BRAND NAME: Dex4 Glucose Go-Pouch
- 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.
|Status||Notes or Restrictions|
|Anthem Blue Cross (HMO, PPO, EPO)|
|Cigna + Oscar|
|Kaiser Foundation Health Plan Northern California|
|Kaiser Foundation Health Plan Southern California|
|Sharp Health Plan|
|Sutter Health Plus|
|Western Health Advantage|
|Non-Formulary||Not Reimbursed||Not Listed|
|Benefits/Policies||Generic Available, Brand Listed for reference only. Brand may not be covered.||
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