ANTI-INFECTIVES
CEPHALOSPORINS
** Ingredient Cost Per Therapy
Click on notes for additional information
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|
| Brand/Generic Name |
Dosage/Strength |
Status |
Notes |
Ingredient Cost |
Keflex
Cephalexin
|
|
 |
 |
$10-$20 |
Key for Product(s) Listed Above (click on symbol for full definition) |
 Formulary
(Brand non-formulary if Generic available) |
Prior Authorization Required
(Once approved Brand and Generic, if available, are formulary) |
 Non-Formulary
(Brand and Generic, if available, are non-formulary) |
Not Reimbursed |
Generic Available |
 Notes or Restrictions |
| |
Brand and Generic are Formulary |
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Disclaimer: This is not a comprehensive list of all products covered on the formulary. Formulary status, ingredient cost, and/or copay may vary subject to availability of newly approved dosage forms and/or strengths.
If you have additional questions regarding your prescription drug benefit, please contact Member Services. |
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