The Vivid Clear Rx Part-time Employee Low Cost Formulary is a list of drugs covered under a pharmacy benefit and developed to serve as a guide for physicians, pharmacists, healthcare professionals and members. This formulary is continually reviewed and updated. Coverage may vary based on employer group. Contact Vivid Clear Rx at (877) 848-4379 for specifics relative to your individual benefit package.
Search for drug coverage below.
Product name | Specialty | Tier | PA Required | Quantity |
|---|---|---|---|---|
| Esterified Estrogens & Methyltestosterone Tab 1.25-2.5 MG | No | 1 | No | No |
| Esterified Estrogens & Methyltestosterone Tab 0.625-1.25 MG | No | 1 | No | No |
| Estradiol & Norethindrone Acetate Tab 0.5-0.1 MG | No | 1 | No | No |
| Estradiol & Norethindrone Acetate Tab 1-0.5 MG | No | 1 | No | No |
| Norethindrone Tab 0.35 MG | No | 1 | No | No |
| Estradiol TD Patch Weekly 0.1 MG/24HR | No | 1 | No | No |
| Estradiol Tab 0.5 MG | No | 1 | No | No |
| Estradiol Tab 1 MG | No | 1 | No | No |
| Estradiol Tab 2 MG | No | 1 | No | No |
| Estradiol TD Patch Weekly 0.0375 MG/24HR (37.5 MCG/24HR) | No | 1 | No | No |
