Drugs for the Eye
Drugs for Itchy Eye

BRAND NAME: Alomide

GENERIC NAME: 
lodoxamide tromethamine No Generic Available
  Status Notes or Restrictions
Anthem Blue Cross (HMO, PPO, EPO) approved.gif (510 bytes) NOTES_restrict.gif (377 bytes)
Cigna + Oscar notlisted.gif (324 bytes)  
Health Net preferred.gif (540 bytes)  
Kaiser Foundation Health Plan Northern California approved.gif (510 bytes)  
Kaiser Foundation Health Plan Southern California approved.gif (510 bytes)  
Oscar approved.gif (510 bytes)  
Sharp Health Plan approved.gif (510 bytes)  
Sutter Health Plus approved.gif (510 bytes) NOTES_restrict.gif (377 bytes)
UnitedHealthcare approved.gif (510 bytes)  
Western Health Advantage preferred.gif (540 bytes)  


preferred.gif (540 bytes)  Preferred

approved.gif (510 bytes)   Approved

priorauth.gif (816 bytes)  Prior Auth.
nonform.gif (625 bytes)    Non-Formulary notreimb.gif (645 bytes)   Not Reimbursed notlisted.gif (324 bytes)   Not Listed
nonform.gif (625 bytes)    Benefits/Policies generic.gif (400 bytes) Generic Available, Brand Listed for reference only. Brand may not be covered.

NOTES.gif (377 bytes)NOTES_restrict.gif (372 bytes)

 Notes or
Restrictions

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