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Revatio
Blue Cross of Idaho
Blue Cross of Idaho Coverage for Revatio
All
4
Commercial
2
Health Exchange
1
Medicare
1
Commercial
Commercial - PPO
PA Required
No Step Therapy
No Quantity Limit
See Details
Commercial - Employer
PA Required
No Step Therapy
No Quantity Limit
See Details
Health Exchange
Health Exchange - POS - Health Insurance Exchange
PA Required
No Step Therapy
No Quantity Limit
See Details
Medicare
Medicare - Medicare Advantage Part D
No PA
No Step Therapy
No Quantity Limit
See Details
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