® |
| 10.01.03 |
Formulary
|
|
Upadacitinib Rinvoq ® |
| 13.05.03 |
Formulary
|
|
Upadacitinib Rinvoq ® |
| 01.05.03 |
Formulary
|
|
Ustekinumab |
| 10.01.03 |
Formulary
|
|
Ustekinumab |
| 13.05.03 |
Formulary
|
|
Ustekinumab |
| 09.01.03 |
Formulary
|
|
Vadadustat Vafseo® |
| 10.02 |
Formulary
|
|
Vamorolone Agamree® |
| 08.01 |
Formulary
|
|
Vedolizumab Entyvio® |
| 11.11 |
Formulary
|
|
Voretigene Neparvovec Luxturna® |
| 09.08.01 |
Formulary
|
|
Vutrisiran Amvuttra ® |
