The Vivid Clear Rx Premier 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 |
|---|---|---|---|---|
| 10ML SYRINGE MIS LUER LOC | No | 3 | No | No |
| "12ML SYRINGE MIS 18GX1""" | No | 3 | No | No |
| "12ML SYRINGE MIS 20GX1.5""" | No | 3 | No | No |
| "12ML SYRINGE MIS 21GX1""" | No | 3 | No | No |
| "12ML SYRINGE MIS 21GX1.5""" | No | 3 | No | No |
| "12ML SYRINGE MIS 22GX1.5""" | No | 3 | No | No |
| 12ML SYRINGE MIS LUER LOK | No | 3 | No | No |
| 12-PANEL POC KIT TOXICOLO | No | 3 | No | No |
| 140ML SYRING MIS CATH TIP | No | 3 | No | No |
| 140ML SYRING MIS LUER-LOC | No | 3 | No | No |
