| DRUG | COVERED | NOT COVERED |
|---|---|---|
| Eliquis | $10 | 30 day free trial |
| Entresto | $10 | 30 day free trial |
| Kerendia | $0 | 30 day free trial |
| Xarelto | $10 | 30 day free trial |
| Afrezza | $35 | - |
| Brilinta | $5 | - |
| Farxiga | $0 | |
| Invokana | $0 | - |
| Janumet | $5 | - |
| Januvia | $5 | - |
| Jardiance | $10 | - |
| Jentadueto | $10 | - |
| Leqvio | $0 | - |
| Livalo | $25 | - |
| Multaq | $0 | - |
| Praluent | $50 | - |
| Repatha | $15 | - |
| Synjardy | $10 | - |
| Toujeo | $35 | - |
| Tradjenta | $10 | - |
| Tresiba | $35 | - |
| V-Go | $99 | - |