BRAND NAME: MoviPrep -  Generic Available Note: Brand name drugs are listed for reference only. The approval status and restrictions indicated below apply only to the brand's generic equivalent. Certain brand drugs may not be covered by your health plan. Please contact your health plan for additional information.

GENERIC NAME:   peg3350-sod sul-NaCl-KCl-asb-C
	Status	Notes or Restrictions
Anthem Blue Cross (HMO, PPO, EPO)
Cigna + Oscar
Health Net
Kaiser Foundation Health Plan Northern California
Kaiser Foundation Health Plan Southern California
Oscar
Sharp Health Plan
Sutter Health Plus
UnitedHealthcare
Western Health Advantage

Preferred	Approved	Prior Auth.
Non-Formulary	Not Reimbursed	Not Listed
Benefits/Policies	Generic Available, Brand Listed for reference only. Brand may not be covered.	Notes or Restrictions

What is a formulary? Why does my health plan have a formulary? What if my doctor wants to prescribe a non-formulary medication? What is a generic drug? How often is the information updated? For additional information, please click on "Your Questions" in the left navigation bar.