[{"drug_name":"amlodipine 5 MG \/ hydrochlorothiazide 25 MG \/ olmesartan medoxomil 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000001"},{"drug_name":"doxepin 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000048"},{"drug_name":"doxepin 10 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1000054"},{"drug_name":"doxepin 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000058"},{"drug_name":"doxepin 150 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000064"},{"drug_name":"doxepin 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000070"},{"drug_name":"doxepin 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000076"},{"drug_name":"doxepin 75 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000097"},{"drug_name":"medroxyprogesterone acetate 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000114"},{"drug_name":"1 ML medroxyprogesterone acetate 150 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1000126"},{"drug_name":"medroxyprogesterone acetate 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000135"},{"drug_name":"medroxyprogesterone acetate 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000141"},{"drug_name":"1 ML medroxyprogesterone acetate 150 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1000153"},{"drug_name":"0.65 ML medroxyprogesterone acetate 160 MG\/ML Prefilled Syringe [depo-subQ provera]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1000158"},{"drug_name":"norethindrone acetate 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000405"},{"drug_name":"{14 (estrogens  conjugated (USP) 0.625 MG \/ medroxyprogesterone acetate 5 MG Oral Tablet) \/ 14 (estrogens  conjugated (USP) 0.625 MG Oral Tablet) } Pack [Premphase 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1000487"},{"drug_name":"{28 (estrogens  conjugated (USP) 0.3 MG \/ medroxyprogesterone acetate 1.5 MG Oral Tablet) } Pack [Prempro 0.3\/1.5 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1000491"},{"drug_name":"{28 (estrogens  conjugated (USP) 0.45 MG \/ medroxyprogesterone acetate 1.5 MG Oral Tablet) } Pack [Prempro 0.45\/1.5 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1000497"},{"drug_name":"{28 (estrogens  conjugated (USP) 0.625 MG \/ medroxyprogesterone acetate 2.5 MG Oral Tablet) } Pack [Prempro 0.625\/2.5 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1000499"},{"drug_name":"{28 (estrogens  conjugated (USP) 0.625 MG \/ medroxyprogesterone acetate 5 MG Oral Tablet) } Pack [Prempro 0.625\/5 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1000500"},{"drug_name":"pilocarpine hydrochloride 10 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000647"},{"drug_name":"pilocarpine hydrochloride 20 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000862"},{"drug_name":"pilocarpine hydrochloride 40 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000897"},{"drug_name":"pilocarpine hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1000913"},{"drug_name":"docetaxel 20 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1001405"},{"drug_name":"calcium carbonate 625 MG \/ ergocalciferol 125 UNT Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1001409"},{"drug_name":"sulfacetamide sodium 100 MG\/ML \/ sulfur 50 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1005856"},{"drug_name":"ulipristal acetate 30 MG Oral Tablet [Ella]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1005928"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Altavera 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1006065"},{"drug_name":"sulfacetamide sodium 100 MG\/ML Medicated Liquid Soap","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1006107"},{"drug_name":"sulfacetamide sodium 100 MG\/ML Medicated Liquid Soap [Ovace]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1006110"},{"drug_name":"sulfacetamide sodium 100 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1006120"},{"drug_name":"24 HR dexmethylphenidate hydrochloride 40 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1006608"},{"drug_name":"sulfacetamide sodium 100 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1006688"},{"drug_name":"clozapine 150 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1006801"},{"drug_name":"amphetamine aspartate 1.875 MG \/ amphetamine sulfate 1.875 MG \/ dextroamphetamine saccharate 1.875 MG \/ dextroamphetamine sulfate 1.875 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1009145"},{"drug_name":"amphetamine aspartate 1.875 MG \/ amphetamine sulfate 1.875 MG \/ dextroamphetamine saccharate 1.875 MG \/ dextroamphetamine sulfate 1.875 MG Oral Tablet [Adderall]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1009147"},{"drug_name":"buprenorphine 2 MG \/ naloxone 0.5 MG Sublingual Film","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1010600"},{"drug_name":"buprenorphine 8 MG \/ naloxone 2 MG Sublingual Film","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1010604"},{"drug_name":"polyethylene glycol 3350 17000 MG Powder for Oral Solution [PureLax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1010732"},{"drug_name":"lidocaine hydrochloride 20 MG\/ML Mucous Membrane Topical Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1010739"},{"drug_name":"lidocaine hydrochloride 30 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1010835"},{"drug_name":"lidocaine hydrochloride 40 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1010895"},{"drug_name":"cetirizine hydrochloride 10 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1011482"},{"drug_name":"1 ML pegloticase 8 MG\/ML Injection [Krystexxa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1011657"},{"drug_name":"lidocaine hydrochloride 0.02 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1011852"},{"drug_name":"nicotine 2 MG Chewing Gum [Thrive]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1011870"},{"drug_name":"prednisolone sodium phosphate 2.5 MG\/ML \/ sulfacetamide sodium 100 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1012021"},{"drug_name":"fingolimod 0.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1012895"},{"drug_name":"{24 (drospirenone 3 MG \/ ethinyl estradiol 0.02 MG \/ levomefolate calcium 0.451 MG Oral Tablet) \/ 4 (levomefolate calcium 0.451 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1013629"},{"drug_name":"alpha 1-proteinase inhibitor  human 1 MG Injection [Glassia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1013867"},{"drug_name":"12 HR clonidine hydrochloride 0.1 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1013930"},{"drug_name":"triamcinolone acetonide 1 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1014314"},{"drug_name":"cetirizine hydrochloride 5 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1014643"},{"drug_name":"cetirizine hydrochloride 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1014673"},{"drug_name":"cetirizine hydrochloride 10 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1014674"},{"drug_name":"cetirizine hydrochloride 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1014675"},{"drug_name":"cetirizine hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1014676"},{"drug_name":"cetirizine hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1014678"},{"drug_name":"cetirizine hydrochloride 1 MG\/ML Oral Solution [Aller-Tec]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1020017"},{"drug_name":"cetirizine hydrochloride 10 MG Oral Tablet [Zyrtec]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1020026"},{"drug_name":"loratadine 10 MG Oral Tablet [Loradamed]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1020126"},{"drug_name":"{84 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Introvale 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1020155"},{"drug_name":"diphenhydramine hydrochloride 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1020477"},{"drug_name":"hydrocortisone 0.025 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"103401"},{"drug_name":"hydrocortisone 10 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"103403"},{"drug_name":"fluocinonide 0.5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"103456"},{"drug_name":"fluocinonide 0.0005 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"103457"},{"drug_name":"dabigatran etexilate 150 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1037045"},{"drug_name":"dabigatran etexilate 75 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1037179"},{"drug_name":"{24 (ethinyl estradiol 0.01 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 2 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 2 (ferrous fumarate 75 MG Oral Tablet) } Pack [Lo Loestrin Fe 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1037185"},{"drug_name":"polysaccharide iron complex 326.1 MG Oral Capsule [Iferex]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1038810"},{"drug_name":"hydrocortisone 10 MG\/ML Topical Lotion [Cortizone]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1039279"},{"drug_name":"tolnaftate 10 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"103951"},{"drug_name":"lamotrigine 100 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"103968"},{"drug_name":"corticotropin 80 UNT\/ML Injectable Solution [Acthar]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1040025"},{"drug_name":"lurasidone hydrochloride 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1040031"},{"drug_name":"lurasidone hydrochloride 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1040041"},{"drug_name":"cimetidine 200 MG Oral Tablet [Tagamet]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"104062"},{"drug_name":"famotidine 20 MG Oral Tablet [Pepcid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"104094"},{"drug_name":"glycerin 2000 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"104155"},{"drug_name":"bismuth subsalicylate 35 MG\/ML Oral Suspension [Kaopectate Reformulated Aug 2006]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1043048"},{"drug_name":"hydrocortisone 10 MG\/ML Topical Lotion [Aquanil HC]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1043063"},{"drug_name":"hydrocortisone 10 MG\/ML Topical Lotion [Beta-HC]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1043074"},{"drug_name":"naphazoline hydrochloride 0.25 MG\/ML \/ pheniramine maleate 3 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1043658"},{"drug_name":"hydrocortisone acetate 10 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1043690"},{"drug_name":"naphazoline hydrochloride 0.27 MG\/ML \/ pheniramine maleate 3.15 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1043704"},{"drug_name":"naphazoline hydrochloride 0.27 MG\/ML \/ pheniramine maleate 3.15 MG\/ML Ophthalmic Solution [Opcon-A]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1043708"},{"drug_name":"dasatinib 140 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1045402"},{"drug_name":"dasatinib 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1045406"},{"drug_name":"2 ML eribulin mesylate 0.5 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1045456"},{"drug_name":"naphazoline hydrochloride 0.25 MG\/ML \/ pheniramine maleate 3 MG\/ML Ophthalmic Solution [Naphcon A]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1046266"},{"drug_name":"1.7 ML denosumab 70 MG\/ML Injection [Xgeva]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1046402"},{"drug_name":"12 HR hyoscyamine sulfate 0.375 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1046770"},{"drug_name":"12 HR hyoscyamine sulfate 0.375 MG Extended Release Oral Tablet [Levbid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1046771"},{"drug_name":"hyoscyamine sulfate 0.125 MG Sublingual Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1046982"},{"drug_name":"hyoscyamine sulfate 0.125 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1046985"},{"drug_name":"20 ML baclofen 0.5 MG\/ML Injection [Gablofen]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1047444"},{"drug_name":"hyoscyamine sulfate 0.025 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1047881"},{"drug_name":"hyoscyamine sulfate 0.125 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1047895"},{"drug_name":"hyoscyamine sulfate 0.125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1047905"},{"drug_name":"hyoscyamine sulfate 0.125 MG Oral Tablet [Levsin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1047907"},{"drug_name":"hyoscyamine sulfate 0.125 MG Sublingual Tablet [Levsin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1047908"},{"drug_name":"phenelzine 15 MG Oral Tablet [Nardil]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"104836"},{"drug_name":"colestipol hydrochloride 1000 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1048445"},{"drug_name":"colestipol hydrochloride 5000 MG Granules for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1048450"},{"drug_name":"metoclopramide 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"104884"},{"drug_name":"ondansetron 4 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"104894"},{"drug_name":"12 HR pseudoephedrine hydrochloride 120 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049154"},{"drug_name":"12 HR pseudoephedrine hydrochloride 120 MG Extended Release Oral Tablet [Sudogest]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049156"},{"drug_name":"pseudoephedrine hydrochloride 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049160"},{"drug_name":"pseudoephedrine hydrochloride 30 MG Oral Tablet [Sudogest]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049162"},{"drug_name":"pseudoephedrine hydrochloride 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049167"},{"drug_name":"pseudoephedrine hydrochloride 60 MG Oral Tablet [Sudogest]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049169"},{"drug_name":"phenylephrine hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049182"},{"drug_name":"acetaminophen 325 MG \/ oxycodone hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049214"},{"drug_name":"acetaminophen 325 MG \/ oxycodone hydrochloride 10 MG Oral Tablet [Endocet]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049216"},{"drug_name":"acetaminophen 325 MG \/ oxycodone hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049221"},{"drug_name":"acetaminophen 325 MG \/ oxycodone hydrochloride 5 MG Oral Tablet [Endocet]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049223"},{"drug_name":"acetaminophen 325 MG \/ oxycodone hydrochloride 7.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049225"},{"drug_name":"acetaminophen 325 MG \/ oxycodone hydrochloride 7.5 MG Oral Tablet [Endocet]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049227"},{"drug_name":"polyethylene glycol 3350 17000 MG Powder for Oral Solution [GentleLax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049423"},{"drug_name":"pseudoephedrine hydrochloride 30 MG Oral Tablet [Sudafed]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049529"},{"drug_name":"pseudoephedrine hydrochloride 30 MG Oral Tablet [Wal-Phed]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049551"},{"drug_name":"oxycodone hydrochloride 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049604"},{"drug_name":"oxycodone hydrochloride 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049611"},{"drug_name":"oxycodone hydrochloride 20 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049615"},{"drug_name":"oxycodone hydrochloride 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049618"},{"drug_name":"oxycodone hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049621"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049630"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Tablet [Benadryl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049632"},{"drug_name":"12 HR pseudoephedrine hydrochloride 120 MG Extended Release Oral Tablet [Sudafed]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049668"},{"drug_name":"oxycodone hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049683"},{"drug_name":"oxycodone hydrochloride 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049686"},{"drug_name":"oxycodone hydrochloride 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049696"},{"drug_name":"pseudoephedrine hydrochloride 3 MG\/ML Oral Solution [Sudafed]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1049770"},{"drug_name":"diphenhydramine hydrochloride 2.5 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1049906"},{"drug_name":"diphenhydramine hydrochloride 2.5 MG\/ML Oral Solution [Benadryl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049908"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1049909"},{"drug_name":"{21 (drospirenone 3 MG \/ ethinyl estradiol 0.03 MG \/ levomefolate calcium 0.451 MG Oral Tablet) \/ 7 (levomefolate calcium 0.451 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1050493"},{"drug_name":"12 HR pseudoephedrine hydrochloride 120 MG Extended Release Oral Tablet [Wal-Phed]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1050506"},{"drug_name":"nicotine 4 MG Chewing Gum [Nicorette]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"105071"},{"drug_name":"cefadroxil 100 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"105171"},{"drug_name":"etravirine 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1052658"},{"drug_name":"etravirine 200 MG Oral Tablet [Intelence]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1052660"},{"drug_name":"magnesium citrate 58.2 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1052760"},{"drug_name":"phenylephrine hydrochloride 10 MG Oral Tablet [Sudafed PE]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1052767"},{"drug_name":"isoniazid 10 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"105292"},{"drug_name":"tetrahydrozoline hydrochloride 0.5 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1052943"},{"drug_name":"mineral oil 0.319 MG\/MG \/ petrolatum 0.577 MG\/MG Ophthalmic Ointment [Stye]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1053146"},{"drug_name":"brompheniramine maleate 0.2 MG\/ML \/ phenylephrine hydrochloride 0.5 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1053258"},{"drug_name":"nystatin 100 UNT\/MG \/ triamcinolone acetonide 0.001 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1053697"},{"drug_name":"nystatin 100000 UNT\/ML \/ triamcinolone acetonide 1 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1053753"},{"drug_name":"busulfan 2 MG Oral Tablet [Myleran]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"105551"},{"drug_name":"chlorambucil 2 MG Oral Tablet [Leukeran]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"105553"},{"drug_name":"fluorouracil 50 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"105583"},{"drug_name":"methotrexate 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"105585"},{"drug_name":"thioguanine 40 MG Oral Tablet [Tabloid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"105590"},{"drug_name":"goserelin 3.6 MG Drug Implant [Zoladex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"105641"},{"drug_name":"aldesleukin 22000000 UNT Injection [Proleukin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"105648"},{"drug_name":"hydrocortisone 10 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"106258"},{"drug_name":"tretinoin 0.25 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"106302"},{"drug_name":"tretinoin 0.5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"106303"},{"drug_name":"benzoyl peroxide 50 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"106309"},{"drug_name":"benzoyl peroxide 100 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"106310"},{"drug_name":"ketoconazole 20 MG\/ML Medicated Shampoo","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"106336"},{"drug_name":"mupirocin 0.02 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"106346"},{"drug_name":"silver sulfadiazine 10 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"106351"},{"drug_name":"permethrin 50 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"106387"},{"drug_name":"insulin isophane  human 70 UNT\/ML \/ insulin  regular  human 30 UNT\/ML Injectable Suspension [Humulin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"106892"},{"drug_name":"rabbit anti-human T-lymphocyte globulin 25 MG Injection [Thymoglobulin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"107050"},{"drug_name":"triamcinolone acetonide 0.00025 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1085633"},{"drug_name":"triamcinolone acetonide 0.001 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1085636"},{"drug_name":"triamcinolone acetonide 0.005 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1085640"},{"drug_name":"triamcinolone acetonide 0.25 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1085644"},{"drug_name":"triamcinolone acetonide 5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1085686"},{"drug_name":"triamcinolone acetonide 0.001 MG\/MG Oral Paste","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1085728"},{"drug_name":"triamcinolone acetonide 0.001 MG\/MG Oral Paste [Oralone]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1085767"},{"drug_name":"spinosad 9 MG\/ML Medicated Shampoo","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1085816"},{"drug_name":"spinosad 9 MG\/ML Medicated Shampoo [Natroba]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1085820"},{"drug_name":"mineral oil 0.15 MG\/MG \/ petrolatum 0.83 MG\/MG Ophthalmic Ointment [Lubrifresh P.M.]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1086613"},{"drug_name":"diphenhydramine hydrochloride 2.5 MG\/ML Oral Solution [Wal-Dryl Childrens]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1086767"},{"drug_name":"vilazodone hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1086772"},{"drug_name":"vilazodone hydrochloride 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1086778"},{"drug_name":"vilazodone hydrochloride 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1086784"},{"drug_name":"diphenhydramine hydrochloride 50 MG Oral Tablet [Sominex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1086857"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Tablet [Sominex]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1086986"},{"drug_name":"loratadine 10 MG Oral Tablet [Wal-itin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1087051"},{"drug_name":"psyllium 3400 MG Powder for Oral Suspension [Wal-Mucil]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1087167"},{"drug_name":"cetirizine hydrochloride 10 MG Oral Tablet [Wal-Zyr]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1087169"},{"drug_name":"hyoscyamine sulfate 0.12 MG \/ methenamine 81.6 MG \/ methylene blue 10.8 MG \/ phenyl salicylate 36.2 MG \/ sodium phosphate  monobasic 40.8 MG Oral Tablet [Uretron DS]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1087457"},{"drug_name":"tetrahydrozoline hydrochloride 0.5 MG\/ML Ophthalmic Solution [Visine]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1088126"},{"drug_name":"mineral oil 0.15 MG\/MG \/ petrolatum 0.85 MG\/MG Ophthalmic Ointment [Altalube]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1088146"},{"drug_name":"polyethylene glycol 3350 17000 MG Powder for Oral Solution [HealthyLax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1088531"},{"drug_name":"potassium bicarbonate 25 MEQ Effervescent Oral Tablet [Effer-K]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1088774"},{"drug_name":"niacin 500 MG Extended Release Oral Tablet [Endur-Acin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1088779"},{"drug_name":"chlorzoxazone 375 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1088934"},{"drug_name":"chlorzoxazone 750 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1088936"},{"drug_name":"psyllium 3400 MG Powder for Oral Suspension [Reguloid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1089355"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Capsule [Wal-Dryl Allergy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1090076"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Tablet [Wal-Dryl Allergy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1090078"},{"drug_name":"phenylephrine hydrochloride 10 MG Oral Tablet [Wal-Phed PE]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1090087"},{"drug_name":"diphenhydramine hydrochloride 50 MG Oral Capsule [Wal-Som Maximum Strength]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1090456"},{"drug_name":"loratadine 10 MG Disintegrating Oral Tablet [Wal-vert]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1090512"},{"drug_name":"1 ML octreotide 0.1 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1090558"},{"drug_name":"1 ML octreotide 0.05 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1090559"},{"drug_name":"1 ML octreotide 0.5 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1090560"},{"drug_name":"triamcinolone acetonide 0.0005 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1090641"},{"drug_name":"psyllium 3400 MG Powder for Oral Suspension [Konsyl]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1090807"},{"drug_name":"ascorbic acid 60 MG \/ beta carotene 5000 UNT \/ copper sulfate 40 MG \/ dl-alpha tocopheryl acetate 30 UNT \/ sodium selenite 0.04 MG \/ zinc oxide 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1090824"},{"drug_name":"ethinyl estradiol 0.005 MG \/ norethindrone acetate 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1090992"},{"drug_name":"ethinyl estradiol 0.005 MG \/ norethindrone acetate 1 MG Oral Tablet [Jinteli]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1090996"},{"drug_name":"methylphenidate hydrochloride 2 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091133"},{"drug_name":"8 HR methylphenidate hydrochloride 10 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091145"},{"drug_name":"methylphenidate hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091150"},{"drug_name":"methylphenidate hydrochloride 10 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091152"},{"drug_name":"24 HR methylphenidate hydrochloride 18 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091155"},{"drug_name":"24 HR methylphenidate hydrochloride 18 MG Extended Release Oral Tablet [Concerta]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1091157"},{"drug_name":"24 HR methylphenidate hydrochloride 27 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091170"},{"drug_name":"24 HR methylphenidate hydrochloride 27 MG Extended Release Oral Tablet [Concerta]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1091172"},{"drug_name":"24 HR methylphenidate hydrochloride 36 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091185"},{"drug_name":"24 HR methylphenidate hydrochloride 36 MG Extended Release Oral Tablet [Concerta]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1091187"},{"drug_name":"24 HR methylphenidate hydrochloride 54 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091210"},{"drug_name":"24 HR methylphenidate hydrochloride 54 MG Extended Release Oral Tablet [Concerta]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1091212"},{"drug_name":"8 HR methylphenidate hydrochloride 20 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091225"},{"drug_name":"methylphenidate hydrochloride 5 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091322"},{"drug_name":"methylphenidate hydrochloride 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091341"},{"drug_name":"methylphenidate hydrochloride 2.5 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091389"},{"drug_name":"methylphenidate hydrochloride 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091392"},{"drug_name":"methylphenidate hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091497"},{"drug_name":"roflumilast 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1091839"},{"drug_name":"acetaminophen 500 MG \/ diphenhydramine hydrochloride 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1092189"},{"drug_name":"rufinamide 40 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1092357"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Tablet [Nytol]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1092416"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Tablet [Banophen]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1092421"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Capsule [Banophen]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1092422"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Tablet [Simply Sleep]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1092466"},{"drug_name":"diphenhydramine hydrochloride 50 MG Oral Capsule [Unisom Sleep]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1093113"},{"drug_name":"docetaxel 10 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1093280"},{"drug_name":"phenazopyridine hydrochloride 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1094104"},{"drug_name":"phenazopyridine hydrochloride 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1094107"},{"drug_name":"phenazopyridine hydrochloride 100 MG Oral Tablet [Pyridium]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1094109"},{"drug_name":"phenazopyridine hydrochloride 200 MG Oral Tablet [Pyridium]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1094122"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 0.4 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Briellyn 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1094543"},{"drug_name":"acetaminophen 500 MG \/ diphenhydramine hydrochloride 25 MG Oral Tablet [Panadol PM]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1094718"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 0.4 MG Chewable Tablet) \/ 7 (ferrous fumarate 75 MG Chewable Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1095224"},{"drug_name":"{6 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.05 MG Oral Tablet) \/ 10 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.125 MG Oral Tablet) \/ 5 (ethinyl estradiol 0.04 MG \/ levonorgestrel 0.075 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Levonest 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1095227"},{"drug_name":"factor XIII  human 1 UNT Injection [Corifact]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1095283"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 0.4 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Balziva 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1095362"},{"drug_name":"acetaminophen 32 MG\/ML Oral Solution [Panadol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1095636"},{"drug_name":"24 HR nevirapine 400 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1095712"},{"drug_name":"24 HR niacin 1000 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1098134"},{"drug_name":"24 HR niacin 500 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1098141"},{"drug_name":"24 HR niacin 750 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1098143"},{"drug_name":"brompheniramine maleate 0.2 MG\/ML \/ pseudoephedrine hydrochloride 3 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1098498"},{"drug_name":"24 HR lamotrigine 300 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1098608"},{"drug_name":"nefazodone hydrochloride 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1098649"},{"drug_name":"nefazodone hydrochloride 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1098666"},{"drug_name":"nefazodone hydrochloride 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1098670"},{"drug_name":"nefazodone hydrochloride 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1098674"},{"drug_name":"nefazodone hydrochloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1098678"},{"drug_name":"{24 (drospirenone 3 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 4 (inert ingredients 1 MG Oral Tablet) } Pack [Loryna 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1099026"},{"drug_name":"{21 (drospirenone 3 MG \/ ethinyl estradiol 0.03 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Syeda 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1099269"},{"drug_name":"docusate sodium 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099279"},{"drug_name":"desipramine hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099288"},{"drug_name":"desipramine hydrochloride 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099292"},{"drug_name":"desipramine hydrochloride 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099296"},{"drug_name":"desipramine hydrochloride 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099300"},{"drug_name":"desipramine hydrochloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099304"},{"drug_name":"desipramine hydrochloride 75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099316"},{"drug_name":"24 HR divalproex sodium 250 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099563"},{"drug_name":"24 HR divalproex sodium 500 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099569"},{"drug_name":"divalproex sodium 125 MG Delayed Release Oral Capsule [Depakote]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1099598"},{"drug_name":"divalproex sodium 125 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099625"},{"drug_name":"divalproex sodium 250 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099678"},{"drug_name":"valproic acid 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099681"},{"drug_name":"valproic acid 50 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099687"},{"drug_name":"divalproex sodium 500 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1099870"},{"drug_name":"ciclopirox 80 MG\/ML Topical Solution [Ciclodan]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1100057"},{"drug_name":"abiraterone acetate 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1100075"},{"drug_name":"donepezil hydrochloride 23 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1100184"},{"drug_name":"pyridoxine hydrochloride 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1100457"},{"drug_name":"linagliptin 5 MG Oral Tablet [Tradjenta]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1100706"},{"drug_name":"psyllium 520 MG Oral Capsule [Wal-Mucil]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1100912"},{"drug_name":"doxylamine succinate 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1101446"},{"drug_name":"doxylamine succinate 25 MG Oral Tablet [Unisom]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1101448"},{"drug_name":"24 HR dexmethylphenidate hydrochloride 25 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1101926"},{"drug_name":"24 HR dexmethylphenidate hydrochloride 35 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1101932"},{"drug_name":"sodium fluoride 0.011 MG\/MG Toothpaste [Dentagel]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1101938"},{"drug_name":"etonogestrel 68 MG Drug Implant [Nexplanon]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1111011"},{"drug_name":"sapropterin dihydrochloride 100 MG Powder for Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1111018"},{"drug_name":"olopatadine 1 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1111339"},{"drug_name":"olopatadine 2 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1111343"},{"drug_name":"olopatadine 2 MG\/ML Ophthalmic Solution [Pataday]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1111345"},{"drug_name":"1 ML glatiramer acetate 20 MG\/ML Prefilled Syringe [Copaxone]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1111642"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 84 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) } Pack [Amethia 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1112687"},{"drug_name":"{28 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.09 MG Oral Tablet) } Pack [Amethyst 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1112715"},{"drug_name":"belatacept 250 MG Injection [Nulojix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1112980"},{"drug_name":"amylase 15000 UNT \/ lipase 3000 UNT \/ protease 9500 UNT Delayed Release Oral Capsule [Creon]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1113046"},{"drug_name":"vandetanib 100 MG Oral Tablet [Caprelsa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1114074"},{"drug_name":"100 ML zoledronic acid 0.04 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1114085"},{"drug_name":"vandetanib 300 MG Oral Tablet [Caprelsa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1114096"},{"drug_name":"rivaroxaban 10 MG Oral Tablet [Xarelto]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1114202"},{"drug_name":"24 HR pramipexole dihydrochloride 2.25 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1114479"},{"drug_name":"24 HR pramipexole dihydrochloride 3.75 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1114485"},{"drug_name":"docusate sodium 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1115005"},{"drug_name":"1.5 ML leuprolide acetate 30 MG\/ML Prefilled Syringe [Lupron]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1115259"},{"drug_name":"1 ML leuprolide acetate 11.25 MG\/ML Prefilled Syringe [Lupron]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1115449"},{"drug_name":"1 ML leuprolide acetate 15 MG\/ML Prefilled Syringe [Lupron]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1115456"},{"drug_name":"1 ML leuprolide acetate 3.75 MG\/ML Prefilled Syringe [Lupron]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1115459"},{"drug_name":"1 ML leuprolide acetate 7.5 MG\/ML Prefilled Syringe [Lupron]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1115464"},{"drug_name":"1.5 ML leuprolide acetate 15 MG\/ML Prefilled Syringe [Lupron]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1115468"},{"drug_name":"1.5 ML leuprolide acetate 7.5 MG\/ML Prefilled Syringe [Lupron]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1115473"},{"drug_name":"oseltamivir 6 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1115698"},{"drug_name":"fexofenadine hydrochloride 180 MG Oral Tablet [Wal-Fex]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1116528"},{"drug_name":"ticagrelor 90 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1116635"},{"drug_name":"ticagrelor 90 MG Oral Tablet [Brilinta]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1116639"},{"drug_name":"chloroquine phosphate 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1116758"},{"drug_name":"dexamethasone phosphate 4 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1116927"},{"drug_name":"bacitracin 0.4 UNT\/MG \/ neomycin 0.0035 MG\/MG \/ polymyxin B 10 UNT\/MG Ophthalmic Ointment [Neo-Polycin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1117090"},{"drug_name":"chloroquine phosphate 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1117531"},{"drug_name":"acetaminophen 500 MG \/ diphenhydramine citrate 38 MG Oral Tablet [Excedrin PM]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1117539"},{"drug_name":"2 ML Rho(D) immune globulin  human 750 UNT\/ML Prefilled Syringe [Rhophylac]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1117765"},{"drug_name":"everolimus 7.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1119400"},{"drug_name":"azelaic acid 5 MG \/ cupric oxide 1.5 MG \/ folic acid 0.5 MG \/ niacinamide 600 MG \/ pyridoxine 5 MG \/ zinc oxide 10 MG Oral Tablet [NicAzel]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1145114"},{"drug_name":"24 HR lamotrigine 250 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1146690"},{"drug_name":"vemurafenib 240 MG Oral Tablet [Zelboraf]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1147228"},{"drug_name":"brentuximab vedotin 50 MG Injection [Adcetris]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1147327"},{"drug_name":"emtricitabine 200 MG \/ rilpivirine 25 MG \/ tenofovir disoproxil fumarate 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1147334"},{"drug_name":"emtricitabine 200 MG \/ rilpivirine 25 MG \/ tenofovir disoproxil fumarate 300 MG Oral Tablet [Complera]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1147337"},{"drug_name":"3 ML icatibant 10 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1148141"},{"drug_name":"24 HR tramadol hydrochloride 100 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1148478"},{"drug_name":"24 HR tramadol hydrochloride 200 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1148485"},{"drug_name":"24 HR tramadol hydrochloride 300 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1148489"},{"drug_name":"crizotinib 200 MG Oral Capsule [Xalkori]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1148502"},{"drug_name":"crizotinib 250 MG Oral Capsule [Xalkori]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1148506"},{"drug_name":"hyoscyamine sulfate 0.125 MG Oral Tablet [Oscimin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1149355"},{"drug_name":"84 HR estradiol 0.00313 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1149632"},{"drug_name":"84 HR estradiol 0.00313 MG\/HR Transdermal System [Alora]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1149645"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 84 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) } Pack [Camrese 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1149667"},{"drug_name":"levobunolol hydrochloride 5 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1150836"},{"drug_name":"aspirin 81 MG Delayed Release Oral Tablet [Ecotrin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1189781"},{"drug_name":"2 ML sodium hyaluronate 10 MG\/ML Prefilled Syringe [Euflexxa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1190179"},{"drug_name":"120 ACTUAT albuterol 0.1 MG\/ACTUAT \/ ipratropium bromide 0.02 MG\/ACTUAT Inhalation Spray [Combivent]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1190225"},{"drug_name":"atropine sulfate 0.005 MG\/ML \/ diphenoxylate hydrochloride 0.5 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1190568"},{"drug_name":"atropine sulfate 0.01 MG\/MG Ophthalmic Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1190570"},{"drug_name":"atropine sulfate 0.025 MG \/ diphenoxylate hydrochloride 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1190572"},{"drug_name":"atropine sulfate 10 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1190655"},{"drug_name":"0.5 ML diphtheria toxoid vaccine  inactivated 4 UNT\/ML \/ tetanus toxoid vaccine  inactivated 10 UNT\/ML Injection [Tenivac]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1190916"},{"drug_name":"0.5 ML diphtheria toxoid vaccine  inactivated 4 UNT\/ML \/ tetanus toxoid vaccine  inactivated 10 UNT\/ML Prefilled Syringe [Tenivac]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1190919"},{"drug_name":"naloxone hydrochloride 0.4 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1191222"},{"drug_name":"1 ML naloxone hydrochloride 0.4 MG\/ML Cartridge","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1191234"},{"drug_name":"2 ML naloxone hydrochloride 1 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1191250"},{"drug_name":"fluocinolone acetonide 0.1 MG\/ML Otic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1191299"},{"drug_name":"fluocinolone acetonide 0.1 MG\/ML Topical Oil","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1191307"},{"drug_name":"fluocinolone acetonide 0.59 MG Drug Implant [Retisert]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1191325"},{"drug_name":"ruxolitinib 10 MG Oral Tablet [Jakafi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1193337"},{"drug_name":"ruxolitinib 5 MG Oral Tablet [Jakafi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1193341"},{"drug_name":"ruxolitinib 15 MG Oral Tablet [Jakafi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1193345"},{"drug_name":"ruxolitinib 20 MG Oral Tablet [Jakafi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1193349"},{"drug_name":"ruxolitinib 25 MG Oral Tablet [Jakafi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1193353"},{"drug_name":"rivaroxaban 15 MG Oral Tablet [Xarelto]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1232084"},{"drug_name":"rivaroxaban 20 MG Oral Tablet [Xarelto]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1232088"},{"drug_name":"0.05 ML aflibercept 40 MG\/ML Injection [Eylea]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1232159"},{"drug_name":"24 HR bupropion hydrochloride 450 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1232585"},{"drug_name":"alpha 1-proteinase inhibitor  human 1 MG Injection [Aralast]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1233711"},{"drug_name":"{24 (drospirenone 3 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 4 (inert ingredients 1 MG Oral Tablet) } Pack [Vestura]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1233850"},{"drug_name":"ascorbic acid 35 MG\/ML \/ cholecalciferol 400 UNT\/ML \/ niacin 8 MG\/ML \/ riboflavin 0.6 MG\/ML \/ sodium fluoride 0.55 MG\/ML \/ thiamine 0.5 MG\/ML \/ vitamin A 1500 UNT\/ML \/ vitamin B12 0.002 MG\/ML \/ vitamin B6 0.4 MG\/ML \/ vitamin E 5 UNT\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1234482"},{"drug_name":"phenylephrine hydrochloride 25 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1234579"},{"drug_name":"lurasidone hydrochloride 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1235247"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 84 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) } Pack [CamreseLo 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1235267"},{"drug_name":"ascorbic acid 60 MG \/ cholecalciferol 0.01 MG \/ folic acid 0.3 MG \/ niacin 13.5 MG \/ riboflavin 1.2 MG \/ sodium fluoride 0.55 MG \/ thiamine 1.05 MG \/ vitamin A 0.75 MG \/ vitamin B12 0.0045 MG \/ vitamin B6 1.05 MG \/ vitamin E 6.75 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1235389"},{"drug_name":"raltegravir 100 MG Chewable Tablet [Isentress]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1235591"},{"drug_name":"raltegravir 25 MG Chewable Tablet [Isentress]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1235595"},{"drug_name":"{7 (ethinyl estradiol 0.035 MG \/ norethindrone 0.5 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norethindrone 0.75 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norethindrone 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Dasetta 7\/7\/7 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1235867"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 0.4 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Philith 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1235874"},{"drug_name":"darunavir 100 MG\/ML Oral Suspension [Prezista]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1236632"},{"drug_name":"Bifidobacterium animalis 6000000000 UNT \/ Bifidobacterium longum 1500000000 UNT \/ Lactobacillus acidophilus 7500000000 UNT Oral Capsule [Florajen3]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1236666"},{"drug_name":"glucarpidase 1000 UNT Injection [Voraxaze]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1242136"},{"drug_name":"lenalidomide 2.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1242231"},{"drug_name":"hyoscyamine sulfate 0.125 MG Disintegrating Oral Tablet [Nulev]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1242705"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Alyacen 1\/35]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1242786"},{"drug_name":"{7 (ethinyl estradiol 0.035 MG \/ norethindrone 0.5 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norethindrone 0.75 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norethindrone 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Alyacen 7\/7\/7]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1242787"},{"drug_name":"vismodegib 150 MG Oral Capsule [Erivedge]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1242998"},{"drug_name":"axitinib 1 MG Oral Tablet [Inlyta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1243010"},{"drug_name":"axitinib 5 MG Oral Tablet [Inlyta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1243014"},{"drug_name":"linagliptin 2.5 MG \/ metformin hydrochloride 1000 MG Oral Tablet [Jentadueto]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1243026"},{"drug_name":"linagliptin 2.5 MG \/ metformin hydrochloride 500 MG Oral Tablet [Jentadueto]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1243033"},{"drug_name":"linagliptin 2.5 MG \/ metformin hydrochloride 850 MG Oral Tablet [Jentadueto]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1243040"},{"drug_name":"ivacaftor 150 MG Oral Tablet [Kalydeco]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1243052"},{"drug_name":"tenofovir disoproxil fumarate 250 MG Oral Tablet [Viread]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1243229"},{"drug_name":"tenofovir disoproxil fumarate 150 MG Oral Tablet [Viread]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1243326"},{"drug_name":"tenofovir disoproxil fumarate 200 MG Oral Tablet [Viread]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1243330"},{"drug_name":"tenofovir disoproxil fumarate 0.04 MG\/MG Oral Powder [Viread]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1243346"},{"drug_name":"calcium carbonate 1250 MG \/ cholecalciferol 200 UNT Oral Tablet [Os-Cal 500 with D]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1243415"},{"drug_name":"flurbiprofen sodium 0.3 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1243585"},{"drug_name":"24 HR metformin hydrochloride 1000 MG \/ sitagliptin phosphate 100 MG Extended Release Oral Tablet [Janumet]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1243833"},{"drug_name":"24 HR metformin hydrochloride 1000 MG \/ sitagliptin phosphate 50 MG Extended Release Oral Tablet [Janumet]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1243843"},{"drug_name":"24 HR metformin hydrochloride 500 MG \/ sitagliptin phosphate 50 MG Extended Release Oral Tablet [Janumet]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1243848"},{"drug_name":"tafluprost 0.015 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1244611"},{"drug_name":"eltrombopag 12.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1245001"},{"drug_name":"magnesium citrate 58.2 MG\/ML Oral Solution [Citroma]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1245168"},{"drug_name":"mifepristone 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1245262"},{"drug_name":"docusate sodium 4 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1245391"},{"drug_name":"2 ML hylan G-F 20 8 MG\/ML Prefilled Syringe [Synvisc]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1245423"},{"drug_name":"6 ML hylan G-F 20 8 MG\/ML Prefilled Syringe [Synvisc]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1245424"},{"drug_name":"docusate sodium 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1245468"},{"drug_name":"carbamide peroxide 65 MG\/ML Otic Solution [Clearcanal]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1245627"},{"drug_name":"docusate sodium 10 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1245686"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Marlissa 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1245919"},{"drug_name":"2 ML sodium hyaluronate 10 MG\/ML Prefilled Syringe [Hyalgan]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1245976"},{"drug_name":"2 ML sodium hyaluronate 15 MG\/ML Prefilled Syringe [Orthovisc]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1245985"},{"drug_name":"120 ACTUAT budesonide 0.08 MG\/ACTUAT \/ formoterol fumarate 0.0045 MG\/ACTUAT Metered Dose Inhaler [Symbicort]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1246290"},{"drug_name":"120 ACTUAT budesonide 0.16 MG\/ACTUAT \/ formoterol fumarate 0.0045 MG\/ACTUAT Metered Dose Inhaler [Symbicort]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1246306"},{"drug_name":"120 ACTUAT formoterol fumarate 0.005 MG\/ACTUAT \/ mometasone furoate 0.1 MG\/ACTUAT Metered Dose Inhaler [Dulera]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1246310"},{"drug_name":"120 ACTUAT formoterol fumarate 0.005 MG\/ACTUAT \/ mometasone furoate 0.2 MG\/ACTUAT Metered Dose Inhaler [Dulera]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1246313"},{"drug_name":"60 ACTUAT budesonide 0.08 MG\/ACTUAT \/ formoterol fumarate 0.0045 MG\/ACTUAT Metered Dose Inhaler [Symbicort]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1246315"},{"drug_name":"60 ACTUAT budesonide 0.16 MG\/ACTUAT \/ formoterol fumarate 0.0045 MG\/ACTUAT Metered Dose Inhaler [Symbicort]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1246317"},{"drug_name":"docusate sodium 100 MG Oral Capsule [Colace]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1247756"},{"drug_name":"docusate sodium 50 MG Oral Capsule [Colace]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1247761"},{"drug_name":"docusate sodium 50 MG \/ sennosides  USP 8.6 MG Oral Tablet [Senexon S]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1248013"},{"drug_name":"docusate sodium 50 MG \/ sennosides  USP 8.6 MG Oral Tablet [SENOKOT-S]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1248015"},{"drug_name":"phenylephrine hydrochloride 1 MG\/ML \/ promethazine hydrochloride 1.25 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1248057"},{"drug_name":"docusate sodium 10 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1248119"},{"drug_name":"diphenhydramine hydrochloride 1.67 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1248354"},{"drug_name":"diphenhydramine hydrochloride 1.67 MG\/ML Oral Solution [Zzzquil]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1248356"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Capsule [Zzzquil]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1248360"},{"drug_name":"nonoxynol-9 0.03 MG\/MG Vaginal Gel [Gynol II]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1250090"},{"drug_name":"etravirine 25 MG Oral Tablet [Intelence]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1250723"},{"drug_name":"potassium phosphate 155 MG \/ sodium phosphate  dibasic 852 MG \/ sodium phosphate  monobasic 130 MG Oral Tablet [K-Phos Neutral]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1251241"},{"drug_name":"{28 (ethinyl estradiol 0.0025 MG \/ norethindrone acetate 0.5 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1251334"},{"drug_name":"{28 (ethinyl estradiol 0.005 MG \/ norethindrone acetate 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1251336"},{"drug_name":"sodium chloride 6.5 MG\/ML Nasal Spray [Ocean brand of sodium chloride]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1251398"},{"drug_name":"84 HR estradiol 0.00208 MG\/HR \/ norethindrone acetate 0.00583 MG\/HR Transdermal System [Combipatch]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1251495"},{"drug_name":"84 HR estradiol 0.00208 MG\/HR \/ norethindrone acetate 0.0104 MG\/HR Transdermal System [Combipatch]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1251501"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 5 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 2 (inert ingredients 1 MG Oral Tablet) } Pack [Viorele 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1252016"},{"drug_name":"0.5 ML measles virus vaccine live  Enders' attenuated Edmonston strain 2000 UNT\/ML \/ mumps virus vaccine live  Jeryl Lynn strain 40000 UNT\/ML \/ rubella virus vaccine live (Wistar RA 27-3 strain) 2000 UNT\/ML \/ varicella-zoster virus vaccine live (Oka-Merck) strain 20000 UNT\/ML Injection [ProQuad]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1292443"},{"drug_name":"0.5 ML varicella-zoster virus vaccine live (Oka-Merck) strain 2700 UNT\/ML Injection [Varivax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1292459"},{"drug_name":"yellow fever virus strain 17D-204 live antigen 4000 UNT\/ML Injectable Suspension [YF-Vax]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1292828"},{"drug_name":"taliglucerase alfa 200 UNT Injection [Elelyso]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1292881"},{"drug_name":"menthol 1.5 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1293192"},{"drug_name":"caffeine 100 MG \/ ergotamine tartrate 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1293504"},{"drug_name":"acetaminophen 500 MG Oral Tablet [Pharbetol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1293942"},{"drug_name":"lurasidone hydrochloride 120 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1297278"},{"drug_name":"calcium carbonate 1250 MG \/ cholecalciferol 200 UNT Oral Tablet [Oysco 500 with D]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1297389"},{"drug_name":"esomeprazole 2.5 MG Granules for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1297658"},{"drug_name":"betaxolol hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1297753"},{"drug_name":"betaxolol hydrochloride 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1297757"},{"drug_name":"esomeprazole 5 MG Granules for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1297761"},{"drug_name":"cyclopentolate hydrochloride 10 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1298066"},{"drug_name":"cyclopentolate hydrochloride 5 MG\/ML Ophthalmic Solution [Cyclogyl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1298366"},{"drug_name":"acetaminophen 325 MG Oral Tablet [Pharbetol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1298830"},{"drug_name":"14 ML pertuzumab 30 MG\/ML Injection [Perjeta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1298953"},{"drug_name":"ibuprofen 200 MG \/ pseudoephedrine hydrochloride 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1299021"},{"drug_name":"tiagabine hydrochloride 12 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1299903"},{"drug_name":"tiagabine hydrochloride 16 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1299909"},{"drug_name":"tiagabine hydrochloride 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1299911"},{"drug_name":"tiagabine hydrochloride 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1299917"},{"drug_name":"0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine  inactivated 0.01 MG\/ML \/ Bordetella pertussis fimbriae 2\/3 vaccine  inactivated 0.01 MG\/ML \/ Bordetella pertussis pertactin vaccine  inactivated 0.006 MG\/ML \/ Bordetella pertussis toxoid vaccine  inactivated 0.005 MG\/ML \/ diphtheria toxoid vaccine  inactivated 4 UNT\/ML \/ tetanus toxoid vaccine  inactivated 10 UNT\/ML Prefilled Syringe [Adacel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1300191"},{"drug_name":"0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine  inactivated 0.01 MG\/ML \/ Bordetella pertussis fimbriae 2\/3 vaccine  inactivated 0.01 MG\/ML \/ Bordetella pertussis pertactin vaccine  inactivated 0.006 MG\/ML \/ Bordetella pertussis toxoid vaccine  inactivated 0.005 MG\/ML \/ diphtheria toxoid vaccine  inactivated 4 UNT\/ML \/ tetanus toxoid vaccine  inactivated 10 UNT\/ML Injection [Adacel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1300206"},{"drug_name":"0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine  inactivated 0.01 MG\/ML \/ Bordetella pertussis fimbriae 2\/3 vaccine  inactivated 0.01 MG\/ML \/ Bordetella pertussis pertactin vaccine  inactivated 0.006 MG\/ML \/ Bordetella pertussis toxoid vaccine  inactivated 0.02 MG\/ML \/ diphtheria toxoid vaccine  inactivated 30 UNT\/ML \/ tetanus toxoid vaccine  inactivated 10 UNT\/ML Injection [Daptacel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1300310"},{"drug_name":"zinc sulfate 220 MG Oral Capsule [Orazinc]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1300354"},{"drug_name":"0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine  inactivated 0.016 MG\/ML \/ Bordetella pertussis pertactin vaccine  inactivated 0.005 MG\/ML \/ Bordetella pertussis toxoid vaccine  inactivated 0.016 MG\/ML \/ diphtheria toxoid vaccine  inactivated 5 UNT\/ML \/ tetanus toxoid vaccine  inactivated 10 UNT\/ML Prefilled Syringe [Boostrix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1300370"},{"drug_name":"0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine  inactivated 0.016 MG\/ML \/ Bordetella pertussis pertactin vaccine  inactivated 0.005 UNT\/ML \/ Bordetella pertussis toxoid vaccine  inactivated 0.016 MG\/ML \/ diphtheria toxoid vaccine  inactivated 5 UNT\/ML \/ tetanus toxoid vaccine  inactivated 10 UNT\/ML Injection [Boostrix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1300378"},{"drug_name":"0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine  inactivated 0.05 MG\/ML \/ Bordetella pertussis pertactin vaccine  inactivated 0.016 MG\/ML \/ Bordetella pertussis toxoid vaccine  inactivated 0.05 MG\/ML \/ diphtheria toxoid vaccine  inactivated 50 UNT\/ML \/ tetanus toxoid vaccine  inactivated 20 UNT\/ML Prefilled Syringe [Infanrix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1300384"},{"drug_name":"0.5 ML Haemophilus influenzae type b strain 1482  capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 0.068 MG\/ML Injection [ActHIB]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1300468"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Dasetta 1\/35 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1300538"},{"drug_name":"0.5 ML Japanese encephalitis virus vaccine Nakayama-NIH strain  inactivated 0.012 MG\/ML Prefilled Syringe [Ixiaro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1300783"},{"drug_name":"24 HR mirabegron 25 MG Extended Release Oral Tablet [Myrbetriq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1300797"},{"drug_name":"24 HR mirabegron 50 MG Extended Release Oral Tablet [Myrbetriq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1300803"},{"drug_name":"0.5 ML Haemophilus influenzae type b strain 20752  capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 0.07 MG\/ML Injection [Hiberix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1300810"},{"drug_name":"20 ML baclofen 1 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1300890"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 0.5 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Wera 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1300911"},{"drug_name":"60 ACTUAT aclidinium bromide 0.4 MG\/ACTUAT Dry Powder Inhaler [Tudorza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1303107"},{"drug_name":"icosapent ethyl 1000 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1304979"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Falmina 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1304988"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norgestrel 0.3 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Elinest 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1305089"},{"drug_name":"{7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Tri-Lo-Marzia 28-Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1305757"},{"drug_name":"cobicistat 150 MG \/ elvitegravir 150 MG \/ emtricitabine 200 MG \/ tenofovir disoproxil fumarate 300 MG Oral Tablet [Stribild]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1306298"},{"drug_name":"24 HR hydromorphone hydrochloride 32 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1306898"},{"drug_name":"buprenorphine 4 MG \/ naloxone 1 MG Sublingual Film","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1307056"},{"drug_name":"buprenorphine 12 MG \/ naloxone 3 MG Sublingual Film","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1307061"},{"drug_name":"enzalutamide 40 MG Oral Capsule [Xtandi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1307309"},{"drug_name":"linaclotide 0.145 MG Oral Capsule [Linzess]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1307415"},{"drug_name":"linaclotide 0.29 MG Oral Capsule [Linzess]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1307421"},{"drug_name":"sildenafil 10 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1307427"},{"drug_name":"bosutinib 100 MG Oral Tablet [Bosulif]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1307630"},{"drug_name":"bosutinib 500 MG Oral Tablet [Bosulif]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1307635"},{"drug_name":"everolimus 2 MG Tablet for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1308428"},{"drug_name":"everolimus 3 MG Tablet for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1308430"},{"drug_name":"everolimus 5 MG Tablet for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1308432"},{"drug_name":"24 HR rivastigmine 0.554 MG\/HR Transdermal System [Exelon]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1308571"},{"drug_name":"teriflunomide 14 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1310525"},{"drug_name":"teriflunomide 7 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1310533"},{"drug_name":"inulin 200 MG \/ Lacticaseibacillus rhamnosus GG 10000000000 UNT Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1310754"},{"drug_name":"{7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [TRI-LINYAH]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1311535"},{"drug_name":"regorafenib 40 MG Oral Tablet [Stivarga]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1312408"},{"drug_name":"phenytoin 25 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1313112"},{"drug_name":"cysteamine 4.4 MG\/ML Ophthalmic Solution [Cystaran]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1313785"},{"drug_name":"phenytoin 50 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1313885"},{"drug_name":"phenytoin 50 MG Chewable Tablet [Dilantin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1313887"},{"drug_name":"tobramycin 75 MG\/ML Inhalation Solution [Bethkis]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1314768"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Kurvelo]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1356074"},{"drug_name":"perampanel 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1356557"},{"drug_name":"perampanel 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1356570"},{"drug_name":"perampanel 6 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1356574"},{"drug_name":"perampanel 8 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1356578"},{"drug_name":"perampanel 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1356582"},{"drug_name":"perampanel 12 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1356586"},{"drug_name":"brompheniramine maleate 0.4 MG\/ML \/ phenylephrine hydrochloride 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1357013"},{"drug_name":"tofacitinib 5 MG Oral Tablet [Xeljanz]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1357547"},{"drug_name":"loratadine 10 MG Disintegrating Oral Tablet [Wal-itin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1358471"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1358763"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Junel Fe 1\/20 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1358765"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Loestrin Fe 1\/20 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1358770"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Microgestin Fe 1\/20 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1358775"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1358776"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) } Pack [Junel 1\/20 21 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1358780"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) } Pack [Loestrin 1\/20 21 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1358781"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) } Pack [Microgestin 1\/20 21 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359020"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359023"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Junel Fe 1.5\/30 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359025"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Loestrin Fe 1.5\/30 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359026"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Microgestin Fe 1.5\/30 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359027"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359028"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) } Pack [Junel 1.5\/30 21 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359030"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) } Pack [Loestrin 1.5\/30 21 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359031"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) } Pack [Microgestin 1.5\/30 21 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359032"},{"drug_name":"{28 (estradiol 0.5 MG \/ norethindrone acetate 0.1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1359124"},{"drug_name":"{28 (estradiol 1 MG \/ norethindrone acetate 0.5 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1359127"},{"drug_name":"{28 (estradiol 1 MG \/ norethindrone acetate 0.5 MG Oral Tablet) } Pack [Mimvey]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1359129"},{"drug_name":"{5 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 9 (ethinyl estradiol 0.035 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359132"},{"drug_name":"{5 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 9 (ethinyl estradiol 0.035 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Tilia Fe]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359134"},{"drug_name":"{5 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 9 (ethinyl estradiol 0.035 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Tri-Legest 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359135"},{"drug_name":"darunavir 800 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359269"},{"drug_name":"darunavir 800 MG Oral Tablet [Prezista]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1359271"},{"drug_name":"bacitracin 0.4 UNT\/MG \/ neomycin 0.0035 MG\/MG \/ polymyxin B 10 UNT\/MG \/ pramoxine hydrochloride 0.01 MG\/MG Topical Ointment [Lanabiotic]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1359345"},{"drug_name":"neomycin 3.5 MG\/ML \/ polymyxin B 10000 UNT\/ML \/ pramoxine hydrochloride 10 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1359360"},{"drug_name":"heparin sodium  porcine 1000 UNT\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1361226"},{"drug_name":"heparin sodium  porcine 20000 UNT\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1361574"},{"drug_name":"heparin sodium  porcine 5000 UNT\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1361615"},{"drug_name":"0.5 ML heparin sodium  porcine 10000 UNT\/ML Cartridge","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1361853"},{"drug_name":"heparin sodium  porcine 10000 UNT\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1362831"},{"drug_name":"chlorpheniramine maleate 0.4 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1363306"},{"drug_name":"chlorpheniramine maleate 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1363309"},{"drug_name":"chlorpheniramine maleate 4 MG Oral Tablet [Aller-Chlor]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1363315"},{"drug_name":"chlorpheniramine maleate 4 MG Oral Tablet [Wal-finate]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1363323"},{"drug_name":"{84 (cabozantinib 20 MG Oral Capsule [Cometriq]) \/ 28 (cabozantinib 80 MG Oral Capsule [Cometriq]) } Pack [Cometriq 140 MG Daily Dose Carton]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1363408"},{"drug_name":"{28 (cabozantinib 20 MG Oral Capsule [Cometriq]) \/ 28 (cabozantinib 80 MG Oral Capsule [Cometriq]) } Pack [Cometriq 100 MG Daily Dose Carton]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1363410"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Capsule [Wal-Sleep Z]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1363475"},{"drug_name":"1 ML pasireotide 0.3 MG\/ML Injection [Signifor]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364114"},{"drug_name":"1 ML pasireotide 0.6 MG\/ML Injection [Signifor]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364118"},{"drug_name":"1 ML pasireotide 0.9 MG\/ML Injection [Signifor]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364122"},{"drug_name":"ponatinib 15 MG Oral Tablet [Iclusig]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364358"},{"drug_name":"ponatinib 45 MG Oral Tablet [Iclusig]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364362"},{"drug_name":"apixaban 2.5 MG Oral Tablet [Eliquis]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364441"},{"drug_name":"apixaban 5 MG Oral Tablet [Eliquis]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364447"},{"drug_name":"teduglutide 5 MG Injection [Gattex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364477"},{"drug_name":"lomitapide 10 MG Oral Capsule [Juxtapid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364490"},{"drug_name":"lomitapide 20 MG Oral Capsule [Juxtapid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364494"},{"drug_name":"lomitapide 5 MG Oral Capsule [Juxtapid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364498"},{"drug_name":"{84 (cabozantinib 20 MG Oral Capsule [Cometriq]) } Pack [Cometriq 60 MG Daily Dose Carton]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364581"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Chateal 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1364848"},{"drug_name":"ascorbic acid 60 MG \/ cholecalciferol 0.01 MG \/ folic acid 0.3 MG \/ niacin 13.5 MG \/ riboflavin 1.2 MG \/ sodium fluoride 1.1 MG \/ thiamine 1.05 MG \/ vitamin A 0.75 MG \/ vitamin B12 0.0045 MG \/ vitamin B6 1.05 MG \/ vitamin E 6.75 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364854"},{"drug_name":"ascorbic acid 60 MG \/ cholecalciferol 0.01 MG \/ folic acid 0.3 MG \/ niacin 13.5 MG \/ riboflavin 1.2 MG \/ sodium fluoride 2.2 MG \/ thiamine 1.05 MG \/ vitamin A 0.75 MG \/ vitamin B12 0.0045 MG \/ vitamin B6 1.05 MG \/ vitamin E 15 UNT Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1364855"},{"drug_name":"24 HR oxcarbazepine 150 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1365653"},{"drug_name":"24 HR oxcarbazepine 300 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1365842"},{"drug_name":"24 HR oxcarbazepine 600 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1365844"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Mono-Linyah 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1365899"},{"drug_name":"ascorbic acid 35 MG\/ML \/ cholecalciferol 0.01 MG\/ML \/ sodium fluoride 0.55 MG\/ML \/ vitamin A palmitate 1500 UNT\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1365980"},{"drug_name":"ascorbic acid 35 MG\/ML \/ cholecalciferol 0.01 MG\/ML \/ sodium fluoride 1.1 MG\/ML \/ vitamin A palmitate 1500 UNT\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1365984"},{"drug_name":"bacitracin zinc 0.5 UNT\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1366116"},{"drug_name":"clobazam 2.5 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1366192"},{"drug_name":"levonorgestrel 0.000583 MG\/HR Intrauterine System [Skyla]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1366339"},{"drug_name":"ergocalciferol 1.25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1367410"},{"drug_name":"21 DAY ethinyl estradiol 0.000625 MG\/HR \/ etonogestrel 0.005 MG\/HR Vaginal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1367436"},{"drug_name":"glycerol phenylbutyrate 1100 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1368453"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Estarylla 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1369737"},{"drug_name":"{7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Tri-Estarylla 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1369770"},{"drug_name":"3 ML sodium hyaluronate 10 MG\/ML Prefilled Syringe [Gel-One]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1369810"},{"drug_name":"hydrocortisone valerate 0.002 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1370750"},{"drug_name":"hydrocortisone valerate 2 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1370754"},{"drug_name":"hydrocortisone butyrate 1 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1370767"},{"drug_name":"mecamylamine hydrochloride 2.5 MG Oral Tablet [Vecamyl]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1373008"},{"drug_name":"amylase 180000 UNT \/ lipase 36000 UNT \/ protease 114000 UNT Delayed Release Oral Capsule [Creon]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1373327"},{"drug_name":"isotretinoin 10 MG Oral Capsule [Zenatane]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1373333"},{"drug_name":"isotretinoin 20 MG Oral Capsule [Zenatane]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1373335"},{"drug_name":"isotretinoin 40 MG Oral Capsule [Zenatane]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1373337"},{"drug_name":"dimethyl fumarate 120 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1373483"},{"drug_name":"dimethyl fumarate 240 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1373491"},{"drug_name":"{14 (dimethyl fumarate 120 MG Delayed Release Oral Capsule) \/ 46 (dimethyl fumarate 240 MG Delayed Release Oral Capsule) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1373497"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 42 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 21 (ethinyl estradiol 0.025 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 21 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1373503"},{"drug_name":"{224 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Kit]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1374574"},{"drug_name":"Lacticaseibacillus rhamnosus GG 15000000000 UNT Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1374744"},{"drug_name":"bromfenac 0.7 MG\/ML Ophthalmic Solution [Prolensa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1375922"},{"drug_name":"doxylamine succinate 10 MG \/ pyridoxine hydrochloride 10 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1375948"},{"drug_name":"1.5 ML cabazitaxel 40 MG\/ML Injection [Jevtana]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1376084"},{"drug_name":"prednisolone acetate 10 MG\/ML Ophthalmic Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1376336"},{"drug_name":"desoximetasone 0.0005 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"141850"},{"drug_name":"acyclovir 50 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"141859"},{"drug_name":"capsaicin 0.75 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"141868"},{"drug_name":"haloperidol 2 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"141935"},{"drug_name":"azithromycin 40 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"141963"},{"drug_name":"polyvinyl alcohol 0.014 ML\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"142004"},{"drug_name":"benzoyl peroxide 100 MG\/ML Medicated Liquid Soap","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"142034"},{"drug_name":"metronidazole 0.0075 MG\/MG Vaginal Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"142046"},{"drug_name":"mesna 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"142113"},{"drug_name":"brimonidine tartrate 2 MG\/ML \/ brinzolamide 10 MG\/ML Ophthalmic Suspension [Simbrinza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1421456"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Capsule) \/ 4 (ferrous fumarate 75 MG Oral Capsule) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1421461"},{"drug_name":"cysteamine 25 MG Delayed Release Oral Capsule [Procysbi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1421473"},{"drug_name":"cysteamine 75 MG Delayed Release Oral Capsule [Procysbi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1421477"},{"drug_name":"lidocaine 40 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1421893"},{"drug_name":"lidocaine 40 MG\/ML Topical Cream [AneCream]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1422080"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.03 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Enskyce 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1422081"},{"drug_name":"lidocaine 40 MG\/ML Topical Cream [LMX]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1422103"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Jencycla 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1422896"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 84 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) } Pack [Daysee 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1423123"},{"drug_name":"trametinib 0.5 MG Oral Tablet [Mekinist]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1425110"},{"drug_name":"trametinib 2 MG Oral Tablet [Mekinist]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1425118"},{"drug_name":"calcium carbonate 500 MG Chewable Tablet [Healthy Mama]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1425181"},{"drug_name":"dabrafenib 50 MG Oral Capsule [Tafinlar]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1425228"},{"drug_name":"dabrafenib 75 MG Oral Capsule [Tafinlar]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1425230"},{"drug_name":"dextroamphetamine sulfate 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1425847"},{"drug_name":"dextroamphetamine sulfate 7.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1425854"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Chewable Tablet) \/ 4 (ferrous fumarate 75 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1426600"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [My Way]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1426881"},{"drug_name":"lenalidomide 20 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1428947"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Lyza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1430383"},{"drug_name":"afatinib 20 MG Oral Tablet [Gilotrif]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1430449"},{"drug_name":"afatinib 30 MG Oral Tablet [Gilotrif]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1430453"},{"drug_name":"afatinib 40 MG Oral Tablet [Gilotrif]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1430457"},{"drug_name":"buprenorphine 1.4 MG \/ naloxone 0.36 MG Sublingual Tablet [Zubsolv]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1431083"},{"drug_name":"buprenorphine 5.7 MG \/ naloxone 1.4 MG Sublingual Tablet [Zubsolv]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1431104"},{"drug_name":"lurasidone hydrochloride 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1431235"},{"drug_name":"24 HR tacrolimus 0.5 MG Extended Release Oral Capsule [Astagraf]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1431977"},{"drug_name":"24 HR tacrolimus 1 MG Extended Release Oral Capsule [Astagraf]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1431982"},{"drug_name":"24 HR tacrolimus 5 MG Extended Release Oral Capsule [Astagraf]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1431987"},{"drug_name":"168 HR buprenorphine 0.015 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1432969"},{"drug_name":"168 HR buprenorphine 0.015 MG\/HR Transdermal System [BuTrans]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1432971"},{"drug_name":"dolutegravir 50 MG Oral Tablet [Tivicay]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1433879"},{"drug_name":"28 ACTUAT teriparatide 0.02 MG\/ACTUAT Pen Injector","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1435115"},{"drug_name":"enalapril maleate 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1435624"},{"drug_name":"24 HR topiramate 50 MG Extended Release Oral Capsule [Trokendi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1436245"},{"drug_name":"24 HR topiramate 25 MG Extended Release Oral Capsule [Trokendi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1437280"},{"drug_name":"24 HR topiramate 100 MG Extended Release Oral Capsule [Trokendi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1437285"},{"drug_name":"24 HR topiramate 200 MG Extended Release Oral Capsule [Trokendi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1437290"},{"drug_name":"albuterol 0.833 MG\/ML \/ ipratropium bromide 0.167 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1437702"},{"drug_name":"diphenhydramine hydrochloride 25 MG Disintegrating Oral Tablet [Wal-Som]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1437725"},{"drug_name":"diphenhydramine hydrochloride 1.67 MG\/ML Oral Solution [Wal-Sleep Z]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1437774"},{"drug_name":"cyclophosphamide 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1437969"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 5 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 2 (inert ingredients 1 MG Oral Tablet) } Pack [Pimtrea Pack]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1438778"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Larin Fe 1\/20]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1440183"},{"drug_name":"hydrocortisone acetate 0.01 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1440184"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Aubra 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1440185"},{"drug_name":"hydrocortisone 25 MG\/ML Topical Cream [Proctozone HC]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1440936"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Larin Fe 1.5\/30]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1440937"},{"drug_name":"0.4 ML methotrexate 25 MG\/ML Auto-Injector [Otrexup]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1441407"},{"drug_name":"0.4 ML methotrexate 37.5 MG\/ML Auto-Injector [Otrexup]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1441413"},{"drug_name":"0.4 ML methotrexate 50 MG\/ML Auto-Injector [Otrexup]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1441418"},{"drug_name":"0.4 ML methotrexate 62.5 MG\/ML Auto-Injector [Otrexup]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1441424"},{"drug_name":"40 ML obinutuzumab 25 MG\/ML Injection [Gazyva]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1442698"},{"drug_name":"ibrutinib 140 MG Oral Capsule [Imbruvica]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1442992"},{"drug_name":"eslicarbazepine acetate 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1482507"},{"drug_name":"eslicarbazepine acetate 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1482515"},{"drug_name":"eslicarbazepine acetate 600 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1482521"},{"drug_name":"eslicarbazepine acetate 800 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1482525"},{"drug_name":"cetirizine hydrochloride 1 MG\/ML Oral Solution [Wal Zyr 24 Hour Allergy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1482533"},{"drug_name":"acetaminophen 325 MG \/ butalbital 50 MG Oral Tablet [Tencon]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1483329"},{"drug_name":"docusate sodium 100 MG Oral Tablet [DOK]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1483574"},{"drug_name":"naltrexone hydrochloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1483744"},{"drug_name":"coagulation factor IX  human 1 UNT \/ coagulation factor X  human 1 UNT \/ factor VII  human 1 UNT \/ protein C  human 1 UNT \/ protein S  human 1 UNT \/ prothrombin  human 1 UNT Injection [Kcentra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1484963"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 0.4 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Vyfemla 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1485332"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 0.4 MG Chewable Tablet) \/ 7 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Wymzya Fe 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1486452"},{"drug_name":"0.5 ML typhoid Vi polysaccharide vaccine  S typhi Ty2 strain 0.05 MG\/ML Prefilled Syringe [Typhim VI]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1486496"},{"drug_name":"sodium fluoride 0.011 MG\/MG Oral Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1486566"},{"drug_name":"sapropterin dihydrochloride 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1486687"},{"drug_name":"raltegravir 100 MG Granules for Oral Suspension [Isentress]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1486841"},{"drug_name":"dapagliflozin 10 MG Oral Tablet [Farxiga]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1486977"},{"drug_name":"dapagliflozin 5 MG Oral Tablet [Farxiga]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1486981"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) } Pack [Larin 1\/20]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1487086"},{"drug_name":"1 ML glatiramer acetate 40 MG\/ML Prefilled Syringe [Copaxone]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1487363"},{"drug_name":"7 ACTUAT umeclidinium 0.0625 MG\/ACTUAT \/ vilanterol 0.025 MG\/ACTUAT Dry Powder Inhaler [Anoro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1487524"},{"drug_name":"30 ACTUAT umeclidinium 0.0625 MG\/ACTUAT \/ vilanterol 0.025 MG\/ACTUAT Dry Powder Inhaler","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1487527"},{"drug_name":"30 ACTUAT umeclidinium 0.0625 MG\/ACTUAT \/ vilanterol 0.025 MG\/ACTUAT Dry Powder Inhaler [Anoro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1487528"},{"drug_name":"tretinoin 0.0008 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1488045"},{"drug_name":"coagulation factor XIII a-subunit (recombinant) 1 UNT Injection [Tretten]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1488304"},{"drug_name":"cholecalciferol 1.25 MG Oral Capsule [Decara]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1488353"},{"drug_name":"droxidopa 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1490026"},{"drug_name":"droxidopa 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1490034"},{"drug_name":"droxidopa 300 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1490038"},{"drug_name":"5 ML elosulfase alfa 1 MG\/ML Injection [Vimizim]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1490052"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [Take Action]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1490063"},{"drug_name":"raloxifene hydrochloride 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1490065"},{"drug_name":"tasimelteon 20 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1490473"},{"drug_name":"3 ML testosterone undecanoate 250 MG\/ML Injection [Aveed]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1490667"},{"drug_name":"metreleptin 5 MG\/ML Injectable Solution [Myalept]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1491634"},{"drug_name":"apremilast 20 MG Oral Tablet [Otezla]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1492742"},{"drug_name":"apremilast 30 MG Oral Tablet [Otezla]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1492746"},{"drug_name":"hydrocortisone 10 MG\/ML Vaginal Cream [Monistat Itch Relief]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1494035"},{"drug_name":"Lacticaseibacillus rhamnosus GG 5000000000 UNT Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1494667"},{"drug_name":"Sprinkle 24 HR topiramate 150 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1494769"},{"drug_name":"propranolol hydrochloride 4.28 MG\/ML Oral Solution [Hemangeol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1495064"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Norlyroc 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1495092"},{"drug_name":"thiamine 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"150921"},{"drug_name":"mometasone furoate 0.001 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"151029"},{"drug_name":"mometasone furoate 1 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"151030"},{"drug_name":"topiramate 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"151226"},{"drug_name":"meloxicam 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"152695"},{"drug_name":"calcium carbonate 1250 MG \/ cholecalciferol 0.01 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"152770"},{"drug_name":"lamivudine 150 MG Oral Tablet [Epivir]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"152931"},{"drug_name":"lamivudine 10 MG\/ML Oral Solution [Epivir]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"152932"},{"drug_name":"ritonavir 100 MG Oral Capsule [Norvir]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"152970"},{"drug_name":"ibuprofen 200 MG Oral Tablet [Advil]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"153008"},{"drug_name":"deflazacort 6 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"153098"},{"drug_name":"adapalene 0.001 MG\/MG Topical Gel [Differin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"153183"},{"drug_name":"zolmitriptan 2.5 MG Oral Tablet [Zomig]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"153353"},{"drug_name":"dextroamphetamine sulfate 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1535454"},{"drug_name":"dextroamphetamine sulfate 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1535470"},{"drug_name":"progesterone 0.04 MG\/MG Vaginal Gel [Crinone]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"153579"},{"drug_name":"progesterone 0.08 MG\/MG Vaginal Gel [Crinone]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"153580"},{"drug_name":"120 ACTUAT mometasone furoate 0.1 MG\/ACTUAT Metered Dose Inhaler [Asmanex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1536144"},{"drug_name":"120 ACTUAT mometasone furoate 0.2 MG\/ACTUAT Metered Dose Inhaler [Asmanex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1536148"},{"drug_name":"mercaptopurine 20 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1536484"},{"drug_name":"168 HR ethinyl estradiol 0.00146 MG\/HR \/ norelgestromin 0.00625 MG\/HR Transdermal System [Xulane]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1536586"},{"drug_name":"potassium bicarbonate 25 MEQ Effervescent Oral Tablet [Klor-Con\/EF]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1537082"},{"drug_name":"4 ML sodium hyaluronate 22 MG\/ML Prefilled Syringe [Monovisc]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1537107"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) } Pack [Larin 1.5\/30]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1537209"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Delyla 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1538130"},{"drug_name":"candesartan cilexetil 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"153822"},{"drug_name":"candesartan cilexetil 8 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"153823"},{"drug_name":"glimepiride 3 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"153842"},{"drug_name":"deflazacort 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"153880"},{"drug_name":"30 ACTUAT umeclidinium 0.0625 MG\/ACTUAT Dry Powder Inhaler [Incruse]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1539885"},{"drug_name":"14 ACTUAT fluticasone furoate 0.1 MG\/ACTUAT \/ vilanterol 0.025 MG\/ACTUAT Dry Powder Inhaler [Breo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1539891"},{"drug_name":"30 ACTUAT fluticasone furoate 0.1 MG\/ACTUAT \/ vilanterol 0.025 MG\/ACTUAT Dry Powder Inhaler [Breo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1539893"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Deblitane 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1539953"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Sharobel 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1539955"},{"drug_name":"benzoyl peroxide 0.05 MG\/MG \/ clindamycin phosphate 0.012 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1540241"},{"drug_name":"benzoyl peroxide 0.05 MG\/MG \/ clindamycin phosphate 0.012 MG\/MG Topical Gel [Neuac]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1540246"},{"drug_name":"hydrocortisone 25 MG\/ML Topical Cream [Proctosol]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1540356"},{"drug_name":"tedizolid phosphate 200 MG Oral Tablet [Sivextro]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1540868"},{"drug_name":"clobetasol propionate 0.5 MG\/ML Medicated Shampoo [Clodan]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1541099"},{"drug_name":"sunitinib 37.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1541890"},{"drug_name":"168 HR buprenorphine 0.0075 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1542997"},{"drug_name":"168 HR buprenorphine 0.0075 MG\/HR Transdermal System [BuTrans]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1542999"},{"drug_name":"tavaborole 43.5 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1543177"},{"drug_name":"belinostat 500 MG Injection [Beleodaq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1543552"},{"drug_name":"{24 (drospirenone 3 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 4 (inert ingredients 1 MG Oral Tablet) } Pack [Nikki 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1543553"},{"drug_name":"lidocaine hydrochloride 10 MG\/ML Topical Lotion [RadiaGuard]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1543717"},{"drug_name":"0.2 ML methotrexate 50 MG\/ML Auto-Injector [Rasuvo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1544383"},{"drug_name":"0.25 ML methotrexate 50 MG\/ML Auto-Injector [Rasuvo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1544386"},{"drug_name":"0.3 ML methotrexate 50 MG\/ML Auto-Injector [Rasuvo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1544388"},{"drug_name":"0.35 ML methotrexate 50 MG\/ML Auto-Injector [Rasuvo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1544390"},{"drug_name":"0.4 ML methotrexate 50 MG\/ML Auto-Injector [Rasuvo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1544394"},{"drug_name":"0.45 ML methotrexate 50 MG\/ML Auto-Injector [Rasuvo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1544396"},{"drug_name":"0.5 ML methotrexate 50 MG\/ML Auto-Injector [Rasuvo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1544398"},{"drug_name":"0.6 ML methotrexate 50 MG\/ML Auto-Injector [Rasuvo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1544402"},{"drug_name":"0.15 ML methotrexate 50 MG\/ML Auto-Injector [Rasuvo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1544404"},{"drug_name":"idelalisib 100 MG Oral Tablet [Zydelig]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1544471"},{"drug_name":"idelalisib 150 MG Oral Tablet [Zydelig]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1544475"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [Afterpill]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1545303"},{"drug_name":"empagliflozin 10 MG Oral Tablet [Jardiance]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1545664"},{"drug_name":"empagliflozin 25 MG Oral Tablet [Jardiance]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1545668"},{"drug_name":"abacavir 600 MG \/ dolutegravir 50 MG \/ lamivudine 300 MG Oral Tablet [Triumeq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1546894"},{"drug_name":"eliglustat 84 MG Oral Capsule [Cerdelga]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1547231"},{"drug_name":"0.5 ML Streptococcus pneumoniae type 1 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 10A capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 11A capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 12F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 14 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 15B capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 17F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 18C capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 19A capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 19F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 2 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 20 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 22F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 23F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 3 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 33F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 4 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 5 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 6B capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 7F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 8 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 9N capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 9V capsular polysaccharide antigen 0.05 MG\/ML Prefilled Syringe [Pneumovax 23]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1547582"},{"drug_name":"30 ACTUAT fluticasone furoate 0.1 MG\/ACTUAT Dry Powder Inhaler [Arnuity]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1547660"},{"drug_name":"14 ACTUAT fluticasone furoate 0.1 MG\/ACTUAT Dry Powder Inhaler [Arnuity]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1547664"},{"drug_name":"14 ACTUAT fluticasone furoate 0.2 MG\/ACTUAT Dry Powder Inhaler [Arnuity]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1547668"},{"drug_name":"30 ACTUAT fluticasone furoate 0.2 MG\/ACTUAT Dry Powder Inhaler [Arnuity]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1547672"},{"drug_name":"tetracaine hydrochloride 5 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1547771"},{"drug_name":"tetracaine hydrochloride 5 MG\/ML Ophthalmic Solution [Altacaine]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1547773"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [Opcicon One-Step]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1549091"},{"drug_name":"lidocaine hydrochloride 0.02 MG\/MG Topical Gel [Glydo]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1549447"},{"drug_name":"pegvisomant 30 MG Injection [Somavert]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1549454"},{"drug_name":"pegvisomant 25 MG Injection [Somavert]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1549456"},{"drug_name":"diphenhydramine hydrochloride 25 MG Disintegrating Oral Tablet [Wal-Sleep Z]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1549559"},{"drug_name":"{42 (rivaroxaban 15 MG Oral Tablet [Xarelto]) \/ 9 (rivaroxaban 20 MG Oral Tablet [Xarelto]) } Pack [Xarelto Kit]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1549683"},{"drug_name":"{1 (15 ML hyaluronidase  human recombinant 160 UNT\/ML Injection) \/ 1 (300 ML immunoglobulin G  human 100 MG\/ML Injection) } Pack [Hyqvia 30 G \/ 300 ML Kit]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1549688"},{"drug_name":"{1 (1.25 ML hyaluronidase  human recombinant 160 UNT\/ML Injection) \/ 1 (25 ML immunoglobulin G  human 100 MG\/ML Injection) } Pack [Hyqvia 2.5 G \/ 25 ML Kit]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1549690"},{"drug_name":"{1 (2.5 ML hyaluronidase  human recombinant 160 UNT\/ML Injection) \/ 1 (50 ML immunoglobulin G  human 100 MG\/ML Injection) } Pack [Hyqvia 5 G \/ 50 ML Kit]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1549692"},{"drug_name":"{1 (100 ML immunoglobulin G  human 100 MG\/ML Injection) \/ 1 (5 ML hyaluronidase  human recombinant 160 UNT\/ML Injection) } Pack [Hyqvia 10 G \/ 100 ML Kit]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1549694"},{"drug_name":"{1 (10 ML hyaluronidase  human recombinant 160 UNT\/ML Injection) \/ 1 (200 ML immunoglobulin G  human 100 MG\/ML Injection) } Pack [Hyqvia 20 G \/ 200 ML Kit]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1549696"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Tarina Fe 1\/20 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1550536"},{"drug_name":"Kentucky bluegrass pollen extract 300 IR \/ orchard grass pollen extract 300 IR \/ perennial rye grass pollen extract 300 IR \/ sweet vernal grass pollen extract 300 IR \/ Timothy grass pollen extract 300 IR Sublingual Tablet [Oralair 300]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1550720"},{"drug_name":"0.5 ML dulaglutide 1.5 MG\/ML Auto-Injector [Trulicity]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1551300"},{"drug_name":"0.5 ML dulaglutide 3 MG\/ML Auto-Injector [Trulicity]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1551306"},{"drug_name":"2 ML midazolam 5 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1551393"},{"drug_name":"1 ML midazolam 5 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1551395"},{"drug_name":"12 HR bupropion hydrochloride 90 MG \/ naltrexone hydrochloride 8 MG Extended Release Oral Tablet [Contrave]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1551474"},{"drug_name":"naloxegol 12.5 MG Oral Tablet [Movantik]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1551923"},{"drug_name":"cobicistat 150 MG Oral Tablet [Tybost]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1551999"},{"drug_name":"60 ACTUAT tiotropium 0.0025 MG\/ACTUAT Inhalation Spray [Spiriva]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1552004"},{"drug_name":"fluocinolone acetonide 0.19 MG Drug Implant [Iluvien]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1552356"},{"drug_name":"ledipasvir 90 MG \/ sofosbuvir 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1591943"},{"drug_name":"pirfenidone 267 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1592279"},{"drug_name":"nintedanib 100 MG Oral Capsule [Ofev]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1592748"},{"drug_name":"nintedanib 150 MG Oral Capsule [Ofev]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1592752"},{"drug_name":"0.5 ML Neisseria meningitidis serogroup B recombinant LP2086 A05 protein variant antigen 0.12 MG\/ML \/ Neisseria meningitidis serogroup B recombinant LP2086 B01 protein variant antigen 0.12 MG\/ML Prefilled Syringe [Trumenba]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1593140"},{"drug_name":"antihemophilic factor  porcine B-domain truncated recombinant 1 UNT Injection [Obizur]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1593156"},{"drug_name":"24 HR dapagliflozin 10 MG \/ metformin hydrochloride 1000 MG Extended Release Oral Tablet [Xigduo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1593775"},{"drug_name":"24 HR dapagliflozin 5 MG \/ metformin hydrochloride 500 MG Extended Release Oral Tablet [Xigduo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1593831"},{"drug_name":"24 HR dapagliflozin 5 MG \/ metformin hydrochloride 1000 MG Extended Release Oral Tablet [Xigduo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1593833"},{"drug_name":"24 HR dapagliflozin 10 MG \/ metformin hydrochloride 500 MG Extended Release Oral Tablet [Xigduo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1593835"},{"drug_name":"lisdexamfetamine dimesylate 10 MG Oral Capsule [Vyvanse]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1593858"},{"drug_name":"sodium chloride 6.5 MG\/ML Nasal Spray [Altamist]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1593876"},{"drug_name":"sodium chloride 6.5 MG\/ML Nasal Spray [Little Noses]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1593881"},{"drug_name":"amylase 105000 UNT \/ lipase 25000 UNT \/ protease 79000 UNT Delayed Release Oral Capsule [Zenpep]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1594673"},{"drug_name":"ferric citrate 1000 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1594680"},{"drug_name":"amylase 14000 UNT \/ lipase 3000 UNT \/ protease 10000 UNT Delayed Release Oral Capsule [Zenpep]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1595292"},{"drug_name":"amylase 24000 UNT \/ lipase 5000 UNT \/ protease 17000 UNT Delayed Release Oral Capsule [Zenpep]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1595457"},{"drug_name":"amylase 42000 UNT \/ lipase 10000 UNT \/ protease 32000 UNT Delayed Release Oral Capsule [Zenpep]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1595462"},{"drug_name":"amylase 63000 UNT \/ lipase 15000 UNT \/ protease 47000 UNT Delayed Release Oral Capsule [Zenpep]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1595473"},{"drug_name":"amylase 84000 UNT \/ lipase 20000 UNT \/ protease 63000 UNT Delayed Release Oral Capsule [Zenpep]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1595478"},{"drug_name":"tobramycin 60 MG\/ML Inhalation Solution [Kitabis]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1596030"},{"drug_name":"7 ACTUAT umeclidinium 0.0625 MG\/ACTUAT Dry Powder Inhaler [Incruse]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1596445"},{"drug_name":"60 ACTUAT testosterone 20.25 MG\/ACTUAT Topical Gel [Androgel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1597075"},{"drug_name":"0.5 ML L1 protein  human papillomavirus type 11 vaccine 0.08 MG\/ML \/ L1 protein  human papillomavirus type 16 vaccine 0.12 MG\/ML \/ L1 protein  human papillomavirus type 18 vaccine 0.08 MG\/ML \/ L1 protein  human papillomavirus type 31 vaccine 0.04 MG\/ML \/ L1 protein  human papillomavirus type 33 vaccine 0.04 MG\/ML \/ L1 protein  human papillomavirus type 45 vaccine 0.04 MG\/ML \/ L1 protein  human papillomavirus type 52 vaccine 0.04 MG\/ML \/ L1 protein  human papillomavirus type 58 vaccine 0.04 MG\/ML \/ L1 protein  human papillomavirus type 6 vaccine 0.06 MG\/ML Injection [Gardasil 9]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1597099"},{"drug_name":"0.5 ML L1 protein  human papillomavirus type 11 vaccine 0.08 MG\/ML \/ L1 protein  human papillomavirus type 16 vaccine 0.12 MG\/ML \/ L1 protein  human papillomavirus type 18 vaccine 0.08 MG\/ML \/ L1 protein  human papillomavirus type 31 vaccine 0.04 MG\/ML \/ L1 protein  human papillomavirus type 33 vaccine 0.04 MG\/ML \/ L1 protein  human papillomavirus type 45 vaccine 0.04 MG\/ML \/ L1 protein  human papillomavirus type 52 vaccine 0.04 MG\/ML \/ L1 protein  human papillomavirus type 58 vaccine 0.04 MG\/ML \/ L1 protein  human papillomavirus type 6 vaccine 0.06 MG\/ML Prefilled Syringe [Gardasil 9]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1597103"},{"drug_name":"1250 MG testosterone 0.0162 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1597120"},{"drug_name":"2500 MG testosterone 0.01 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1597123"},{"drug_name":"2500 MG testosterone 0.0162 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1597126"},{"drug_name":"blinatumomab 0.035 MG Injection [Blincyto]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1597267"},{"drug_name":"buprenorphine 11.4 MG \/ naloxone 2.9 MG Sublingual Tablet [Zubsolv]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1597570"},{"drug_name":"buprenorphine 8.6 MG \/ naloxone 2.1 MG Sublingual Tablet [Zubsolv]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1597575"},{"drug_name":"pasireotide 20 MG Injection [Signifor]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1597599"},{"drug_name":"pasireotide 40 MG Injection [Signifor]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1597603"},{"drug_name":"nonoxynol-9 0.04 MG\/MG Vaginal Gel [VCF Contraceptive]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1597814"},{"drug_name":"pasireotide 60 MG Injection [Signifor]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1597822"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [Aftera]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1598658"},{"drug_name":"atazanavir 50 MG Oral Powder [Reyataz]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1598989"},{"drug_name":"C1 esterase inhibitor (recombinant) 2100 UNT Injection [Ruconest]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1599841"},{"drug_name":"60 ACTUAT testosterone 30 MG\/ACTUAT Topical Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1599949"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [EContra]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1600602"},{"drug_name":"amphetamine sulfate 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1600695"},{"drug_name":"cobicistat 150 MG \/ darunavir 800 MG Oral Tablet [Prezcobix]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1600710"},{"drug_name":"naloxegol 25 MG Oral Tablet [Movantik]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1601373"},{"drug_name":"palbociclib 100 MG Oral Capsule [Ibrance]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1601386"},{"drug_name":"palbociclib 125 MG Oral Capsule [Ibrance]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1601390"},{"drug_name":"palbociclib 75 MG Oral Capsule [Ibrance]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1601394"},{"drug_name":"0.5 ML meningococcal group B vaccine 0.1 MG\/ML \/ Neisseria meningitidis serogroup B recombinant FHBP fusion protein antigen 0.1 MG\/ML \/ Neisseria meningitidis serogroup B recombinant NHBA fusion protein antigen 0.1 MG\/ML \/ Neisseria meningitidis serogroup B strain NZ98\/254 outer membrane vesicle 0.05 MG\/ML Prefilled Syringe [Bexsero]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1601407"},{"drug_name":"atazanavir 300 MG \/ cobicistat 150 MG Oral Tablet [Evotaz]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1601660"},{"drug_name":"empagliflozin 10 MG \/ linagliptin 5 MG Oral Tablet [Glyxambi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1602115"},{"drug_name":"empagliflozin 25 MG \/ linagliptin 5 MG Oral Tablet [Glyxambi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1602120"},{"drug_name":"1.5 ML aripiprazole 200 MG\/ML Prefilled Syringe [Abilify]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1602604"},{"drug_name":"2 ML aripiprazole 200 MG\/ML Prefilled Syringe [Abilify]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1602607"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 84 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) } Pack [Ashlyna 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1603861"},{"drug_name":"metronidazole 0.013 MG\/MG Vaginal Gel [Nuvessa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1604336"},{"drug_name":"{30 (lenvatinib 10 MG Oral Capsule [Lenvima]) \/ 30 (lenvatinib 4 MG Oral Capsule [Lenvima]) } Pack [Lenvima 14]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1604350"},{"drug_name":"{60 (lenvatinib 10 MG Oral Capsule [Lenvima]) \/ 30 (lenvatinib 4 MG Oral Capsule [Lenvima]) } Pack [Lenvima 24]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1604352"},{"drug_name":"{30 (lenvatinib 10 MG Oral Capsule [Lenvima]) } Pack [Lenvima 10]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1604384"},{"drug_name":"{60 (lenvatinib 10 MG Oral Capsule [Lenvima]) } Pack [Lenvima 20]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1604395"},{"drug_name":"1.5 ML insulin glargine 300 UNT\/ML Pen Injector","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1604539"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.03 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Juleber 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1605086"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Larin 24 Fe 1\/20]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1605091"},{"drug_name":"0.4 ML darbepoetin alfa 0.025 MG\/ML Prefilled Syringe [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1605172"},{"drug_name":"levonorgestrel 0.000813 MG\/HR Intrauterine System [Liletta]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1605257"},{"drug_name":"{4 (apremilast 10 MG Oral Tablet [Otezla]) \/ 4 (apremilast 20 MG Oral Tablet [Otezla]) \/ 47 (apremilast 30 MG Oral Tablet [Otezla]) } Pack [Otezla 28-Day 10\/20\/30 Starter Pack]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1605455"},{"drug_name":"5 ML dinutuximab 3.5 MG\/ML Injection [Unituxin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1606283"},{"drug_name":"asenapine 2.5 MG Sublingual Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1606337"},{"drug_name":"metoprolol tartrate 37.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1606347"},{"drug_name":"metoprolol tartrate 75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1606349"},{"drug_name":"ivacaftor 50 MG Oral Granules [Kalydeco]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1606866"},{"drug_name":"ivacaftor 75 MG Oral Granules [Kalydeco]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1606870"},{"drug_name":"30 ACTUAT aclidinium bromide 0.4 MG\/ACTUAT Dry Powder Inhaler [Tudorza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1607112"},{"drug_name":"24 HR desvenlafaxine succinate 25 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1607617"},{"drug_name":"deferasirox 180 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1607784"},{"drug_name":"deferasirox 360 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1607792"},{"drug_name":"deferasirox 90 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1607796"},{"drug_name":"0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine  inactivated 0.04 MG\/ML \/ Bordetella pertussis fimbriae 2\/3 vaccine  inactivated 0.01 MG\/ML \/ Bordetella pertussis pertactin vaccine  inactivated 0.006 MG\/ML \/ Bordetella pertussis toxoid vaccine  inactivated 0.04 MG\/ML \/ diphtheria toxoid vaccine  inactivated 30 UNT\/ML \/ poliovirus vaccine inactivated  type 1 (Mahoney) 80 UNT\/ML \/ poliovirus vaccine inactivated  type 2 (MEF-1) 16 UNT\/ML \/ poliovirus vaccine inactivated  type 3 (Saukett) 64 UNT\/ML \/ tetanus toxoid vaccine  inactivated 10 UNT\/ML Injection [Quadracel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1607808"},{"drug_name":"{24 (ethinyl estradiol 0.025 MG \/ norethindrone 0.8 MG Chewable Tablet) \/ 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1607990"},{"drug_name":"cholic acid 250 MG Oral Capsule [Cholbam]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1608274"},{"drug_name":"cholic acid 50 MG Oral Capsule [Cholbam]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1608276"},{"drug_name":"bacitracin 0.5 UNT\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1648110"},{"drug_name":"nitrofurantoin  macrocrystals 25 MG \/ nitrofurantoin  monohydrate 75 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1648755"},{"drug_name":"nitrofurantoin  macrocrystals 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1648759"},{"drug_name":"lomitapide 30 MG Oral Capsule [Juxtapid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1648772"},{"drug_name":"14 ACTUAT fluticasone furoate 0.2 MG\/ACTUAT \/ vilanterol 0.025 MG\/ACTUAT Dry Powder Inhaler [Breo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1648785"},{"drug_name":"30 ACTUAT fluticasone furoate 0.2 MG\/ACTUAT \/ vilanterol 0.025 MG\/ACTUAT Dry Powder Inhaler [Breo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1648789"},{"drug_name":"triamcinolone acetonide 5 MG\/ML Topical Cream [Triderm]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1648999"},{"drug_name":"doxycycline monohydrate 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1649401"},{"drug_name":"doxycycline hyclate 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1649405"},{"drug_name":"1 ML filgrastim 0.3 MG\/ML Injection [Neupogen]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1649946"},{"drug_name":"200 ACTUAT albuterol 0.09 MG\/ACTUAT Dry Powder Inhaler [ProAir]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1649961"},{"drug_name":"1.6 ML filgrastim 0.3 MG\/ML Injection [Neupogen]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1649964"},{"drug_name":"doxycycline hyclate 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1649988"},{"drug_name":"doxycycline monohydrate 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1649990"},{"drug_name":"doxycycline monohydrate 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1650142"},{"drug_name":"doxycycline hyclate 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1650143"},{"drug_name":"{24 (ethinyl estradiol 0.025 MG \/ norethindrone 0.8 MG Chewable Tablet) \/ 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Layolis Fe 28]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1650201"},{"drug_name":"0.5 ML interferon beta-1a 0.06 MG\/ML Auto-Injector [Avonex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1650901"},{"drug_name":"0.88 ML paliperidone palmitate 310 MG\/ML Prefilled Syringe [Invega]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1650968"},{"drug_name":"1.32 ML paliperidone palmitate 311 MG\/ML Prefilled Syringe [Invega]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1650972"},{"drug_name":"1.75 ML paliperidone palmitate 312 MG\/ML Prefilled Syringe [Invega]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1650974"},{"drug_name":"2.63 ML paliperidone palmitate 311 MG\/ML Prefilled Syringe [Invega]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1650976"},{"drug_name":"60 ACTUAT olodaterol 0.0025 MG\/ACTUAT \/ tiotropium 0.0025 MG\/ACTUAT Inhalation Spray [Stiolto]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1651275"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Junel Fe 24 1\/20 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1652084"},{"drug_name":"hyoscyamine sulfate 0.125 MG Sublingual Tablet [Oscimin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1652363"},{"drug_name":"citric acid 1002 MG \/ potassium citrate 3300 MG Powder for Oral Solution [Cytra-K]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1652638"},{"drug_name":"3 ML insulin lispro 100 UNT\/ML Pen Injector","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1652639"},{"drug_name":"doxycycline monohydrate 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1652673"},{"drug_name":"3 ML insulin aspart  human 100 UNT\/ML Cartridge","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1653196"},{"drug_name":"3 ML insulin aspart  human 100 UNT\/ML Pen Injector","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1653202"},{"drug_name":"sapropterin dihydrochloride 500 MG Powder for Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1653217"},{"drug_name":"1 ML etanercept 50 MG\/ML Auto-Injector [Enbrel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1653225"},{"drug_name":"BCG  live  Tice strain 50 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1653579"},{"drug_name":"1 ML darbepoetin alfa 0.2 MG\/ML Injection [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1654955"},{"drug_name":"0.8 ML adalimumab 50 MG\/ML Auto-Injector [Humira]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1655728"},{"drug_name":"ivacaftor 125 MG \/ lumacaftor 200 MG Oral Tablet [ORKAMBI]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1655934"},{"drug_name":"40 ML methotrexate 25 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1655956"},{"drug_name":"10 ML methotrexate 25 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1655959"},{"drug_name":"2 ML methotrexate 25 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1655960"},{"drug_name":"sacubitril 24 MG \/ valsartan 26 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1656340"},{"drug_name":"sacubitril 49 MG \/ valsartan 51 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1656349"},{"drug_name":"sacubitril 97 MG \/ valsartan 103 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1656354"},{"drug_name":"belimumab 120 MG Injection [Benlysta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1656398"},{"drug_name":"belimumab 400 MG Injection [Benlysta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1656402"},{"drug_name":"40 ML ipilimumab 5 MG\/ML Injection [Yervoy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657007"},{"drug_name":"10 ML ipilimumab 5 MG\/ML Injection [Yervoy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657013"},{"drug_name":"4 ML bevacizumab 25 MG\/ML Injection [Avastin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657068"},{"drug_name":"16 ML bevacizumab 25 MG\/ML Injection [Avastin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657074"},{"drug_name":"4 ML nivolumab 10 MG\/ML Injection [Opdivo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657192"},{"drug_name":"10 ML nivolumab 10 MG\/ML Injection [Opdivo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657196"},{"drug_name":"omalizumab 150 MG Injection [Xolair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657212"},{"drug_name":"1 ML palivizumab 100 MG\/ML Injection [Synagis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657343"},{"drug_name":"0.5 ML palivizumab 100 MG\/ML Injection [Synagis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657362"},{"drug_name":"50 ML cetuximab 2 MG\/ML Injection [Erbitux]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657660"},{"drug_name":"100 ML cetuximab 2 MG\/ML Injection [Erbitux]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657664"},{"drug_name":"5 ML panitumumab 20 MG\/ML Injection [Vectibix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657705"},{"drug_name":"20 ML panitumumab 20 MG\/ML Injection [Vectibix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657723"},{"drug_name":"4 ML pembrolizumab 25 MG\/ML Injection [Keytruda]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657751"},{"drug_name":"10 ML ramucirumab 10 MG\/ML Injection [Cyramza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657777"},{"drug_name":"50 ML ramucirumab 10 MG\/ML Injection [Cyramza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657781"},{"drug_name":"10 ML rituximab 10 MG\/ML Injection [Rituxan]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657864"},{"drug_name":"50 ML rituximab 10 MG\/ML Injection [Rituxan]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1657868"},{"drug_name":"50 ML ofatumumab 20 MG\/ML Injection [Arzerra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1658044"},{"drug_name":"5 ML ofatumumab 20 MG\/ML Injection [Arzerra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1658048"},{"drug_name":"ado-trastuzumab emtansine 100 MG Injection [KADCYLA]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1658087"},{"drug_name":"ado-trastuzumab emtansine 160 MG Injection [KADCYLA]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1658091"},{"drug_name":"1 ML hepatitis A virus strain CR 326F antigen  inactivated 50 UNT\/ML Injection [Vaqta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1658102"},{"drug_name":"0.5 ML hepatitis A virus strain CR 326F antigen  inactivated 50 UNT\/ML Injection [Vaqta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1658106"},{"drug_name":"5 ML hepatitis B immune globulin 312 UNT\/ML Injection [Nabi-HB]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1658127"},{"drug_name":"siltuximab 100 MG Injection [Sylvant]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1658135"},{"drug_name":"siltuximab 400 MG Injection [Sylvant]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1658141"},{"drug_name":"1 ML hepatitis B immune globulin 312 UNT\/ML Injection [Nabi-HB]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1658148"},{"drug_name":"1 ML hepatitis B surface antigen vaccine 0.01 MG\/ML Injection [Recombivax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1658150"},{"drug_name":"0.5 ML hepatitis B surface antigen vaccine 0.01 MG\/ML Injection [Recombivax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1658155"},{"drug_name":"1 ML hepatitis B surface antigen vaccine 0.02 MG\/ML Injection [Engerix-B]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1658157"},{"drug_name":"1 ML hepatitis B immune globulin 312 UNT\/ML Injection [HepaGam B]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1658159"},{"drug_name":"1 ML hepatitis B immune globulin 220 UNT\/ML Injection [Hyperhep B]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1658165"},{"drug_name":"5 ML hepatitis B immune globulin 220 UNT\/ML Injection [Hyperhep B]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1658175"},{"drug_name":"0.5 ML yellow fever virus strain 17D-204 live antigen 4000 UNT\/ML Injection [YF-Vax]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1658241"},{"drug_name":"5 ML hepatitis B immune globulin 312 UNT\/ML Injection [HepaGam B]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1658423"},{"drug_name":"0.5 ML Streptococcus pneumoniae type 1 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 10A capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 11A capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 12F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 14 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 15B capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 17F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 18C capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 19A capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 19F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 2 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 20 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 22F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 23F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 3 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 33F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 4 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 5 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 6B capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 7F capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 8 capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 9N capsular polysaccharide antigen 0.05 MG\/ML \/ Streptococcus pneumoniae type 9V capsular polysaccharide antigen 0.05 MG\/ML Injection [Pneumovax 23]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1658472"},{"drug_name":"0.5 ML heparin sodium  porcine 10000 UNT\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1658634"},{"drug_name":"1 ML heparin sodium  porcine 10000 UNT\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1658637"},{"drug_name":"2 ML heparin sodium  porcine 1000 UNT\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1658647"},{"drug_name":"1 ML heparin sodium  porcine 1000 UNT\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1658659"},{"drug_name":"1 ML alirocumab 150 MG\/ML Auto-Injector [Praluent]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1659161"},{"drug_name":"1 ML alirocumab 75 MG\/ML Auto-Injector [Praluent]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1659183"},{"drug_name":"1 ML heparin sodium  porcine 5000 UNT\/ML Cartridge","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1659260"},{"drug_name":"1 ML heparin sodium  porcine 5000 UNT\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1659263"},{"drug_name":"hydrocortisone 25 MG\/ML Topical Cream [Anusol HC]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1659445"},{"drug_name":"aripiprazole 400 MG Injection [Abilify]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1659814"},{"drug_name":"aripiprazole 300 MG Injection [Abilify]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1659818"},{"drug_name":"sonidegib 200 MG Oral Capsule [Odomzo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1659927"},{"drug_name":"1 ML naloxone hydrochloride 0.4 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1659929"},{"drug_name":"antithrombin III  human 1 UNT Injection [Thrombate III]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1659991"},{"drug_name":"anti-inhibitor coagulant complex 1 UNT Injection [Feiba]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1660001"},{"drug_name":"thiotepa 100 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1660004"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.03 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Cyred 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1660690"},{"drug_name":"60 ACTUAT formoterol fumarate 0.005 MG\/ACTUAT \/ mometasone furoate 0.1 MG\/ACTUAT Metered Dose Inhaler [Dulera]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1660934"},{"drug_name":"60 ACTUAT formoterol fumarate 0.005 MG\/ACTUAT \/ mometasone furoate 0.2 MG\/ACTUAT Metered Dose Inhaler [Dulera]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1660938"},{"drug_name":"{84 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Setlakin 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1661092"},{"drug_name":"tioconazole 0.065 MG\/MG Vaginal Ointment [Monistat Simple Therapy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1661176"},{"drug_name":"alpha 1-proteinase inhibitor  human 1 MG Injection [Prolastin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1661220"},{"drug_name":"factor VIII  human 1 UNT \/ von Willebrand factor  human 1 UNT Injection [Wilate]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1661335"},{"drug_name":"factor VIII  human 1 UNT \/ von Willebrand factor  human 1 UNT Injection [Alphanate]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1661345"},{"drug_name":"factor VIII  human 1 UNT \/ von Willebrand factor  human 1 UNT Injection [Humate-P]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1661352"},{"drug_name":"{56 (tobramycin 28 MG Inhalation Powder [Tobi]) } Pack [TOBI Podhaler Weekly Kit]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1661560"},{"drug_name":"adapalene 0.003 MG\/MG \/ benzoyl peroxide 0.025 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1663745"},{"drug_name":"empagliflozin 5 MG \/ metformin hydrochloride 500 MG Oral Tablet [Synjardy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1664321"},{"drug_name":"empagliflozin 12.5 MG \/ metformin hydrochloride 500 MG Oral Tablet [Synjardy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1664325"},{"drug_name":"empagliflozin 5 MG \/ metformin hydrochloride 1000 MG Oral Tablet [Synjardy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1664328"},{"drug_name":"ceftriaxone 500 MG Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1665005"},{"drug_name":"ceftriaxone 1000 MG Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1665021"},{"drug_name":"empagliflozin 12.5 MG \/ metformin hydrochloride 1000 MG Oral Tablet [Synjardy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1665369"},{"drug_name":"1 ML evolocumab 140 MG\/ML Auto-Injector [Repatha]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1665900"},{"drug_name":"1 ML evolocumab 140 MG\/ML Prefilled Syringe [Repatha]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1665906"},{"drug_name":"coagulation factor IX  human 1 UNT Injection [Alphanine SD]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1666309"},{"drug_name":"nonacog alfa 1 UNT Injection [Rixubis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1666314"},{"drug_name":"nonacog alfa 1 UNT Injection [BeneFIX]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1666317"},{"drug_name":"coagulation factor IX recombinant immunoglobulin G1 fusion protein 1 UNT Injection [Alprolix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1666323"},{"drug_name":"nonacog alfa 1 UNT Injection [Ixinity]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1666328"},{"drug_name":"ticagrelor 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1666332"},{"drug_name":"ticagrelor 60 MG Oral Tablet [Brilinta]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1666334"},{"drug_name":"buprenorphine 2.9 MG \/ naloxone 0.71 MG Sublingual Tablet [Zubsolv]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1666385"},{"drug_name":"doxycycline monohydrate 100 MG Oral Capsule [Mondoxyne]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1666542"},{"drug_name":"20 ML baclofen 2 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1666613"},{"drug_name":"20 ML baclofen 2 MG\/ML Injection [Gablofen]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1666615"},{"drug_name":"5 ML baclofen 2 MG\/ML Injection [Lioresal]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1666623"},{"drug_name":"2 ML midazolam 1 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1666798"},{"drug_name":"5 ML midazolam 1 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1666800"},{"drug_name":"1 ML midazolam 5 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1666814"},{"drug_name":"2 ML midazolam 5 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1666823"},{"drug_name":"cariprazine 1.5 MG Oral Capsule [Vraylar]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1667666"},{"drug_name":"cariprazine 3 MG Oral Capsule [Vraylar]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1667670"},{"drug_name":"cariprazine 4.5 MG Oral Capsule [Vraylar]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1667674"},{"drug_name":"cariprazine 6 MG Oral Capsule [Vraylar]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1667678"},{"drug_name":"60 ACTUAT tiotropium 0.00125 MG\/ACTUAT Inhalation Spray [Spiriva]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1667882"},{"drug_name":"3 ML insulin degludec 100 UNT\/ML Pen Injector","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1670011"},{"drug_name":"3 ML insulin degludec 200 UNT\/ML Pen Injector","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1670021"},{"drug_name":"tipiracil 6.14 MG \/ trifluridine 15 MG Oral Tablet [Lonsurf]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1670322"},{"drug_name":"tipiracil 8.19 MG \/ trifluridine 20 MG Oral Tablet [Lonsurf]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1670324"},{"drug_name":"factor IX complex 1 UNT Injection [Profilnine]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1670392"},{"drug_name":"1.6 ML aripiprazole lauroxil 276 MG\/ML Prefilled Syringe [Aristada]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1673274"},{"drug_name":"2.4 ML aripiprazole lauroxil 276 MG\/ML Prefilled Syringe [Aristada]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1673278"},{"drug_name":"3.2 ML aripiprazole lauroxil 276 MG\/ML Prefilled Syringe [Aristada]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1673280"},{"drug_name":"deferiprone 100 MG\/ML Oral Solution [Ferriprox]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1716268"},{"drug_name":"trabectedin 1 MG Injection [Yondelis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1718594"},{"drug_name":"20 ML 6-aminocaproic acid 250 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1718760"},{"drug_name":"20 ML dexmedetomidine 0.004 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1718900"},{"drug_name":"50 ML dexmedetomidine 0.004 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1718906"},{"drug_name":"100 ML dexmedetomidine 0.004 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1718909"},{"drug_name":"antihemophilic factor  human 1 UNT Injection [Hemofil]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1718965"},{"drug_name":"antihemophilic factor  human 1 UNT Injection [Koate]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1718970"},{"drug_name":"antihemophilic factor  human recombinant residues 743-1636 deleted 1 UNT Injection [Xyntha]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1718996"},{"drug_name":"antihemophilic factor  human recombinant 1 UNT Injection [Advate]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1719225"},{"drug_name":"antihemophilic factor  human recombinant 1 UNT Injection [Kogenate]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1719231"},{"drug_name":"coagulation factor X  human 1 UNT Injection [Coagadex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1719240"},{"drug_name":"antihemophilic factor  human recombinant 1 UNT Injection [Recombinate]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1719243"},{"drug_name":"turoctocog alfa 1 UNT Injection [Novoeight]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1719246"},{"drug_name":"efmoroctocog alfa 1 UNT Injection [Eloctate]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1719611"},{"drug_name":"1 ML haloperidol 5 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1719646"},{"drug_name":"1 ML haloperidol decanoate 100 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1719803"},{"drug_name":"1 ML haloperidol decanoate 50 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1719862"},{"drug_name":"antihemophilic factor  human recombinant residues 743-1636 deleted 1 UNT Prefilled Syringe [Xyntha]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1720166"},{"drug_name":"0.45 ML asfotase alfa 40 MG\/ML Injection [Strensiq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1720268"},{"drug_name":"0.7 ML asfotase alfa 40 MG\/ML Injection [Strensiq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1720272"},{"drug_name":"1 ML asfotase alfa 40 MG\/ML Injection [Strensiq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1720276"},{"drug_name":"0.8 ML asfotase alfa 100 MG\/ML Injection [Strensiq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1720280"},{"drug_name":"mepolizumab 100 MG Injection [Nucala]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1720606"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Vienva 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1720616"},{"drug_name":"levoleucovorin 50 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1720760"},{"drug_name":"17.5 ML levoleucovorin 10 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1720765"},{"drug_name":"25 ML levoleucovorin 10 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1720773"},{"drug_name":"2.5 ML sodium hyaluronate 10 MG\/ML Prefilled Syringe [Supartz]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1721082"},{"drug_name":"1 ML talimogene laherparepvec 1000000 UNT\/ML Injection [Imlygic]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1721283"},{"drug_name":"1 ML talimogene laherparepvec 100000000 UNT\/ML Injection [Imlygic]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1721289"},{"drug_name":"osimertinib 40 MG Oral Tablet [Tagrisso]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1721571"},{"drug_name":"osimertinib 80 MG Oral Tablet [Tagrisso]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1721583"},{"drug_name":"cobicistat 150 MG \/ elvitegravir 150 MG \/ emtricitabine 200 MG \/ tenofovir alafenamide 10 MG Oral Tablet [Genvoya]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1721619"},{"drug_name":"5 ML daratumumab 20 MG\/ML Injection [Darzalex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1721956"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Microgestin 24 Fe 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1721965"},{"drug_name":"cobimetinib 20 MG Oral Tablet [Cotellic]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1722376"},{"drug_name":"{7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Tri-Lo- Estarylla 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1722676"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Blisovi 24 Fe 1\/20 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1722680"},{"drug_name":"8 ML ziv-aflibercept 25 MG\/ML Injection [Zaltrap]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1723189"},{"drug_name":"4 ML ziv-aflibercept 25 MG\/ML Injection [Zaltrap]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1723194"},{"drug_name":"1 ML desmopressin acetate 0.004 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1723232"},{"drug_name":"dabigatran etexilate 110 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1723476"},{"drug_name":"50 ML necitumumab 16 MG\/ML Injection [Portrazza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1723750"},{"drug_name":"ixazomib 2.3 MG Oral Capsule [Ninlaro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1723763"},{"drug_name":"ixazomib 3 MG Oral Capsule [Ninlaro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1723767"},{"drug_name":"ixazomib 4 MG Oral Capsule [Ninlaro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1723772"},{"drug_name":"thyroid (USP) 90 MG Oral Tablet [NP Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1724437"},{"drug_name":"thyroid (USP) 30 MG Oral Tablet [NP Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1724439"},{"drug_name":"thyroid (USP) 60 MG Oral Tablet [NP Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1724481"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Blisovi 21 Fe 1\/20 28 Day Pack]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1724801"},{"drug_name":"naloxone hydrochloride 40 MG\/ML Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1725059"},{"drug_name":"naloxone hydrochloride 40 MG\/ML Nasal Spray [Narcan]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1725064"},{"drug_name":"bendamustine hydrochloride 25 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1726097"},{"drug_name":"bendamustine hydrochloride 25 MG\/ML Injectable Solution [Bendeka]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1726102"},{"drug_name":"elotuzumab 300 MG Injection [Empliciti]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1726115"},{"drug_name":"elotuzumab 400 MG Injection [Empliciti]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1726119"},{"drug_name":"imiglucerase 400 UNT Injection [Cerezyme]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1726268"},{"drug_name":"ixabepilone 45 MG Injection [IXEMPRA]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1726274"},{"drug_name":"ixabepilone 15 MG Injection [IXEMPRA]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1726278"},{"drug_name":"2 ML irinotecan hydrochloride 20 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1726319"},{"drug_name":"5 ML irinotecan hydrochloride 20 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1726324"},{"drug_name":"15 ML irinotecan hydrochloride 20 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1726333"},{"drug_name":"20 ML daratumumab 20 MG\/ML Injection [Darzalex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1726440"},{"drug_name":"25 ML irinotecan hydrochloride 20 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1726492"},{"drug_name":"0.4 ML adalimumab 100 MG\/ML Prefilled Syringe [Humira]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1726846"},{"drug_name":"10 ML sebelipase alfa 2 MG\/ML Injection [Kanuma]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1726984"},{"drug_name":"2 ML sugammadex 100 MG\/ML Injection [Bridion]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1726997"},{"drug_name":"5 ML sugammadex 100 MG\/ML Injection [Bridion]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1727001"},{"drug_name":"alectinib 150 MG Oral Capsule [Alecensa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1727485"},{"drug_name":"{24 (ethinyl estradiol 0.025 MG \/ norethindrone 0.8 MG Chewable Tablet) \/ 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Kaitlib Fe 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1727521"},{"drug_name":"pemetrexed 500 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1728072"},{"drug_name":"pemetrexed 100 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1728077"},{"drug_name":"romiplostim 0.25 MG Injection [Nplate]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1728095"},{"drug_name":"romiplostim 0.5 MG Injection [Nplate]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1728099"},{"drug_name":"simoctocog alfa 1 UNT Injection [Nuwiq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1729091"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Blisovi 21 Fe 1.5\/30 28 Day Pack]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1729516"},{"drug_name":"levetiracetam 500 MG Oral Tablet [Roweepra]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1731020"},{"drug_name":"3 ML insulin  regular  human 500 UNT\/ML Pen Injector [Humulin R]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1731317"},{"drug_name":"deferoxamine mesylate 2000 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1731345"},{"drug_name":"deferoxamine mesylate 500 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1731350"},{"drug_name":"5 ML cytarabine 20 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1731355"},{"drug_name":"incobotulinumtoxinA 50 UNT Injection [Xeomin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1732157"},{"drug_name":"incobotulinumtoxinA 100 UNT Injection [Xeomin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1732161"},{"drug_name":"incobotulinumtoxinA 200 UNT Injection [Xeomin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1732165"},{"drug_name":"25 ML epirubicin hydrochloride 2 MG\/ML Injection [Ellence]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1732183"},{"drug_name":"100 ML epirubicin hydrochloride 2 MG\/ML Injection [Ellence]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1732187"},{"drug_name":"ertapenem 1000 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1734683"},{"drug_name":"2.5 ML sodium hyaluronate 10 MG\/ML Prefilled Syringe [Genvisc]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1734865"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [Option 2]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1736014"},{"drug_name":"dexrazoxane 250 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1736585"},{"drug_name":"dexrazoxane 500 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1736590"},{"drug_name":"0.5 ML rimabotulinumtoxinB 5000 UNT\/ML Injection [Myobloc]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1736642"},{"drug_name":"2 ML rimabotulinumtoxinB 5000 UNT\/ML Injection [Myobloc]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1736646"},{"drug_name":"1 ML rimabotulinumtoxinB 5000 UNT\/ML Injection [Myobloc]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1736648"},{"drug_name":"ethinyl estradiol 0.0025 MG \/ norethindrone acetate 0.5 MG Oral Tablet [Fyavolv]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1736654"},{"drug_name":"ethinyl estradiol 0.005 MG \/ norethindrone acetate 1 MG Oral Tablet [Fyavolv]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1736656"},{"drug_name":"cisplatin 50 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1736854"},{"drug_name":"1 ML paricalcitol 0.005 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1736919"},{"drug_name":"1 ML paricalcitol 0.002 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1736931"},{"drug_name":"10 ML pamidronate disodium 3 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1737449"},{"drug_name":"10 ML pamidronate disodium 6 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1737451"},{"drug_name":"10 ML pamidronate disodium 9 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1737453"},{"drug_name":"mebendazole 100 MG Chewable Tablet [Emverm]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1737789"},{"drug_name":"1 ML ziconotide acetate 0.1 MG\/ML Injection [Prialt]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1738354"},{"drug_name":"5 ML ziconotide acetate 0.1 MG\/ML Injection [Prialt]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1738358"},{"drug_name":"paroxetine hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1738483"},{"drug_name":"paroxetine hydrochloride 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1738495"},{"drug_name":"paroxetine hydrochloride 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1738503"},{"drug_name":"paroxetine hydrochloride 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1738511"},{"drug_name":"24 HR paroxetine hydrochloride 12.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1738803"},{"drug_name":"24 HR paroxetine hydrochloride 25 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1738805"},{"drug_name":"24 HR paroxetine hydrochloride 37.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1738807"},{"drug_name":"5 ML brivaracetam 10 MG\/ML Injection [Briviact]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1739754"},{"drug_name":"uridine triacetate 10000 MG Oral Granules [Vistogard]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1739800"},{"drug_name":"fludarabine phosphate 50 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1740864"},{"drug_name":"2 ML fludarabine phosphate 25 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1740865"},{"drug_name":"antihemophilic factor (recombinant) pegylated 1 UNT Injection [Adynovate]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1741409"},{"drug_name":"emtricitabine 200 MG \/ rilpivirine 25 MG \/ tenofovir alafenamide 25 MG Oral Tablet [Odefsey]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1741739"},{"drug_name":"{1 (cariprazine 1.5 MG Oral Capsule [Vraylar]) \/ 6 (cariprazine 3 MG Oral Capsule [Vraylar]) } Pack [Vraylar 1.5\/3 Mixed Pack]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1741747"},{"drug_name":"antihemophilic factor  human recombinant 1 UNT Injection [Kovaltry]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1743374"},{"drug_name":"albutrepenonacog alfa 1 UNT Injection [IDELVION]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1743999"},{"drug_name":"emtricitabine 100 MG \/ tenofovir disoproxil fumarate 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1744001"},{"drug_name":"emtricitabine 100 MG \/ tenofovir disoproxil fumarate 150 MG Oral Tablet [Truvada]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1744003"},{"drug_name":"emtricitabine 133 MG \/ tenofovir disoproxil fumarate 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1744005"},{"drug_name":"emtricitabine 133 MG \/ tenofovir disoproxil fumarate 200 MG Oral Tablet [Truvada]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1744007"},{"drug_name":"emtricitabine 167 MG \/ tenofovir disoproxil fumarate 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1744009"},{"drug_name":"emtricitabine 167 MG \/ tenofovir disoproxil fumarate 250 MG Oral Tablet [Truvada]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1744011"},{"drug_name":"melphalan 50 MG Injection [Evomela]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1745090"},{"drug_name":"1 ML ixekizumab 80 MG\/ML Auto-Injector [Taltz]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1745108"},{"drug_name":"1 ML ixekizumab 80 MG\/ML Prefilled Syringe [Taltz]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1745114"},{"drug_name":"doxylamine succinate 25 MG Oral Tablet [Wal-Som (doxylamine)]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1746511"},{"drug_name":"2.5 ML defibrotide sodium 80 MG\/ML Injection [Defitelio]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1746532"},{"drug_name":"0.4 ML methotrexate 31.3 MG\/ML Auto-Injector [Otrexup]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1747181"},{"drug_name":"0.4 ML methotrexate 43.8 MG\/ML Auto-Injector [Otrexup]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1747187"},{"drug_name":"0.4 ML methotrexate 56.3 MG\/ML Auto-Injector [Otrexup]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1747194"},{"drug_name":"venetoclax 100 MG Oral Tablet [Venclexta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1747567"},{"drug_name":"venetoclax 10 MG Oral Tablet [Venclexta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1747577"},{"drug_name":"venetoclax 50 MG Oral Tablet [Venclexta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1747579"},{"drug_name":"{14 (venetoclax 10 MG Oral Tablet [Venclexta]) \/ 21 (venetoclax 100 MG Oral Tablet [Venclexta]) \/ 7 (venetoclax 50 MG Oral Tablet [Venclexta]) } Pack [Venclexta Starting Pack]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1747580"},{"drug_name":"emtricitabine 200 MG \/ tenofovir alafenamide 25 MG Oral Tablet [Descovy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1747697"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [React]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1788864"},{"drug_name":"nonoxynol-9 280 MG Vaginal Film [VCF Contraceptive]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1788961"},{"drug_name":"abobotulinumtoxinA 500 UNT Injection [Dysport]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1789953"},{"drug_name":"abobotulinumtoxinA 300 UNT Injection [Dysport]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1789958"},{"drug_name":"bromfenac 0.75 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1790141"},{"drug_name":"cabozantinib 20 MG Oral Tablet [Cabometyx]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1790167"},{"drug_name":"cabozantinib 40 MG Oral Tablet [Cabometyx]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1790171"},{"drug_name":"cabozantinib 60 MG Oral Tablet [Cabometyx]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1790175"},{"drug_name":"nitisinone 4 MG\/ML Oral Suspension [Orfadin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1790317"},{"drug_name":"2.2 ML Rho(D) immune globulin  human 1136 UNT\/ML Injection [WinRho]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1790379"},{"drug_name":"4.4 ML Rho(D) immune globulin  human 1136 UNT\/ML Injection [WinRho]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1790383"},{"drug_name":"1.3 ML Rho(D) immune globulin  human 1154 UNT\/ML Injection [WinRho]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1790508"},{"drug_name":"13 ML Rho(D) immune globulin  human 1154 UNT\/ML Injection [WinRho]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1790513"},{"drug_name":"hydrocortisone 25 MG\/ML Topical Cream [Procto-Med]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1790684"},{"drug_name":"{30 (lenvatinib 10 MG Oral Capsule [Lenvima]) \/ 60 (lenvatinib 4 MG Oral Capsule [Lenvima]) } Pack [Lenvima 18]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1792393"},{"drug_name":"20 ML atezolizumab 60 MG\/ML Injection [Tecentriq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1792785"},{"drug_name":"2 ML hydroxyzine hydrochloride 50 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1794552"},{"drug_name":"1 ML hydroxyzine hydrochloride 50 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1794554"},{"drug_name":"cholecalciferol 0.01 MG\/ML Oral Solution [D-Vi-Sol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1794559"},{"drug_name":"lonoctocog alfa 1 UNT Injection [Afstyla]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1796384"},{"drug_name":"1 ML pralatrexate 20 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1796419"},{"drug_name":"1 ML pralatrexate 20 MG\/ML Injection [Folotyn]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1796421"},{"drug_name":"2 ML pralatrexate 20 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1796424"},{"drug_name":"2 ML pralatrexate 20 MG\/ML Injection [Folotyn]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1796425"},{"drug_name":"{60 (lenvatinib 4 MG Oral Capsule [Lenvima]) } Pack [Lenvima 8]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1796665"},{"drug_name":"estradiol 0.01 MG Vaginal Insert [Yuvafem]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797113"},{"drug_name":"ipratropium bromide 0.021 MG\/ACTUAT Metered Dose Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797833"},{"drug_name":"ipratropium bromide 0.042 MG\/ACTUAT Metered Dose Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797844"},{"drug_name":"azelastine hydrochloride 0.137 MG\/ACTUAT \/ fluticasone propionate 0.05 MG\/ACTUAT Metered Dose Nasal Spray [Dymista]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1797849"},{"drug_name":"cromolyn sodium 5.2 MG\/ACTUAT Metered Dose Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797851"},{"drug_name":"cromolyn sodium 5.2 MG\/ACTUAT Metered Dose Nasal Spray [Nasalcrom]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797853"},{"drug_name":"flunisolide 0.025 MG\/ACTUAT Metered Dose Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797863"},{"drug_name":"mometasone furoate 0.05 MG\/ACTUAT Metered Dose Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797865"},{"drug_name":"azelastine hydrochloride 0.137 MG\/ACTUAT Metered Dose Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797867"},{"drug_name":"mometasone furoate 0.05 MG\/ACTUAT Metered Dose Nasal Spray [Nasonex]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797870"},{"drug_name":"nafarelin 0.2 MG\/ACTUAT Metered Dose Nasal Spray [Synarel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1797880"},{"drug_name":"azelastine hydrochloride 0.206 MG\/ACTUAT Metered Dose Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797883"},{"drug_name":"azelastine hydrochloride 0.206 MG\/ACTUAT Metered Dose Nasal Spray [Astepro]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797884"},{"drug_name":"olopatadine hydrochloride 0.665 MG\/ACTUAT Metered Dose Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797895"},{"drug_name":"fluticasone propionate 0.05 MG\/ACTUAT Metered Dose Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797907"},{"drug_name":"fluticasone propionate 0.05 MG\/ACTUAT Metered Dose Nasal Spray [Aller-Flo]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797909"},{"drug_name":"triamcinolone acetonide 0.055 MG\/ACTUAT Metered Dose Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797913"},{"drug_name":"triamcinolone acetonide 0.055 MG\/ACTUAT Metered Dose Nasal Spray [Nasacort]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797915"},{"drug_name":"fluticasone propionate 0.05 MG\/ACTUAT Metered Dose Nasal Spray [Flonase]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1797933"},{"drug_name":"obeticholic acid 5 MG Oral Tablet [Ocaliva]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1798370"},{"drug_name":"obeticholic acid 10 MG Oral Tablet [Ocaliva]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1798375"},{"drug_name":"1 ML heparin sodium  porcine 5000 UNT\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1798389"},{"drug_name":"nitisinone 20 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1798999"},{"drug_name":"sofosbuvir 400 MG \/ velpatasvir 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1799212"},{"drug_name":"topotecan 4 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1799416"},{"drug_name":"sodium polystyrene sulfonate 250 MG\/ML Oral Suspension [SPS]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1799654"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Mili 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1800499"},{"drug_name":"{7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Tri-Mili 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1800500"},{"drug_name":"{4 (0.8 ML adalimumab 50 MG\/ML Auto-Injector [Humira]) } Pack [Humira Pen - Psoriasis Starter Pack]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1801278"},{"drug_name":"Sugar-Free cholestyramine resin 4000 MG Powder for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1801279"},{"drug_name":"Smoking Cessation 12 HR bupropion hydrochloride 150 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1801289"},{"drug_name":"Microencapsulated potassium chloride 20 MEQ Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1801294"},{"drug_name":"Microencapsulated potassium chloride 20 MEQ Extended Release Oral Tablet [Klor-Con]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1801295"},{"drug_name":"Microencapsulated potassium chloride 10 MEQ Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1801298"},{"drug_name":"Microencapsulated potassium chloride 10 MEQ Extended Release Oral Tablet [Klor-Con]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1801299"},{"drug_name":"3.5 ML evolocumab 120 MG\/ML Cartridge [Repatha]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1801322"},{"drug_name":"lifitegrast 50 MG\/ML Ophthalmic Solution [Xiidra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1801840"},{"drug_name":"agalsidase beta 35 MG Injection [Fabrazyme]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1804758"},{"drug_name":"agalsidase beta 5 MG Injection [Fabrazyme]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1804762"},{"drug_name":"bendamustine hydrochloride 100 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1805001"},{"drug_name":"bendamustine hydrochloride 25 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1805007"},{"drug_name":"50\/50 Release 24 HR methylphenidate hydrochloride 20 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1806177"},{"drug_name":"50\/50 Release 24 HR methylphenidate hydrochloride 30 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1806179"},{"drug_name":"30\/70 Release 24 HR methylphenidate hydrochloride 10 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1806181"},{"drug_name":"50\/50 Release 24 HR methylphenidate hydrochloride 40 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1806183"},{"drug_name":"50\/50 Release 24 HR methylphenidate hydrochloride 60 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1806185"},{"drug_name":"30\/70 Release 24 HR methylphenidate hydrochloride 20 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1806187"},{"drug_name":"30\/70 Release 24 HR methylphenidate hydrochloride 30 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1806189"},{"drug_name":"30\/70 Release 24 HR methylphenidate hydrochloride 40 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1806191"},{"drug_name":"30\/70 Release 24 HR methylphenidate hydrochloride 50 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1806193"},{"drug_name":"50\/50 Release 24 HR methylphenidate hydrochloride 10 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1806195"},{"drug_name":"30\/70 Release 24 HR methylphenidate hydrochloride 60 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1806197"},{"drug_name":"{28 (estradiol 0.5 MG \/ norethindrone acetate 0.1 MG Oral Tablet) } Pack [Amabelz 0.5\/0.1 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1806683"},{"drug_name":"carfilzomib 30 MG Injection [Kyprolis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1806937"},{"drug_name":"carfilzomib 60 MG Injection [Kyprolis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1806942"},{"drug_name":"2 ML diazepam 5 MG\/ML Cartridge","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1807459"},{"drug_name":"vancomycin 1000 MG Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1807513"},{"drug_name":"vancomycin 500 MG Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1807516"},{"drug_name":"2 ML immunoglobulin G  human 180 MG\/ML Injection [GamaSTAN]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809034"},{"drug_name":"10 ML immunoglobulin G  human 180 MG\/ML Injection [GamaSTAN]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809038"},{"drug_name":"50 ML immunoglobulin G  human 200 MG\/ML Injection [Hizentra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809063"},{"drug_name":"20 ML immunoglobulin G  human 200 MG\/ML Injection [Hizentra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809067"},{"drug_name":"10 ML immunoglobulin G  human 200 MG\/ML Injection [Hizentra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809069"},{"drug_name":"5 ML immunoglobulin G  human 200 MG\/ML Injection [Hizentra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809077"},{"drug_name":"50 ML immunoglobulin G  human 100 MG\/ML Injection [Bivigam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809416"},{"drug_name":"100 ML immunoglobulin G  human 100 MG\/ML Injection [Bivigam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809422"},{"drug_name":"10 ML immunoglobulin G  human 50 MG\/ML Injection [Flebogamma]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809429"},{"drug_name":"10 ML immunoglobulin G  human 100 MG\/ML Injection [Gammaked]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809436"},{"drug_name":"50 ML immunoglobulin G  human 100 MG\/ML Injection [Gammaked]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809440"},{"drug_name":"100 ML immunoglobulin G  human 100 MG\/ML Injection [Gammaked]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809441"},{"drug_name":"200 ML immunoglobulin G  human 100 MG\/ML Injection [Gammaked]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809445"},{"drug_name":"100 ML immunoglobulin G  human 50 MG\/ML Injection [Flebogamma]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809457"},{"drug_name":"200 ML immunoglobulin G  human 50 MG\/ML Injection [Flebogamma]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809464"},{"drug_name":"400 ML immunoglobulin G  human 50 MG\/ML Injection [Flebogamma]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809475"},{"drug_name":"20 ML immunoglobulin G  human 100 MG\/ML Injection [Octagam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809499"},{"drug_name":"50 ML immunoglobulin G  human 100 MG\/ML Injection [Octagam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809501"},{"drug_name":"100 ML immunoglobulin G  human 100 MG\/ML Injection [Octagam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809502"},{"drug_name":"200 ML immunoglobulin G  human 100 MG\/ML Injection [Octagam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809503"},{"drug_name":"100 ML immunoglobulin G  human 50 MG\/ML Injection [Gammaplex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809511"},{"drug_name":"200 ML immunoglobulin G  human 50 MG\/ML Injection [Gammaplex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809513"},{"drug_name":"400 ML immunoglobulin G  human 50 MG\/ML Injection [Gammaplex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809514"},{"drug_name":"100 ML immunoglobulin G  human 100 MG\/ML Injection [Privigen]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809517"},{"drug_name":"200 ML immunoglobulin G  human 100 MG\/ML Injection [Privigen]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809520"},{"drug_name":"50 ML immunoglobulin G  human 100 MG\/ML Injection [Privigen]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809521"},{"drug_name":"400 ML immunoglobulin G  human 100 MG\/ML Injection [Privigen]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809525"},{"drug_name":"50 ML immunoglobulin G  human 100 MG\/ML Injection [Gamunex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809578"},{"drug_name":"10 ML immunoglobulin G  human 100 MG\/ML Injection [Gamunex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809580"},{"drug_name":"25 ML immunoglobulin G  human 100 MG\/ML Injection [Gamunex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809581"},{"drug_name":"100 ML immunoglobulin G  human 100 MG\/ML Injection [Gamunex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809582"},{"drug_name":"200 ML immunoglobulin G  human 100 MG\/ML Injection [Gamunex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809583"},{"drug_name":"400 ML immunoglobulin G  human 100 MG\/ML Injection [Gamunex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809584"},{"drug_name":"20 ML immunoglobulin G  human 50 MG\/ML Injection [Octagam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809643"},{"drug_name":"50 ML immunoglobulin G  human 50 MG\/ML Injection [Octagam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809647"},{"drug_name":"100 ML immunoglobulin G  human 50 MG\/ML Injection [Octagam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809648"},{"drug_name":"200 ML immunoglobulin G  human 50 MG\/ML Injection [Octagam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809649"},{"drug_name":"10 ML immunoglobulin G  human 100 MG\/ML Injection [Gammagard]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809665"},{"drug_name":"25 ML immunoglobulin G  human 100 MG\/ML Injection [Gammagard]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809667"},{"drug_name":"50 ML immunoglobulin G  human 100 MG\/ML Injection [Gammagard]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809668"},{"drug_name":"100 ML immunoglobulin G  human 100 MG\/ML Injection [Gammagard]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809670"},{"drug_name":"200 ML immunoglobulin G  human 100 MG\/ML Injection [Gammagard]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809671"},{"drug_name":"300 ML immunoglobulin G  human 100 MG\/ML Injection [Gammagard]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809672"},{"drug_name":"immunoglobulin G  human 5000 MG Injection [Gammagard]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809730"},{"drug_name":"immunoglobulin G  human 10000 MG Injection [Gammagard]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809738"},{"drug_name":"hydrocortisone acetate 25 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809843"},{"drug_name":"hydrocortisone acetate 25 MG\/ML Topical Cream [MiCort-HC]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1809845"},{"drug_name":"2 ML eteplirsen 50 MG\/ML Injection [Exondys]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1810578"},{"drug_name":"10 ML eteplirsen 50 MG\/ML Injection [Exondys]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1810582"},{"drug_name":"icosapent ethyl 500 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1811180"},{"drug_name":"aspirin 81 MG \/ omeprazole 40 MG Delayed Release Oral Tablet [Yosprala]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1811918"},{"drug_name":"Osmotic 24 HR nifedipine 30 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1812011"},{"drug_name":"Osmotic 24 HR nifedipine 60 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1812013"},{"drug_name":"Osmotic 24 HR nifedipine 90 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1812015"},{"drug_name":"1 ML dexamethasone phosphate 4 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1812095"},{"drug_name":"1 ML dexamethasone phosphate 4 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1812194"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Ayuna 28 Day Pack]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1812279"},{"drug_name":"Sprinkle 24 HR topiramate 200 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1812419"},{"drug_name":"Sprinkle 24 HR topiramate 25 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1812421"},{"drug_name":"Sprinkle 24 HR topiramate 50 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1812425"},{"drug_name":"Sprinkle 24 HR topiramate 100 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1812427"},{"drug_name":"ivacaftor 125 MG \/ lumacaftor 100 MG Oral Tablet [ORKAMBI]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1812470"},{"drug_name":"vonicog alfa 1 UNT Injection [Vonvendi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1812598"},{"drug_name":"Vibrio cholerae CVD 103-HGR strain live antigen 12000000 UNT\/ML Oral Suspension [Vaxchora]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1812951"},{"drug_name":"5 ML immunoglobulin G  human 200 MG\/ML Injection [Cuvitru]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1813415"},{"drug_name":"10 ML immunoglobulin G  human 200 MG\/ML Injection [Cuvitru]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1813417"},{"drug_name":"20 ML immunoglobulin G  human 200 MG\/ML Injection [Cuvitru]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1813420"},{"drug_name":"40 ML immunoglobulin G  human 200 MG\/ML Injection [Cuvitru]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1813424"},{"drug_name":"40 ML bezlotoxumab 25 MG\/ML Injection [Zinplava]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1855057"},{"drug_name":"thyroid (USP) 15 MG Oral Tablet [NP Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1855086"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [Her Style]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1855519"},{"drug_name":"{1 (0.4 ML adalimumab 100 MG\/ML Prefilled Syringe [Humira]) \/ 1 (0.8 ML adalimumab 100 MG\/ML Prefilled Syringe [Humira]) } Pack [Humira Pediatric Crohn's Disease Starter Package (2 count)]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1855527"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Nylia 1\/35 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1856402"},{"drug_name":"{7 (ethinyl estradiol 0.035 MG \/ norethindrone 0.5 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norethindrone 0.75 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norethindrone 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Nylia 7\/7\/7 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1856424"},{"drug_name":"levonorgestrel 0.000729 MG\/HR Intrauterine System [Kyleena]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1856546"},{"drug_name":"maraviroc 20 MG\/ML Oral Solution [Selzentry]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1857925"},{"drug_name":"{7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Tri-Lo-Mili]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1858836"},{"drug_name":"ferrous sulfate 324 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1860100"},{"drug_name":"Abuse-Deterrent 12 HR oxycodone hydrochloride 20 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1860129"},{"drug_name":"Abuse-Deterrent 12 HR oxycodone hydrochloride 40 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1860137"},{"drug_name":"Abuse-Deterrent 12 HR oxycodone hydrochloride 80 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1860148"},{"drug_name":"Abuse-Deterrent 12 HR oxycodone hydrochloride 10 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1860157"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Afirmelle 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1860414"},{"drug_name":"2 ML docetaxel 10 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1860619"},{"drug_name":"8 ML docetaxel 20 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1861411"},{"drug_name":"rucaparib 300 MG Oral Tablet [Rubraca]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1862590"},{"drug_name":"rucaparib 200 MG Oral Tablet [Rubraca]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1862595"},{"drug_name":"1 ML vincristine sulfate 1 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1863343"},{"drug_name":"2 ML vincristine sulfate 1 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1863354"},{"drug_name":"5 ML nusinersen 2.4 MG\/ML Injection [Spinraza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1863565"},{"drug_name":"buprenorphine 0.7 MG \/ naloxone 0.18 MG Sublingual Tablet [Zubsolv]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1864414"},{"drug_name":"0.05 ML ranibizumab 10 MG\/ML Prefilled Syringe [Lucentis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1864425"},{"drug_name":"hydrocortisone 10 MG\/ML Topical Cream [Proctocort]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1865144"},{"drug_name":"chorionic gonadotropin 5000 UNT\/ML Injectable Solution [Novarel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1865295"},{"drug_name":"crisaborole 0.02 MG\/MG Topical Ointment [Eucrisa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1865962"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.03 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Isibloom 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1866047"},{"drug_name":"psyllium 400 MG Oral Capsule [Metamucil]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1866518"},{"drug_name":"potassium chloride 20 MEQ Powder for Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1867544"},{"drug_name":"potassium chloride 20 MEQ Powder for Oral Solution [Klor-Con]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1867547"},{"drug_name":"pirfenidone 267 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1868014"},{"drug_name":"pirfenidone 801 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1868018"},{"drug_name":"2 ML sodium hyaluronate 10 MG\/ML Injection [Hyalgan]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1869320"},{"drug_name":"2 ML sodium hyaluronate 8.4 MG\/ML Prefilled Syringe [Gel-Syn]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1869381"},{"drug_name":"glutamine 5000 MG Powder for Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1869684"},{"drug_name":"linaclotide 0.072 MG Oral Capsule [Linzess]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1869699"},{"drug_name":"NDA019430 0.3 ML epinephrine 1 MG\/ML Auto-Injector","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1870207"},{"drug_name":"NDA020800 0.15 ML epinephrine 1 MG\/ML Auto-Injector","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1870225"},{"drug_name":"NDA020800 0.3 ML epinephrine 1 MG\/ML Auto-Injector","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1870230"},{"drug_name":"deflazacort 18 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1870954"},{"drug_name":"deflazacort 36 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1870958"},{"drug_name":"deflazacort 22.75 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1870964"},{"drug_name":"lisdexamfetamine dimesylate 40 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1871456"},{"drug_name":"lisdexamfetamine dimesylate 30 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1871460"},{"drug_name":"lisdexamfetamine dimesylate 20 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1871462"},{"drug_name":"lisdexamfetamine dimesylate 10 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1871464"},{"drug_name":"lisdexamfetamine dimesylate 60 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1871466"},{"drug_name":"lisdexamfetamine dimesylate 50 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1871468"},{"drug_name":"telotristat ethyl 250 MG Oral Tablet [Xermelo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1872458"},{"drug_name":"docusate sodium 50 MG \/ sennosides  USP 8.6 MG Oral Tablet [Colace w\/Sennosides]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1872920"},{"drug_name":"0.4 ML adalimumab 100 MG\/ML Auto-Injector [Humira]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1872980"},{"drug_name":"{3 (0.8 ML adalimumab 100 MG\/ML Prefilled Syringe [Humira]) } Pack [Humira Prefilled Syringe 80 MG\/0.8 ML Starter Pack - Pediatric Crohn's Disease]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1873087"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Chewable Tablet) \/ 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Mibelas 24 Fe Chewable 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1873704"},{"drug_name":"{21 (ribociclib 200 MG Oral Tablet [Kisqali]) } Pack [Kisqali 200 MG Daily Dose Carton]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1873991"},{"drug_name":"{42 (ribociclib 200 MG Oral Tablet [Kisqali]) } Pack [Kisqali 400 MG Daily Dose Carton]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1873993"},{"drug_name":"{63 (ribociclib 200 MG Oral Tablet [Kisqali]) } Pack [Kisqali 600 MG Daily Dose Carton]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1873995"},{"drug_name":"24 HR desvenlafaxine succinate 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1874553"},{"drug_name":"24 HR desvenlafaxine succinate 50 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1874559"},{"drug_name":"10 ML avelumab 20 MG\/ML Injection [Bavencio]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1875547"},{"drug_name":"2 ML etelcalcetide 5 MG\/ML Injection [Parsabiv]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1876132"},{"drug_name":"1 ML etelcalcetide 5 MG\/ML Injection [Parsabiv]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1876136"},{"drug_name":"0.5 ML etelcalcetide 5 MG\/ML Injection [Parsabiv]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1876138"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 42 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 21 (ethinyl estradiol 0.025 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 21 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) } Pack [Rivelsa 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1876397"},{"drug_name":"2 ML dupilumab 150 MG\/ML Prefilled Syringe [Dupixent]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1876406"},{"drug_name":"1 ML haloperidol 5 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1876502"},{"drug_name":"50 ML immunoglobulin G  human 100 MG\/ML Injection [Gammaplex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1876671"},{"drug_name":"100 ML immunoglobulin G  human 100 MG\/ML Injection [Gammaplex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1876673"},{"drug_name":"200 ML immunoglobulin G  human 100 MG\/ML Injection [Gammaplex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1876674"},{"drug_name":"0.5 ML yellow fever virus strain 17D-204 live antigen 2000 UNT\/ML Injection [Stamaril]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1876710"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 5 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 2 (inert ingredients 1 MG Oral Tablet) } Pack [Simliya 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1876810"},{"drug_name":"deutetrabenazine 12 MG Oral Tablet [Austedo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1876916"},{"drug_name":"deutetrabenazine 6 MG Oral Tablet [Austedo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1876920"},{"drug_name":"deutetrabenazine 9 MG Oral Tablet [Austedo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1876924"},{"drug_name":"abiraterone acetate 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1918042"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 84 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) } Pack [Simpesse 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1918056"},{"drug_name":"60 ACTUAT fluticasone propionate 0.113 MG\/ACTUAT \/ salmeterol 0.014 MG\/ACTUAT Dry Powder Inhaler [AirDuo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1918199"},{"drug_name":"60 ACTUAT fluticasone propionate 0.232 MG\/ACTUAT \/ salmeterol 0.014 MG\/ACTUAT Dry Powder Inhaler [AirDuo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1918205"},{"drug_name":"60 ACTUAT fluticasone propionate 0.055 MG\/ACTUAT \/ salmeterol 0.014 MG\/ACTUAT Dry Powder Inhaler [AirDuo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1918211"},{"drug_name":"valbenazine 40 MG Oral Capsule [Ingrezza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1918230"},{"drug_name":"niraparib 100 MG Oral Capsule [Zejula]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1918242"},{"drug_name":"diphenhydramine hydrochloride 25 MG Oral Capsule [Dormin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1919073"},{"drug_name":"midostaurin 25 MG Oral Capsule [Rydapt]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1919094"},{"drug_name":"thiotepa 100 MG Injection [Tepadina]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1919209"},{"drug_name":"2.4 ML durvalumab 50 MG\/ML Injection [Imfinzi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1919512"},{"drug_name":"10 ML durvalumab 50 MG\/ML Injection [Imfinzi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1919516"},{"drug_name":"0.1 ML adalimumab 100 MG\/ML Prefilled Syringe [Humira]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1921010"},{"drug_name":"0.2 ML adalimumab 100 MG\/ML Prefilled Syringe [Humira]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1921017"},{"drug_name":"1.56 ML abaloparatide 2 MG\/ML Pen Injector [Tymlos]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1921081"},{"drug_name":"brigatinib 30 MG Oral Tablet [Alunbrig]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1921228"},{"drug_name":"0.8 ML adalimumab 100 MG\/ML Auto-Injector [Humira]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1921240"},{"drug_name":"{3 (0.8 ML adalimumab 100 MG\/ML Auto-Injector [Humira]) } Pack [Humira Pen 80 MG\/0.8 ML - Starter Package for Crohn's Disease  Ulcerative Colitis or Hidradenitis Suppurativa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1921245"},{"drug_name":"{2 (0.4 ML adalimumab 100 MG\/ML Auto-Injector [Humira]) \/ 1 (0.8 ML adalimumab 100 MG\/ML Auto-Injector [Humira]) } Pack [Humira Pen 80 MG\/0.8 ML and 40 MG\/0.4 ML - Psoriasis\/Uveitis Starter Package]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1921468"},{"drug_name":"rucaparib 250 MG Oral Tablet [Rubraca]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1921589"},{"drug_name":"trastuzumab 150 MG Injection [Herceptin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1922512"},{"drug_name":"Atrial Fibrillation sotalol hydrochloride 120 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1922720"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [My Choice]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1922759"},{"drug_name":"Atrial Fibrillation sotalol hydrochloride 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1922763"},{"drug_name":"Atrial Fibrillation sotalol hydrochloride 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1922765"},{"drug_name":"Preservative-Free dorzolamide 20 MG\/ML \/ timolol 5 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1922783"},{"drug_name":"{28 (letrozole 2.5 MG Oral Tablet [Femara]) \/ 21 (ribociclib 200 MG Oral Tablet [Kisqali]) } Pack [Kisqali Femara Co-Pack 200]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1923054"},{"drug_name":"{28 (letrozole 2.5 MG Oral Tablet [Femara]) \/ 42 (ribociclib 200 MG Oral Tablet [Kisqali]) } Pack [Kisqali Femara Co-Pack 400]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1923056"},{"drug_name":"{28 (letrozole 2.5 MG Oral Tablet [Femara]) \/ 63 (ribociclib 200 MG Oral Tablet [Kisqali]) } Pack [Kisqali Femara Co-Pack 600]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1923058"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.03 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Kalliga 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1923421"},{"drug_name":"sotalol hydrochloride 120 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1923422"},{"drug_name":"sotalol hydrochloride 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1923424"},{"drug_name":"sotalol hydrochloride 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1923426"},{"drug_name":"timolol 2.5 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1923428"},{"drug_name":"dorzolamide 20 MG\/ML \/ timolol 5 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1923432"},{"drug_name":"thyroid (USP) 120 MG Oral Tablet [NP Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1923809"},{"drug_name":"deferasirox 90 MG Oral Granules","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1923822"},{"drug_name":"deferasirox 360 MG Oral Granules","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1923826"},{"drug_name":"deferasirox 180 MG Oral Granules","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1923828"},{"drug_name":"raltegravir 600 MG Oral Tablet [Isentress]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1924315"},{"drug_name":"100 ML edaravone 0.3 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1924316"},{"drug_name":"3.9 ML aripiprazole lauroxil 273 MG\/ML Prefilled Syringe [Aristada]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1925264"},{"drug_name":"riboflavin 5'-phosphate 1.46 MG\/ML Ophthalmic Solution [Photrexa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1925830"},{"drug_name":"ritonavir 100 MG Oral Powder [Norvir]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1926069"},{"drug_name":"0.5 UNT Doses 3 ML insulin lispro 100 UNT\/ML Pen Injector","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1926331"},{"drug_name":"hemin 350 MG Injection [Panhematin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1926454"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Aurovela Fe 1\/20 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1926946"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) } Pack [Aurovela 1\/20 21 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1927366"},{"drug_name":"3-Bead 24 HR amphetamine aspartate 12.5 MG \/ amphetamine sulfate 12.5 MG \/ dextroamphetamine saccharate 12.5 MG \/ dextroamphetamine sulfate 12.5 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1927610"},{"drug_name":"3-Bead 24 HR amphetamine aspartate 6.25 MG \/ amphetamine sulfate 6.25 MG \/ dextroamphetamine saccharate 6.25 MG \/ dextroamphetamine sulfate 6.25 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1927617"},{"drug_name":"3-Bead 24 HR amphetamine aspartate 3.125 MG \/ amphetamine sulfate 3.125 MG \/ dextroamphetamine saccharate 3.125 MG \/ dextroamphetamine sulfate 3.125 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1927630"},{"drug_name":"3-Bead 24 HR amphetamine aspartate 9.375 MG \/ amphetamine sulfate 9.375 MG \/ dextroamphetamine saccharate 9.375 MG \/ dextroamphetamine sulfate 9.375 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1927637"},{"drug_name":"11.7 ML hyaluronidase  human recombinant 2000 UNT\/ML \/ rituximab 120 MG\/ML Injection [Rituxan Hycela]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1927890"},{"drug_name":"13.4 ML hyaluronidase  human recombinant 2000 UNT\/ML \/ rituximab 120 MG\/ML Injection [Rituxan Hycela]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1927894"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Aurovela Fe 24 1\/20 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1927957"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) } Pack [Aurovela 1.5\/30 21 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1928007"},{"drug_name":"1 ML belimumab 200 MG\/ML Auto-Injector [Benlysta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1939299"},{"drug_name":"1 ML belimumab 200 MG\/ML Prefilled Syringe [Benlysta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1939348"},{"drug_name":"enasidenib 100 MG Oral Tablet [Idhifa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1940372"},{"drug_name":"enasidenib 50 MG Oral Tablet [Idhifa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1940376"},{"drug_name":"24 HR dapagliflozin 2.5 MG \/ metformin hydrochloride 1000 MG Extended Release Oral Tablet [Xigduo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1940498"},{"drug_name":"neratinib 40 MG Oral Tablet [Nerlynx]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1940654"},{"drug_name":"glecaprevir 100 MG \/ pibrentasvir 40 MG Oral Tablet [Mavyret]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1940709"},{"drug_name":"nitisinone 10 MG Oral Tablet [Nityr]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1941470"},{"drug_name":"nitisinone 5 MG Oral Tablet [Nityr]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1941473"},{"drug_name":"nitisinone 2 MG Oral Tablet [Nityr]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1941476"},{"drug_name":"olaparib 100 MG Oral Tablet [Lynparza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1942485"},{"drug_name":"olaparib 150 MG Oral Tablet [Lynparza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1942489"},{"drug_name":"cytarabine liposome 100 MG \/ daunorubicin liposomal 44 MG Injection [Vyxeos]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1942748"},{"drug_name":"inotuzumab ozogamicin 0.9 MG Injection [Besponsa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1942959"},{"drug_name":"3-Month 1.5 ML leuprolide acetate 20 MG\/ML Prefilled Syringe [Lupron]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1946520"},{"drug_name":"4-Month 1.5 ML leuprolide acetate 20 MG\/ML Prefilled Syringe [Lupron]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1946522"},{"drug_name":"Matrix Delivery 24 HR tramadol hydrochloride 300 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1946525"},{"drug_name":"Matrix Delivery 24 HR tramadol hydrochloride 200 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1946527"},{"drug_name":"Matrix Delivery 24 HR tramadol hydrochloride 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1946529"},{"drug_name":"methotrexate 25 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1946772"},{"drug_name":"triamcinolone acetonide 32 MG Injection [Zilretta]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1947133"},{"drug_name":"fibrinogen  human 1 MG Injection [Fibryga]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1947382"},{"drug_name":"acetazolamide 125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197303"},{"drug_name":"acetazolamide 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197304"},{"drug_name":"acetic acid 20 MG\/ML Otic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197305"},{"drug_name":"acyclovir 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197310"},{"drug_name":"acyclovir 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197311"},{"drug_name":"acyclovir 0.05 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197312"},{"drug_name":"acyclovir 800 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197313"},{"drug_name":"albuterol 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197316"},{"drug_name":"albuterol 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197318"},{"drug_name":"allopurinol 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197319"},{"drug_name":"allopurinol 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197320"},{"drug_name":"alprazolam 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197321"},{"drug_name":"alprazolam 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197322"},{"drug_name":"amcinonide 0.001 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197328"},{"drug_name":"6-aminocaproic acid 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197351"},{"drug_name":"amlodipine 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197361"},{"drug_name":"ammonium lactate 120 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197362"},{"drug_name":"amoxapine 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197363"},{"drug_name":"amoxapine 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197364"},{"drug_name":"amoxapine 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197365"},{"drug_name":"amoxapine 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197366"},{"drug_name":"atenolol 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197379"},{"drug_name":"atenolol 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197380"},{"drug_name":"atenolol 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197381"},{"drug_name":"atenolol 100 MG \/ chlorthalidone 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197382"},{"drug_name":"atenolol 50 MG \/ chlorthalidone 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197383"},{"drug_name":"azathioprine 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197388"},{"drug_name":"baclofen 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197391"},{"drug_name":"baclofen 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197392"},{"drug_name":"benzonatate 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197397"},{"drug_name":"betamethasone 0.0005 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197405"},{"drug_name":"bromocriptine 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197411"},{"drug_name":"bromocriptine 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197412"},{"drug_name":"bumetanide 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197417"},{"drug_name":"bumetanide 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197418"},{"drug_name":"bumetanide 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197419"},{"drug_name":"acetaminophen 325 MG \/ butalbital 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197426"},{"drug_name":"calcium acetate 667 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197433"},{"drug_name":"carbamazepine 200 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197442"},{"drug_name":"carbidopa 10 MG \/ levodopa 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197443"},{"drug_name":"carbidopa 25 MG \/ levodopa 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197444"},{"drug_name":"carbidopa 25 MG \/ levodopa 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197445"},{"drug_name":"carisoprodol 350 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197446"},{"drug_name":"levocarnitine 330 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197448"},{"drug_name":"cefaclor 500 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197449"},{"drug_name":"cefprozil 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197452"},{"drug_name":"cefprozil 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197453"},{"drug_name":"clorazepate dipotassium 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197464"},{"drug_name":"clorazepate dipotassium 3.75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197465"},{"drug_name":"clorazepate dipotassium 7.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197466"},{"drug_name":"chlorthalidone 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197499"},{"drug_name":"chlorthalidone 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197500"},{"drug_name":"chlorzoxazone 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197501"},{"drug_name":"chlorzoxazone 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197502"},{"drug_name":"cimetidine 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197505"},{"drug_name":"cimetidine 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197506"},{"drug_name":"cimetidine 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197507"},{"drug_name":"cimetidine 800 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197508"},{"drug_name":"ciprofloxacin 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197511"},{"drug_name":"ciprofloxacin 750 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197512"},{"drug_name":"clarithromycin 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197516"},{"drug_name":"clarithromycin 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197517"},{"drug_name":"clindamycin 150 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197518"},{"drug_name":"clindamycin 10 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197519"},{"drug_name":"clonazepam 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197527"},{"drug_name":"clonazepam 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197528"},{"drug_name":"clonazepam 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197529"},{"drug_name":"clozapine 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"197535"},{"drug_name":"clozapine 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"197536"},{"drug_name":"colchicine 0.6 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197541"},{"drug_name":"cyclophosphamide 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197549"},{"drug_name":"cyclophosphamide 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197550"},{"drug_name":"cyclosporine 100 MG Oral Capsule [Sandimmune]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197552"},{"drug_name":"cyclosporine 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197553"},{"drug_name":"dapsone 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197557"},{"drug_name":"dapsone 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197558"},{"drug_name":"desonide 0.5 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197572"},{"drug_name":"desoximetasone 0.0025 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197575"},{"drug_name":"dexamethasone 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197577"},{"drug_name":"dexamethasone 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197579"},{"drug_name":"dexamethasone 1.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197580"},{"drug_name":"dexamethasone 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197582"},{"drug_name":"dexamethasone 6 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197583"},{"drug_name":"diazepam 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197589"},{"drug_name":"diazepam 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197590"},{"drug_name":"diazepam 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197591"},{"drug_name":"dicloxacillin 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197595"},{"drug_name":"dicloxacillin 500 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197596"},{"drug_name":"diflunisal 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197603"},{"drug_name":"digoxin 0.125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197604"},{"drug_name":"digoxin 0.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197606"},{"drug_name":"dipyridamole 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197622"},{"drug_name":"disulfiram 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197623"},{"drug_name":"doxazosin 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197625"},{"drug_name":"doxazosin 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197626"},{"drug_name":"doxazosin 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197627"},{"drug_name":"doxazosin 8 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197628"},{"drug_name":"erythromycin 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197650"},{"drug_name":"estazolam 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197653"},{"drug_name":"estazolam 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197654"},{"drug_name":"estradiol 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197657"},{"drug_name":"estradiol 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197658"},{"drug_name":"estradiol 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197659"},{"drug_name":"estrogens  conjugated (USP) 0.3 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197660"},{"drug_name":"estrogens  conjugated (USP) 0.9 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197661"},{"drug_name":"estrogens  conjugated (USP) 1.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197662"},{"drug_name":"ethosuximide 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197682"},{"drug_name":"etodolac 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197684"},{"drug_name":"etodolac 300 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197685"},{"drug_name":"etodolac 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197686"},{"drug_name":"etoposide 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197687"},{"drug_name":"72 HR fentanyl 0.075 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197696"},{"drug_name":"fluconazole 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197698"},{"drug_name":"fluconazole 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197699"},{"drug_name":"fluconazole 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197700"},{"drug_name":"fluconazole 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197701"},{"drug_name":"flurandrenolide 0.5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197718"},{"drug_name":"flurbiprofen 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197724"},{"drug_name":"furosemide 10 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197730"},{"drug_name":"furosemide 8 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197731"},{"drug_name":"furosemide 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197732"},{"drug_name":"gentamicin 1 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197735"},{"drug_name":"glyburide 1.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197737"},{"drug_name":"glycopyrrolate 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197738"},{"drug_name":"glycopyrrolate 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197739"},{"drug_name":"guanfacine 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197745"},{"drug_name":"guanfacine 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197746"},{"drug_name":"haloperidol 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197754"},{"drug_name":"hydrochlorothiazide 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197770"},{"drug_name":"hydrocortisone 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197782"},{"drug_name":"hydrocortisone 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197783"},{"drug_name":"hydrocortisone 25 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197785"},{"drug_name":"hydrocortisone 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197787"},{"drug_name":"hydroxyurea 500 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197797"},{"drug_name":"ibuprofen 20 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"197803"},{"drug_name":"ibuprofen 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"197805"},{"drug_name":"ibuprofen 600 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"197806"},{"drug_name":"ibuprofen 800 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"197807"},{"drug_name":"indapamide 1.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197815"},{"drug_name":"indapamide 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197816"},{"drug_name":"indomethacin 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197817"},{"drug_name":"indomethacin 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197818"},{"drug_name":"isoniazid 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197832"},{"drug_name":"isosorbide dinitrate 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197839"},{"drug_name":"isotretinoin 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197843"},{"drug_name":"isotretinoin 20 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197844"},{"drug_name":"isotretinoin 40 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197845"},{"drug_name":"ketoprofen 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197855"},{"drug_name":"leucovorin 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197862"},{"drug_name":"leucovorin 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197863"},{"drug_name":"lidocaine 25 MG\/ML \/ prilocaine 25 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197877"},{"drug_name":"lisinopril 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197884"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ lisinopril 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197885"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ lisinopril 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197886"},{"drug_name":"hydrochlorothiazide 25 MG \/ lisinopril 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197887"},{"drug_name":"lithium carbonate 300 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197889"},{"drug_name":"lithium carbonate 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197890"},{"drug_name":"lithium carbonate 300 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197891"},{"drug_name":"lithium carbonate 450 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197892"},{"drug_name":"lithium carbonate 600 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197893"},{"drug_name":"lorazepam 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197900"},{"drug_name":"lorazepam 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197901"},{"drug_name":"lorazepam 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197902"},{"drug_name":"lovastatin 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197903"},{"drug_name":"lovastatin 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197904"},{"drug_name":"lovastatin 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197905"},{"drug_name":"melphalan 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197919"},{"drug_name":"meprobamate 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197928"},{"drug_name":"meprobamate 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197929"},{"drug_name":"mercaptopurine 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197931"},{"drug_name":"metaxalone 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197935"},{"drug_name":"methazolamide 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197939"},{"drug_name":"methazolamide 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197940"},{"drug_name":"methimazole 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197941"},{"drug_name":"methimazole 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197942"},{"drug_name":"methocarbamol 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197943"},{"drug_name":"methocarbamol 750 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197944"},{"drug_name":"methyldopa 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197956"},{"drug_name":"methyldopa 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"197958"},{"drug_name":"methylprednisolone 8 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197973"},{"drug_name":"metolazone 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197978"},{"drug_name":"metolazone 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197979"},{"drug_name":"metyrosine 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197980"},{"drug_name":"minocycline 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197984"},{"drug_name":"minocycline 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197985"},{"drug_name":"minoxidil 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197986"},{"drug_name":"minoxidil 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197987"},{"drug_name":"mitoxantrone 2 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"197989"},{"drug_name":"nadolol 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198006"},{"drug_name":"nadolol 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198007"},{"drug_name":"nadolol 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198008"},{"drug_name":"naproxen 375 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198012"},{"drug_name":"naproxen 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198013"},{"drug_name":"naproxen 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198014"},{"drug_name":"niacin 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198024"},{"drug_name":"niacinamide 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198025"},{"drug_name":"24 HR nicotine 0.583 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"198029"},{"drug_name":"24 HR nicotine 0.875 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"198030"},{"drug_name":"24 HR nicotine 0.292 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"198031"},{"drug_name":"nifedipine 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198032"},{"drug_name":"nifedipine 20 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198033"},{"drug_name":"24 HR nifedipine 30 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198034"},{"drug_name":"24 HR nifedipine 60 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198035"},{"drug_name":"24 HR nifedipine 90 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198036"},{"drug_name":"nitroglycerin 0.3 MG Sublingual Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198038"},{"drug_name":"nitroglycerin 0.4 MG Sublingual Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198039"},{"drug_name":"nitroglycerin 0.6 MG Sublingual Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198040"},{"drug_name":"nortriptyline 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198045"},{"drug_name":"nortriptyline 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198046"},{"drug_name":"nortriptyline 75 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198047"},{"drug_name":"omeprazole 20 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198051"},{"drug_name":"ondansetron 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198052"},{"drug_name":"penicillamine 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198071"},{"drug_name":"perphenazine 16 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198075"},{"drug_name":"perphenazine 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198076"},{"drug_name":"perphenazine 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198077"},{"drug_name":"perphenazine 8 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198078"},{"drug_name":"phenobarbital 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"198083"},{"drug_name":"phenobarbital 16.2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"198086"},{"drug_name":"phenobarbital 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"198089"},{"drug_name":"vitamin K1 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198102"},{"drug_name":"piroxicam 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198107"},{"drug_name":"piroxicam 20 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198108"},{"drug_name":"prazosin 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198141"},{"drug_name":"prednisone 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198144"},{"drug_name":"prednisone 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198145"},{"drug_name":"prednisone 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198146"},{"drug_name":"prednisone 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198148"},{"drug_name":"primidone 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198150"},{"drug_name":"probenecid 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198152"},{"drug_name":"colchicine 0.5 MG \/ probenecid 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198153"},{"drug_name":"prochlorperazine 25 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198159"},{"drug_name":"propylthiouracil 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198175"},{"drug_name":"pyrazinamide 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198181"},{"drug_name":"pyrimethamine 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198182"},{"drug_name":"ramipril 2.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198188"},{"drug_name":"ramipril 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198189"},{"drug_name":"ranitidine 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"198191"},{"drug_name":"ranitidine 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"198193"},{"drug_name":"rifampin 150 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198201"},{"drug_name":"rifampin 300 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198202"},{"drug_name":"simvastatin 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198211"},{"drug_name":"sodium fluoride 0.55 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"198215"},{"drug_name":"spironolactone 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198222"},{"drug_name":"spironolactone 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198223"},{"drug_name":"hydrochlorothiazide 25 MG \/ spironolactone 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198224"},{"drug_name":"sulfasalazine 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198232"},{"drug_name":"sulindac 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198238"},{"drug_name":"sulindac 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198239"},{"drug_name":"tamoxifen 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198240"},{"drug_name":"temazepam 15 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198241"},{"drug_name":"temazepam 30 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198242"},{"drug_name":"temazepam 7.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198243"},{"drug_name":"terconazole 80 MG Vaginal Insert","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198245"},{"drug_name":"thioridazine 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198270"},{"drug_name":"thioridazine 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198274"},{"drug_name":"thioridazine 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198275"},{"drug_name":"tiopronin 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198287"},{"drug_name":"tolmetin 400 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"198296"},{"drug_name":"tolmetin 600 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"198297"},{"drug_name":"tretinoin 1 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198300"},{"drug_name":"hydrochlorothiazide 25 MG \/ triamterene 37.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198316"},{"drug_name":"triazolam 0.125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198317"},{"drug_name":"triazolam 0.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198318"},{"drug_name":"trifluoperazine 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198322"},{"drug_name":"trifluoperazine 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198323"},{"drug_name":"trifluoperazine 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198324"},{"drug_name":"trifluoperazine 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198325"},{"drug_name":"trimethoprim 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198332"},{"drug_name":"sulfamethoxazole 400 MG \/ trimethoprim 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198334"},{"drug_name":"sulfamethoxazole 800 MG \/ trimethoprim 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198335"},{"drug_name":"urea 400 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"198342"},{"drug_name":"zidovudine 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"198352"},{"drug_name":"felbamate 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198358"},{"drug_name":"felbamate 600 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198359"},{"drug_name":"prochlorperazine 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198365"},{"drug_name":"torsemide 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198369"},{"drug_name":"torsemide 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198370"},{"drug_name":"torsemide 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198371"},{"drug_name":"torsemide 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198372"},{"drug_name":"tacrolimus 1 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198377"},{"drug_name":"tacrolimus 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198378"},{"drug_name":"1 ML tacrolimus 5 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198379"},{"drug_name":"tioconazole 0.065 MG\/MG Vaginal Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198380"},{"drug_name":"famciclovir 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198382"},{"drug_name":"lamotrigine 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198427"},{"drug_name":"lamotrigine 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198428"},{"drug_name":"lamotrigine 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198429"},{"drug_name":"lamotrigine 25 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198430"},{"drug_name":"acetaminophen 120 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"198434"},{"drug_name":"acetaminophen 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198440"},{"drug_name":"acetaminophen 650 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"198443"},{"drug_name":"aspirin 300 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"198464"},{"drug_name":"aspirin 325 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"198467"},{"drug_name":"bisacodyl 10 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198509"},{"drug_name":"capsaicin 0.25 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198555"},{"drug_name":"dibucaine 0.01 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198601"},{"drug_name":"ferrous fumarate 325 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"198624"},{"drug_name":"ferrous gluconate 324 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198630"},{"drug_name":"valbenazine 80 MG Oral Capsule [Ingrezza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1986331"},{"drug_name":"folic acid 0.4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198640"},{"drug_name":"folic acid 0.8 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198641"},{"drug_name":"tisagenlecleucel 250000000 CELLS Injection [Kymriah]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1986447"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Aurovela Fe 1.5\/30 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1986791"},{"drug_name":"0.5 ML varicella zoster virus glycoprotein E  recombinant 0.1 MG\/ML Injection [Shingrix]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1986830"},{"drug_name":"hydrocortisone 5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198707"},{"drug_name":"68 ML axicabtagene ciloleucel 2940000 CELLS\/ML Injection [Yescarta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1987407"},{"drug_name":"magnesium oxide 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198741"},{"drug_name":"polysaccharide iron complex 150 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198806"},{"drug_name":"24 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule [Tiadylt]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1988308"},{"drug_name":"24 HR diltiazem hydrochloride 180 MG Extended Release Oral Capsule [Tiadylt]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1988311"},{"drug_name":"24 HR diltiazem hydrochloride 240 MG Extended Release Oral Capsule [Tiadylt]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1988316"},{"drug_name":"24 HR diltiazem hydrochloride 300 MG Extended Release Oral Capsule [Tiadylt]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1988319"},{"drug_name":"24 HR diltiazem hydrochloride 360 MG Extended Release Oral Capsule [Tiadylt]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1988324"},{"drug_name":"24 HR diltiazem hydrochloride 420 MG Extended Release Oral Capsule [Tiadylt]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1988330"},{"drug_name":"simethicone 66.7 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"198857"},{"drug_name":"inulin 200 MG \/ Lacticaseibacillus rhamnosus GG 20000000000 UNT Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1988574"},{"drug_name":"sodium bicarbonate 325 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198859"},{"drug_name":"sodium bicarbonate 650 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198861"},{"drug_name":"12 ML letermovir 20 MG\/ML Injection [Prevymis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1988657"},{"drug_name":"24 ML letermovir 20 MG\/ML Injection [Prevymis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1988661"},{"drug_name":"letermovir 240 MG Oral Tablet [Prevymis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1988671"},{"drug_name":"letermovir 480 MG Oral Tablet [Prevymis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1988675"},{"drug_name":"brigatinib 90 MG Oral Tablet [Alunbrig]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1988768"},{"drug_name":"brigatinib 180 MG Oral Tablet [Alunbrig]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1988772"},{"drug_name":"{23 (brigatinib 180 MG Oral Tablet [Alunbrig]) \/ 7 (brigatinib 90 MG Oral Tablet [Alunbrig]) } Pack [Alunbrig Initiation Pack]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1988786"},{"drug_name":"ascorbic acid 1000 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198897"},{"drug_name":"bosentan 32 MG Tablet for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1989081"},{"drug_name":"1 ML benralizumab 30 MG\/ML Prefilled Syringe [Fasenra]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1989109"},{"drug_name":"zinc oxide 0.2 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198911"},{"drug_name":"vitamin B6 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"198946"},{"drug_name":"dolutegravir 50 MG \/ rilpivirine 25 MG Oral Tablet [Juluca]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1989506"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Hailey 24 Fe 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1989507"},{"drug_name":"1 ML emicizumab-kxwh 30 MG\/ML Injection [Hemlibra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1989804"},{"drug_name":"0.7 ML emicizumab-kxwh 150 MG\/ML Injection [Hemlibra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1989811"},{"drug_name":"0.4 ML emicizumab-kxwh 150 MG\/ML Injection [Hemlibra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1989815"},{"drug_name":"1 ML emicizumab-kxwh 150 MG\/ML Injection [Hemlibra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1989817"},{"drug_name":"5 ML vestronidase alfa-vjbk 2 MG\/ML Injection [Mepsevii]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1989828"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Hailey Fe 1\/20 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1989873"},{"drug_name":"famotidine 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199047"},{"drug_name":"mycophenolate mofetil 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199058"},{"drug_name":"ascorbic acid 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199083"},{"drug_name":"coagulation factor IX (recombinant)  glycopegylated 1 UNT Injection [Rebinyn]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1990862"},{"drug_name":"pyrantel pamoate 144 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199106"},{"drug_name":"omeprazole 10 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199119"},{"drug_name":"bicalutamide 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199123"},{"drug_name":"0.25 MG  0.5 MG Dose 1.5 ML semaglutide 1.34 MG\/ML Pen Injector [Ozempic]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1991311"},{"drug_name":"24 ML nivolumab 10 MG\/ML Injection [Opdivo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1991413"},{"drug_name":"lamivudine 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"199147"},{"drug_name":"lamivudine 10 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"199148"},{"drug_name":"acarbose 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199149"},{"drug_name":"acarbose 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199150"},{"drug_name":"tretinoin 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199159"},{"drug_name":"melatonin 3 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199163"},{"drug_name":"phenobarbital 97.2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"199164"},{"drug_name":"phenobarbital 32.4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"199167"},{"drug_name":"phenobarbital 64.8 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"199168"},{"drug_name":"famciclovir 125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199192"},{"drug_name":"famciclovir 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199193"},{"drug_name":"cetirizine hydrochloride 10 MG Oral Tablet [Aller-Tec]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1991946"},{"drug_name":"riluzole 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199206"},{"drug_name":"anastrozole 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199224"},{"drug_name":"Emollient clobetasol propionate 0.5 MG\/ML Topical Foam","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1992273"},{"drug_name":"Emollient clobetasol propionate 0.5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1992281"},{"drug_name":"24 HR timolol 5 MG\/ML Ophthalmic Solution [Istalol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1992300"},{"drug_name":"12 HR timolol 5 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1992303"},{"drug_name":"{74 (apixaban 5 MG Oral Tablet [Eliquis]) } Pack [Eliquis 30-Day Starter Pack]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1992428"},{"drug_name":"glimepiride 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199245"},{"drug_name":"glimepiride 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199246"},{"drug_name":"glimepiride 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199247"},{"drug_name":"6 ML arsenic trioxide 2 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1992545"},{"drug_name":"netarsudil 0.2 MG\/ML Ophthalmic Solution [Rhopressa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1992873"},{"drug_name":"benznidazole 12.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1993222"},{"drug_name":"trandolapril 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199351"},{"drug_name":"trandolapril 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199352"},{"drug_name":"trandolapril 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199353"},{"drug_name":"potassium citrate 5 MEQ Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199376"},{"drug_name":"12 HR carbamazepine 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199378"},{"drug_name":"potassium citrate 10 MEQ Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199381"},{"drug_name":"risperidone 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199387"},{"drug_name":"etodolac 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199390"},{"drug_name":"nevirapine 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"199422"},{"drug_name":"ibrutinib 70 MG Oral Capsule [Imbruvica]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1994362"},{"drug_name":"clobazam 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199450"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [VyLibra 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1994758"},{"drug_name":"{7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Tri-VyLibra 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1994764"},{"drug_name":"24 HR methylphenidate hydrochloride 72 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"1995461"},{"drug_name":"amylase 168000 UNT \/ lipase 40000 UNT \/ protease 126000 UNT Delayed Release Oral Capsule [Zenpep]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1995479"},{"drug_name":"0.5 ML voretigene neparvovec-rzyl 5000000000000 VECTOR-GENOMES\/ML Injection [Luxturna]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1995886"},{"drug_name":"clotrimazole 20 MG\/ML Vaginal Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199603"},{"drug_name":"0.5 ML buprenorphine 200 MG\/ML Prefilled Syringe [Sublocade]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1996189"},{"drug_name":"1.5 ML buprenorphine 200 MG\/ML Prefilled Syringe [Sublocade]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1996193"},{"drug_name":"zafirlukast 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199655"},{"drug_name":"zidovudine 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"199663"},{"drug_name":"Breath-Actuated 120 ACTUAT beclomethasone dipropionate 0.08 MG\/ACTUAT Metered Dose Inhaler [Qvar]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1998772"},{"drug_name":"Breath-Actuated 120 ACTUAT beclomethasone dipropionate 0.04 MG\/ACTUAT Metered Dose Inhaler [Qvar]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1998774"},{"drug_name":"levofloxacin 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199884"},{"drug_name":"levofloxacin 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199885"},{"drug_name":"topiramate 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199888"},{"drug_name":"topiramate 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199889"},{"drug_name":"topiramate 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199890"},{"drug_name":"hydrochlorothiazide 12.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"199903"},{"drug_name":"hydroxyurea 100 MG Oral Tablet [Siklos]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1999314"},{"drug_name":"hydroxyurea 1000 MG Oral Tablet [Siklos]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1999316"},{"drug_name":"{28 (ivacaftor 150 MG \/ tezacaftor 100 MG Oral Tablet) \/ 28 (ivacaftor 150 MG Oral Tablet) } Pack [Symdeko (100 MG \/ 150 MG; 150 MG)]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1999389"},{"drug_name":"2.5 ML sodium hyaluronate 10 MG\/ML Prefilled Syringe [Visco-3]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1999408"},{"drug_name":"apalutamide 60 MG Oral Tablet [Erleada]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1999587"},{"drug_name":"12 HR doxylamine succinate 20 MG \/ pyridoxine hydrochloride 20 MG Extended Release Oral Tablet [Bonjesta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1999657"},{"drug_name":"bictegravir 50 MG \/ emtricitabine 200 MG \/ tenofovir alafenamide 25 MG Oral Tablet [Biktarvy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1999673"},{"drug_name":"25 ML lutetium Lu 177 dotatate 10 MCI\/ML Injection [Lutathera]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"1999687"},{"drug_name":"{21 (drospirenone 3 MG \/ ethinyl estradiol 0.03 MG \/ levomefolate calcium 0.451 MG Oral Tablet) \/ 7 (levomefolate calcium 0.451 MG Oral Tablet) } Pack [Tydemy 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"1999724"},{"drug_name":"ivermectin 6 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"199998"},{"drug_name":"ibrutinib 140 MG Oral Tablet [Imbruvica]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2000019"},{"drug_name":"ibrutinib 280 MG Oral Tablet [Imbruvica]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2000023"},{"drug_name":"ibrutinib 420 MG Oral Tablet [Imbruvica]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2000027"},{"drug_name":"ibrutinib 560 MG Oral Tablet [Imbruvica]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2000031"},{"drug_name":"vancomycin 25 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2000127"},{"drug_name":"carvedilol 6.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200031"},{"drug_name":"carvedilol 12.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200032"},{"drug_name":"carvedilol 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200033"},{"drug_name":"olanzapine 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200034"},{"drug_name":"mycophenolate mofetil 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200060"},{"drug_name":"letrozole 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200064"},{"drug_name":"{21 (ethinyl estradiol 0.05 MG \/ ethynodiol diacetate 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Kelnor 1\/50 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2000695"},{"drug_name":"lamivudine 150 MG \/ zidovudine 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"200082"},{"drug_name":"irbesartan 75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200094"},{"drug_name":"irbesartan 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200095"},{"drug_name":"irbesartan 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200096"},{"drug_name":"roflumilast 0.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2001319"},{"drug_name":"acarbose 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200132"},{"drug_name":"efavirenz 400 MG \/ lamivudine 300 MG \/ tenofovir disoproxil fumarate 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2001424"},{"drug_name":"efavirenz 400 MG \/ lamivudine 300 MG \/ tenofovir disoproxil fumarate 300 MG Oral Tablet [Symfi]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2001430"},{"drug_name":"niacin 250 MG Extended Release Oral Tablet [Endur-Acin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2001472"},{"drug_name":"niacin 750 MG Extended Release Oral Tablet [Endur-Acin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2001474"},{"drug_name":"lamotrigine 150 MG Oral Tablet [Subvenite]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2001506"},{"drug_name":"lamotrigine 25 MG Oral Tablet [Subvenite]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2001508"},{"drug_name":"BX Rating 24 HR methylphenidate hydrochloride 18 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2001564"},{"drug_name":"BX Rating 24 HR methylphenidate hydrochloride 27 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2001565"},{"drug_name":"BX Rating 24 HR methylphenidate hydrochloride 36 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2001566"},{"drug_name":"BX Rating 24 HR methylphenidate hydrochloride 54 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2001568"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 84 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) } Pack [Jaimiess 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2001751"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 5 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 2 (inert ingredients 1 MG Oral Tablet) } Pack [Volnea 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2001756"},{"drug_name":"camphor 5 MG\/ML \/ menthol 5 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200176"},{"drug_name":"zolmitriptan 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200193"},{"drug_name":"zolmitriptan 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200194"},{"drug_name":"10 ML daunorubicin 5 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2002002"},{"drug_name":"montelukast 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200224"},{"drug_name":"3 ML insulin glargine 300 UNT\/ML Pen Injector","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2002419"},{"drug_name":"potassium phosphate 155 MG \/ sodium phosphate  dibasic 852 MG \/ sodium phosphate  monobasic 130 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"200251"},{"drug_name":"repaglinide 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200256"},{"drug_name":"repaglinide 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200257"},{"drug_name":"repaglinide 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200258"},{"drug_name":"nilotinib 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2002717"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ valsartan 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200284"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ valsartan 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200285"},{"drug_name":"fenofibrate 67 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200311"},{"drug_name":"paricalcitol 0.005 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200321"},{"drug_name":"lamivudine 300 MG \/ tenofovir disoproxil fumarate 300 MG Oral Tablet [Cimduo]","plans":[{"step_therapy":true,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2003255"},{"drug_name":"capecitabine 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200327"},{"drug_name":"capecitabine 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200328"},{"drug_name":"omeprazole 40 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200329"},{"drug_name":"{24 (drospirenone 3 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 4 (inert ingredients 1 MG Oral Tablet) } Pack [Lo-Zumandimine 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2003375"},{"drug_name":"simvastatin 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200345"},{"drug_name":"cefdinir 300 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200346"},{"drug_name":"citalopram 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200371"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [New Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2003710"},{"drug_name":"lamotrigine 100 MG Oral Tablet [Subvenite]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2003796"},{"drug_name":"lamotrigine 200 MG Oral Tablet [Subvenite]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2003801"},{"drug_name":"acetaminophen 500 MG Oral Tablet [Panadol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"200977"},{"drug_name":"ibuprofen 200 MG Oral Tablet [Motrin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"201126"},{"drug_name":"zidovudine 100 MG Oral Capsule [Retrovir]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"201907"},{"drug_name":"ketoconazole 20 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"203088"},{"drug_name":"hydrocortisone 0.01 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"203105"},{"drug_name":"malathion 5 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"204119"},{"drug_name":"desonide 0.0005 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"204135"},{"drug_name":"efavirenz 600 MG \/ lamivudine 300 MG \/ tenofovir disoproxil fumarate 300 MG Oral Tablet [Symfi]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2043464"},{"drug_name":"Bifidobacterium animalis 15000000000 UNT \/ Lactobacillus acidophilus 16000000000 UNT Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2043695"},{"drug_name":"1 ML burosumab-twza 10 MG\/ML Injection [Crysvita]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2043864"},{"drug_name":"1 ML burosumab-twza 20 MG\/ML Injection [Crysvita]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2043870"},{"drug_name":"1 ML burosumab-twza 30 MG\/ML Injection [Crysvita]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2043878"},{"drug_name":"haloperidol 5 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"204416"},{"drug_name":"hydrocortisone 10 MG\/ML \/ neomycin 3.5 MG\/ML \/ polymyxin B 10000 UNT\/ML Otic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"204423"},{"drug_name":"ibuprofen 40 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"204442"},{"drug_name":"fostamatinib 100 MG Oral Tablet [Tavalisse]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2044928"},{"drug_name":"fostamatinib 150 MG Oral Tablet [Tavalisse]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2044932"},{"drug_name":"{28 (tolvaptan 30 MG Oral Tablet) \/ 28 (tolvaptan 60 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2044966"},{"drug_name":"{28 (tolvaptan 15 MG Oral Tablet) \/ 28 (tolvaptan 45 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2044968"},{"drug_name":"{28 (tolvaptan 30 MG Oral Tablet) \/ 28 (tolvaptan 90 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2044970"},{"drug_name":"tisagenlecleucel 600000000 CELLS Injection [Kymriah]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2044975"},{"drug_name":"{21 (drospirenone 3 MG \/ ethinyl estradiol 0.03 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Zumandimine 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2045196"},{"drug_name":"fluocinolone acetonide 0.1 MG\/ML Otic Solution [Flac]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2045201"},{"drug_name":"30 ACTUAT fluticasone furoate 0.05 MG\/ACTUAT Dry Powder Inhaler [Arnuity]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2045382"},{"drug_name":"0.05 ML ranibizumab 6 MG\/ML Prefilled Syringe [Lucentis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2045502"},{"drug_name":"avatrombopag 20 MG Oral Tablet [Doptelet]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2045958"},{"drug_name":"{10 (avatrombopag 20 MG Oral Tablet [Doptelet]) } Pack [Doptelet 40 MG Daily Dose Carton]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2045959"},{"drug_name":"{15 (avatrombopag 20 MG Oral Tablet [Doptelet]) } Pack [Doptelet 60 MG Daily Dose Carton]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2045961"},{"drug_name":"bacitracin 0.4 UNT\/MG \/ neomycin 0.0035 MG\/MG \/ polymyxin B 5 UNT\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"204602"},{"drug_name":"16 ML bevacizumab-awwb 25 MG\/ML Injection [Mvasi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2046145"},{"drug_name":"4 ML bevacizumab-awwb 25 MG\/ML Injection [Mvasi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2046149"},{"drug_name":"riboflavin 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"204623"},{"drug_name":"riboflavin 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"204624"},{"drug_name":"riboflavin 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"204625"},{"drug_name":"0.5 ML pegvaliase-pqpz 20 MG\/ML Prefilled Syringe [Palynziq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2046370"},{"drug_name":"0.5 ML pegvaliase-pqpz 5 MG\/ML Prefilled Syringe [Palynziq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2046376"},{"drug_name":"1 ML pegvaliase-pqpz 20 MG\/ML Prefilled Syringe [Palynziq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2046380"},{"drug_name":"selenium sulfide 10 MG\/ML Medicated Shampoo","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"204642"},{"drug_name":"abiraterone acetate 125 MG Oral Tablet [Yonsa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2046585"},{"drug_name":"carfilzomib 10 MG Injection [Kyprolis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2046644"},{"drug_name":"1 ML epoetin alfa-epbx 40000 UNT\/ML Injection [Retacrit]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2047623"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) } Pack [Hailey 1.5\/30 21 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2047760"},{"drug_name":"1 ML testosterone cypionate 200 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2047882"},{"drug_name":"0.6 ML pegfilgrastim-jmdb 10 MG\/ML Prefilled Syringe [Fulphila]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2048025"},{"drug_name":"azithromycin 600 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"204844"},{"drug_name":"tofacitinib 10 MG Oral Tablet [Xeljanz]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2048568"},{"drug_name":"mesna 100 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"204870"},{"drug_name":"hydrocortisone 10 MG\/ML \/ neomycin 3.5 MG\/ML \/ polymyxin B 10000 UNT\/ML Ophthalmic Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"204874"},{"drug_name":"encorafenib 75 MG Oral Capsule [Braftovi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2049121"},{"drug_name":"binimetinib 15 MG Oral Tablet [Mektovi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2049133"},{"drug_name":"{84 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Iclevia 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2049264"},{"drug_name":"pimavanserin 10 MG Oral Tablet [Nuplazid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2049271"},{"drug_name":"pimavanserin 34 MG Oral Capsule [Nuplazid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2049278"},{"drug_name":"2.4 ML aripiprazole lauroxil 281.3 MG\/ML Prefilled Syringe [Aristada]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2049343"},{"drug_name":"lidocaine 30 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2049533"},{"drug_name":"cobicistat 150 MG \/ darunavir 800 MG \/ emtricitabine 200 MG \/ tenofovir alafenamide 10 MG Oral Tablet [Symtuza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2049677"},{"drug_name":"pasireotide 30 MG Injection [Signifor]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2049732"},{"drug_name":"pasireotide 10 MG Injection [Signifor]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2049736"},{"drug_name":"elagolix 150 MG Oral Tablet [Orilissa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2049858"},{"drug_name":"elagolix 200 MG Oral Tablet [Orilissa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2049862"},{"drug_name":"ivosidenib 250 MG Oral Tablet [Tibsovo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2049884"},{"drug_name":"0.5 ML hepatitis B surface antigen vaccine 0.04 MG\/ML Prefilled Syringe [Heplisav-B]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2050059"},{"drug_name":"mineral oil 1000 MG\/ML Enema","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"205121"},{"drug_name":"5 ML cyclosporine 50 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"205175"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Incassia 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2052064"},{"drug_name":"tacrolimus 0.2 MG Granules for Oral Suspension [Prograf]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2052609"},{"drug_name":"tacrolimus 1 MG Granules for Oral Suspension [Prograf]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2052704"},{"drug_name":"24 HR methylphenidate hydrochloride 72 MG Extended Release Oral Tablet [Relexxii]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2052826"},{"drug_name":"leflunomide 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"205284"},{"drug_name":"leflunomide 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"205285"},{"drug_name":"efavirenz 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"205290"},{"drug_name":"efavirenz 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"205292"},{"drug_name":"prednisone 5 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"205301"},{"drug_name":"telmisartan 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"205304"},{"drug_name":"telmisartan 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"205305"},{"drug_name":"topiramate 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"205315"},{"drug_name":"topiramate 15 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"205316"},{"drug_name":"celecoxib 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"205322"},{"drug_name":"celecoxib 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"205323"},{"drug_name":"lisinopril 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"205326"},{"drug_name":"miglitol 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"205329"},{"drug_name":"2 ML iobenguane I-131 15 MCI\/ML Injection [Azedra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2053291"},{"drug_name":"22.5 ML iobenguane I-131 15 MCI\/ML Injection [Azedra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2053297"},{"drug_name":"miglitol 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"205330"},{"drug_name":"miglitol 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"205331"},{"drug_name":"ivacaftor 125 MG \/ lumacaftor 100 MG Oral Granules [ORKAMBI]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2053512"},{"drug_name":"ivacaftor 188 MG \/ lumacaftor 150 MG Oral Granules [ORKAMBI]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2053519"},{"drug_name":"5 ML patisiran lipid complex 2 MG\/ML Injection [Onpattro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2053529"},{"drug_name":"5 ML mogamulizumab-kpkc 4 MG\/ML Injection [Poteligeo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2054086"},{"drug_name":"{30 (lenvatinib 4 MG Oral Capsule [Lenvima]) } Pack [Lenvima 4]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2054157"},{"drug_name":"{90 (lenvatinib 4 MG Oral Capsule [Lenvima]) } Pack [Lenvima 12]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2054159"},{"drug_name":"{7 (valbenazine 40 MG Oral Capsule [Ingrezza]) \/ 21 (valbenazine 80 MG Oral Capsule [Ingrezza]) } Pack [Ingrezza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2054269"},{"drug_name":"{14 (migalastat 123 MG Oral Capsule [Galafold]) } Pack [Galafold 28 Day Wallet]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2054275"},{"drug_name":"lusutrombopag 3 MG Oral Tablet [Mulpleta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2054995"},{"drug_name":"tecovirimat 200 MG Oral Capsule [Tpoxx]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2055115"},{"drug_name":"dornase alfa 1 MG\/ML Inhalation Solution [Pulmozyme]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"205532"},{"drug_name":"estramustine 140 MG Oral Capsule [Emcyt]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"205562"},{"drug_name":"2 ML lanadelumab-flyo 150 MG\/ML Injection [Takhzyro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2055650"},{"drug_name":"antihemophilic factor (recombinant)  PEGylated-aucl 1 UNT Injection [Jivi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2055664"},{"drug_name":"0.8 ML risperidone 150 MG\/ML Prefilled Syringe [Perseris]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2055672"},{"drug_name":"0.6 ML risperidone 150 MG\/ML Prefilled Syringe [Perseris]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2055676"},{"drug_name":"doravirine 100 MG Oral Tablet [Pifeltro]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2055766"},{"drug_name":"doravirine 100 MG \/ lamivudine 300 MG \/ tenofovir disoproxil fumarate 300 MG Oral Tablet [Delstrigo]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2055815"},{"drug_name":"ammonium lactate 120 MG\/ML Topical Lotion [Amlactin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"205643"},{"drug_name":"flutamide 125 MG Oral Capsule [Eulexin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"205646"},{"drug_name":"1.5 ML fremanezumab-vfrm 150 MG\/ML Prefilled Syringe [Ajovy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2056700"},{"drug_name":"everolimus 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2056895"},{"drug_name":"7 ML cemiplimab-rwlc 50 MG\/ML Injection [Libtayo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2058835"},{"drug_name":"1 ML galcanezumab-gnlm 120 MG\/ML Auto-Injector [Emgality]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2058877"},{"drug_name":"1 ML galcanezumab-gnlm 120 MG\/ML Prefilled Syringe [Emgality]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2058887"},{"drug_name":"cannabidiol 100 MG\/ML Oral Solution [Epidiolex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2058906"},{"drug_name":"dacomitinib 15 MG Oral Tablet [Vizimpro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2058922"},{"drug_name":"dacomitinib 30 MG Oral Tablet [Vizimpro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2058926"},{"drug_name":"dacomitinib 45 MG Oral Tablet [Vizimpro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2058932"},{"drug_name":"1 ML omalizumab 150 MG\/ML Prefilled Syringe [Xolair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2058946"},{"drug_name":"0.5 ML omalizumab 150 MG\/ML Prefilled Syringe [Xolair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2058950"},{"drug_name":"eltrombopag 12.5 MG Powder for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2058980"},{"drug_name":"rivaroxaban 2.5 MG Oral Tablet [Xarelto]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2059017"},{"drug_name":"1.5 ML elapegademase-lvlr 1.6 MG\/ML Injection [Revcovi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2059228"},{"drug_name":"riluzole 5 MG\/ML Oral Suspension [Tiglutik]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2059266"},{"drug_name":"aluminum chloride 200 MG\/ML Topical Solution [Drysol]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"206208"},{"drug_name":"5 ML lymphocyte immune globulin  anti-thymocyte globulin  equine 50 MG\/ML Injection [ATGAM]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"206289"},{"drug_name":"hydrocortisone 0.01 MG\/MG Topical Ointment [Cortizone]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"206314"},{"drug_name":"hydrocortisone 10 MG\/ML Topical Solution [Sarnol-HC]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"206331"},{"drug_name":"hydrocortisone 10 MG\/ML Topical Cream [Ala-Cort]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"206347"},{"drug_name":"hydrocortisone 10 MG\/ML Topical Cream [Cortizone]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"206352"},{"drug_name":"lithium carbonate 300 MG Extended Release Oral Tablet [Lithobid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"206786"},{"drug_name":"mesalamine 250 MG Extended Release Oral Capsule [Pentasa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"206791"},{"drug_name":"loratadine 10 MG Oral Tablet [Claritin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"206805"},{"drug_name":"isosorbide dinitrate 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"206842"},{"drug_name":"ibuprofen 20 MG\/ML Oral Suspension [Advil]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"206878"},{"drug_name":"isotretinoin 10 MG Oral Capsule [Accutane]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"206880"},{"drug_name":"isotretinoin 20 MG Oral Capsule [Accutane]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"206883"},{"drug_name":"isotretinoin 40 MG Oral Capsule [Accutane]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"206902"},{"drug_name":"ibuprofen 400 MG Oral Tablet [Ibu]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"206905"},{"drug_name":"ibuprofen 600 MG Oral Tablet [Ibu]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"206913"},{"drug_name":"ibuprofen 800 MG Oral Tablet [Ibu]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"206917"},{"drug_name":"ketoprofen 75 MG Oral Capsule [Orudis]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"206992"},{"drug_name":"interferon beta-1b 0.3 MG Injection [Betaseron]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"207059"},{"drug_name":"methsuximide 300 MG Oral Capsule [Celontin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"207088"},{"drug_name":"nitroglycerin 0.02 MG\/MG Topical Ointment [Nitro-Bid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"207273"},{"drug_name":"mitotane 500 MG Oral Tablet [Lysodren]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"207373"},{"drug_name":"procarbazine 50 MG Oral Capsule [Matulane]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"207588"},{"drug_name":"diazoxide 50 MG\/ML Oral Suspension [Proglycem]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"207634"},{"drug_name":"24 HR nicotine 0.875 MG\/HR Transdermal System [Habitrol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"207716"},{"drug_name":"tobramycin 0.003 MG\/MG Ophthalmic Ointment [Tobrex]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"207850"},{"drug_name":"succimer 100 MG Oral Capsule [Chemet]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"207949"},{"drug_name":"tolmetin 600 MG Oral Tablet [Tolectin 600]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"208048"},{"drug_name":"silver sulfadiazine 10 MG\/ML Topical Cream [SSD]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"208185"},{"drug_name":"sulfamethoxazole 40 MG\/ML \/ trimethoprim 8 MG\/ML Oral Suspension [Sulfatrim]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"208406"},{"drug_name":"benzoyl peroxide 0.1 MG\/MG Topical Gel [Persa-Gel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"208510"},{"drug_name":"thyroid (USP) 15 MG Oral Tablet [Armour Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"208534"},{"drug_name":"thyroid (USP) 30 MG Oral Tablet [Armour Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"208535"},{"drug_name":"thyroid (USP) 60 MG Oral Tablet [Armour Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"208540"},{"drug_name":"thyroid (USP) 90 MG Oral Tablet [Armour Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"208543"},{"drug_name":"thyroid (USP) 120 MG Oral Tablet [Armour Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"208544"},{"drug_name":"thyroid (USP) 120 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"208545"},{"drug_name":"thyroid (USP) 180 MG Oral Tablet [Armour Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"208547"},{"drug_name":"thyroid (USP) 240 MG Oral Tablet [Armour Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"208549"},{"drug_name":"thyroid (USP) 300 MG Oral Tablet [Armour Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"208551"},{"drug_name":"dexamethasone 0.001 MG\/MG \/ tobramycin 0.003 MG\/MG Ophthalmic Ointment [Tobradex]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"208821"},{"drug_name":"prednisolone 1.2 MG\/ML Ophthalmic Suspension [Pred Mild]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"209002"},{"drug_name":"50 ML cytomegalovirus immune globulin  human 50 MG\/ML Injection [Cytogam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"209029"},{"drug_name":"disopyramide 100 MG Oral Capsule [Norpace]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"209066"},{"drug_name":"nicotine 2 MG Chewing Gum [Nicorette]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"209326"},{"drug_name":"acetaminophen 120 MG Rectal Suppository [Feverall]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"209353"},{"drug_name":"acetaminophen 325 MG Rectal Suppository [Feverall]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"209361"},{"drug_name":"acetaminophen 650 MG Rectal Suppository [Feverall]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"209364"},{"drug_name":"acetaminophen 325 MG Oral Tablet [Tylenol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"209387"},{"drug_name":"acetaminophen 500 MG Oral Tablet [Tylenol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"209459"},{"drug_name":"bisacodyl 10 MG Rectal Suppository [Dulcolax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"209601"},{"drug_name":"bisacodyl 5 MG Delayed Release Oral Tablet [Dulcolax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"209613"},{"drug_name":"tolnaftate 10 MG\/ML Topical Cream [Fungi-Guard]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"209645"},{"drug_name":"disopyramide 150 MG Oral Capsule [Norpace]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"209692"},{"drug_name":"cysteamine 150 MG Oral Capsule [Cystagon]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"209788"},{"drug_name":"cysteamine 50 MG Oral Capsule [Cystagon]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"209789"},{"drug_name":"acetaminophen 160 MG Chewable Tablet [Mapap]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"209870"},{"drug_name":"1.14 ML dupilumab 175 MG\/ML Prefilled Syringe [Dupixent]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2099302"},{"drug_name":"1.5 ML inotersen 189 MG\/ML Prefilled Syringe [Tegsedi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2099323"},{"drug_name":"fluocinolone acetonide 0.18 MG Drug Implant [Yutiq]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2099366"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Hailey Fe 1.5\/30 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2099508"},{"drug_name":"acyclovir 0.05 MG\/MG Topical Ointment [Zovirax]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"209977"},{"drug_name":"talazoparib 0.25 MG Oral Capsule [Talzenna]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2099952"},{"drug_name":"talazoparib 1 MG Oral Capsule [Talzenna]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2099956"},{"drug_name":"calcium carbonate 500 MG Chewable Tablet [Tums]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"210117"},{"drug_name":"sodium polystyrene sulfonate 15000 MG Powder for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2101899"},{"drug_name":"selenium sulfide 10 MG\/ML Medicated Shampoo [Selsun Blue]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"210208"},{"drug_name":"10 ML immune globulin intravenous (human) - ifas 100 MG\/ML Injection [Panzyga]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2102440"},{"drug_name":"25 ML immune globulin intravenous (human) - ifas 100 MG\/ML Injection [Panzyga]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2102456"},{"drug_name":"50 ML immune globulin intravenous (human) - ifas 100 MG\/ML Injection [Panzyga]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2102460"},{"drug_name":"100 ML immune globulin intravenous (human) - ifas 100 MG\/ML Injection [Panzyga]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2102464"},{"drug_name":"200 ML immune globulin intravenous (human) - ifas 100 MG\/ML Injection [Panzyga]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2102470"},{"drug_name":"300 ML immune globulin intravenous (human) - ifas 100 MG\/ML Injection [Panzyga]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2102472"},{"drug_name":"prochlorperazine 5 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2102949"},{"drug_name":"lorlatinib 25 MG Oral Tablet [Lorbrena]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2103175"},{"drug_name":"lorlatinib 100 MG Oral Tablet [Lorbrena]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2103179"},{"drug_name":"simethicone 66.7 MG\/ML Oral Suspension [Little Tummys]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"210318"},{"drug_name":"{7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Tri-VyLibra Lo 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2104192"},{"drug_name":"cenegermin-bkbj 0.02 MG\/ML Ophthalmic Solution [Oxervate]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2104341"},{"drug_name":"2 ML emapalumab-lzsg 5 MG\/ML Injection [Gamifant]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2104616"},{"drug_name":"10 ML emapalumab-lzsg 5 MG\/ML Injection [Gamifant]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2104622"},{"drug_name":"vitamin E 100 UNT Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"210467"},{"drug_name":"levothyroxine sodium 0.137 MG Oral Tablet [Euthyrox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2104866"},{"drug_name":"coal tar 5 MG\/ML Medicated Shampoo [DHS Tar Shampoo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"210490"},{"drug_name":"larotrectinib 100 MG Oral Capsule [Vitrakvi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2105645"},{"drug_name":"larotrectinib 20 MG\/ML Oral Solution [Vitrakvi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2105653"},{"drug_name":"larotrectinib 25 MG Oral Capsule [Vitrakvi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2105657"},{"drug_name":"gilteritinib 40 MG Oral Tablet [Xospata]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2105817"},{"drug_name":"glasdegib 100 MG Oral Tablet [Daurismo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2105856"},{"drug_name":"glasdegib 25 MG Oral Tablet [Daurismo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2105860"},{"drug_name":"0.5 ML diphtheria toxoid vaccine  inactivated 4 UNT\/ML \/ tetanus toxoid vaccine  inactivated 4 UNT\/ML Injection [Tdvax]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2106334"},{"drug_name":"levoleucovorin 175 MG Injection [Khapzory]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2106373"},{"drug_name":"calcium polycarbophil 625 MG Oral Tablet [FiberCon]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"210665"},{"drug_name":"docusate sodium 50 MG \/ sennosides  USP 8.6 MG Oral Tablet [Laxacin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2106884"},{"drug_name":"{24 (drospirenone 3 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 4 (inert ingredients 1 MG Oral Tablet) } Pack [Jasmiel 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2106997"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Tarina 24 FE 1\/20 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2107008"},{"drug_name":"amifampridine 10 MG Oral Tablet [Firdapse]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2107518"},{"drug_name":"insulin degludec 100 UNT\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2107520"},{"drug_name":"dexamethasone 0.4 MG Drug Implant [Dextenza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2108020"},{"drug_name":"coagulation factor Xa (recombinant)  inactivated-zhzo 200 MG Injection [Andexxa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2108130"},{"drug_name":"magnesium hydroxide 80 MG\/ML Oral Suspension [Phillips Milk of Magnesia]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"210887"},{"drug_name":"tafenoquine 150 MG Oral Tablet [Krintafel]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2109239"},{"drug_name":"sodium chloride 70 MG\/ML Inhalation Solution [PulmoSal]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2109530"},{"drug_name":"magnesium oxide 400 MG Oral Tablet [Mag-Ox 400]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"210958"},{"drug_name":"0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine  inactivated 0.04 MG\/ML \/ Bordetella pertussis fimbriae 2\/3 vaccine  inactivated 0.01 MG\/ML \/ Bordetella pertussis pertactin vaccine  inactivated 0.006 MG\/ML \/ Bordetella pertussis toxoid vaccine  inactivated 0.04 MG\/ML \/ diphtheria toxoid vaccine  inactivated 30 UNT\/ML \/ Haemophilus influenzae b (Ross strain) capsular polysaccharide meningococcal protein conjugate vaccine 0.006 MG\/ML \/ hepatitis B surface antigen vaccine 0.02 MG\/ML \/ poliovirus vaccine inactivated  type 1 (Mahoney) 58 UNT\/ML \/ poliovirus vaccine inactivated  type 2 (MEF-1) 14 UNT\/ML \/ poliovirus vaccine inactivated  type 3 (Saukett) 52 UNT\/ML \/ tetanus toxoid vaccine  inactivated 10 UNT\/ML Injection [Vaxelis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2109620"},{"drug_name":"2.5 ML sodium hyaluronate 10 MG\/ML Prefilled Syringe [Trivisc]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2109948"},{"drug_name":"3 ML hyaluronic acid 8 MG\/ML Prefilled Syringe [Hymovis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2109981"},{"drug_name":"Pulmonary Hypertension tadalafil 20 MG Oral Tablet [Alyq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2110455"},{"drug_name":"84 HR estradiol 0.00104 MG\/HR Transdermal System [Dotti]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2110774"},{"drug_name":"84 HR estradiol 0.00156 MG\/HR Transdermal System [Dotti]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2110777"},{"drug_name":"84 HR estradiol 0.00208 MG\/HR Transdermal System [Dotti]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2110780"},{"drug_name":"84 HR estradiol 0.00313 MG\/HR Transdermal System [Dotti]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2110783"},{"drug_name":"84 HR estradiol 0.00417 MG\/HR Transdermal System [Dotti]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2110786"},{"drug_name":"pentosan polysulfate 100 MG Oral Capsule [Elmiron]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"211140"},{"drug_name":"bismuth subsalicylate 262 MG Chewable Tablet [Pepto-bismol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"211151"},{"drug_name":"acetaminophen 325 MG \/ butalbital 50 MG \/ caffeine 40 MG Oral Capsule [Esgic]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"211161"},{"drug_name":"bismuth subsalicylate 17.5 MG\/ML Oral Suspension [Pepto-bismol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"211176"},{"drug_name":"sodium fluoride 2 MG\/ML Mouthwash [Prevident Dental Rinse]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"211275"},{"drug_name":"penciclovir 10 MG\/ML Topical Cream [Denavir]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"211343"},{"drug_name":"goserelin 10.8 MG Drug Implant [Zoladex]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"211544"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 84 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) } Pack [Lojaimiess 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2117770"},{"drug_name":"50 ML immunoglobulin G  human 200 MG\/ML Injection [Cuvitru]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2117971"},{"drug_name":"carbamazepine 200 MG Oral Tablet [Epitol]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"211817"},{"drug_name":"aspirin 81 MG Chewable Tablet [St. Joseph Aspirin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"211832"},{"drug_name":"aspirin 325 MG Oral Tablet [Bayer Aspirin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"211874"},{"drug_name":"bismuth subsalicylate 35 MG\/ML Oral Suspension [Pepto-bismol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"211915"},{"drug_name":"14 ML atezolizumab 60 MG\/ML Injection [Tecentriq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2119696"},{"drug_name":"latanoprost 0.05 MG\/ML \/ netarsudil 0.2 MG\/ML Ophthalmic Solution [Rocklatan]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2119706"},{"drug_name":"5 ML hyaluronidase-oysk 2000 UNT\/ML \/ trastuzumab-oysk 120 MG\/ML Injection [Herceptin Hylecta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2119719"},{"drug_name":"aspirin 325 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"212033"},{"drug_name":"2 ML diazepam 5 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2120550"},{"drug_name":"famotidine 10 MG Oral Tablet [Pepcid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"212072"},{"drug_name":"aspirin 325 MG Delayed Release Oral Tablet [Ecotrin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"212086"},{"drug_name":"ceritinib 150 MG Oral Tablet [Zykadia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2121061"},{"drug_name":"nelfinavir 250 MG Oral Tablet [Viracept]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"212118"},{"drug_name":"0.5 ML heparin sodium  porcine 10000 UNT\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2121591"},{"drug_name":"20 ML brexanolone 5 MG\/ML Injection [Zulresso]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2121786"},{"drug_name":"dolutegravir 50 MG \/ lamivudine 300 MG Oral Tablet [Dovato]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2122526"},{"drug_name":"NDA021457 200 ACTUAT albuterol 0.09 MG\/ACTUAT Metered Dose Inhaler","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2123072"},{"drug_name":"NDA020503 200 ACTUAT albuterol 0.09 MG\/ACTUAT Metered Dose Inhaler","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2123111"},{"drug_name":"1.17 ML romosozumab-aqqg 89.7 MG\/ML Prefilled Syringe [Evenity]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2123190"},{"drug_name":"{2 (1.17 ML romosozumab-aqqg 89.7 MG\/ML Prefilled Syringe [Evenity]) } Pack [Evenity 210 MG Dose]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2123191"},{"drug_name":"Pulmonary Hypertension tadalafil 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2123194"},{"drug_name":"salicylic acid 0.06 MG\/MG Topical Gel [Keralyt]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"212332"},{"drug_name":"niacin 750 MG Extended Release Oral Tablet [Slo-Niacin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"212579"},{"drug_name":"cyclosporine 25 MG Oral Capsule [Sandimmune]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"212810"},{"drug_name":"5 ML cyclosporine 50 MG\/ML Injection [Sandimmune]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"212844"},{"drug_name":"cyclosporine 100 MG\/ML Oral Solution [Sandimmune]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"212957"},{"drug_name":"5 ML pegaspargase 750 UNT\/ML Injection [Oncaspar]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"213040"},{"drug_name":"zolmitriptan 5 MG Oral Tablet [Zomig]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"213167"},{"drug_name":"sodium phenylbutyrate 500 MG Oral Tablet [Buphenyl]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"213196"},{"drug_name":"ciprofloxacin 50 MG\/ML Oral Suspension [Cipro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"213224"},{"drug_name":"ciprofloxacin 100 MG\/ML Oral Suspension [Cipro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"213226"},{"drug_name":"loteprednol etabonate 2 MG\/ML Ophthalmic Suspension [Alrex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"213262"},{"drug_name":"brinzolamide 10 MG\/ML Ophthalmic Suspension [Azopt]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"213272"},{"drug_name":"hydroxyurea 200 MG Oral Capsule [Droxia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"213282"},{"drug_name":"hydroxyurea 300 MG Oral Capsule [Droxia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"213283"},{"drug_name":"hydroxyurea 400 MG Oral Capsule [Droxia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"213284"},{"drug_name":"sacrosidase 8500 UNT\/ML Oral Solution [Sucraid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"213337"},{"drug_name":"thalidomide 50 MG Oral Capsule [Thalomid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"213360"},{"drug_name":"abacavir 20 MG\/ML Oral Solution [Ziagen]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"213461"},{"drug_name":"bacitracin 0.5 UNT\/MG \/ polymyxin B 10 UNT\/MG Ophthalmic Ointment [Polycin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"213621"},{"drug_name":"Bifidobacterium animalis 7500000000 UNT \/ Lactobacillus acidophilus 8000000000 UNT Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2166201"},{"drug_name":"10 ACTUAT tiotropium 0.0025 MG\/ACTUAT Inhalation Spray [Spiriva]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2166204"},{"drug_name":"10 ACTUAT olodaterol 0.0025 MG\/ACTUAT \/ tiotropium 0.0025 MG\/ACTUAT Inhalation Spray [Stiolto]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2166928"},{"drug_name":"Lacticaseibacillus rhamnosus GG 5000000000 UNT Oral Powder","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2168350"},{"drug_name":"Lacticaseibacillus rhamnosus GG 2500000000 UNT Oral Powder","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2168439"},{"drug_name":"tafamidis 61 MG Oral Capsule [Vyndamax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2168540"},{"drug_name":"tafamidis meglumine 20 MG Oral Capsule [Vyndaqel]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2168548"},{"drug_name":"{2 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 1 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 3.1 - 3.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170247"},{"drug_name":"{1 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 2 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 3.6 - 4.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170249"},{"drug_name":"{3 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 4.1 - 4.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170251"},{"drug_name":"{2 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 2 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 4.6 - 5.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170253"},{"drug_name":"{2 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 2.6 - 3.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170255"},{"drug_name":"{9 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 13.1 - 13.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170257"},{"drug_name":"{1 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 6 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 9.6 - 10.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170259"},{"drug_name":"{7 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 10.1 - 10.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170261"},{"drug_name":"{2 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 6 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 10.6 - 11.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170263"},{"drug_name":"{1 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 7 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 11.1 - 11.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170265"},{"drug_name":"{8 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 11.6 - 12.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170267"},{"drug_name":"{5 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 7.1 - 7.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170272"},{"drug_name":"{2 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 7 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 12.1 - 12.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170274"},{"drug_name":"{2 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 4 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 7.6 - 8.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170276"},{"drug_name":"{1 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 5 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 8.1 - 8.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170279"},{"drug_name":"{6 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 8.6 - 9.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170282"},{"drug_name":"{2 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 5 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 9.1 - 9.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170284"},{"drug_name":"{1 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 3 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 5.1 - 5.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170289"},{"drug_name":"{4 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 5.6 - 6.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170291"},{"drug_name":"{2 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 3 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 6.1 - 6.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170293"},{"drug_name":"{1 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 4 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 6.6 - 7.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170295"},{"drug_name":"{1 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 8 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 12.6 - 13.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170297"},{"drug_name":"300 ML immunoglobulin G  human 100 MG\/ML Injection [Octagam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170634"},{"drug_name":"1 ML mepolizumab 100 MG\/ML Auto-Injector [Nucala]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2170993"},{"drug_name":"midazolam 50 MG\/ML Nasal Spray [Nayzilam]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2173500"},{"drug_name":"1 ML mepolizumab 100 MG\/ML Prefilled Syringe [Nucala]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2173822"},{"drug_name":"polatuzumab vedotin-piiq 140 MG Injection [Polivy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2174100"},{"drug_name":"{28 (ivacaftor 75 MG \/ tezacaftor 50 MG Oral Tablet) \/ 28 (ivacaftor 75 MG Oral Tablet) } Pack [Symdeko (50 MG \/ 75 MG; 75 MG)]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2174390"},{"drug_name":"trastuzumab-anns 21 MG\/ML Injectable Solution [Kanjinti]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2174809"},{"drug_name":"meclizine hydrochloride 25 MG Chewable Tablet [Dramamine Less Drowsy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2176732"},{"drug_name":"bendamustine hydrochloride 25 MG\/ML Injectable Solution [Belrapzo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2178266"},{"drug_name":"Emollient clobetasol propionate 0.5 MG\/ML Topical Foam [Tovet]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2180345"},{"drug_name":"glucagon 3 MG Nasal Powder [Baqsimi]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2180671"},{"drug_name":"deferiprone 1000 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2180997"},{"drug_name":"1 ML etanercept 50 MG\/ML Cartridge [Enbrel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2182340"},{"drug_name":"dexchlorpheniramine maleate 0.4 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2183907"},{"drug_name":"dexchlorpheniramine maleate 0.4 MG\/ML Oral Solution [Ryclora]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2183912"},{"drug_name":"120 ACTUAT formoterol fumarate 0.005 MG\/ACTUAT \/ mometasone furoate 0.05 MG\/ACTUAT Metered Dose Inhaler [Dulera]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2196592"},{"drug_name":"120 ACTUAT mometasone furoate 0.05 MG\/ACTUAT Metered Dose Inhaler [Asmanex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2196792"},{"drug_name":"24 HR upadacitinib 15 MG Extended Release Oral Tablet [Rinvoq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2196900"},{"drug_name":"dengue virus live antigen  CYD serotype 1 100000 UNT \/ dengue virus live antigen  CYD serotype 2 100000 UNT \/ dengue virus live antigen  CYD serotype 3 100000 UNT \/ dengue virus live antigen  CYD serotype 4 100000 UNT Injection [Dengvaxia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2197703"},{"drug_name":"Lacticaseibacillus rhamnosus GG 10000000000 UNT Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2200018"},{"drug_name":"1 ML benralizumab 30 MG\/ML Auto-Injector [Fasenra]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2205634"},{"drug_name":"{56 (elexacaftor 100 MG \/ ivacaftor 75 MG \/ tezacaftor 50 MG Oral Tablet) \/ 28 (ivacaftor 150 MG Oral Tablet) } Pack [Trikafta (100 MG \/ 50 MG \/ 75 MG; 150 MG)]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2257013"},{"drug_name":"dexamethasone phosphate 1 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"226343"},{"drug_name":"21 DAY ethinyl estradiol 0.000625 MG\/HR \/ etonogestrel 0.005 MG\/HR Vaginal System [EluRyng]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2266506"},{"drug_name":"lanolin 1000 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2266756"},{"drug_name":"lanolin 1000 MG\/ML Topical Cream [Lansinoh]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2266759"},{"drug_name":"2 ML golodirsen 50 MG\/ML Injection [Vyondys 53]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2267216"},{"drug_name":"copper 313 MG Drug Implant [ParaGard]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2267310"},{"drug_name":"ubrogepant 100 MG Oral Tablet [Ubrelvy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2268227"},{"drug_name":"ubrogepant 50 MG Oral Tablet [Ubrelvy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2268231"},{"drug_name":"{1 (0.1 ML) (diazepam 100 MG\/ML Nasal Spray [Valtoco]) } Pack [Valtoco 10 MG Dose Kit]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2272622"},{"drug_name":"{2 (0.1 ML) (diazepam 100 MG\/ML Nasal Spray [Valtoco]) } Pack [Valtoco 20 MG Dose Kit]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2272624"},{"drug_name":"{1 (0.1 ML) (diazepam 50 MG\/ML Nasal Spray [Valtoco]) } Pack [Valtoco 5 MG Dose Kit]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2272630"},{"drug_name":"{2 (0.1 ML) (diazepam 75 MG\/ML Nasal Spray [Valtoco]) } Pack [Valtoco 15 MG Dose Kit]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2272636"},{"drug_name":"antihemophilic factor (recombinant) pegylated-exei 1 UNT Injection [Esperoct]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2275729"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Chewable Tablet) \/ 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Charlotte 24 Fe Chewable 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2280761"},{"drug_name":"olopatadine 1 MG\/ML Ophthalmic Solution [Pataday]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2281304"},{"drug_name":"rimegepant 75 MG Disintegrating Oral Tablet [Nurtec]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2282320"},{"drug_name":"cysteamine 300 MG Delayed Release Oral Granules [Procysbi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2284514"},{"drug_name":"cysteamine 75 MG Delayed Release Oral Granules [Procysbi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2284516"},{"drug_name":"1.5 ML fremanezumab-vfrm 150 MG\/ML Auto-Injector [Ajovy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2287905"},{"drug_name":"0.5 ML Neisseria meningitidis serogroup A capsular polysaccharide tetanus toxoid protein conjugate vaccine 0.02 MG\/ML \/ Neisseria meningitidis serogroup C capsular polysaccharide tetanus toxoid protein conjugate vaccine 0.02 MG\/ML \/ Neisseria meningitidis serogroup W-135 capsular polysaccharide tetanus toxoid protein conjugate vaccine 0.02 MG\/ML \/ Neisseria meningitidis serogroup Y capsular polysaccharide tetanus toxoid protein conjugate vaccine 0.02 MG\/ML Injection [Menquadfi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2360588"},{"drug_name":"Bifidobacterium animalis 16000000000 UNT \/ Lactobacillus acidophilus 16000000000 UNT Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2362247"},{"drug_name":"{28 (elagolix 300 MG \/ estradiol 1 MG \/ norethindrone 0.5 MG Oral Capsule) \/ 28 (elagolix 300 MG Oral Capsule) } Pack [Oriahnn 28 Day Kit]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2371768"},{"drug_name":"0.375 ML leuprolide acetate 120 MG\/ML Prefilled Syringe [Fensolvi]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2371773"},{"drug_name":"theophylline 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"237178"},{"drug_name":"dolutegravir 5 MG Tablet for Oral Suspension [Tivicay]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2374566"},{"drug_name":"2 ML dupilumab 150 MG\/ML Auto-Injector [Dupixent]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2375329"},{"drug_name":"levamlodipine 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2377367"},{"drug_name":"levamlodipine 2.5 MG Oral Tablet [Conjupri]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2377369"},{"drug_name":"levamlodipine 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2377371"},{"drug_name":"levamlodipine 5 MG Oral Tablet [Conjupri]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2377373"},{"drug_name":"168 HR estradiol 0.00208 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"238003"},{"drug_name":"168 HR estradiol 0.00417 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"238004"},{"drug_name":"12 HR fostemsavir 600 MG Extended Release Oral Tablet [Rukobia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2380551"},{"drug_name":"aspirin 325 MG \/ butalbital 50 MG \/ caffeine 40 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"238134"},{"drug_name":"mesalamine 66.7 MG\/ML Enema","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"238151"},{"drug_name":"acetaminophen 325 MG \/ butalbital 50 MG \/ caffeine 40 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"238153"},{"drug_name":"acetaminophen 325 MG \/ butalbital 50 MG \/ caffeine 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"238154"},{"drug_name":"selenium sulfide 25 MG\/ML Medicated Shampoo","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"238600"},{"drug_name":"coagulation factor VIIa (recombinant)-jncw 5 MG Injection [Sevenfact]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2386870"},{"drug_name":"coagulation factor VIIa (recombinant)-jncw 1 MG Injection [Sevenfact]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2386874"},{"drug_name":"6-aminocaproic acid 250 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"238719"},{"drug_name":"5 ML viltolarsen 50 MG\/ML Injection [Viltepso]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2389849"},{"drug_name":"risdiplam 0.75 MG\/ML Oral Solution [Evrysdi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2390946"},{"drug_name":"0.4 ML ofatumumab 50 MG\/ML Pen Injector [Kesimpta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2390954"},{"drug_name":"amoxicillin 50 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"239191"},{"drug_name":"0.5 ML etanercept 50 MG\/ML Injection [Enbrel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2392142"},{"drug_name":"griseofulvin 25 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"239238"},{"drug_name":"griseofulvin 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"239239"},{"drug_name":"0.5 ML dulaglutide 6 MG\/ML Auto-Injector [Trulicity]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2395779"},{"drug_name":"0.5 ML dulaglutide 9 MG\/ML Auto-Injector [Trulicity]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2395785"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Lyleq 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2397128"},{"drug_name":"3 ML semaglutide 1.34 MG\/ML Pen Injector [Ozempic]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2398842"},{"drug_name":"84 HR estradiol 0.00104 MG\/HR Transdermal System [Lyllana]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2399892"},{"drug_name":"84 HR estradiol 0.00156 MG\/HR Transdermal System [Lyllana]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2399895"},{"drug_name":"84 HR estradiol 0.00208 MG\/HR Transdermal System [Lyllana]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2399898"},{"drug_name":"84 HR estradiol 0.00313 MG\/HR Transdermal System [Lyllana]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2399901"},{"drug_name":"84 HR estradiol 0.00417 MG\/HR Transdermal System [Lyllana]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2399904"},{"drug_name":"cholecalciferol 0.125 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"240029"},{"drug_name":"betamethasone 0.5 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"240209"},{"drug_name":"cytarabine 20 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"240416"},{"drug_name":"clarithromycin 25 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"240741"},{"drug_name":"10 ML cladribine 1 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"240754"},{"drug_name":"168 HR estradiol 0.00312 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"241527"},{"drug_name":"cyclosporine  modified 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"241834"},{"drug_name":"84 HR estradiol 0.00156 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"241946"},{"drug_name":"insulin lispro 100 UNT\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"242120"},{"drug_name":"168 HR estradiol 0.00104 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"242333"},{"drug_name":"montelukast 5 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"242438"},{"drug_name":"ofloxacin 3 MG\/ML Otic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"242446"},{"drug_name":"cilostazol 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"242461"},{"drug_name":"cilostazol 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"242462"},{"drug_name":"ferrous gluconate 240 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"242590"},{"drug_name":"abacavir 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"242679"},{"drug_name":"abacavir 20 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"242680"},{"drug_name":"metronidazole 7.5 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"242736"},{"drug_name":"levalbuterol 0.417 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"242754"},{"drug_name":"griseofulvin 125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"242831"},{"drug_name":"84 HR estradiol 0.00208 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"242891"},{"drug_name":"84 HR estradiol 0.00417 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"242892"},{"drug_name":"aspirin 81 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"243670"},{"drug_name":"polymyxin B 10000 UNT\/ML \/ trimethoprim 1 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"244967"},{"drug_name":"72 HR fentanyl 0.025 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"245134"},{"drug_name":"72 HR fentanyl 0.05 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"245135"},{"drug_name":"72 HR fentanyl 0.1 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"245136"},{"drug_name":"albuterol 5 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"245314"},{"drug_name":"cholecalciferol 0.025 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"245500"},{"drug_name":"tretinoin 0.0005 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"245723"},{"drug_name":"clobazam 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"246172"},{"drug_name":"hydrocortisone 0.01 MG\/MG Topical Ointment [Aquaphor Itch Relief]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2462510"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Capsule) \/ 4 (ferrous fumarate 75 MG Oral Capsule) } Pack [Gemmily 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2463741"},{"drug_name":"0.5 ML modified Vaccinia Ankara-Bavarian Nordic 198000000 UNT\/ML Injection [Jynneos]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2464832"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Chewable Tablet) \/ 7 (inert ingredients 1 MG Chewable Tablet) } Pack [Tyblume 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2465331"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Nymyo 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2468058"},{"drug_name":"0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine  inactivated 0.04 MG\/ML \/ Bordetella pertussis fimbriae 2\/3 vaccine  inactivated 0.01 MG\/ML \/ Bordetella pertussis pertactin vaccine  inactivated 0.006 MG\/ML \/ Bordetella pertussis toxoid vaccine  inactivated 0.04 MG\/ML \/ diphtheria toxoid vaccine  inactivated 30 UNT\/ML \/ Haemophilus influenzae b (Ross strain) capsular polysaccharide meningococcal protein conjugate vaccine 0.006 MG\/ML \/ hepatitis B surface antigen vaccine 0.02 MG\/ML \/ poliovirus vaccine inactivated  type 1 (Mahoney) 58 UNT\/ML \/ poliovirus vaccine inactivated  type 2 (MEF-1) 14 UNT\/ML \/ poliovirus vaccine inactivated  type 3 (Saukett) 52 UNT\/ML \/ tetanus toxoid vaccine  inactivated 10 UNT\/ML Prefilled Syringe [Vaxelis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2468239"},{"drug_name":"{7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Tri-Nymyo 28 Day Pack]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2471314"},{"drug_name":"{28 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.09 MG Oral Tablet) } Pack [Dolishale 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2472307"},{"drug_name":"bismuth subsalicylate 262 MG Chewable Tablet [Kaopectate Reformulated Aug 2006]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2476644"},{"drug_name":"2 ML casimersen 50 MG\/ML Injection [Amondys 45]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2480105"},{"drug_name":"ribavirin 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"248109"},{"drug_name":"mesalamine 1000 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"248420"},{"drug_name":"84 HR estradiol 0.00104 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"248478"},{"drug_name":"fluoxetine 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"248642"},{"drug_name":"azithromycin 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"248656"},{"drug_name":"20 ML cytarabine 100 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"249364"},{"drug_name":"permethrin 10 MG\/ML Medicated Shampoo","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"250387"},{"drug_name":"cholecalciferol 0.01 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"251154"},{"drug_name":"ferrous sulfate 75 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"251156"},{"drug_name":"ethosuximide 50 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"251322"},{"drug_name":"pantoprazole 20 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"251872"},{"drug_name":"topiramate 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"252413"},{"drug_name":"lamotrigine 50 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"252478"},{"drug_name":"lamotrigine 200 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"252479"},{"drug_name":"budesonide 0.5 MG\/ML Inhalation Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"252559"},{"drug_name":"melatonin 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"252732"},{"drug_name":"magnesium hydroxide 80 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"253017"},{"drug_name":"{4 (0.8 ML adalimumab 100 MG\/ML Auto-Injector [Humira]) } Pack [Humira Pen 80 MG\/0.8 ML - Starter Package for Pediatric Ulcerative Colitis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2531134"},{"drug_name":"glucose 3750 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2531368"},{"drug_name":"PMDD fluoxetine 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2532159"},{"drug_name":"PMDD fluoxetine 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2532163"},{"drug_name":"0.6 ML dasiglucagon 1 MG\/ML Prefilled Syringe [Zegalogue]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2535243"},{"drug_name":"0.6 ML dasiglucagon 1 MG\/ML Auto-Injector [Zegalogue]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2535249"},{"drug_name":"ferrous gluconate 225 MG Oral Tablet [Fergon]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2539185"},{"drug_name":"naloxone hydrochloride 80 MG\/ML Nasal Spray [Kloxxado]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2540709"},{"drug_name":"valbenazine 60 MG Oral Capsule [Ingrezza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2541513"},{"drug_name":"{2 (thyrotropin alfa 0.9 MG Injection [Thyrogen]) } Pack [Thyrogen Kit (0.9 MG Vial)]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2554805"},{"drug_name":"estradiol 1 MG \/ norethindrone acetate 0.5 MG \/ relugolix 40 MG Oral Tablet [Myfembree]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2556800"},{"drug_name":"1.5 ML somapacitan-beco 6.7 MG\/ML Pen Injector [Sogroya]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2557403"},{"drug_name":"glecaprevir 50 MG \/ pibrentasvir 20 MG Oral Pellet [Mavyret]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2557910"},{"drug_name":"1.14 ML dupilumab 175 MG\/ML Auto-Injector [Dupixent]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2559707"},{"drug_name":"3 ML insulin glargine-yfgn 100 UNT\/ML Pen Injector","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2563971"},{"drug_name":"insulin glargine-yfgn 100 UNT\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2563976"},{"drug_name":"0.5 ML Streptococcus pneumoniae serotype 1 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 10A capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 11A capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 12F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 14 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 15B capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 18C capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 19A capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 19F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 22F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 23F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 3 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 33F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 4 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 5 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 6A capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 6B capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0088 MG\/ML \/ Streptococcus pneumoniae serotype 7F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 8 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 9V capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML Prefilled Syringe [Prevnar 20]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2566314"},{"drug_name":"0.5 ML Streptococcus pneumoniae serotype 1 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 14 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 18C capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 19A capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 19F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 22F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 23F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 3 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 33F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 4 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 5 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 6A capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 6B capsular antigen diphtheria CRM197 protein conjugate vaccine 0.008 MG\/ML \/ Streptococcus pneumoniae serotype 7F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML \/ Streptococcus pneumoniae serotype 9V capsular antigen diphtheria CRM197 protein conjugate vaccine 0.004 MG\/ML Prefilled Syringe [Vaxneuvance]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2566422"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Capsule) \/ 4 (ferrous fumarate 75 MG Oral Capsule) } Pack [Taysofy 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2566439"},{"drug_name":"3 ML icatibant 10 MG\/ML Prefilled Syringe [Sajazir]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2569480"},{"drug_name":"3.5 ML paliperidone palmitate 312 MG\/ML Prefilled Syringe [Invega]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2570419"},{"drug_name":"5 ML paliperidone palmitate 312 MG\/ML Prefilled Syringe [Invega]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2570421"},{"drug_name":"1.5 ML somapacitan-beco 3.3 MG\/ML Pen Injector [Sogroya]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2571805"},{"drug_name":"atogepant 10 MG Oral Tablet [Qulipta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2571842"},{"drug_name":"atogepant 30 MG Oral Tablet [Qulipta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2571846"},{"drug_name":"atogepant 60 MG Oral Tablet [Qulipta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2571850"},{"drug_name":"0.4 ML cyclosporine 0.5 MG\/ML Ophthalmic Suspension [Restasis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2572293"},{"drug_name":"0.25 ML tick-borne encephalitis purified antigen 0.0048 MG\/ML Prefilled Syringe [Ticovac]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2583647"},{"drug_name":"0.5 ML tick-borne encephalitis purified antigen 0.0048 MG\/ML Prefilled Syringe [Ticovac]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2583650"},{"drug_name":"bictegravir 30 MG \/ emtricitabine 120 MG \/ tenofovir alafenamide 15 MG Oral Tablet [Biktarvy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2584356"},{"drug_name":"corticotropin 80 UNT\/ML Injectable Solution [Cortrophin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2584475"},{"drug_name":"0.5 ML acellular pertussis vaccine  inactivated 96 UNT\/ML \/ diphtheria toxoid vaccine  inactivated 30 UNT\/ML \/ Haemophilus influenzae type b  capsular polysaccharide inactivated tetanus toxoid conjugate vaccine 68 UNT\/ML \/ poliovirus vaccine inactivated  type 1 (Mahoney) 58 UNT\/ML \/ poliovirus vaccine inactivated  type 2 (MEF-1) 14 UNT\/ML \/ poliovirus vaccine inactivated  type 3 (Saukett) 52 UNT\/ML \/ tetanus toxoid vaccine  inactivated 20 UNT\/ML Injection [Pentacel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2585717"},{"drug_name":"carbidopa 25 MG \/ levodopa 100 MG Oral Tablet [Dhivy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2586032"},{"drug_name":"topiramate 25 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2586427"},{"drug_name":"0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine  inactivated 0.04 MG\/ML \/ Bordetella pertussis fimbriae 2\/3 vaccine  inactivated 0.01 MG\/ML \/ Bordetella pertussis pertactin vaccine  inactivated 0.006 MG\/ML \/ Bordetella pertussis toxoid vaccine  inactivated 0.04 MG\/ML \/ diphtheria toxoid vaccine  inactivated 30 UNT\/ML \/ poliovirus vaccine inactivated  type 1 (Mahoney) 58 UNT\/ML \/ poliovirus vaccine inactivated  type 2 (MEF-1) 14 UNT\/ML \/ poliovirus vaccine inactivated  type 3 (Saukett) 52 UNT\/ML \/ tetanus toxoid vaccine  inactivated 10 UNT\/ML Injection [Quadracel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2587057"},{"drug_name":"Bacillus coagulans 1000000000 UNT Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2587664"},{"drug_name":"{20 (nirmatrelvir 150 MG Oral Tablet) \/ 10 (ritonavir 100 MG Oral Tablet) } Pack [Paxlovid 5-Day]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2587899"},{"drug_name":"rivaroxaban 1 MG\/ML Oral Suspension [Xarelto]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2588066"},{"drug_name":"3 ML cabotegravir 200 MG\/ML Injection [Apretude]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2588080"},{"drug_name":"1 ML hepatitis B surface antigen (isoform L)  recombinant 0.01 MG\/ML \/ hepatitis B surface antigen (isoform M)  recombinant 0.01 MG\/ML \/ hepatitis B surface antigen (isoform S)  recombinant 0.01 MG\/ML Injection [Prehevbrio]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2588240"},{"drug_name":"1 ML tralokinumab-ldrm 150 MG\/ML Prefilled Syringe [Adbry]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2589384"},{"drug_name":"0.5 ML naloxone hydrochloride 10 MG\/ML Prefilled Syringe [Zimhi]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2589618"},{"drug_name":"torsemide 20 MG Oral Tablet [Soaanz]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2589877"},{"drug_name":"24 HR upadacitinib 30 MG Extended Release Oral Tablet [Rinvoq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2590054"},{"drug_name":"emtricitabine 120 MG \/ tenofovir alafenamide 15 MG Oral Tablet [Descovy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2590643"},{"drug_name":"12 HR aspirin 25 MG \/ dipyridamole 200 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"259081"},{"drug_name":"atorvastatin 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"259255"},{"drug_name":"0.5 ML Bordetella pertussis filamentous hemagglutinin vaccine  inactivated 0.04 MG\/ML \/ Bordetella pertussis fimbriae 2\/3 vaccine  inactivated 0.01 MG\/ML \/ Bordetella pertussis pertactin vaccine  inactivated 0.006 MG\/ML \/ Bordetella pertussis toxoid vaccine  inactivated 0.04 MG\/ML \/ diphtheria toxoid vaccine  inactivated 30 UNT\/ML \/ poliovirus vaccine inactivated  type 1 (Mahoney) 58 UNT\/ML \/ poliovirus vaccine inactivated  type 2 (MEF-1) 14 UNT\/ML \/ poliovirus vaccine inactivated  type 3 (Saukett) 52 UNT\/ML \/ tetanus toxoid vaccine  inactivated 10 UNT\/ML Prefilled Syringe [Quadracel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2593121"},{"drug_name":"leuprolide 42 MG Prefilled Syringe [Camcevi]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2595049"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Capsule) \/ 4 (ferrous fumarate 75 MG Oral Capsule) } Pack [Merzee 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2595466"},{"drug_name":"0.4 ML mepolizumab 100 MG\/ML Prefilled Syringe [Nucala]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2596445"},{"drug_name":"24 HR upadacitinib 45 MG Extended Release Oral Tablet [Rinvoq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2596960"},{"drug_name":"abacavir 60 MG \/ dolutegravir 5 MG \/ lamivudine 30 MG Tablet for Oral Suspension [Triumeq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2598352"},{"drug_name":"vitamin B12 1 MG\/ML Injectable Solution [Dodex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2598453"},{"drug_name":"{28 (alpelisib 125 MG Oral Tablet [Vijoice]) } Pack [Vijoice 125 MG 28 Day]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2598465"},{"drug_name":"{28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 50 MG 28 Day]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2598467"},{"drug_name":"{28 (alpelisib 200 MG Oral Tablet [Vijoice]) \/ 28 (alpelisib 50 MG Oral Tablet [Vijoice]) } Pack [Vijoice 250 MG 28 Day]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2598470"},{"drug_name":"3 ML semaglutide 2.68 MG\/ML Pen Injector [Ozempic]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2599365"},{"drug_name":"{10 (nirmatrelvir 150 MG Oral Tablet) \/ 10 (ritonavir 100 MG Oral Tablet) } Pack [Paxlovid 150 MG \/100 MG Dose Pack]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2599543"},{"drug_name":"methylprednisolone 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"259966"},{"drug_name":"2 ML sodium hyaluronate 10 MG\/ML Prefilled Syringe [Triluron]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2601105"},{"drug_name":"progesterone 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"260243"},{"drug_name":"carbidopa 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"260260"},{"drug_name":"1 ML droperidol 2.5 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2603284"},{"drug_name":"0.5 ML measles virus vaccine live  attenuated Schwarz strain 5024 UNT\/ML \/ mumps virus vaccine live  RIT-4385 strain 31684 UNT\/ML \/ rubella virus vaccine live (Wistar RA 27-3 strain) 3990 UNT\/ML Injection [Priorix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2603514"},{"drug_name":"molnupiravir 200 MG Oral Capsule [Lagevrio]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2603740"},{"drug_name":"terazosin 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"260376"},{"drug_name":"Bifidobacterium animalis 16000000000 UNT \/ Lactobacillus acidophilus 17000000000 UNT Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2604779"},{"drug_name":"lidocaine hydrochloride 0.02 MG\/MG Topical Gel [Regenecare]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2604879"},{"drug_name":"diphenhydramine hydrochloride 50 MG Oral Tablet [Benadryl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2605033"},{"drug_name":"0.5 ML influenza A virus A\/Darwin\/9\/2021 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/2570\/2019 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Michigan\/01\/2021 antigen 0.03 MG\/ML \/ influenza B virus B\/Phuket\/3073\/2013 antigen 0.03 MG\/ML Prefilled Syringe [Fluzone Quadrivalent 2022-2023]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2605543"},{"drug_name":"0.5 ML influenza A virus A\/Darwin\/9\/2021 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/2570\/2019 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Michigan\/01\/2021 antigen 0.03 MG\/ML \/ influenza B virus B\/Phuket\/3073\/2013 antigen 0.03 MG\/ML Injection [Fluzone Quadrivalent 2022-2023]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2605549"},{"drug_name":"0.5 ML influenza A virus A\/Darwin\/6\/2021 (H3N2) antigen 0.09 MG\/ML \/ influenza A virus A\/Wisconsin\/588\/2019 (H1N1) antigen 0.09 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.09 MG\/ML \/ influenza B virus B\/Phuket\/3073\/2013 antigen 0.09 MG\/ML Prefilled Syringe [Flublok Quadrivalent 2022-2023]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2605570"},{"drug_name":"24 HR methylphenidate hydrochloride 45 MG Extended Release Oral Tablet [Relexxii]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2605943"},{"drug_name":"24 HR methylphenidate hydrochloride 63 MG Extended Release Oral Tablet [Relexxii]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2605946"},{"drug_name":"pirfenidone 534 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2606490"},{"drug_name":"leuprolide acetate 22.5 MG Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2606516"},{"drug_name":"aspirin 325 MG Oral Tablet [Bufferin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"260847"},{"drug_name":"niacin 500 MG Extended Release Oral Tablet [Slo-Niacin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"260852"},{"drug_name":"{24 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Chewable Tablet) \/ 4 (ferrous fumarate 75 MG Oral Tablet) } Pack [Finzala 24 Fe Chewable 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2608695"},{"drug_name":"famotidine 20 MG Oral Tablet [Zantac Reformulated Aug 2022]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2609246"},{"drug_name":"sodium phenylbutyrate 0.483 MG\/MG Oral Pellet [Pheburane]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2610134"},{"drug_name":"polysaccharide iron complex 150 MG Oral Capsule [Nu-Iron 150]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"261021"},{"drug_name":"SARS-CoV-2 (COVID-19) vaccine  mRNA-BNT162b2 0.05 MG\/ML \/ SARS-CoV-2 (COVID-19) vaccine  mRNA-BNT162b2 OMICRON (BA.4\/BA.5) 0.05 MG\/ML Injectable Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2610319"},{"drug_name":"SARS-CoV-2 (COVID-19) vaccine  mRNA-1273 0.05 MG\/ML \/ SARS-CoV-2 (COVID-19) vaccine  mRNA-1273 OMICRON (BA.4\/BA.5) 0.05 MG\/ML Injectable Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2610328"},{"drug_name":"20 ML betibeglogene autotemcel 20000000 CELLS\/ML Injection [Zynteglo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2610436"},{"drug_name":"ivacaftor 94 MG \/ lumacaftor 75 MG Oral Granules [ORKAMBI]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2611460"},{"drug_name":"nystatin 100 UNT\/MG Topical Powder [Nystop]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"261178"},{"drug_name":"methocarbamol 1000 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2611794"},{"drug_name":"sapropterin dihydrochloride 100 MG Powder for Oral Solution [Javygtor]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2611951"},{"drug_name":"20 ML elivaldogene autotemcel 30000000 CELLS\/ML Injection [Skysona]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2612558"},{"drug_name":"sapropterin dihydrochloride 100 MG Oral Tablet [Javygtor]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2612671"},{"drug_name":"ivermectin 3 MG Oral Tablet [Stromectol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"261314"},{"drug_name":"ferrous gluconate 240 MG Oral Tablet [Ferate]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"261385"},{"drug_name":"0.25 MG  0.5 MG Dose 3 ML semaglutide 0.68 MG\/ML Pen Injector [Ozempic]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2619154"},{"drug_name":"ramipril 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"261962"},{"drug_name":"sapropterin dihydrochloride 500 MG Powder for Oral Solution [Javygtor]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2621237"},{"drug_name":"bendamustine hydrochloride 25 MG\/ML Injectable Solution [Vivimusta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2622914"},{"drug_name":"21 DAY ethinyl estradiol 0.000625 MG\/HR \/ etonogestrel 0.005 MG\/HR Vaginal System [Haloette]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2622921"},{"drug_name":"lenacapavir 300 MG Oral Tablet [Sunlenca]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2625896"},{"drug_name":"{4 (lenacapavir 300 MG Oral Tablet [Sunlenca]) } Pack [Sunlenca 4-Tablet Pack]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2625898"},{"drug_name":"{5 (lenacapavir 300 MG Oral Tablet [Sunlenca]) } Pack [Sunlenca 5-Tablet Pack]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2625900"},{"drug_name":"{2 (1.5 ML lenacapavir 309 MG\/ML Injection [Sunlenca]) } Pack [Sunlenca 927 MG Kit]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2625912"},{"drug_name":"{10 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 46 - 50 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626781"},{"drug_name":"{11 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 51 - 55 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626783"},{"drug_name":"{12 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 56 - 60 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626785"},{"drug_name":"{13 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 61 - 65 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626787"},{"drug_name":"{14 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 66 - 70 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626789"},{"drug_name":"{15 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 71 - 75 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626791"},{"drug_name":"{16 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 76 - 80 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626793"},{"drug_name":"{17 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 81 - 85 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626795"},{"drug_name":"{18 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 86 - 90 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626797"},{"drug_name":"{19 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 91 - 95 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626799"},{"drug_name":"{20 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 96 - 100 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626801"},{"drug_name":"{21 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 101 - 105 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626803"},{"drug_name":"{22 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 106 - 110 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626805"},{"drug_name":"{23 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 111 - 115 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626807"},{"drug_name":"{24 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 116 - 120 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626809"},{"drug_name":"{25 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 121 - 125 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626811"},{"drug_name":"{26 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 126 - 130 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626813"},{"drug_name":"{27 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 131 - 135 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626815"},{"drug_name":"{28 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 136 - 140 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626817"},{"drug_name":"{29 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 141 - 145 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626819"},{"drug_name":"{48 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 236 - 240 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626821"},{"drug_name":"{47 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 231 - 235 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626823"},{"drug_name":"{46 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 226 - 230 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626825"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Emzahh 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2626828"},{"drug_name":"{30 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 146 - 150 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626830"},{"drug_name":"{31 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 151 - 155 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626832"},{"drug_name":"{32 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 156 - 160 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626834"},{"drug_name":"{33 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 161 - 165 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626836"},{"drug_name":"{34 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 166 - 170 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626838"},{"drug_name":"{35 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 171 - 175 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626840"},{"drug_name":"{37 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 181 - 185 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626844"},{"drug_name":"{38 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 186 - 190 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626846"},{"drug_name":"{39 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 191 - 195 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626848"},{"drug_name":"{45 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 221 - 225 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626850"},{"drug_name":"{44 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 216 - 220 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626852"},{"drug_name":"{43 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 211 - 215 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626854"},{"drug_name":"{42 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 206 - 210 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626856"},{"drug_name":"{41 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 201 - 205 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626858"},{"drug_name":"{40 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 196 - 200 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2626860"},{"drug_name":"{36 (10 ML etranacogene dezaparvovec-drlb 10000000000000 VECTOR-GENOMES\/ML Injection [Hemgenix]) } Pack [Hemgenix Kit 176 - 180 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2627142"},{"drug_name":"metaxalone 640 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2627781"},{"drug_name":"rotavirus vaccine  live attenuated  G1P[8] human 89-12 strain 667000 UNT\/ML Oral Suspension [Rotarix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2627825"},{"drug_name":"24 HR deutetrabenazine 12 MG Extended Release Oral Tablet [Austedo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630147"},{"drug_name":"24 HR deutetrabenazine 24 MG Extended Release Oral Tablet [Austedo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630153"},{"drug_name":"24 HR deutetrabenazine 6 MG Extended Release Oral Tablet [Austedo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630157"},{"drug_name":"{14 (24 HR deutetrabenazine 12 MG Extended Release Oral Tablet [Austedo]) \/ 14 (24 HR deutetrabenazine 24 MG Extended Release Oral Tablet [Austedo]) \/ 14 (24 HR deutetrabenazine 6 MG Extended Release Oral Tablet [Austedo]) } Pack [Austedo XR Once Daily  4 Week Titration Pack  6 MG \/ 12 MG \/ 24 MG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630160"},{"drug_name":"{2 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 8 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 13.6 - 14.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630832"},{"drug_name":"{1 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 9 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 14.1 - 14.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630833"},{"drug_name":"{10 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 14.6 - 15.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630839"},{"drug_name":"{2 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 9 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 15.1 - 15.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630840"},{"drug_name":"{1 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 10 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 15.6 - 16.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630855"},{"drug_name":"{11 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 16.1 - 16.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630856"},{"drug_name":"{2 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 10 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 16.6 - 17.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630857"},{"drug_name":"{1 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 11 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 17.1 - 17.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630858"},{"drug_name":"{12 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 17.6 - 18.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630859"},{"drug_name":"{2 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 11 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 18.1 - 18.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630860"},{"drug_name":"{1 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 12 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 18.6 - 19.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630861"},{"drug_name":"{13 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 19.1 - 19.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630862"},{"drug_name":"{2 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 12 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 19.6 - 20.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630863"},{"drug_name":"{1 (5.5 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) \/ 13 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 20.1 - 20.5 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630864"},{"drug_name":"{14 (8.3 ML onasemnogene abeparvovec-xioi 20000000000000 VECTOR-GENOMES\/ML Injection [Zolgensma]) } Pack [Zolgensma Kit 20.6 - 21.0 kg]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2630865"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [Curae]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2631024"},{"drug_name":"antihemophilic factor (recombinant)  Fc-VWF-XTEN fusion protein-ehtl 1 UNT Injection [Altuviiio]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2631093"},{"drug_name":"{1 (acetaminophen 325 MG \/ dextromethorphan hydrobromide 10 MG \/ doxylamine succinate 6.25 MG \/ phenylephrine hydrochloride 5 MG Oral Tablet) \/ 1 (acetaminophen 325 MG \/ dextromethorphan hydrobromide 10 MG \/ guaifenesin 200 MG \/ phenylephrine hydrochloride 5 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2634817"},{"drug_name":"0.28 ML risperidone 357 MG\/ML Prefilled Syringe [Uzedy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2636039"},{"drug_name":"0.35 ML risperidone 357 MG\/ML Prefilled Syringe [Uzedy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2636042"},{"drug_name":"0.42 ML risperidone 357 MG\/ML Prefilled Syringe [Uzedy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2636044"},{"drug_name":"0.56 ML risperidone 357 MG\/ML Prefilled Syringe [Uzedy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2636046"},{"drug_name":"0.7 ML risperidone 357 MG\/ML Prefilled Syringe [Uzedy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2636048"},{"drug_name":"0.14 ML risperidone 357 MG\/ML Prefilled Syringe [Uzedy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2636050"},{"drug_name":"0.21 ML risperidone 357 MG\/ML Prefilled Syringe [Uzedy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2636052"},{"drug_name":"0.5 ML respiratory syncytial virus pre-fusion F protein  recombinant 0.24 MG\/ML Injection [Arexvy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2636599"},{"drug_name":"2.4 ML aripiprazole 300 MG\/ML Prefilled Syringe [Abilify]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2636640"},{"drug_name":"3.2 ML aripiprazole 300 MG\/ML Prefilled Syringe [Abilify]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2636646"},{"drug_name":"1.5 ML somapacitan-beco 10 MG\/ML Pen Injector [Sogroya]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2636954"},{"drug_name":"30 ACTUAT fluticasone furoate 0.05 MG\/ACTUAT \/ vilanterol 0.025 MG\/ACTUAT Dry Powder Inhaler [Breo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2637476"},{"drug_name":"0.16 ML buprenorphine 50 MG\/ML Prefilled Syringe [Brixadi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2639027"},{"drug_name":"0.32 ML buprenorphine 50 MG\/ML Prefilled Syringe [Brixadi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2639030"},{"drug_name":"0.48 ML buprenorphine 50 MG\/ML Prefilled Syringe [Brixadi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2639032"},{"drug_name":"0.64 ML buprenorphine 50 MG\/ML Prefilled Syringe [Brixadi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2639034"},{"drug_name":"0.18 ML buprenorphine 356 MG\/ML Prefilled Syringe [Brixadi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2639039"},{"drug_name":"0.27 ML buprenorphine 356 MG\/ML Prefilled Syringe [Brixadi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2639042"},{"drug_name":"0.36 ML buprenorphine 356 MG\/ML Prefilled Syringe [Brixadi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2639044"},{"drug_name":"Pediatric 1.5 ML leuprolide acetate 30 MG\/ML Prefilled Syringe [Lupron]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2639669"},{"drug_name":"nalmefene 27 MG\/ML Nasal Spray [Opvee]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2639727"},{"drug_name":"Pediatric 1 ML leuprolide acetate 7.5 MG\/ML Prefilled Syringe [Lupron]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2639743"},{"drug_name":"Pediatric 1.5 ML leuprolide acetate 7.5 MG\/ML Prefilled Syringe [Lupron]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2639750"},{"drug_name":"0.8 ML adalimumab-bwwd 50 MG\/ML Auto-Injector [Hadlima]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2640300"},{"drug_name":"0.8 ML adalimumab-bwwd 50 MG\/ML Prefilled Syringe [Hadlima]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2640305"},{"drug_name":"0.4 ML adalimumab-bwwd 100 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2640425"},{"drug_name":"0.4 ML adalimumab-bwwd 100 MG\/ML Prefilled Syringe [Hadlima]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2640428"},{"drug_name":"0.4 ML adalimumab-bwwd 100 MG\/ML Auto-Injector","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2640430"},{"drug_name":"0.4 ML adalimumab-bwwd 100 MG\/ML Auto-Injector [Hadlima]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2640432"},{"drug_name":"8 ML valoctocogene roxaparvovec-rvox 20000000000000 VECTOR-GENOMES\/ML Injection [Roctavian]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641620"},{"drug_name":"0.1 ML adalimumab-adaz 100 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641644"},{"drug_name":"0.4 ML adalimumab-adaz 100 MG\/ML Auto-Injector","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641655"},{"drug_name":"0.4 ML adalimumab-adaz 100 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641660"},{"drug_name":"0.8 ML adalimumab-adaz 100 MG\/ML Auto-Injector","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641662"},{"drug_name":"{10 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 10.0 - 10.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641688"},{"drug_name":"{11 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 10.5 - 11.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641690"},{"drug_name":"{12 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 11.5 - 12.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641692"},{"drug_name":"{13 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 12.5 - 13.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641694"},{"drug_name":"{14 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 13.5 - 14.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641696"},{"drug_name":"{15 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 14.5 - 15.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641698"},{"drug_name":"{16 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 15.5 - 16.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641700"},{"drug_name":"{17 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 16.5 - 17.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641702"},{"drug_name":"{18 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 17.5 - 18.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641704"},{"drug_name":"{19 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 18.5 - 19.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641706"},{"drug_name":"{20 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 19.5 - 20.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641708"},{"drug_name":"{21 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 20.5 - 21.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641710"},{"drug_name":"{22 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 21.5 - 22.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641712"},{"drug_name":"{23 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 22.5 - 23.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641714"},{"drug_name":"{24 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 23.5 - 24.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641716"},{"drug_name":"{25 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 24.5 - 25.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641718"},{"drug_name":"{26 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 25.5 - 26.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641720"},{"drug_name":"{27 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 26.5 - 27.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641722"},{"drug_name":"{28 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 27.5 - 28.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641724"},{"drug_name":"{29 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 28.5 - 29.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641726"},{"drug_name":"{30 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 29.5 - 30.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641728"},{"drug_name":"{31 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 30.5 - 31.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641730"},{"drug_name":"{32 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 31.5 - 32.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641732"},{"drug_name":"{33 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 32.5 - 33.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641734"},{"drug_name":"{34 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 33.5 - 34.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641736"},{"drug_name":"{35 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 34.5 - 35.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641738"},{"drug_name":"{36 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 35.5 - 36.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641740"},{"drug_name":"{37 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 36.5 - 37.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641742"},{"drug_name":"{38 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 37.5 - 38.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641744"},{"drug_name":"{39 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 38.5 - 39.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641746"},{"drug_name":"{40 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 39.5 - 40.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641748"},{"drug_name":"{41 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 40.5 - 41.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641751"},{"drug_name":"{42 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 41.5 - 42.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641753"},{"drug_name":"{43 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 42.5 - 43.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641755"},{"drug_name":"{44 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 43.5 - 44.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641757"},{"drug_name":"{45 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 44.5 - 45.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641759"},{"drug_name":"{46 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 45.5 - 46.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641761"},{"drug_name":"{47 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 46.5 - 47.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641763"},{"drug_name":"{48 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 47.5 - 48.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641765"},{"drug_name":"{49 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 48.5 - 49.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641767"},{"drug_name":"{50 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 49.5 - 50.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641769"},{"drug_name":"{51 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 50.5 - 51.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641771"},{"drug_name":"{52 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 51.5 - 52.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641773"},{"drug_name":"{53 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 52.5 - 53.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641775"},{"drug_name":"{54 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 53.5 - 54.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641777"},{"drug_name":"{55 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 54.5 - 55.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641779"},{"drug_name":"{56 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 55.5 - 56.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641781"},{"drug_name":"{57 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 56.5 - 57.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641783"},{"drug_name":"{58 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 57.5 - 58.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641785"},{"drug_name":"{59 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 58.5 - 59.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641787"},{"drug_name":"{60 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 59.5 - 60.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641789"},{"drug_name":"{61 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 60.5 - 61.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641831"},{"drug_name":"{62 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 61.5 - 62.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641833"},{"drug_name":"{63 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 62.5 - 63.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641835"},{"drug_name":"{64 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 63.5 - 64.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641837"},{"drug_name":"{65 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 64.5 - 65.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641839"},{"drug_name":"{66 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 65.5 - 66.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641841"},{"drug_name":"{67 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 66.5 - 67.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641843"},{"drug_name":"{68 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 67.5 - 68.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641845"},{"drug_name":"{69 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit 68.5 - 69.4 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641847"},{"drug_name":"{70 (10 ML delandistrogene moxeparvovec-rokl 13300000000000 VECTOR-GENOMES\/ML Injection [Elevidys]) } Pack [Elevidys Kit > 69.5 KG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2641849"},{"drug_name":"0.5 ML respiratory syncytial virus pre-fusion F protein  A  recombinant  stabilized 0.12 MG\/ML \/ respiratory syncytial virus pre-fusion F protein  B  recombinant  stabilized 0.12 MG\/ML Injection [Abrysvo]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2642148"},{"drug_name":"miglustat 100 MG Oral Capsule [Yargesa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2642350"},{"drug_name":"0.5 ML nirsevimab-alip 100 MG\/ML Prefilled Syringe [Beyfortus]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2642412"},{"drug_name":"1 ML nirsevimab-alip 100 MG\/ML Prefilled Syringe [Beyfortus]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2642415"},{"drug_name":"thyroid (USP) 120 MG Oral Tablet [Niva Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2642816"},{"drug_name":"thyroid (USP) 15 MG Oral Tablet [Niva Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2642818"},{"drug_name":"thyroid (USP) 30 MG Oral Tablet [Niva Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2642824"},{"drug_name":"thyroid (USP) 60 MG Oral Tablet [Niva Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2642828"},{"drug_name":"thyroid (USP) 90 MG Oral Tablet [Niva Thyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2642830"},{"drug_name":"21 DAY ethinyl estradiol 0.000625 MG\/HR \/ etonogestrel 0.005 MG\/HR Vaginal System [Enilloring]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2644707"},{"drug_name":"2 ML omalizumab 150 MG\/ML Prefilled Syringe [Xolair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2663918"},{"drug_name":"2 ML omalizumab 150 MG\/ML Auto-Injector [Xolair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2663923"},{"drug_name":"BX Rating tacrolimus 0.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2665161"},{"drug_name":"BX Rating tacrolimus 1 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2665162"},{"drug_name":"BX Rating tacrolimus 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2665163"},{"drug_name":"triamcinolone acetonide 0.001 MG\/MG Oral Paste [Kourzeq]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2665617"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norgestrel 0.3 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Turqoz 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2665903"},{"drug_name":"24 HR methylphenidate hydrochloride 18 MG Extended Release Oral Tablet [Relexxii]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2668496"},{"drug_name":"24 HR methylphenidate hydrochloride 27 MG Extended Release Oral Tablet [Relexxii]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2668499"},{"drug_name":"24 HR methylphenidate hydrochloride 36 MG Extended Release Oral Tablet [Relexxii]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2668502"},{"drug_name":"24 HR methylphenidate hydrochloride 54 MG Extended Release Oral Tablet [Relexxii]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2668505"},{"drug_name":"amylase 252600 UNT \/ lipase 60000 UNT \/ protease 189600 UNT Delayed Release Oral Capsule [Zenpep]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2669472"},{"drug_name":"0.5 ML Neisseria meningitidis serogroup A capsular polysaccharide tetanus toxoid protein conjugate vaccine 0.01 MG\/ML \/ Neisseria meningitidis serogroup B recombinant LP2086 A05 protein variant antigen 0.12 MG\/ML \/ Neisseria meningitidis serogroup B recombinant LP2086 B01 protein variant antigen 0.12 MG\/ML \/ Neisseria meningitidis serogroup C capsular polysaccharide tetanus toxoid protein conjugate vaccine 0.01 MG\/ML \/ Neisseria meningitidis serogroup W-135 capsular polysaccharide tetanus toxoid protein conjugate vaccine 0.01 MG\/ML \/ Neisseria meningitidis serogroup Y capsular polysaccharide tetanus toxoid protein conjugate vaccine 0.01 MG\/ML Injection [Penbraya]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2670566"},{"drug_name":"50 ML immunoglobulin G  human 200 MG\/ML Prefilled Syringe [Hizentra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2670629"},{"drug_name":"thyroid (USP) 15 MG Oral Tablet [Adthyza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2671591"},{"drug_name":"thyroid (USP) 30 MG Oral Tablet [Adthyza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2671594"},{"drug_name":"thyroid (USP) 60 MG Oral Tablet [Adthyza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2671596"},{"drug_name":"thyroid (USP) 90 MG Oral Tablet [Adthyza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2671598"},{"drug_name":"thyroid (USP) 120 MG Oral Tablet [Adthyza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2671600"},{"drug_name":"1.5 ML exagamglogene autotemcel 13000000 CELLS\/ML Injection [Casgevy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2671677"},{"drug_name":"salicylic acid 0.06 MG\/MG Topical Gel [Salyntra]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2672367"},{"drug_name":"chikungunya virus antigen  live attenuated LR2006 OPY1 strain 2000 UNT Injection [Ixchiq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2673247"},{"drug_name":"1 ML omalizumab 150 MG\/ML Auto-Injector [Xolair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2673761"},{"drug_name":"0.5 ML omalizumab 150 MG\/ML Auto-Injector [Xolair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2673763"},{"drug_name":"0.25 ML ixekizumab 80 MG\/ML Prefilled Syringe [Taltz]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2674932"},{"drug_name":"0.5 ML ixekizumab 80 MG\/ML Prefilled Syringe [Taltz]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2674934"},{"drug_name":"riluzole 5 MG\/ML Oral Suspension [Teglutik]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2675565"},{"drug_name":"Twice-Daily clindamycin 0.01 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2676585"},{"drug_name":"rilpivirine 2.5 MG Tablet for Oral Suspension [Edurant]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2678248"},{"drug_name":"0.5 ML benralizumab 20 MG\/ML Prefilled Syringe [Fasenra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2679502"},{"drug_name":"1 ML naloxone hydrochloride 0.4 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2679504"},{"drug_name":"baclofen 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2679605"},{"drug_name":"16 ML docetaxel 10 MG\/ML Injection [Docivyx]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2679784"},{"drug_name":"2 ML docetaxel 10 MG\/ML Injection [Docivyx]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2679786"},{"drug_name":"8 ML docetaxel 10 MG\/ML Injection [Docivyx]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2679788"},{"drug_name":"naloxone hydrochloride 16 MG\/ML Nasal Spray [Rextovy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2680741"},{"drug_name":"Sprinkle valbenazine 40 MG Oral Capsule [Ingrezza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2680780"},{"drug_name":"Sprinkle valbenazine 60 MG Oral Capsule [Ingrezza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2680782"},{"drug_name":"Sprinkle valbenazine 80 MG Oral Capsule [Ingrezza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2680784"},{"drug_name":"upadacitinib 1 MG\/ML Oral Solution [Rinvoq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2681019"},{"drug_name":"{4 (apremilast 10 MG Oral Tablet [Otezla]) \/ 51 (apremilast 20 MG Oral Tablet [Otezla]) } Pack [Otezla 28-Day 10\/20 Starter Pack]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2682430"},{"drug_name":"24 HR deutetrabenazine 30 MG Extended Release Oral Tablet [Austedo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2683285"},{"drug_name":"24 HR deutetrabenazine 36 MG Extended Release Oral Tablet [Austedo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2683291"},{"drug_name":"24 HR deutetrabenazine 42 MG Extended Release Oral Tablet [Austedo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2683297"},{"drug_name":"24 HR deutetrabenazine 48 MG Extended Release Oral Tablet [Austedo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2683303"},{"drug_name":"everolimus 2.5 MG Oral Tablet [Torpenz]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2685202"},{"drug_name":"everolimus 10 MG Oral Tablet [Torpenz]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2685204"},{"drug_name":"everolimus 5 MG Oral Tablet [Torpenz]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2685206"},{"drug_name":"everolimus 7.5 MG Oral Tablet [Torpenz]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2685208"},{"drug_name":"clotrimazole 10 MG\/ML Topical Cream [Trimazole]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2685228"},{"drug_name":"tolnaftate 10 MG\/ML Topical Cream [Tritolnacide]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2685262"},{"drug_name":"ondansetron 16 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2685489"},{"drug_name":"2 ML tralokinumab-ldrm 150 MG\/ML Auto-Injector [Adbry]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2686065"},{"drug_name":"24 HR deutetrabenazine 18 MG Extended Release Oral Tablet [Austedo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2686156"},{"drug_name":"{7 (24 HR deutetrabenazine 12 MG Extended Release Oral Tablet [Austedo]) \/ 7 (24 HR deutetrabenazine 18 MG Extended Release Oral Tablet [Austedo]) \/ 7 (24 HR deutetrabenazine 24 MG Extended Release Oral Tablet [Austedo]) \/ 7 (24 HR deutetrabenazine 30 MG Extended Release Oral Tablet [Austedo]) } Pack [Austedo XR Once Daily  4 Week Titration Pack  12 MG \/ 18 MG \/ 24 MG \/ 30 MG]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2686613"},{"drug_name":"0.5 ML influenza A virus A\/Thailand\/8\/2022 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.03 MG\/ML Prefilled Syringe [Fluarix 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2686938"},{"drug_name":"0.5 ML influenza A virus A\/Thailand\/8\/2022 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.03 MG\/ML Prefilled Syringe [Flulaval 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2686945"},{"drug_name":"0.5 ML influenza A virus A\/Thailand\/8\/2022 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.03 MG\/ML Prefilled Syringe [Fluad 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2687364"},{"drug_name":"0.5 ML influenza A virus A\/California\/122\/2022 (H3N2) antigen 0.12 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.12 MG\/ML \/ influenza B virus B\/Michigan\/01\/2021 antigen 0.12 MG\/ML Prefilled Syringe [Fluzone 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2687729"},{"drug_name":"0.5 ML influenza A virus A\/Massachusetts\/18\/2022 (H3N2) antigen 0.09 MG\/ML \/ influenza A virus A\/West Virginia\/30\/2022 (H1N1) antigen 0.09 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.09 MG\/ML Prefilled Syringe [Flublok 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2687742"},{"drug_name":"influenza A virus A\/California\/122\/2022 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Michigan\/01\/2021 antigen 0.03 MG\/ML Injectable Suspension [Fluzone 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2688053"},{"drug_name":"0.5 ML influenza A virus A\/California\/122\/2022 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Michigan\/01\/2021 antigen 0.03 MG\/ML Prefilled Syringe [Fluzone 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2688056"},{"drug_name":"0.5 ML influenza A virus A\/Thailand\/8\/2022 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.03 MG\/ML Prefilled Syringe [Afluria 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2688111"},{"drug_name":"influenza A virus A\/Thailand\/8\/2022 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.03 MG\/ML Injectable Suspension [Afluria 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2688118"},{"drug_name":"0.5 ML influenza A virus A\/Georgia\/12\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza A virus A\/Sydney\/1304\/2022 (H3N2) antigen 0.03 MG\/ML \/ influenza B virus B\/Singapore\/WUH4618\/2021 antigen 0.03 MG\/ML Prefilled Syringe [Flucelvax 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2688130"},{"drug_name":"influenza A virus A\/Georgia\/12\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza A virus A\/Sydney\/1304\/2022 (H3N2) antigen 0.03 MG\/ML \/ influenza B virus B\/Singapore\/WUH4618\/2021 antigen 0.03 MG\/ML Injectable Suspension [Flucelvax 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2688136"},{"drug_name":"0.25 ML SARS-CoV-2 (COVID-19) vaccine  mRNA-1273 OMICRON (KP.2) 0.1 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2691172"},{"drug_name":"0.5 ML SARS-CoV-2 (COVID-19) vaccine  mRNA-1273 OMICRON (KP.2) 0.1 MG\/ML Prefilled Syringe [Spikevax 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2691181"},{"drug_name":"SARS-CoV-2 (COVID-19) vaccine  mRNA-BNT162b2 OMICRON (KP.2) 0.01 MG\/ML Injectable Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2691196"},{"drug_name":"0.3 ML SARS-CoV-2 (COVID-19) vaccine  mRNA-BNT162b2 OMICRON (KP.2) 0.0333 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2691200"},{"drug_name":"0.3 ML SARS-CoV-2 (COVID-19) vaccine  mRNA-BNT162b2 OMICRON (KP.2) 0.1 MG\/ML Prefilled Syringe [Comirnaty 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2691212"},{"drug_name":"influenza A virus A\/Norway\/31694\/2022 (H1N1) antigen 158000000 UNT\/ML \/ influenza A virus A\/Thailand\/8\/2022 (H3N2) antigen 158000000 UNT\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 158000000 UNT\/ML Nasal Spray [FluMist 2024-2025]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2691308"},{"drug_name":"dasatinib 100 MG Oral Tablet [Phyrago]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2691837"},{"drug_name":"dasatinib 140 MG Oral Tablet [Phyrago]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2691839"},{"drug_name":"dasatinib 20 MG Oral Tablet [Phyrago]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2691841"},{"drug_name":"dasatinib 50 MG Oral Tablet [Phyrago]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2691843"},{"drug_name":"dasatinib 70 MG Oral Tablet [Phyrago]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2691845"},{"drug_name":"dasatinib 80 MG Oral Tablet [Phyrago]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2691847"},{"drug_name":"0.5 ML SARS-CoV-2 (COVID-19) vaccine  protein NVX-CoV2705 0.01 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2692309"},{"drug_name":"epinephrine 20 MG\/ML Nasal Spray [Neffy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2693448"},{"drug_name":"2 ML lebrikizumab-lbkz 125 MG\/ML Prefilled Syringe [Ebglyss]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2693791"},{"drug_name":"2 ML lebrikizumab-lbkz 125 MG\/ML Pen Injector [Ebglyss]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2693907"},{"drug_name":"norethindrone acetate 5 MG Oral Tablet [Gallifrey]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2696255"},{"drug_name":"abiraterone acetate 250 MG Oral Tablet [Abirtega]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2702601"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 0.4 MG Chewable Tablet) \/ 7 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Xelria Fe 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2703268"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Feirza 1\/20 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2703269"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Feirza 1.5\/30 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2703270"},{"drug_name":"{5 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 9 (ethinyl estradiol 0.035 MG \/ norethindrone acetate 1 MG Oral Tablet) \/ 7 (ferrous fumarate 75 MG Oral Tablet) } Pack [Xarah Fe 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2703554"},{"drug_name":"{24 (ethinyl estradiol 0.025 MG \/ norethindrone 0.8 MG Chewable Tablet) \/ 4 (ferrous fumarate 75 MG Chewable Tablet) } Pack [Galbriela 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2704559"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Orquidea 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2704560"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ ethynodiol diacetate 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Valtya 1\/35 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2704561"},{"drug_name":"{21 (ethinyl estradiol 0.05 MG \/ ethynodiol diacetate 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Valtya 1\/50 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2704562"},{"drug_name":"suzetrigine 50 MG Oral Tablet [Journavx]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2704839"},{"drug_name":"{6 (nirmatrelvir 150 MG Oral Tablet) \/ 5 (ritonavir 100 MG Oral Tablet) } Pack [Paxlovid 300 MG \/100 MG ; 150 MG \/ 100 MG Dose Pack]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2704987"},{"drug_name":"risdiplam 5 MG Oral Tablet [Evrysdi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2705369"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 42 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 21 (ethinyl estradiol 0.025 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 21 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) } Pack [Rosyrah 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2705814"},{"drug_name":"thyroid (USP) 30 MG Oral Tablet [Renthyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2706317"},{"drug_name":"thyroid (USP) 60 MG Oral Tablet [Renthyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2706323"},{"drug_name":"thyroid (USP) 90 MG Oral Tablet [Renthyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2706329"},{"drug_name":"thyroid (USP) 120 MG Oral Tablet [Renthyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2706331"},{"drug_name":"thyroid (USP) 15 MG Oral Tablet [Renthyroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2706333"},{"drug_name":"{28 (estradiol 1 MG \/ norethindrone acetate 0.5 MG Oral Tablet) } Pack [Abigale 1\/0.5 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2706646"},{"drug_name":"{28 (estradiol 0.5 MG \/ norethindrone acetate 0.1 MG Oral Tablet) } Pack [Abigale Lo 0.5\/0.1 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2706647"},{"drug_name":"epinephrine 10 MG\/ML Nasal Spray [Neffy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2709209"},{"drug_name":"miconazole nitrate 20 MG\/ML Topical Cream [Desenex]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2709228"},{"drug_name":"leuprolide acetate 22.5 MG Injection [Lutrate]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2709448"},{"drug_name":"chenodeoxycholate 250 MG Oral Tablet [Ctexli]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2710422"},{"drug_name":"cobicistat 150 MG \/ darunavir 675 MG Oral Tablet [Prezcobix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2710426"},{"drug_name":"thyroid (USP) 65 MG Oral Tablet [Adthyza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2711703"},{"drug_name":"thyroid (USP) 130 MG Oral Tablet [Adthyza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2711707"},{"drug_name":"docusate sodium 250 MG Oral Capsule [Prolaxa]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2711894"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norethindrone acetate 1.5 MG Oral Tablet) } Pack [Luizza 1.5\/30 21 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2712092"},{"drug_name":"flurbiprofen 100 MG Oral Tablet [Lurbipr]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2712492"},{"drug_name":"sapropterin dihydrochloride 100 MG Powder for Oral Solution [Zelvysia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2712689"},{"drug_name":"sapropterin dihydrochloride 500 MG Powder for Oral Solution [Zelvysia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2712691"},{"drug_name":"cholecalciferol 0.01 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2714172"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ norethindrone acetate 1 MG Oral Tablet) } Pack [Luizza 1\/20 21 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2714657"},{"drug_name":"lidocaine hydrochloride 40 MG\/ML Topical Cream [Lidoguard]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2716403"},{"drug_name":"28 ACTUAT teriparatide 0.02 MG\/ACTUAT Pen Injector [Bonsity]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2716408"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Meleya 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2716571"},{"drug_name":"deflazacort 18 MG Oral Tablet [Jaythari]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2716704"},{"drug_name":"deflazacort 30 MG Oral Tablet [Jaythari]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2716706"},{"drug_name":"deflazacort 36 MG Oral Tablet [Jaythari]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2716708"},{"drug_name":"deflazacort 6 MG Oral Tablet [Jaythari]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2716710"},{"drug_name":"lenacapavir 300 MG Oral Tablet [Yeztugo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2717197"},{"drug_name":"{2 (1.5 ML lenacapavir 309 MG\/ML Injection [Yeztugo]) } Pack [Yeztugo 927 MG Kit]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2717203"},{"drug_name":"influenza A virus A\/Georgia\/12\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/800\/2024 (H3N2) antigen 0.03 MG\/ML \/ influenza B virus B\/Singapore\/WUH4618\/2021 antigen 0.03 MG\/ML Injectable Suspension [Flucelvax 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2718374"},{"drug_name":"0.5 ML influenza A virus A\/Georgia\/12\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/800\/2024 (H3N2) antigen 0.03 MG\/ML \/ influenza B virus B\/Singapore\/WUH4618\/2021 antigen 0.03 MG\/ML Prefilled Syringe [Flucelvax 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2718382"},{"drug_name":"0.5 ML influenza A virus A\/Croatia\/10136RV\/2023 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.03 MG\/ML Prefilled Syringe [Fluad 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2718393"},{"drug_name":"0.5 ML influenza A virus A\/Croatia\/10136RV\/2023 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.03 MG\/ML Prefilled Syringe [Afluria 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2718400"},{"drug_name":"influenza A virus A\/Croatia\/10136RV\/2023 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.03 MG\/ML Injectable Suspension [Afluria 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2718406"},{"drug_name":"0.5 ML influenza A virus A\/Croatia\/10136RV\/2023 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.03 MG\/ML Prefilled Syringe [Flulaval 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2718462"},{"drug_name":"0.5 ML influenza A virus A\/Croatia\/10136RV\/2023 (H3N2) antigen 0.12 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.12 MG\/ML \/ influenza B virus B\/Michigan\/01\/2021 antigen 0.12 MG\/ML Prefilled Syringe [Fluzone 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2718469"},{"drug_name":"deflazacort 22.75 MG\/ML Oral Suspension [Pyquvi]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2719198"},{"drug_name":"0.5 ML influenza A virus A\/Croatia\/10136RV\/2023 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Michigan\/01\/2021 antigen 0.03 MG\/ML Prefilled Syringe [Fluzone 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2719212"},{"drug_name":"influenza A virus A\/Croatia\/10136RV\/2023 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Michigan\/01\/2021 antigen 0.03 MG\/ML Injectable Suspension [Fluzone 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2719216"},{"drug_name":"0.5 ML influenza A virus A\/District of Columbia\/27\/2023 (H3N2) antigen 0.09 MG\/ML \/ influenza A virus A\/West Virginia\/30\/2022 (H1N1) antigen 0.09 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.09 MG\/ML Prefilled Syringe [Flublok 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2719311"},{"drug_name":"tolvaptan 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2719335"},{"drug_name":"tolvaptan 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2719337"},{"drug_name":"0.5 ML varicella zoster virus glycoprotein E  recombinant 0.1 MG\/ML Prefilled Syringe [Shingrix]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2719778"},{"drug_name":"0.5 ML influenza A virus A\/Croatia\/10136RV\/2023 (H3N2) antigen 0.03 MG\/ML \/ influenza A virus A\/Victoria\/4897\/2022 (H1N1) antigen 0.03 MG\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 0.03 MG\/ML Prefilled Syringe [Fluarix 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2720034"},{"drug_name":"0.375 ML leuprolide acetate 60 MG\/ML Prefilled Syringe [Vabrinty]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2720345"},{"drug_name":"0.375 ML leuprolide acetate 120 MG\/ML Prefilled Syringe [Vabrinty]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2720348"},{"drug_name":"flurbiprofen 100 MG Oral Tablet [Lurbiro]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2720355"},{"drug_name":"Home Admin influenza A virus A\/Norway\/31694\/2022 (H1N1) antigen 158000000 UNT\/ML \/ influenza A virus A\/Perth\/722\/2024 (H3N2) antigen 158000000 UNT\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 158000000 UNT\/ML Nasal Spray [FluMist 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2720400"},{"drug_name":"influenza A virus A\/Norway\/31694\/2022 (H1N1) antigen 158000000 UNT\/ML \/ influenza A virus A\/Perth\/722\/2024 (H3N2) antigen 158000000 UNT\/ML \/ influenza B virus B\/Austria\/1359417\/2021 antigen 158000000 UNT\/ML Nasal Spray [FluMist 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2720402"},{"drug_name":"0.5 ML nalmefene 3 MG\/ML Auto-Injector [Zurnai]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2720812"},{"drug_name":"0.25 ML SARS-CoV-2 (COVID-19) vaccine  mRNA-1273 OMICRON (LP.8.1) 0.1 MG\/ML Prefilled Syringe [Spikevax 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2722435"},{"drug_name":"0.5 ML SARS-CoV-2 (COVID-19) vaccine  mRNA-1273 OMICRON (LP.8.1) 0.1 MG\/ML Prefilled Syringe [Spikevax 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2722438"},{"drug_name":"0.3 ML SARS-CoV-2 (COVID-19) vaccine  mRNA-BNT162b2 OMICRON (LP.8.1) 0.1 MG\/ML Prefilled Syringe [Comirnaty 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2722605"},{"drug_name":"0.3 ML SARS-CoV-2 (COVID-19) vaccine  mRNA-BNT162b2 OMICRON (LP.8.1) 0.0333 MG\/ML Injection [Comirnaty 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2722614"},{"drug_name":"0.2 ML SARS-CoV-2 (COVID-19) vaccine  mRNA-1283 OMICRON (LP.8.1) 0.05 MG\/ML Prefilled Syringe [Mnexspike 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2722661"},{"drug_name":"0.5 ML SARS-CoV-2 (COVID-19) vaccine  protein NVX-CoV2705 0.01 MG\/ML Prefilled Syringe [Nuvaxovid 2025-2026]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2723014"},{"drug_name":"0.5 ML leuprolide acetate 60 MG\/ML Prefilled Syringe [Vabrinty]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2723399"},{"drug_name":"liothyronine sodium 0.025 MG Oral Tablet [Liomny]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2723581"},{"drug_name":"liothyronine sodium 0.05 MG Oral Tablet [Liomny]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2723583"},{"drug_name":"liothyronine sodium 0.005 MG Oral Tablet [Liomny]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2723585"},{"drug_name":"copper 1.75 SQCM Drug Implant [Miudella]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2724428"},{"drug_name":"thyroid (USP) 15 MG Oral Tablet [Evexithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2725187"},{"drug_name":"thyroid (USP) 30 MG Oral Tablet [Evexithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2725189"},{"drug_name":"thyroid (USP) 60 MG Oral Tablet [Evexithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2725191"},{"drug_name":"thyroid (USP) 120 MG Oral Tablet [Evexithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2725193"},{"drug_name":"thyroid (USP) 180 MG Oral Tablet [Evexithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2725195"},{"drug_name":"thyroid (USP) 90 MG Oral Tablet [Evexithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"2725201"},{"drug_name":"deflazacort 6 MG Oral Tablet [Kymbee]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2725491"},{"drug_name":"deflazacort 18 MG Oral Tablet [Kymbee]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2725493"},{"drug_name":"deflazacort 30 MG Oral Tablet [Kymbee]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2725495"},{"drug_name":"deflazacort 36 MG Oral Tablet [Kymbee]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2725497"},{"drug_name":"deflazacort 22.75 MG\/ML Oral Suspension [Jaythari]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"2727381"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [Shewise]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"2730936"},{"drug_name":"lamotrigine 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"282401"},{"drug_name":"ascorbic acid 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"282402"},{"drug_name":"calcium carbonate 1250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"282465"},{"drug_name":"2 ML droperidol 2.5 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"282485"},{"drug_name":"telmisartan 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"282755"},{"drug_name":"prednisolone 3 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283077"},{"drug_name":"sodium phosphate  dibasic 59.3 MG\/ML \/ sodium phosphate  monobasic 161 MG\/ML Enema","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283100"},{"drug_name":"piperonyl butoxide 40 MG\/ML \/ pyrethrins 3.3 MG\/ML Medicated Shampoo","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283219"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ telmisartan 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283316"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ telmisartan 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283317"},{"drug_name":"mirtazapine 15 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283406"},{"drug_name":"mirtazapine 30 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283407"},{"drug_name":"benzonatate 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283417"},{"drug_name":"mirtazapine 45 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283485"},{"drug_name":"gabapentin 50 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283523"},{"drug_name":"olanzapine 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283639"},{"drug_name":"citalopram 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283672"},{"drug_name":"ropinirole 3 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"283858"},{"drug_name":"ginger root 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"284059"},{"drug_name":"fluorouracil 5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"284191"},{"drug_name":"zolmitriptan 2.5 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"284201"},{"drug_name":"ferrous fumarate 324 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"284202"},{"drug_name":"clindamycin 300 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"284215"},{"drug_name":"famotidine 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"284245"},{"drug_name":"prochlorperazine 25 MG Rectal Suppository [Compro]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"284254"},{"drug_name":"bisacodyl 10 MG Rectal Suppository [The Magic Bullet]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"284283"},{"drug_name":"calcium polycarbophil 625 MG Oral Tablet [Fiber Tab]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"284308"},{"drug_name":"ketotifen 0.25 MG\/ML Ophthalmic Solution [Zaditor]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"284380"},{"drug_name":"fluorouracil 5 MG\/ML Topical Cream [Carac]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"284539"},{"drug_name":"methotrexate 5 MG Oral Tablet [Trexall]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"284592"},{"drug_name":"methotrexate 10 MG Oral Tablet [Trexall]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"284593"},{"drug_name":"methotrexate 7.5 MG Oral Tablet [Trexall]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"284594"},{"drug_name":"methotrexate 15 MG Oral Tablet [Trexall]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"284595"},{"drug_name":"insulin glargine 100 UNT\/ML Injectable Solution [Lantus]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"285018"},{"drug_name":"travoprost 0.04 MG\/ML Ophthalmic Solution [Travatan]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"285032"},{"drug_name":"acetaminophen 32 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"307668"},{"drug_name":"acetaminophen 32 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"307675"},{"drug_name":"acetaminophen 80 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"307696"},{"drug_name":"acetylcysteine 100 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"307718"},{"drug_name":"acetylcysteine 200 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"307719"},{"drug_name":"acyclovir 40 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"307730"},{"drug_name":"adapalene 0.001 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"307731"},{"drug_name":"adapalene 1 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"307732"},{"drug_name":"aluminum hydroxide 40 MG\/ML \/ magnesium hydroxide 40 MG\/ML \/ simethicone 4 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"307746"},{"drug_name":"alprazolam 0.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308047"},{"drug_name":"alprazolam 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308048"},{"drug_name":"aluminum hydroxide 64 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"308078"},{"drug_name":"amlodipine 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308135"},{"drug_name":"amlodipine 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308136"},{"drug_name":"amoxicillin 125 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"308177"},{"drug_name":"amoxicillin 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308182"},{"drug_name":"amoxicillin 80 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308189"},{"drug_name":"amoxicillin 500 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308191"},{"drug_name":"amoxicillin 875 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308194"},{"drug_name":"ampicillin 500 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308212"},{"drug_name":"apraclonidine 5 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"308345"},{"drug_name":"ascorbic acid 1000 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308382"},{"drug_name":"aspirin 81 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"308416"},{"drug_name":"azithromycin 20 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"308459"},{"drug_name":"azithromycin 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"308460"},{"drug_name":"bacitracin 0.4 UNT\/MG \/ neomycin 0.0035 MG\/MG \/ polymyxin B 10 UNT\/MG Ophthalmic Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"308493"},{"drug_name":"bacitracin 0.5 UNT\/MG \/ polymyxin B 10 UNT\/MG Ophthalmic Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"308511"},{"drug_name":"20 ML baclofen 0.5 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308517"},{"drug_name":"benzoyl peroxide 0.025 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"308689"},{"drug_name":"benzoyl peroxide 0.05 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308694"},{"drug_name":"benzoyl peroxide 50 MG\/ML Medicated Liquid Soap","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308696"},{"drug_name":"betamethasone 0.5 MG\/ML \/ clotrimazole 10 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308714"},{"drug_name":"betamethasone 0.5 MG\/ML \/ clotrimazole 10 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"308715"},{"drug_name":"bexarotene 0.01 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308724"},{"drug_name":"bexarotene 75 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308725"},{"drug_name":"bisacodyl 5 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308753"},{"drug_name":"bismuth subsalicylate 262 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308761"},{"drug_name":"bismuth subsalicylate 17.5 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308762"},{"drug_name":"bismuth subsalicylate 35 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308763"},{"drug_name":"salmon calcitonin 200 UNT\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308866"},{"drug_name":"calcitriol 0.00025 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308867"},{"drug_name":"calcitriol 0.0005 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308868"},{"drug_name":"calcium carbonate 500 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308907"},{"drug_name":"calcium polycarbophil 625 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308934"},{"drug_name":"captopril 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308962"},{"drug_name":"captopril 12.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308963"},{"drug_name":"captopril 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308964"},{"drug_name":"carbamazepine 100 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308973"},{"drug_name":"carbamazepine 20 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308976"},{"drug_name":"12 HR carbamazepine 200 MG Extended Release Oral Capsule [Carbatrol]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"308977"},{"drug_name":"carbamazepine 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308979"},{"drug_name":"carbidopa 25 MG \/ levodopa 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308988"},{"drug_name":"carbidopa 50 MG \/ levodopa 200 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"308989"},{"drug_name":"cefaclor 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"309045"},{"drug_name":"cefadroxil 1000 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"309047"},{"drug_name":"cefadroxil 50 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309048"},{"drug_name":"cefadroxil 500 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309049"},{"drug_name":"cefdinir 25 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309054"},{"drug_name":"cefixime 20 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309058"},{"drug_name":"cefpodoxime 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309076"},{"drug_name":"cefpodoxime 20 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"309077"},{"drug_name":"cefpodoxime 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309078"},{"drug_name":"cefpodoxime 10 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"309079"},{"drug_name":"cefprozil 25 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309080"},{"drug_name":"cefprozil 50 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309081"},{"drug_name":"ceftriaxone 250 MG Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309092"},{"drug_name":"cefuroxime 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309097"},{"drug_name":"cefuroxime 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309098"},{"drug_name":"cephalexin 25 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309110"},{"drug_name":"cephalexin 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309112"},{"drug_name":"cephalexin 50 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309113"},{"drug_name":"cephalexin 500 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309114"},{"drug_name":"ciclopirox 80 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309291"},{"drug_name":"ciprofloxacin 3 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309307"},{"drug_name":"ciprofloxacin 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309309"},{"drug_name":"cisplatin 1 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"309311"},{"drug_name":"citalopram 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309314"},{"drug_name":"clarithromycin 50 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"309322"},{"drug_name":"Once-Daily clindamycin 0.01 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309332"},{"drug_name":"clindamycin 10 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309333"},{"drug_name":"clopidogrel 75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309362"},{"drug_name":"clotrimazole 10 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309367"},{"drug_name":"clotrimazole 10 MG\/ML Vaginal Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309368"},{"drug_name":"clotrimazole 10 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309370"},{"drug_name":"clozapine 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"309374"},{"drug_name":"coal tar 5 MG\/ML Medicated Shampoo","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309381"},{"drug_name":"coal tar 10 MG\/ML Medicated Shampoo","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309402"},{"drug_name":"vitamin B12 1 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309594"},{"drug_name":"dexamethasone 0.001 MG\/MG \/ neomycin 0.0035 MG\/MG \/ polymyxin B 10 UNT\/MG Ophthalmic Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309679"},{"drug_name":"dexamethasone 1 MG\/ML \/ neomycin 3.5 MG\/ML \/ polymyxin B 10000 UNT\/ML Ophthalmic Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309680"},{"drug_name":"dexamethasone 1 MG\/ML \/ tobramycin 3 MG\/ML Ophthalmic Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309683"},{"drug_name":"dexamethasone 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"309684"},{"drug_name":"dexamethasone 0.1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"309686"},{"drug_name":"2 ML dexmedetomidine 0.1 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309710"},{"drug_name":"diazepam 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309843"},{"drug_name":"digoxin 0.125 MG Oral Tablet [Lanoxin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"309888"},{"drug_name":"digoxin 0.25 MG Oral Tablet [Lanoxin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"309889"},{"drug_name":"dipyridamole 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309952"},{"drug_name":"dipyridamole 75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309955"},{"drug_name":"disopyramide 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309958"},{"drug_name":"disopyramide 150 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"309960"},{"drug_name":"dofetilide 0.125 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310003"},{"drug_name":"dofetilide 0.25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310004"},{"drug_name":"dofetilide 0.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310005"},{"drug_name":"dorzolamide 20 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310015"},{"drug_name":"erythromycin 0.005 MG\/MG Ophthalmic Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"310149"},{"drug_name":"erythromycin 0.02 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"310152"},{"drug_name":"erythromycin 250 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310155"},{"drug_name":"erythromycin 500 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310157"},{"drug_name":"estradiol 0.1 MG\/ML Vaginal Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310169"},{"drug_name":"84 HR estradiol 0.00417 MG\/HR Transdermal System [Alora]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"310180"},{"drug_name":"estrogens  conjugated (USP) 0.625 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310197"},{"drug_name":"24 HR etodolac 400 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310245"},{"drug_name":"24 HR etodolac 600 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310247"},{"drug_name":"etoposide 20 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310248"},{"drug_name":"exemestane 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310261"},{"drug_name":"famotidine 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310273"},{"drug_name":"felbamate 120 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310285"},{"drug_name":"fenofibrate 134 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310288"},{"drug_name":"fenofibrate 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310289"},{"drug_name":"ferrous sulfate 325 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310324"},{"drug_name":"ferrous sulfate 325 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310325"},{"drug_name":"finasteride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310346"},{"drug_name":"fluconazole 10 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310352"},{"drug_name":"fluconazole 40 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310353"},{"drug_name":"fluocinonide 0.0005 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310362"},{"drug_name":"fluocinonide 0.5 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310364"},{"drug_name":"fluorometholone 1 MG\/ML Ophthalmic Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310377"},{"drug_name":"fluorouracil 20 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"310379"},{"drug_name":"fluorouracil 50 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310380"},{"drug_name":"fluoxetine 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310384"},{"drug_name":"fluoxetine 20 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310385"},{"drug_name":"fluoxetine 4 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310386"},{"drug_name":"folic acid 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310410"},{"drug_name":"furosemide 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310429"},{"drug_name":"gabapentin 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310430"},{"drug_name":"gabapentin 300 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310431"},{"drug_name":"gabapentin 400 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310432"},{"drug_name":"gabapentin 600 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310433"},{"drug_name":"gabapentin 800 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310434"},{"drug_name":"galantamine 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310436"},{"drug_name":"galantamine 8 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310437"},{"drug_name":"gemfibrozil 600 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310459"},{"drug_name":"gentamicin 0.001 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310465"},{"drug_name":"gentamicin 3 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310467"},{"drug_name":"glipizide 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310488"},{"drug_name":"24 HR glipizide 2.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310489"},{"drug_name":"glipizide 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310490"},{"drug_name":"glucose 4000 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310519"},{"drug_name":"glyburide 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310534"},{"drug_name":"glyburide 3 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"310536"},{"drug_name":"glyburide 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310537"},{"drug_name":"glyburide 6 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"310539"},{"drug_name":"gramicidin 0.025 MG\/ML \/ neomycin 1.75 MG\/ML \/ polymyxin B 10000 UNT\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"310594"},{"drug_name":"granisetron 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310599"},{"drug_name":"griseofulvin 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310600"},{"drug_name":"haloperidol 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310670"},{"drug_name":"haloperidol 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310671"},{"drug_name":"haloperidol 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310672"},{"drug_name":"hydrocortisone 10 MG\/ML \/ neomycin 3.5 MG\/ML \/ polymyxin B 10000 UNT\/ML Otic Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310687"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ irbesartan 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310792"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ irbesartan 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310793"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ quinapril 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"310797"},{"drug_name":"hydrochlorothiazide 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310798"},{"drug_name":"hydrochlorothiazide 25 MG \/ quinapril 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"310809"},{"drug_name":"hydrochlorothiazide 25 MG \/ triamterene 37.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310812"},{"drug_name":"hydrochlorothiazide 50 MG \/ triamterene 75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310818"},{"drug_name":"hydrocortisone 10 MG\/ML Rectal Cream","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"310868"},{"drug_name":"hydrocortisone 10 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310869"},{"drug_name":"hydrocortisone 1.67 MG\/ML Enema","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310878"},{"drug_name":"hydrocortisone 25 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310891"},{"drug_name":"ibuprofen 100 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"310963"},{"drug_name":"ibuprofen 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"310965"},{"drug_name":"imiquimod 50 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310982"},{"drug_name":"indomethacin 75 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"310992"},{"drug_name":"infliximab 100 MG Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"310994"},{"drug_name":"insulin isophane  human 100 UNT\/ML Injectable Suspension [Humulin N]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"311026"},{"drug_name":"insulin  regular  human 100 UNT\/ML Injectable Solution [Humulin R]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"311036"},{"drug_name":"insulin aspart  human 100 UNT\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"311040"},{"drug_name":"isoniazid 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311166"},{"drug_name":"isosorbide mononitrate 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"311192"},{"drug_name":"24 HR isosorbide mononitrate 120 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311196"},{"drug_name":"isosorbide mononitrate 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"311197"},{"drug_name":"itraconazole 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311204"},{"drug_name":"ivermectin 3 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311207"},{"drug_name":"ketotifen 0.25 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311237"},{"drug_name":"lamotrigine 25 MG Tablet for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311264"},{"drug_name":"lamotrigine 5 MG Tablet for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311265"},{"drug_name":"lansoprazole 30 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311277"},{"drug_name":"levalbuterol 0.21 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311286"},{"drug_name":"levetiracetam 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311288"},{"drug_name":"levetiracetam 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311289"},{"drug_name":"levetiracetam 750 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311290"},{"drug_name":"levofloxacin 750 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311296"},{"drug_name":"lisinopril 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311353"},{"drug_name":"lisinopril 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311354"},{"drug_name":"lithium carbonate 150 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311355"},{"drug_name":"lopinavir 80 MG\/ML \/ ritonavir 20 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"311369"},{"drug_name":"loratadine 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311372"},{"drug_name":"loratadine 10 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311373"},{"drug_name":"lorazepam 2 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311376"},{"drug_name":"loxapine 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311385"},{"drug_name":"loxapine 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311386"},{"drug_name":"meloxicam 7.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311486"},{"drug_name":"melphalan 50 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311487"},{"drug_name":"metoclopramide 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311666"},{"drug_name":"metoclopramide 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311668"},{"drug_name":"metolazone 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311671"},{"drug_name":"metronidazole 7.5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311678"},{"drug_name":"metronidazole 0.0075 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311679"},{"drug_name":"metronidazole 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311681"},{"drug_name":"midazolam 1 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311700"},{"drug_name":"midazolam 5 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311702"},{"drug_name":"mirtazapine 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311725"},{"drug_name":"mirtazapine 45 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311726"},{"drug_name":"misoprostol 0.1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311727"},{"drug_name":"mometasone furoate 1 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311753"},{"drug_name":"montelukast 4 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311759"},{"drug_name":"moxifloxacin 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311787"},{"drug_name":"mupirocin 20 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311877"},{"drug_name":"mycophenolate mofetil 200 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311880"},{"drug_name":"mycophenolate mofetil 500 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311881"},{"drug_name":"nabumetone 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311892"},{"drug_name":"nabumetone 750 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311893"},{"drug_name":"naproxen 25 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311913"},{"drug_name":"naproxen 500 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311915"},{"drug_name":"naratriptan 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311918"},{"drug_name":"nateglinide 120 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311919"},{"drug_name":"nevirapine 10 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"311943"},{"drug_name":"niacin 250 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311955"},{"drug_name":"niacin 500 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311960"},{"drug_name":"niacin 750 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311963"},{"drug_name":"nicotine 4 MG Chewing Gum","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"311975"},{"drug_name":"nitrofurantoin 5 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311989"},{"drug_name":"nitrofurantoin  macrocrystals 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"311995"},{"drug_name":"nitroglycerin 2.5 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"312013"},{"drug_name":"nitroglycerin 6.5 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"312018"},{"drug_name":"nitroglycerin 9 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"312020"},{"drug_name":"nortriptyline 2 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312036"},{"drug_name":"nystatin 100000 UNT\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312055"},{"drug_name":"nystatin 500000 UNT Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312059"},{"drug_name":"1 ML octreotide 0.05 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312068"},{"drug_name":"1 ML octreotide 0.1 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312069"},{"drug_name":"1 ML octreotide 0.5 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312070"},{"drug_name":"octreotide 1 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312071"},{"drug_name":"ofloxacin 3 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312075"},{"drug_name":"olanzapine 10 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312076"},{"drug_name":"olanzapine 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312077"},{"drug_name":"olanzapine 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312078"},{"drug_name":"olanzapine 7.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312079"},{"drug_name":"ondansetron 0.8 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312085"},{"drug_name":"ondansetron 8 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312086"},{"drug_name":"ondansetron 8 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312087"},{"drug_name":"oseltamivir 75 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312122"},{"drug_name":"oxaprozin 600 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312132"},{"drug_name":"oxcarbazepine 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312136"},{"drug_name":"oxcarbazepine 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312137"},{"drug_name":"oxcarbazepine 600 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312138"},{"drug_name":"pentoxifylline 400 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312301"},{"drug_name":"phenelzine 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"312347"},{"drug_name":"phenobarbital 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"312357"},{"drug_name":"phenobarbital 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"312362"},{"drug_name":"pioglitazone 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312440"},{"drug_name":"pioglitazone 45 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312441"},{"drug_name":"potassium chloride 10 MEQ Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312504"},{"drug_name":"potassium chloride 1.33 MEQ\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312515"},{"drug_name":"potassium chloride 8 MEQ Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"312529"},{"drug_name":"potassium iodide 1000 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"312541"},{"drug_name":"prazosin 1 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312593"},{"drug_name":"prazosin 2 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312594"},{"drug_name":"prednisolone 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312614"},{"drug_name":"prednisone 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312615"},{"drug_name":"prednisone 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312617"},{"drug_name":"prochlorperazine 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312635"},{"drug_name":"progesterone 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312641"},{"drug_name":"quetiapine 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312743"},{"drug_name":"quetiapine 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312744"},{"drug_name":"quetiapine 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312745"},{"drug_name":"quinapril 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312748"},{"drug_name":"quinapril 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312749"},{"drug_name":"quinapril 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312750"},{"drug_name":"ribavirin 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"312817"},{"drug_name":"risperidone 0.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312828"},{"drug_name":"risperidone 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312829"},{"drug_name":"risperidone 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312830"},{"drug_name":"risperidone 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312831"},{"drug_name":"risperidone 3 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312832"},{"drug_name":"rivastigmine 3 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312835"},{"drug_name":"rivastigmine 6 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312836"},{"drug_name":"rizatriptan 10 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312837"},{"drug_name":"rizatriptan 5 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312839"},{"drug_name":"rizatriptan 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312840"},{"drug_name":"ropinirole 0.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312845"},{"drug_name":"ropinirole 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312846"},{"drug_name":"ropinirole 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312847"},{"drug_name":"ropinirole 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312849"},{"drug_name":"salicylic acid 0.06 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"312893"},{"drug_name":"salsalate 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"312899"},{"drug_name":"sennosides  USP 8.6 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312935"},{"drug_name":"sertraline 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312938"},{"drug_name":"sertraline 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312940"},{"drug_name":"sertraline 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312941"},{"drug_name":"simvastatin 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312961"},{"drug_name":"simvastatin 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"312962"},{"drug_name":"sodium chloride 9 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"312997"},{"drug_name":"sodium fluoride 1.1 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"313036"},{"drug_name":"sorbitol 700 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"313092"},{"drug_name":"spironolactone 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313096"},{"drug_name":"sucralfate 100 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313123"},{"drug_name":"sulfamethoxazole 40 MG\/ML \/ trimethoprim 8 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313134"},{"drug_name":"sulfasalazine 500 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313142"},{"drug_name":"sumatriptan 5 MG\/ACTUAT Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313159"},{"drug_name":"sumatriptan 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313160"},{"drug_name":"sumatriptan 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313161"},{"drug_name":"0.5 ML sumatriptan 12 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313165"},{"drug_name":"tacrolimus 0.0003 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313189"},{"drug_name":"tacrolimus 0.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313190"},{"drug_name":"tamoxifen 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313195"},{"drug_name":"tazarotene 0.0005 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313199"},{"drug_name":"tazarotene 1 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313200"},{"drug_name":"tazarotene 0.001 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313201"},{"drug_name":"temozolomide 20 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313209"},{"drug_name":"temozolomide 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313210"},{"drug_name":"temozolomide 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313211"},{"drug_name":"terazosin 1 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313215"},{"drug_name":"terazosin 2 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313217"},{"drug_name":"terazosin 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313219"},{"drug_name":"terbinafine 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313222"},{"drug_name":"terconazole 4 MG\/ML Vaginal Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313226"},{"drug_name":"terconazole 8 MG\/ML Vaginal Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313227"},{"drug_name":"theophylline 400 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313291"},{"drug_name":"theophylline 5.33 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313306"},{"drug_name":"thiamine 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313323"},{"drug_name":"thiamine 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313326"},{"drug_name":"thioridazine 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313354"},{"drug_name":"thiothixene 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313361"},{"drug_name":"thiothixene 1 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313362"},{"drug_name":"thiothixene 2 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313364"},{"drug_name":"thiothixene 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313366"},{"drug_name":"thyroid (USP) 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"313387"},{"drug_name":"thyroid (USP) 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"313391"},{"drug_name":"thyroid (USP) 90 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"313393"},{"drug_name":"timolol 0.0025 MG\/MG Ophthalmic Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313407"},{"drug_name":"timolol 0.005 MG\/MG Ophthalmic Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313408"},{"drug_name":"tizanidine 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313412"},{"drug_name":"tizanidine 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313413"},{"drug_name":"tobramycin 3 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313415"},{"drug_name":"tobramycin 10 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"313416"},{"drug_name":"toremifene 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313428"},{"drug_name":"tranylcypromine 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313447"},{"drug_name":"tretinoin 0.0001 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313450"},{"drug_name":"tretinoin 0.00025 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313451"},{"drug_name":"trientine hydrochloride 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313472"},{"drug_name":"trimipramine 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313496"},{"drug_name":"trimipramine 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313498"},{"drug_name":"trimipramine 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313499"},{"drug_name":"tropicamide 5 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313521"},{"drug_name":"valacyclovir 1000 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313564"},{"drug_name":"valacyclovir 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313565"},{"drug_name":"valganciclovir 450 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313566"},{"drug_name":"valrubicin 40 MG\/ML Intravesical Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313567"},{"drug_name":"vancomycin 125 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313570"},{"drug_name":"vancomycin 250 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313571"},{"drug_name":"venlafaxine 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313580"},{"drug_name":"24 HR venlafaxine 150 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313581"},{"drug_name":"venlafaxine 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313582"},{"drug_name":"24 HR venlafaxine 37.5 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313583"},{"drug_name":"venlafaxine 37.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313584"},{"drug_name":"24 HR venlafaxine 75 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313585"},{"drug_name":"venlafaxine 75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313586"},{"drug_name":"vitamin E 90 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313713"},{"drug_name":"zafirlukast 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313758"},{"drug_name":"zaleplon 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313761"},{"drug_name":"zaleplon 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313762"},{"drug_name":"zinc sulfate 220 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313773"},{"drug_name":"ziprasidone 40 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313776"},{"drug_name":"ziprasidone 60 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313777"},{"drug_name":"ziprasidone 80 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313778"},{"drug_name":"acetaminophen 325 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313782"},{"drug_name":"acetic acid 20 MG\/ML \/ hydrocortisone 10 MG\/ML Otic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313786"},{"drug_name":"amoxicillin 25 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313797"},{"drug_name":"ascorbic acid 500 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313803"},{"drug_name":"acetaminophen 160 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"313820"},{"drug_name":"amoxicillin 40 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313850"},{"drug_name":"adapalene 1 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313852"},{"drug_name":"cefaclor 50 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"313888"},{"drug_name":"salmon calcitonin 200 UNT\/ACTUAT Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313919"},{"drug_name":"calcipotriene 0.05 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313921"},{"drug_name":"12 HR carbamazepine 300 MG Extended Release Oral Capsule [Carbatrol]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"313931"},{"drug_name":"epinephrine 1 MG\/ML Nasal Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"313967"},{"drug_name":"fludrocortisone acetate 0.1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313979"},{"drug_name":"furosemide 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313988"},{"drug_name":"fluoxetine 40 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313989"},{"drug_name":"fluoxetine 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"313990"},{"drug_name":"glyburide 1.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"314000"},{"drug_name":"24 HR glipizide 5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314006"},{"drug_name":"haloperidol 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314034"},{"drug_name":"haloperidol 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314035"},{"drug_name":"isosorbide dinitrate 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314055"},{"drug_name":"latanoprost 0.05 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314072"},{"drug_name":"loxapine 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314075"},{"drug_name":"lisinopril 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314076"},{"drug_name":"lisinopril 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314077"},{"drug_name":"loxapine 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314078"},{"drug_name":"levofloxacin 5 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"314080"},{"drug_name":"metronidazole 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314106"},{"drug_name":"minocycline 75 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314108"},{"drug_name":"mirtazapine 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314111"},{"drug_name":"nicotine 2 MG Chewing Gum","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"314119"},{"drug_name":"niacin 250 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314131"},{"drug_name":"naratriptan 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314135"},{"drug_name":"nateglinide 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314142"},{"drug_name":"octreotide 0.2 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314152"},{"drug_name":"olanzapine 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314154"},{"drug_name":"olanzapine 5 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314155"},{"drug_name":"prednisolone 10 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"314165"},{"drug_name":"potassium chloride 2.67 MEQ\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314182"},{"drug_name":"2 ML prochlorperazine 5 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314192"},{"drug_name":"pantoprazole 40 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314200"},{"drug_name":"quinapril 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314203"},{"drug_name":"ropinirole 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314208"},{"drug_name":"rizatriptan 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314209"},{"drug_name":"risperidone 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314211"},{"drug_name":"rivastigmine 1.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314214"},{"drug_name":"rivastigmine 4.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314215"},{"drug_name":"simethicone 80 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314216"},{"drug_name":"sumatriptan 20 MG\/ACTUAT Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314227"},{"drug_name":"sirolimus 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314230"},{"drug_name":"simvastatin 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314231"},{"drug_name":"sucralfate 1000 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314234"},{"drug_name":"tropicamide 10 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314238"},{"drug_name":"theophylline 450 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314241"},{"drug_name":"tacrolimus 0.001 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314266"},{"drug_name":"thyroid (USP) 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"314267"},{"drug_name":"tazarotene 0.5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314268"},{"drug_name":"venlafaxine 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314277"},{"drug_name":"zonisamide 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314285"},{"drug_name":"ziprasidone 20 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"314286"},{"drug_name":"erythromycin 333 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"315090"},{"drug_name":"sodium fluoride 1.1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"315102"},{"drug_name":"24 HR glipizide 10 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"315107"},{"drug_name":"levocarnitine 100 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"315134"},{"drug_name":"potassium chloride 8 MEQ Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"315183"},{"drug_name":"prednisone 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"315187"},{"drug_name":"sodium fluoride 2.2 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"315213"},{"drug_name":"sumatriptan 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"315223"},{"drug_name":"24 HR isosorbide mononitrate 30 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"317110"},{"drug_name":"misoprostol 0.2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"317128"},{"drug_name":"nortriptyline 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"317136"},{"drug_name":"temozolomide 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"317160"},{"drug_name":"captopril 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"317173"},{"drug_name":"quetiapine 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"317174"},{"drug_name":"pioglitazone 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"317573"},{"drug_name":"theophylline 300 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"317769"},{"drug_name":"ergoloid mesylates  USP 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"318179"},{"drug_name":"erythromycin 20 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"318202"},{"drug_name":"aspirin 81 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"318272"},{"drug_name":"cyclosporine 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"328160"},{"drug_name":"primidone 125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"328176"},{"drug_name":"dexamethasone 0.75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"343033"},{"drug_name":"theophylline 200 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"346574"},{"drug_name":"ascorbic acid 100 MG \/ D-biotin 0.3 MG \/ folic acid 1 MG \/ niacinamide 20 MG \/ pantothenic acid 10 MG \/ pyridoxine hydrochloride 10 MG \/ riboflavin 1.7 MG \/ thiamine 1.5 MG \/ vitamin B12 0.006 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"348025"},{"drug_name":"theophylline 600 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"348472"},{"drug_name":"itraconazole 10 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"348506"},{"drug_name":"budesonide 0.125 MG\/ML Inhalation Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349094"},{"drug_name":"clonazepam 0.125 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349194"},{"drug_name":"clonazepam 0.25 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349195"},{"drug_name":"clonazepam 1 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349196"},{"drug_name":"clonazepam 2 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349197"},{"drug_name":"clonazepam 0.5 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349198"},{"drug_name":"valsartan 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349199"},{"drug_name":"valsartan 320 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349200"},{"drug_name":"valsartan 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349201"},{"drug_name":"sirolimus 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349208"},{"drug_name":"tenofovir disoproxil fumarate 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"349251"},{"drug_name":"bosentan 62.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349253"},{"drug_name":"fenofibrate 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349287"},{"drug_name":"escitalopram 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349332"},{"drug_name":"desonide 0.5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349351"},{"drug_name":"hydrochlorothiazide 25 MG \/ valsartan 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349353"},{"drug_name":"olmesartan medoxomil 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349373"},{"drug_name":"olmesartan medoxomil 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349401"},{"drug_name":"olmesartan medoxomil 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349405"},{"drug_name":"treprostinil 1 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349407"},{"drug_name":"treprostinil 10 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349408"},{"drug_name":"treprostinil 2.5 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349409"},{"drug_name":"treprostinil 5 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349410"},{"drug_name":"desloratadine 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349420"},{"drug_name":"frovatriptan 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349462"},{"drug_name":"gefitinib 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349472"},{"drug_name":"efavirenz 600 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"349477"},{"drug_name":"sodium oxybate 500 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"349482"},{"drug_name":"valsartan 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349483"},{"drug_name":"aripiprazole 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349490"},{"drug_name":"lamivudine 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"349491"},{"drug_name":"celecoxib 400 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349514"},{"drug_name":"aripiprazole 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349545"},{"drug_name":"aripiprazole 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349547"},{"drug_name":"aripiprazole 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349553"},{"drug_name":"ezetimibe 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349556"},{"drug_name":"levalbuterol 0.103 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349590"},{"drug_name":"atomoxetine 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349591"},{"drug_name":"atomoxetine 18 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349592"},{"drug_name":"atomoxetine 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349593"},{"drug_name":"atomoxetine 40 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349594"},{"drug_name":"atomoxetine 60 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"349595"},{"drug_name":"olanzapine 15 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351107"},{"drug_name":"olanzapine 20 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351108"},{"drug_name":"budesonide 0.25 MG\/ML Inhalation Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351109"},{"drug_name":"5 ML zoledronic acid 0.8 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351114"},{"drug_name":"fenofibrate 54 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351133"},{"drug_name":"zolmitriptan 5 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351134"},{"drug_name":"albuterol 0.417 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351136"},{"drug_name":"albuterol 0.21 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351137"},{"drug_name":"urea 400 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"351155"},{"drug_name":"dutasteride 0.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351172"},{"drug_name":"nitisinone 2 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351173"},{"drug_name":"nitisinone 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351174"},{"drug_name":"nitisinone 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351175"},{"drug_name":"ziprasidone 20 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351223"},{"drug_name":"montelukast 4 MG Oral Granules","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351246"},{"drug_name":"escitalopram 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351249"},{"drug_name":"escitalopram 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351250"},{"drug_name":"metaxalone 800 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351254"},{"drug_name":"lansoprazole 30 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351260"},{"drug_name":"lansoprazole 15 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351261"},{"drug_name":"buprenorphine 2 MG Sublingual Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351264"},{"drug_name":"buprenorphine 8 MG Sublingual Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351265"},{"drug_name":"buprenorphine 2 MG \/ naloxone 0.5 MG Sublingual Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351266"},{"drug_name":"buprenorphine 8 MG \/ naloxone 2 MG Sublingual Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351267"},{"drug_name":"escitalopram 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351285"},{"drug_name":"insulin aspart protamine  human 70 UNT\/ML \/ insulin aspart  human 30 UNT\/ML Injectable Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"351297"},{"drug_name":"24 HR nicotine 0.583 MG\/HR Transdermal System [Nicoderm C-Q]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"351427"},{"drug_name":"24 HR nicotine 0.875 MG\/HR Transdermal System [Nicoderm C-Q]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"351429"},{"drug_name":"24 HR nicotine 0.292 MG\/HR Transdermal System [Nicoderm C-Q]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"351433"},{"drug_name":"loratadine 10 MG Disintegrating Oral Tablet [Alavert]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"351855"},{"drug_name":"insulin  regular  human 500 UNT\/ML Injectable Solution [Humulin R]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"351859"},{"drug_name":"verteporfin 15 MG Injection [Visudyne]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"351914"},{"drug_name":"minocycline 1 MG Oral Powder [Arestin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"351974"},{"drug_name":"oxcarbazepine 60 MG\/ML Oral Suspension [Trileptal]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"351992"},{"drug_name":"1 ML darbepoetin alfa 0.025 MG\/ML Injection [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"352044"},{"drug_name":"1 ML darbepoetin alfa 0.04 MG\/ML Injection [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"352045"},{"drug_name":"1 ML darbepoetin alfa 0.06 MG\/ML Injection [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"352046"},{"drug_name":"1 ML darbepoetin alfa 0.1 MG\/ML Injection [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"352047"},{"drug_name":"tenofovir disoproxil fumarate 300 MG Oral Tablet [Viread]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"352050"},{"drug_name":"pimecrolimus 10 MG\/ML Topical Cream [Elidel]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"352085"},{"drug_name":"lamivudine 300 MG Oral Tablet [Epivir]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"352230"},{"drug_name":"1 ML peginterferon alfa-2a 0.18 MG\/ML Injection [Pegasys]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"352297"},{"drug_name":"24 HR isosorbide mononitrate 60 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"353538"},{"drug_name":"benzoyl peroxide 0.05 MG\/MG \/ clindamycin 0.01 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"358917"},{"drug_name":"azathioprine 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"359228"},{"drug_name":"azathioprine 75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"359229"},{"drug_name":"calcium acetate 667 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"359296"},{"drug_name":"24 HR clarithromycin 500 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"359385"},{"drug_name":"eletriptan 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"359493"},{"drug_name":"eletriptan 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"359494"},{"drug_name":"24 HR etodolac 500 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"359500"},{"drug_name":"24 HR ketoprofen 200 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"359697"},{"drug_name":"nicotine 2 MG Oral Lozenge","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"359817"},{"drug_name":"nicotine 4 MG Oral Lozenge","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"359818"},{"drug_name":"sirolimus 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"360110"},{"drug_name":"glipizide 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"379804"},{"drug_name":"isosorbide dinitrate 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"381056"},{"drug_name":"levetiracetam 1000 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"387003"},{"drug_name":"nebivolol 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"387013"},{"drug_name":"aspirin 325 MG Delayed Release Oral Tablet [Bayer Aspirin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"387090"},{"drug_name":"betamethasone 0.0005 MG\/MG \/ calcipotriene 0.00005 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"388525"},{"drug_name":"quetiapine 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"389201"},{"drug_name":"deferiprone 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"389242"},{"drug_name":"lactulose 667 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"391937"},{"drug_name":"sodium fluoride 0.011 MG\/MG Toothpaste","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"392038"},{"drug_name":"digoxin 0.05 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"393245"},{"drug_name":"miglustat 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"401938"},{"drug_name":"risperidone 1 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"401953"},{"drug_name":"risperidone 2 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"401954"},{"drug_name":"risperidone 25 MG Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"402010"},{"drug_name":"risperidone 37.5 MG Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"402011"},{"drug_name":"risperidone 50 MG Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"402012"},{"drug_name":"omeprazole 20 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"402014"},{"drug_name":"cyclosporine 0.5 MG\/ML Ophthalmic Suspension [Restasis]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"402092"},{"drug_name":"atazanavir 200 MG Oral Capsule [Reyataz]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"402093"},{"drug_name":"fosamprenavir 700 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"402109"},{"drug_name":"aripiprazole 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"402131"},{"drug_name":"bortezomib 3.5 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"402243"},{"drug_name":"atazanavir 150 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"402246"},{"drug_name":"atazanavir 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"402247"},{"drug_name":"12 HR carbamazepine 200 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"402505"},{"drug_name":"12 HR carbamazepine 400 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"402506"},{"drug_name":"24 HR felodipine 10 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"402695"},{"drug_name":"24 HR felodipine 5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"402696"},{"drug_name":"24 HR felodipine 2.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"402698"},{"drug_name":"aprepitant 80 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403810"},{"drug_name":"aprepitant 125 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403811"},{"drug_name":"risperidone 0.5 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403825"},{"drug_name":"estrogens  conjugated (USP) 0.45 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403849"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ olmesartan medoxomil 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403853"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ olmesartan medoxomil 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403854"},{"drug_name":"hydrochlorothiazide 25 MG \/ olmesartan medoxomil 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403855"},{"drug_name":"emtricitabine 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"403875"},{"drug_name":"imatinib 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403878"},{"drug_name":"imatinib 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403879"},{"drug_name":"levetiracetam 100 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403884"},{"drug_name":"ciprofloxacin 3 MG\/ML \/ dexamethasone 1 MG\/ML Otic Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403908"},{"drug_name":"168 HR estradiol 0.00156 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403922"},{"drug_name":"168 HR estradiol 0.0025 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403923"},{"drug_name":"zonisamide 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403966"},{"drug_name":"zonisamide 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403967"},{"drug_name":"fluoxetine 25 MG \/ olanzapine 6 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403969"},{"drug_name":"fluoxetine 25 MG \/ olanzapine 12 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403970"},{"drug_name":"fluoxetine 50 MG \/ olanzapine 12 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403971"},{"drug_name":"fluoxetine 50 MG \/ olanzapine 6 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"403972"},{"drug_name":"isotretinoin 10 MG Oral Capsule [Amnesteem]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"404058"},{"drug_name":"isotretinoin 10 MG Oral Capsule [Claravis]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"404059"},{"drug_name":"isotretinoin 20 MG Oral Capsule [Amnesteem]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"404061"},{"drug_name":"isotretinoin 20 MG Oral Capsule [Claravis]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"404062"},{"drug_name":"isotretinoin 40 MG Oral Capsule [Amnesteem]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"404064"},{"drug_name":"isotretinoin 40 MG Oral Capsule [Claravis]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"404065"},{"drug_name":"benzoyl peroxide 0.1 MG\/MG Topical Gel [Acne-Clear]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"404127"},{"drug_name":"sennosides  USP 8.6 MG Oral Tablet [Senokot]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"404186"},{"drug_name":"polysaccharide iron complex 150 MG Oral Capsule [Ferrex-150]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"404280"},{"drug_name":"ferrous fumarate 324 MG Oral Tablet [Ferrocite]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"404369"},{"drug_name":"testosterone 75 MG Drug Implant [Testopel]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"404405"},{"drug_name":"thalidomide 100 MG Oral Capsule [Thalomid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"404449"},{"drug_name":"thalidomide 200 MG Oral Capsule [Thalomid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"404450"},{"drug_name":"pegvisomant 10 MG Injection [Somavert]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"404457"},{"drug_name":"pegvisomant 15 MG Injection [Somavert]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"404458"},{"drug_name":"pegvisomant 20 MG Injection [Somavert]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"404459"},{"drug_name":"azathioprine 75 MG Oral Tablet [Azasan]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"404475"},{"drug_name":"azathioprine 100 MG Oral Tablet [Azasan]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"404476"},{"drug_name":"5 ML laronidase 0.58 MG\/ML Injection [Aldurazyme]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"404492"},{"drug_name":"emtricitabine 200 MG Oral Capsule [Emtriva]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"404587"},{"drug_name":"12 HR carbamazepine 100 MG Extended Release Oral Capsule [Carbatrol]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"404742"},{"drug_name":"cefixime 400 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"409823"},{"drug_name":"vitamin E 180 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"412113"},{"drug_name":"cefixime 40 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"419849"},{"drug_name":"calcium carbonate 1500 MG \/ cholecalciferol 0.01 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"428485"},{"drug_name":"calcium acetate 668 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"428703"},{"drug_name":"clozapine 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"429212"},{"drug_name":"benznidazole 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"430551"},{"drug_name":"baclofen 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"430902"},{"drug_name":"cinacalcet 90 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"432400"},{"drug_name":"cinacalcet 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"432401"},{"drug_name":"cinacalcet 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"432402"},{"drug_name":"24 HR alprazolam 0.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"433798"},{"drug_name":"24 HR alprazolam 2 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"433799"},{"drug_name":"24 HR alprazolam 1 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"433800"},{"drug_name":"24 HR alprazolam 3 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"433801"},{"drug_name":"clozapine 100 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"476177"},{"drug_name":"clozapine 25 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"476179"},{"drug_name":"6-aminocaproic acid 1000 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"476271"},{"drug_name":"ezetimibe 10 MG \/ simvastatin 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"476345"},{"drug_name":"ezetimibe 10 MG \/ simvastatin 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"476349"},{"drug_name":"ezetimibe 10 MG \/ simvastatin 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"476350"},{"drug_name":"ezetimibe 10 MG \/ simvastatin 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"476351"},{"drug_name":"emtricitabine 200 MG \/ tenofovir disoproxil fumarate 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"476556"},{"drug_name":"cefdinir 50 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"476576"},{"drug_name":"mirtazapine 7.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"476809"},{"drug_name":"hydrochlorothiazide 25 MG \/ telmisartan 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"477130"},{"drug_name":"lanthanum carbonate 500 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"477347"},{"drug_name":"solifenacin succinate 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"477367"},{"drug_name":"solifenacin succinate 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"477372"},{"drug_name":"levofloxacin 25 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"477391"},{"drug_name":"fenofibrate 145 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"477560"},{"drug_name":"fenofibrate 48 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"477562"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"483325"},{"drug_name":"fenofibrate 130 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"483425"},{"drug_name":"fenofibrate 43 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"483427"},{"drug_name":"pregabalin 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"483438"},{"drug_name":"pregabalin 150 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"483440"},{"drug_name":"pregabalin 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"483442"},{"drug_name":"pregabalin 300 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"483444"},{"drug_name":"pregabalin 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"483446"},{"drug_name":"pregabalin 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"483448"},{"drug_name":"pregabalin 75 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"483450"},{"drug_name":"mycophenolic acid 180 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485020"},{"drug_name":"mycophenolic acid 360 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485023"},{"drug_name":"azacitidine 100 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485246"},{"drug_name":"24 HR darifenacin 15 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485421"},{"drug_name":"24 HR darifenacin 7.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485423"},{"drug_name":"eszopiclone 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485440"},{"drug_name":"eszopiclone 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485442"},{"drug_name":"eszopiclone 3 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485465"},{"drug_name":"tizanidine 6 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485484"},{"drug_name":"tizanidine 4 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485485"},{"drug_name":"tizanidine 2 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485486"},{"drug_name":"aripiprazole 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485496"},{"drug_name":"fluocinonide 1 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485647"},{"drug_name":"olanzapine 10 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"485968"},{"drug_name":"benzoyl peroxide 0.1 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"486131"},{"drug_name":"24 HR nitroglycerin 0.6 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"486146"},{"drug_name":"24 HR nitroglycerin 0.2 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"486148"},{"drug_name":"24 HR nitroglycerin 0.4 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"486152"},{"drug_name":"84 HR estradiol 0.00104 MG\/HR Transdermal System [Alora]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"486155"},{"drug_name":"sodium chloride 0.154 MEQ\/ML Irrigation Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"486515"},{"drug_name":"amphetamine aspartate 7.5 MG \/ amphetamine sulfate 7.5 MG \/ dextroamphetamine saccharate 7.5 MG \/ dextroamphetamine sulfate 7.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"541363"},{"drug_name":"amphetamine aspartate 7.5 MG \/ amphetamine sulfate 7.5 MG \/ dextroamphetamine saccharate 7.5 MG \/ dextroamphetamine sulfate 7.5 MG Oral Tablet [Adderall]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"541365"},{"drug_name":"methyltestosterone 10 MG Oral Tablet [Methitest]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"541524"},{"drug_name":"amphetamine aspartate 1.25 MG \/ amphetamine sulfate 1.25 MG \/ dextroamphetamine saccharate 1.25 MG \/ dextroamphetamine sulfate 1.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"541878"},{"drug_name":"amphetamine aspartate 1.25 MG \/ amphetamine sulfate 1.25 MG \/ dextroamphetamine saccharate 1.25 MG \/ dextroamphetamine sulfate 1.25 MG Oral Tablet [Adderall]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"541879"},{"drug_name":"amphetamine aspartate 2.5 MG \/ amphetamine sulfate 2.5 MG \/ dextroamphetamine saccharate 2.5 MG \/ dextroamphetamine sulfate 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"541892"},{"drug_name":"amphetamine aspartate 2.5 MG \/ amphetamine sulfate 2.5 MG \/ dextroamphetamine saccharate 2.5 MG \/ dextroamphetamine sulfate 2.5 MG Oral Tablet [Adderall]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"541894"},{"drug_name":"nelfinavir 625 MG Oral Tablet [Viracept]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"542370"},{"drug_name":"citric acid 66.8 MG\/ML \/ sodium citrate 100 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"543014"},{"drug_name":"ammonium lactate 120 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"543460"},{"drug_name":"nystatin 100000 UNT\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"543546"},{"drug_name":"ibuprofen 20 MG\/ML Oral Suspension [Motrin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"544393"},{"drug_name":"lactulose 667 MG\/ML Oral Solution [Constulose]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"544452"},{"drug_name":"lactulose 667 MG\/ML Oral Solution [Generlac]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"544455"},{"drug_name":"potassium iodide 1000 MG\/ML Oral Solution [SSKI brand of Potassium Iodide]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"544597"},{"drug_name":"leuprolide acetate 5 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"545835"},{"drug_name":"amoxicillin 250 MG \/ clavulanate 125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"562251"},{"drug_name":"clindamycin 15 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"562266"},{"drug_name":"epoprostenol 0.5 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"562501"},{"drug_name":"epoprostenol 1.5 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"562502"},{"drug_name":"amoxicillin 875 MG \/ clavulanate 125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"562508"},{"drug_name":"sodium fluoride 2 MG\/ML Mouthwash","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"562510"},{"drug_name":"12 HR acetazolamide 500 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"562524"},{"drug_name":"ropinirole 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"562704"},{"drug_name":"pimecrolimus 10 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"562806"},{"drug_name":"betaine 1000 MG Powder for Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"562847"},{"drug_name":"sildenafil 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"577033"},{"drug_name":"72 HR fentanyl 0.012 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"577057"},{"drug_name":"pregabalin 225 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"577127"},{"drug_name":"omega-3 acid ethyl esters (USP) 1000 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"577208"},{"drug_name":"ramelteon 8 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"577348"},{"drug_name":"capsaicin 0.35 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"577395"},{"drug_name":"candesartan cilexetil 16 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"577776"},{"drug_name":"amphetamine aspartate 3.75 MG \/ amphetamine sulfate 3.75 MG \/ dextroamphetamine saccharate 3.75 MG \/ dextroamphetamine sulfate 3.75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"577957"},{"drug_name":"amphetamine aspartate 3.75 MG \/ amphetamine sulfate 3.75 MG \/ dextroamphetamine saccharate 3.75 MG \/ dextroamphetamine sulfate 3.75 MG Oral Tablet [Adderall]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"577960"},{"drug_name":"amphetamine aspartate 5 MG \/ amphetamine sulfate 5 MG \/ dextroamphetamine saccharate 5 MG \/ dextroamphetamine sulfate 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"577961"},{"drug_name":"amphetamine aspartate 5 MG \/ amphetamine sulfate 5 MG \/ dextroamphetamine saccharate 5 MG \/ dextroamphetamine sulfate 5 MG Oral Tablet [Adderall]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"577962"},{"drug_name":"bromfenac 0.9 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"578018"},{"drug_name":"iron carbonyl 15 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"578104"},{"drug_name":"candesartan cilexetil 16 MG \/ hydrochlorothiazide 12.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"578325"},{"drug_name":"candesartan cilexetil 32 MG \/ hydrochlorothiazide 12.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"578330"},{"drug_name":"galantamine 12 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"579148"},{"drug_name":"mineral oil 0.319 MG\/MG \/ petrolatum 0.577 MG\/MG Ophthalmic Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"579999"},{"drug_name":"mineral oil 0.415 MG\/MG \/ petrolatum 0.568 MG\/MG Ophthalmic Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"580001"},{"drug_name":"tiotropium 0.018 MG Inhalation Powder [Spiriva]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"580261"},{"drug_name":"mesalamine 500 MG Extended Release Oral Capsule [Pentasa]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"580286"},{"drug_name":"psyllium 520 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"581417"},{"drug_name":"6-aminocaproic acid 250 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"582299"},{"drug_name":"podofilox 5 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"582926"},{"drug_name":"salsalate 750 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"583170"},{"drug_name":"paclitaxel 100 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"583214"},{"drug_name":"20 ML ziconotide acetate 0.025 MG\/ML Injection [Prialt]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"583453"},{"drug_name":"stannous fluoride 6.3 MG\/ML Mouthwash","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"583459"},{"drug_name":"5 ML galsulfase 1 MG\/ML Injection [Naglazyme]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"584222"},{"drug_name":"nystatin 100 UNT\/MG Topical Powder [Nyamyc]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"584414"},{"drug_name":"lansoprazole 15 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"596843"},{"drug_name":"lansoprazole 15 MG Delayed Release Oral Capsule [Prevacid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"596918"},{"drug_name":"duloxetine 20 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"596926"},{"drug_name":"duloxetine 30 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"596930"},{"drug_name":"duloxetine 60 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"596934"},{"drug_name":"carboplatin 10 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"597195"},{"drug_name":"lopinavir 200 MG \/ ritonavir 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"597730"},{"drug_name":"sorafenib 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"597747"},{"drug_name":"deferasirox 125 MG Tablet for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"597768"},{"drug_name":"deferasirox 250 MG Tablet for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"597770"},{"drug_name":"deferasirox 500 MG Tablet for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"597772"},{"drug_name":"tobramycin 40 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"597823"},{"drug_name":"erythromycin 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"598006"},{"drug_name":"interferon alfa-n3 5000000 UNT\/ML Injectable Solution [Alferon N]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"598014"},{"drug_name":"amoxicillin 250 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"598025"},{"drug_name":"abacavir 600 MG \/ lamivudine 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"602393"},{"drug_name":"clindamycin 20 MG\/ML Vaginal Cream [Clindesse]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"602427"},{"drug_name":"lanthanum carbonate 1000 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"602635"},{"drug_name":"lenalidomide 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"602910"},{"drug_name":"lenalidomide 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"602912"},{"drug_name":"aripiprazole 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"602964"},{"drug_name":"naproxen 375 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"603103"},{"drug_name":"erlotinib 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"603203"},{"drug_name":"erlotinib 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"603206"},{"drug_name":"erlotinib 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"603208"},{"drug_name":"tipranavir 250 MG Oral Capsule [Aptivus]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"603378"},{"drug_name":"esomeprazole 20 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"606726"},{"drug_name":"esomeprazole 40 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"606730"},{"drug_name":"atomoxetine 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"608139"},{"drug_name":"atomoxetine 80 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"608143"},{"drug_name":"mecasermin 10 MG\/ML Injectable Solution [Increlex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"615882"},{"drug_name":"emtricitabine 10 MG\/ML Oral Solution [Emtriva]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"616148"},{"drug_name":"sunitinib 12.5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"616279"},{"drug_name":"sunitinib 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"616285"},{"drug_name":"sunitinib 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"616289"},{"drug_name":"duloxetine 40 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"616402"},{"drug_name":"quetiapine 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"616483"},{"drug_name":"quetiapine 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"616487"},{"drug_name":"lubiprostone 0.024 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"616578"},{"drug_name":"risperidone 3 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"616698"},{"drug_name":"risperidone 4 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"616705"},{"drug_name":"12 HR ranolazine 500 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"616749"},{"drug_name":"fenofibrate 150 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"616852"},{"drug_name":"fenofibrate 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"616853"},{"drug_name":"amoxicillin 500 MG \/ clavulanate 125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"617296"},{"drug_name":"amoxicillin 200 MG \/ clavulanate 28.5 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"617309"},{"drug_name":"atorvastatin 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"617310"},{"drug_name":"atorvastatin 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"617311"},{"drug_name":"atorvastatin 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"617312"},{"drug_name":"amoxicillin 400 MG \/ clavulanate 57 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"617316"},{"drug_name":"amoxicillin 50 MG\/ML \/ clavulanate 12.5 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"617322"},{"drug_name":"amoxicillin 40 MG\/ML \/ clavulanate 5.7 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"617423"},{"drug_name":"amoxicillin 80 MG\/ML \/ clavulanate 11.4 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"617430"},{"drug_name":"amoxicillin 120 MG\/ML \/ clavulanate 8.58 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"617993"},{"drug_name":"12 HR amoxicillin 1000 MG \/ clavulanate 62.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"617995"},{"drug_name":"potassium chloride 10 MEQ Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"628953"},{"drug_name":"potassium chloride 10 MEQ Extended Release Oral Tablet [Klor-Con]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"628958"},{"drug_name":"sodium fluoride 0.011 MG\/MG Toothpaste [Prevident]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"630194"},{"drug_name":"sodium fluoride 0.011 MG\/MG Toothpaste [Denta 5000 Plus]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"630196"},{"drug_name":"albuterol 0.83 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"630208"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ valsartan 320 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"636042"},{"drug_name":"hydrochlorothiazide 25 MG \/ valsartan 320 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"636045"},{"drug_name":"decitabine 50 MG Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"636631"},{"drug_name":"varenicline 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"636671"},{"drug_name":"varenicline 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"636676"},{"drug_name":"varenicline 0.5 MG Oral Tablet [Chantix]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"637188"},{"drug_name":"varenicline 1 MG Oral Tablet [Chantix]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"637190"},{"drug_name":"naltrexone 380 MG Injection [Vivitrol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"637216"},{"drug_name":"topotecan 1 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"637549"},{"drug_name":"candesartan cilexetil 32 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"639537"},{"drug_name":"vitamin B6 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"639566"},{"drug_name":"emtricitabine 200 MG \/ tenofovir disoproxil fumarate 300 MG Oral Tablet [Truvada]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"639888"},{"drug_name":"bismuth subsalicylate 17.5 MG\/ML Oral Suspension [Kaopectate Reformulated Aug 2006]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"642346"},{"drug_name":"lanthanum carbonate 750 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"642452"},{"drug_name":"aripiprazole 10 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"643019"},{"drug_name":"aripiprazole 15 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"643022"},{"drug_name":"efavirenz 600 MG \/ emtricitabine 200 MG \/ tenofovir disoproxil fumarate 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"643066"},{"drug_name":"ibuprofen 200 MG Oral Tablet [Wal-Profen]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"643102"},{"drug_name":"dasatinib 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"643105"},{"drug_name":"dasatinib 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"643107"},{"drug_name":"dasatinib 70 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"643109"},{"drug_name":"lenalidomide 15 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"643712"},{"drug_name":"lenalidomide 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"643720"},{"drug_name":"aprepitant 40 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"644088"},{"drug_name":"risperidone 0.25 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"645037"},{"drug_name":"capsaicin 1 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"646333"},{"drug_name":"nystatin 100 UNT\/MG Topical Powder","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"646456"},{"drug_name":"3 ML idursulfase 2 MG\/ML Injection [Elaprase]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"647118"},{"drug_name":"niacin 250 MG Extended Release Oral Tablet [Slo-Niacin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"647346"},{"drug_name":"bosentan 125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"656659"},{"drug_name":"potassium phosphate 155 MG \/ sodium phosphate  dibasic 852 MG \/ sodium phosphate  monobasic 130 MG Oral Tablet [Phospha 250 Neutral]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"656742"},{"drug_name":"atazanavir 300 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"664741"},{"drug_name":"atazanavir 300 MG Oral Capsule [Reyataz]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"664743"},{"drug_name":"sitagliptin phosphate 100 MG Oral Tablet [Januvia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"665036"},{"drug_name":"sitagliptin phosphate 25 MG Oral Tablet [Januvia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"665040"},{"drug_name":"sitagliptin phosphate 50 MG Oral Tablet [Januvia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"665044"},{"drug_name":"loratadine 5 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"665078"},{"drug_name":"loratadine 5 MG Chewable Tablet [Claritin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"668469"},{"drug_name":"vorinostat 100 MG Oral Capsule [Zolinza]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"668606"},{"drug_name":"arformoterol 0.0075 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"668956"},{"drug_name":"darunavir 600 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"670026"},{"drug_name":"lapatinib 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"672149"},{"drug_name":"24 HR paliperidone 3 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"672567"},{"drug_name":"24 HR paliperidone 6 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"672569"},{"drug_name":"24 HR paliperidone 9 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"672571"},{"drug_name":"celecoxib 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"686379"},{"drug_name":"erythromycin ethylsuccinate 40 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"686400"},{"drug_name":"erythromycin ethylsuccinate 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"686405"},{"drug_name":"erythromycin ethylsuccinate 80 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"686418"},{"drug_name":"mesalamine 1200 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"686429"},{"drug_name":"carvedilol 3.125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"686924"},{"drug_name":"amphetamine aspartate 3.125 MG \/ amphetamine sulfate 3.125 MG \/ dextroamphetamine saccharate 3.125 MG \/ dextroamphetamine sulfate 3.125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"687043"},{"drug_name":"amphetamine aspartate 3.125 MG \/ amphetamine sulfate 3.125 MG \/ dextroamphetamine saccharate 3.125 MG \/ dextroamphetamine sulfate 3.125 MG Oral Tablet [Adderall]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"687045"},{"drug_name":"porfimer sodium 75 MG Injection [Photofrin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"687066"},{"drug_name":"estrogens  conjugated (USP) 0.625 MG\/ML Vaginal Cream [Premarin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"688242"},{"drug_name":"esomeprazole 20 MG Granules for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"692576"},{"drug_name":"esomeprazole 40 MG Granules for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"692578"},{"drug_name":"capsaicin 0.35 MG\/ML Topical Lotion [Castiva Warming]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"692730"},{"drug_name":"loratadine 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"692783"},{"drug_name":"30 ML eculizumab 10 MG\/ML Injection [Soliris]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"700387"},{"drug_name":"thalidomide 150 MG Oral Capsule [Thalomid]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"700418"},{"drug_name":"temozolomide 140 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"700883"},{"drug_name":"temozolomide 180 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"700885"},{"drug_name":"mineral oil 0.425 MG\/MG \/ petrolatum 0.568 MG\/MG Ophthalmic Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"701984"},{"drug_name":"mineral oil 0.425 MG\/MG \/ petrolatum 0.573 MG\/MG Ophthalmic Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"702008"},{"drug_name":"carbamide peroxide 65 MG\/ML Otic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"702050"},{"drug_name":"ferrous sulfate 44 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"702249"},{"drug_name":"prednisolone 4 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"702306"},{"drug_name":"phenobarbital 4 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"702519"},{"drug_name":"cholecalciferol 1.25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"705728"},{"drug_name":"100 ML zoledronic acid 0.05 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"705824"},{"drug_name":"mineral oil 0.03 MG\/MG \/ petrolatum 0.94 MG\/MG Ophthalmic Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"706820"},{"drug_name":"risperidone 12.5 MG Injection","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"706822"},{"drug_name":"risperidone 12.5 MG Injection [Risperdal]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"706825"},{"drug_name":"risperidone 37.5 MG Injection [Risperdal]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"706827"},{"drug_name":"risperidone 50 MG Injection [Risperdal]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"706829"},{"drug_name":"risperidone 25 MG Injection [Risperdal]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"706831"},{"drug_name":"sodium chloride 70 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"706943"},{"drug_name":"sodium chloride 6.5 MG\/ML Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"707251"},{"drug_name":"sodium chloride 6.5 MG\/ML Nasal Solution [Ayr Saline Nasal]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"707333"},{"drug_name":"sodium chloride 70 MG\/ML Inhalation Solution [Hyper-Sal]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"707347"},{"drug_name":"sodium chloride 6.5 MG\/ML Nasal Spray [Ayr Saline Nasal]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"707359"},{"drug_name":"sodium chloride 6.5 MG\/ML Nasal Spray [Deep Sea]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"707381"},{"drug_name":"ketotifen 0.25 MG\/ML Ophthalmic Solution [Alaway]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"707594"},{"drug_name":"clozapine 12.5 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"721773"},{"drug_name":"fluoxetine 25 MG \/ olanzapine 3 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"721787"},{"drug_name":"24 HR quetiapine 200 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"721791"},{"drug_name":"24 HR quetiapine 300 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"721794"},{"drug_name":"24 HR quetiapine 400 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"721796"},{"drug_name":"adapalene 0.003 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"722111"},{"drug_name":"ambrisentan 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"722116"},{"drug_name":"ambrisentan 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"722122"},{"drug_name":"amlodipine 10 MG \/ valsartan 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"722126"},{"drug_name":"amlodipine 10 MG \/ valsartan 320 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"722131"},{"drug_name":"amlodipine 5 MG \/ valsartan 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"722134"},{"drug_name":"amlodipine 5 MG \/ valsartan 320 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"722137"},{"drug_name":"1.2 ML temsirolimus 25 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"722289"},{"drug_name":"24 HR rivastigmine 0.396 MG\/HR Transdermal System [Exelon]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"725105"},{"drug_name":"NDA019430 0.3 ML epinephrine 0.5 MG\/ML Auto-Injector","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"727316"},{"drug_name":"NDA019430 0.3 ML epinephrine 1 MG\/ML Auto-Injector [Epipen]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"727347"},{"drug_name":"NDA019430 0.3 ML epinephrine 0.5 MG\/ML Auto-Injector [Epipen]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"727386"},{"drug_name":"0.5 ML filgrastim 0.6 MG\/ML Prefilled Syringe [Neupogen]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"727537"},{"drug_name":"0.8 ML filgrastim 0.6 MG\/ML Prefilled Syringe [Neupogen]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"727545"},{"drug_name":"0.8 ML adalimumab 50 MG\/ML Prefilled Syringe [Humira]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"727705"},{"drug_name":"0.5 ML interferon beta-1a 0.06 MG\/ML Prefilled Syringe [Avonex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"727816"},{"drug_name":"oseltamivir 30 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"728109"},{"drug_name":"oseltamivir 45 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"728113"},{"drug_name":"maraviroc 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"728223"},{"drug_name":"maraviroc 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"728225"},{"drug_name":"12 HR ranolazine 1000 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"728231"},{"drug_name":"protein C  human 1 UNT Injection [Ceprotin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"728491"},{"drug_name":"0.5 ML darbepoetin alfa 0.2 MG\/ML Prefilled Syringe [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"730046"},{"drug_name":"amlodipine 10 MG \/ olmesartan medoxomil 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"730861"},{"drug_name":"amlodipine 10 MG \/ olmesartan medoxomil 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"730866"},{"drug_name":"amlodipine 5 MG \/ olmesartan medoxomil 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"730869"},{"drug_name":"amlodipine 5 MG \/ olmesartan medoxomil 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"730872"},{"drug_name":"sodium phosphate  dibasic 35.5 MG\/ML \/ sodium phosphate  monobasic 96.4 MG\/ML Enema","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"730955"},{"drug_name":"0.4 ML darbepoetin alfa 0.1 MG\/ML Prefilled Syringe [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"731227"},{"drug_name":"0.6 ML darbepoetin alfa 0.5 MG\/ML Prefilled Syringe [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"731229"},{"drug_name":"0.3 ML darbepoetin alfa 0.5 MG\/ML Prefilled Syringe [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"731231"},{"drug_name":"0.4 ML darbepoetin alfa 0.5 MG\/ML Prefilled Syringe [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"731235"},{"drug_name":"1 ML darbepoetin alfa 0.5 MG\/ML Prefilled Syringe [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"731241"},{"drug_name":"0.42 ML darbepoetin alfa 0.06 MG\/ML Prefilled Syringe [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"731245"},{"drug_name":"0.3 ML darbepoetin alfa 0.2 MG\/ML Prefilled Syringe [Aranesp]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"731250"},{"drug_name":"insulin lispro 50 UNT\/ML \/ insulin lispro protamine  human 50 UNT\/ML Injectable Suspension [Humalog Mix]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"731281"},{"drug_name":"0.5 ML peginterferon alfa-2a 0.36 MG\/ML Prefilled Syringe [Pegasys]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"731328"},{"drug_name":"Rho(D) immune globulin  human 250 UNT Prefilled Syringe [MICRhoGAM]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"731380"},{"drug_name":"Rho(D) immune globulin  human 1500 UNT Prefilled Syringe [RhoGAM]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"731383"},{"drug_name":"ibuprofen 40 MG\/ML Oral Suspension [Advil]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"731531"},{"drug_name":"ibuprofen 100 MG Chewable Tablet [Advil]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"731536"},{"drug_name":"raltegravir 400 MG Oral Tablet [Isentress]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"744846"},{"drug_name":"200 ACTUAT levalbuterol 0.045 MG\/ACTUAT Metered Dose Inhaler","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"745791"},{"drug_name":"200 ACTUAT levalbuterol 0.045 MG\/ACTUAT Metered Dose Inhaler [Xopenex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"746466"},{"drug_name":"nilotinib 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"746606"},{"drug_name":"lopinavir 100 MG \/ ritonavir 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"746645"},{"drug_name":"NDA020503 200 ACTUAT albuterol 0.09 MG\/ACTUAT Metered Dose Inhaler [Proventil]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"746763"},{"drug_name":"120 ACTUAT mometasone furoate 0.22 MG\/ACTUAT Dry Powder Inhaler [Asmanex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"746804"},{"drug_name":"14 ACTUAT mometasone furoate 0.22 MG\/ACTUAT Dry Powder Inhaler [Asmanex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"746811"},{"drug_name":"30 ACTUAT mometasone furoate 0.22 MG\/ACTUAT Dry Powder Inhaler [Asmanex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"746813"},{"drug_name":"60 ACTUAT mometasone furoate 0.22 MG\/ACTUAT Dry Powder Inhaler [Asmanex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"746815"},{"drug_name":"topotecan 0.25 MG Oral Capsule [Hycamtin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"748738"},{"drug_name":"topotecan 1 MG Oral Capsule [Hycamtin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"748740"},{"drug_name":"{24 (drospirenone 3 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 4 (inert ingredients 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748798"},{"drug_name":"{21 (drospirenone 3 MG \/ ethinyl estradiol 0.03 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748800"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ ethynodiol diacetate 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748804"},{"drug_name":"{21 (ethinyl estradiol 0.05 MG \/ ethynodiol diacetate 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748806"},{"drug_name":"{6 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.05 MG Oral Tablet) \/ 10 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.125 MG Oral Tablet) \/ 5 (ethinyl estradiol 0.04 MG \/ levonorgestrel 0.075 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748832"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ ethynodiol diacetate 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Zovia 1\/35E 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748859"},{"drug_name":"{6 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.05 MG Oral Tablet) \/ 10 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.125 MG Oral Tablet) \/ 5 (ethinyl estradiol 0.04 MG \/ levonorgestrel 0.075 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Trivora 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748865"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748868"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748878"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Levora 0.15\/30 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748879"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748961"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Camila 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748962"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Nora-BE 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"748977"},{"drug_name":"{12 (ethinyl estradiol 0.035 MG \/ norethindrone 0.5 MG Oral Tablet) \/ 9 (ethinyl estradiol 0.035 MG \/ norethindrone 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Leena 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"749148"},{"drug_name":"{7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"749157"},{"drug_name":"clopidogrel 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"749196"},{"drug_name":"sevelamer carbonate 800 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"749206"},{"drug_name":"{11 (varenicline 0.5 MG Oral Tablet) \/ 42 (varenicline 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"749289"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 84 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"749761"},{"drug_name":"{3 (azithromycin 500 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"749780"},{"drug_name":"{6 (azithromycin 250 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"749783"},{"drug_name":"{7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"749784"},{"drug_name":"{56 (varenicline 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"749788"},{"drug_name":"0.2 ML lanreotide 300 MG\/ML Prefilled Syringe [Somatuline]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"749813"},{"drug_name":"0.5 ML lanreotide 240 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"749814"},{"drug_name":"0.3 ML lanreotide 300 MG\/ML Prefilled Syringe [Somatuline]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"749818"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"749860"},{"drug_name":"stannous fluoride 6.3 MG\/ML Mouthwash [Perio Med]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"750104"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norgestrel 0.3 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Low-Ogestrel 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"750244"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ norgestrel 0.3 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Cryselle 28]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"750265"},{"drug_name":"{12 (ethinyl estradiol 0.035 MG \/ norethindrone 0.5 MG Oral Tablet) \/ 9 (ethinyl estradiol 0.035 MG \/ norethindrone 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Aranelle 28]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"750267"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Aviane 28]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"750268"},{"drug_name":"24 HR rivastigmine 0.192 MG\/HR Transdermal System [Exelon]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"751302"},{"drug_name":"{28 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.09 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"751553"},{"drug_name":"nebivolol 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"751612"},{"drug_name":"nebivolol 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"751618"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 0.5 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Nortrel 0.5\/35 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"751868"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Nortrel 1\/35 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"751870"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 1 MG Oral Tablet) } Pack [Nortrel 1\/35 21 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"751871"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norethindrone 0.5 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Necon 0.5\/35 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"751875"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Lutera 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"751884"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Lessina 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"751885"},{"drug_name":"{21 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Portia 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"751890"},{"drug_name":"{84 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"751901"},{"drug_name":"0.5 ML interferon gamma-1b 0.2 MG\/ML Injection [Actimmune]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"751970"},{"drug_name":"9 HR methylphenidate 1.11 MG\/HR Transdermal System [Daytrana]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"753437"},{"drug_name":"9 HR methylphenidate 1.67 MG\/HR Transdermal System [Daytrana]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"753439"},{"drug_name":"9 HR methylphenidate 2.22 MG\/HR Transdermal System [Daytrana]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"753442"},{"drug_name":"9 HR methylphenidate 3.33 MG\/HR Transdermal System [Daytrana]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"753443"},{"drug_name":"{7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Tri-Previfem 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"753479"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Sprintec 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"753481"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.03 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Apri 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"753482"},{"drug_name":"{21 (ethinyl estradiol 0.035 MG \/ ethynodiol diacetate 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Kelnor 1\/35 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"753483"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.03 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Reclipsen 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"753543"},{"drug_name":"{21 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Sronyx 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"753544"},{"drug_name":"{1 (aprepitant 125 MG Oral Capsule) \/ 2 (aprepitant 80 MG Oral Capsule) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"754508"},{"drug_name":"etravirine 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"754761"},{"drug_name":"zidovudine 10 MG\/ML Oral Solution [Retrovir]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"755298"},{"drug_name":"lactulose 667 MG\/ML Oral Solution [Enulose]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"755470"},{"drug_name":"loratadine 1 MG\/ML Oral Solution [Wal-itin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"755478"},{"drug_name":"albuterol 0.4 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"755497"},{"drug_name":"lithium citrate 60 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"756059"},{"drug_name":"zidovudine 10 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"756209"},{"drug_name":"theophylline 5.33 MG\/ML Oral Solution [Elixophyllin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"756226"},{"drug_name":"etravirine 100 MG Oral Tablet [Intelence]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"758555"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 5 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 2 (inert ingredients 1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"759743"},{"drug_name":"{6 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.05 MG Oral Tablet) \/ 10 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.125 MG Oral Tablet) \/ 5 (ethinyl estradiol 0.04 MG \/ levonorgestrel 0.075 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Enpresse 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"761977"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 5 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 2 (inert ingredients 1 MG Oral Tablet) } Pack [Kariva 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"762001"},{"drug_name":"{7 (ethinyl estradiol 0.035 MG \/ norethindrone 0.5 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norethindrone 0.75 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norethindrone 1 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Nortrel 7\/7\/7 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"762007"},{"drug_name":"{7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.035 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Tri-Sprintec 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"762333"},{"drug_name":"{7 (desogestrel 0.1 MG \/ ethinyl estradiol 0.025 MG Oral Tablet) \/ 7 (desogestrel 0.125 MG \/ ethinyl estradiol 0.025 MG Oral Tablet) \/ 7 (desogestrel 0.15 MG \/ ethinyl estradiol 0.025 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Velivet 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"762334"},{"drug_name":"Salmonella typhi Ty21a live antigen 2000000000 UNT Delayed Release Oral Capsule [Vivotif]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"762602"},{"drug_name":"{84 (ethinyl estradiol 0.03 MG \/ levonorgestrel 0.15 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Jolessa 91 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"762663"},{"drug_name":"aminolevulinate 200 MG\/ML Topical Solution [Levulan]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"762674"},{"drug_name":"{21 (methylprednisolone 4 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"762675"},{"drug_name":"0.25 ML somatropin 0.8 MG\/ML Prefilled Syringe [Genotropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"762833"},{"drug_name":"0.25 ML somatropin 1.6 MG\/ML Prefilled Syringe [Genotropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"762836"},{"drug_name":"0.25 ML somatropin 2.4 MG\/ML Prefilled Syringe [Genotropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"762839"},{"drug_name":"0.25 ML somatropin 3.2 MG\/ML Prefilled Syringe [Genotropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"762843"},{"drug_name":"0.25 ML somatropin 4.8 MG\/ML Prefilled Syringe [Genotropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"762849"},{"drug_name":"0.25 ML somatropin 5.6 MG\/ML Prefilled Syringe [Genotropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"762852"},{"drug_name":"0.25 ML somatropin 6.4 MG\/ML Prefilled Syringe [Genotropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"762859"},{"drug_name":"0.25 ML somatropin 7.2 MG\/ML Prefilled Syringe [Genotropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"762868"},{"drug_name":"0.25 ML somatropin 4 MG\/ML Prefilled Syringe [Genotropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"762875"},{"drug_name":"0.25 ML somatropin 8 MG\/ML Prefilled Syringe [Genotropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"762897"},{"drug_name":"permethrin 10 MG\/ML Medicated Shampoo [Nix Cream Rinse]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"763066"},{"drug_name":"poliovirus vaccine inactivated  type 1 (Mahoney) 80 UNT\/ML \/ poliovirus vaccine inactivated  type 2 (MEF-1) 16 UNT\/ML \/ poliovirus vaccine inactivated  type 3 (Saukett) 64 UNT\/ML Injectable Suspension [Ipol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"763106"},{"drug_name":"{48 (prednisone 5 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"763179"},{"drug_name":"{21 (prednisone 5 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"763181"},{"drug_name":"{48 (prednisone 10 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"763183"},{"drug_name":"{21 (prednisone 10 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"763185"},{"drug_name":"sennosides  USP 8.6 MG Oral Tablet [Senna-Time]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"763296"},{"drug_name":"pantoprazole 40 MG Oral Granules [Protonix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"763308"},{"drug_name":"1 ML somatropin 5 MG\/ML Cartridge [Genotropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"763489"},{"drug_name":"24 HR desvenlafaxine 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"790264"},{"drug_name":"30 ACTUAT mometasone furoate 0.11 MG\/ACTUAT Dry Powder Inhaler [Asmanex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"790284"},{"drug_name":"24 HR desvenlafaxine 50 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"790288"},{"drug_name":"aspirin 81 MG Delayed Release Oral Tablet [Bayer Aspirin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"794229"},{"drug_name":"capsaicin 1 MG\/ML Topical Cream [Capzasin-HP]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"794244"},{"drug_name":"darunavir 600 MG Oral Tablet [Prezista]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"794610"},{"drug_name":"lubiprostone 0.008 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"794639"},{"drug_name":"{56 (varenicline 1 MG Oral Tablet [Chantix]) } Pack [Chantix Continuing Months Of Therapy]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"795735"},{"drug_name":"{11 (varenicline 0.5 MG Oral Tablet [Chantix]) \/ 42 (varenicline 1 MG Oral Tablet [Chantix]) } Pack [Chantix First Month of Therapy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"795737"},{"drug_name":"isopropyl alcohol 0.7 ML\/ML Medicated Pad","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"797544"},{"drug_name":"eptacog alfa activated 0.001 MG Injection [Novoseven]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"798104"},{"drug_name":"human-bovine reassortant rotavirus strain G1 vaccine 1100000 UNT\/ML \/ human-bovine reassortant rotavirus strain G2 vaccine 1400000 UNT\/ML \/ human-bovine reassortant rotavirus strain G3 vaccine 1100000 UNT\/ML \/ human-bovine reassortant rotavirus strain G4 vaccine 1000000 UNT\/ML \/ human-bovine reassortant rotavirus strain P1A[8] vaccine 1150000 UNT\/ML Oral Suspension [RotaTeq]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"798300"},{"drug_name":"1 ML hepatitis B surface antigen vaccine 0.02 MG\/ML Prefilled Syringe [Engerix-B]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"798428"},{"drug_name":"0.5 ML hepatitis B surface antigen vaccine 0.02 MG\/ML Prefilled Syringe [Engerix-B]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"798430"},{"drug_name":"0.5 ML Haemophilus influenzae b (Ross strain) capsular polysaccharide meningococcal protein conjugate vaccine 0.265 MG\/ML Injection [PedvaxHIB]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"798451"},{"drug_name":"1 ML hepatitis A vaccine (inactivated) strain HM175 1440 UNT\/ML Prefilled Syringe [Havrix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"798479"},{"drug_name":"0.5 ML hepatitis A vaccine (inactivated) strain HM175 1440 UNT\/ML Prefilled Syringe [Havrix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"798482"},{"drug_name":"60 ACTUAT ciclesonide 0.16 MG\/ACTUAT Metered Dose Inhaler [Alvesco]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"799037"},{"drug_name":"60 ACTUAT ciclesonide 0.08 MG\/ACTUAT Metered Dose Inhaler [Alvesco]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"799040"},{"drug_name":"dasatinib 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"799047"},{"drug_name":"24 HR ropinirole 8 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"799054"},{"drug_name":"24 HR ropinirole 2 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"799055"},{"drug_name":"24 HR ropinirole 4 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"799056"},{"drug_name":"polyethylene glycol 3350 420000 MG \/ potassium chloride 1480 MG \/ sodium bicarbonate 5720 MG \/ sodium chloride 11200 MG Powder for Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"801054"},{"drug_name":"NDA020983 60 ACTUAT albuterol 0.09 MG\/ACTUAT Metered Dose Inhaler [Ventolin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"801095"},{"drug_name":"{21 (drospirenone 3 MG \/ ethinyl estradiol 0.03 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Ocella 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"801185"},{"drug_name":"0.5 ML diazepam 5 MG\/ML Rectal Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"801957"},{"drug_name":"0.5 ML diazepam 5 MG\/ML Rectal Gel [Diastat]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"801958"},{"drug_name":"2 ML diazepam 5 MG\/ML Rectal Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"801961"},{"drug_name":"4 ML diazepam 5 MG\/ML Rectal Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"801966"},{"drug_name":"1 ML etanercept 50 MG\/ML Prefilled Syringe [Enbrel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"802652"},{"drug_name":"candesartan cilexetil 32 MG \/ hydrochlorothiazide 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"802749"},{"drug_name":"1 ML hepatitis A vaccine (inactivated) strain HM175 720 UNT\/ML \/ hepatitis B surface antigen vaccine 0.02 MG\/ML Prefilled Syringe [Twinrix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"803371"},{"drug_name":"cholecalciferol 0.05 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"804146"},{"drug_name":"0.5 ML measles virus vaccine live  Enders' attenuated Edmonston strain 2000 UNT\/ML \/ mumps virus vaccine live  Jeryl Lynn strain 25000 UNT\/ML \/ rubella virus vaccine live (Wistar RA 27-3 strain) 2000 UNT\/ML Injection [M-M-R II]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"804186"},{"drug_name":"capsaicin 1 MG\/ML Topical Cream [Zostrix]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"804752"},{"drug_name":"1 ML baclofen 0.05 MG\/ML Injection [Lioresal]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"805679"},{"drug_name":"typhoid Vi polysaccharide vaccine  S typhi Ty2 strain 0.05 MG\/ML Injectable Solution [Typhim VI]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"807225"},{"drug_name":"levonorgestrel 0.000833 MG\/HR Intrauterine System [Mirena]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"807283"},{"drug_name":"24 HR levetiracetam 500 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"807832"},{"drug_name":"24 HR venlafaxine 150 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"808744"},{"drug_name":"24 HR venlafaxine 225 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"808748"},{"drug_name":"24 HR venlafaxine 37.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"808751"},{"drug_name":"24 HR venlafaxine 75 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"808753"},{"drug_name":"0.5 ML etanercept 50 MG\/ML Prefilled Syringe [Enbrel]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"809159"},{"drug_name":"simethicone 66.7 MG\/ML Oral Suspension [Mylicon]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"809376"},{"drug_name":"silodosin 8 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"809477"},{"drug_name":"calcium carbonate 1500 MG \/ cholecalciferol 200 UNT Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"809533"},{"drug_name":"calcium carbonate 1250 MG \/ cholecalciferol 200 UNT Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"809536"},{"drug_name":"calcium carbonate 625 MG \/ cholecalciferol 125 UNT Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"809555"},{"drug_name":"C1 esterase inhibitor (human) 500 UNT Injection [Cinryze]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"809871"},{"drug_name":"lacosamide 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"809987"},{"drug_name":"lacosamide 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"809992"},{"drug_name":"lacosamide 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"809996"},{"drug_name":"lacosamide 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"810000"},{"drug_name":"24 HR fesoterodine fumarate 4 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"810071"},{"drug_name":"24 HR fesoterodine fumarate 8 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"810077"},{"drug_name":"{7 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 84 (ethinyl estradiol 0.02 MG \/ levonorgestrel 0.1 MG Oral Tablet) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"810096"},{"drug_name":"rufinamide 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"824295"},{"drug_name":"rufinamide 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"824301"},{"drug_name":"psyllium 3400 MG Powder for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"824586"},{"drug_name":"24 HR ropinirole 12 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"824959"},{"drug_name":"24 HR mesalamine 375 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"825130"},{"drug_name":"0.5 ML hepatitis B immune globulin 220 UNT\/ML Prefilled Syringe [Hyperhep B]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"825159"},{"drug_name":"1 ML hepatitis B immune globulin 220 UNT\/ML Prefilled Syringe [Hyperhep B]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"825161"},{"drug_name":"{6 (0.8 ML adalimumab 50 MG\/ML Auto-Injector [Humira]) } Pack [Humira Pen - Crohn's Disease Starter Pack]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"825170"},{"drug_name":"aspirin 81 MG Chewable Tablet [Bayer Aspirin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"825180"},{"drug_name":"0.375 ML leuprolide acetate 120 MG\/ML Prefilled Syringe [Eligard]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"825325"},{"drug_name":"0.5 ML leuprolide acetate 60 MG\/ML Prefilled Syringe [Eligard]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"825333"},{"drug_name":"0.25 ML leuprolide acetate 30 MG\/ML Prefilled Syringe [Eligard]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"825334"},{"drug_name":"0.375 ML leuprolide acetate 60 MG\/ML Prefilled Syringe [Eligard]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"825335"},{"drug_name":"eltrombopag 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"825421"},{"drug_name":"eltrombopag 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"825427"},{"drug_name":"silodosin 4 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"826612"},{"drug_name":"nebivolol 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"827073"},{"drug_name":"Bifidobacterium infantis 4 MG Oral Capsule [Align]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"827349"},{"drug_name":"carbamide peroxide 65 MG\/ML Otic Solution [Debrox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"827654"},{"drug_name":"carbamide peroxide 65 MG\/ML Otic Solution [Murine Ear]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"827710"},{"drug_name":"cortisone acetate 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"828248"},{"drug_name":"loratadine 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"828269"},{"drug_name":"cyclobenzaprine hydrochloride 7.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"828299"},{"drug_name":"cyclobenzaprine hydrochloride 7.5 MG Oral Tablet [Fexmid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"828301"},{"drug_name":"cyclobenzaprine hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"828320"},{"drug_name":"cyclobenzaprine hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"828348"},{"drug_name":"pramoxine hydrochloride 10 MG\/ML Rectal Foam","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"828365"},{"drug_name":"pramoxine hydrochloride 10 MG\/ML Rectal Foam [Proctofoam]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"828367"},{"drug_name":"fenofibric acid 135 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"828373"},{"drug_name":"fenofibric acid 45 MG Delayed Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"828379"},{"drug_name":"acetaminophen 32 MG\/ML Oral Suspension [Tylenol]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"828555"},{"drug_name":"1.2 ML plerixafor 20 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"828700"},{"drug_name":"adapalene 0.001 MG\/MG \/ benzoyl peroxide 0.025 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"829539"},{"drug_name":"0.5 ML acellular pertussis vaccine  inactivated 0.116 MG\/ML \/ diphtheria toxoid vaccine  inactivated 50 UNT\/ML \/ hepatitis B surface antigen vaccine 0.02 MG\/ML \/ poliovirus vaccine inactivated  type 1 (Mahoney) 80 UNT\/ML \/ poliovirus vaccine inactivated  type 2 (MEF-1) 16 UNT\/ML \/ poliovirus vaccine inactivated  type 3 (Saukett) 64 UNT\/ML \/ tetanus toxoid vaccine  inactivated 20 UNT\/ML Prefilled Syringe [PEDIARIX]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"829989"},{"drug_name":"1 ML hepatitis B surface antigen vaccine 0.01 MG\/ML Prefilled Syringe [Recombivax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"830245"},{"drug_name":"0.5 ML hepatitis B surface antigen vaccine 0.01 MG\/ML Prefilled Syringe [Recombivax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"830253"},{"drug_name":"1 ML hepatitis B surface antigen vaccine 0.04 MG\/ML Injection [Recombivax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"830263"},{"drug_name":"1 ML rabies virus vaccine flury-lep strain 2.5 UNT\/ML Injection [RabAvert]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"830463"},{"drug_name":"1 ML rabies virus vaccine wistar strain PM-1503-3M (human)  inactivated 2.5 UNT\/ML Injection [Imovax]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"830470"},{"drug_name":"0.5 ML acellular pertussis vaccine  inactivated 0.116 MG\/ML \/ diphtheria toxoid vaccine  inactivated 50 UNT\/ML \/ poliovirus vaccine inactivated  type 1 (Mahoney) 80 UNT\/ML \/ poliovirus vaccine inactivated  type 2 (MEF-1) 16 UNT\/ML \/ poliovirus vaccine inactivated  type 3 (Saukett) 64 UNT\/ML \/ tetanus toxoid vaccine  inactivated 20 UNT\/ML Prefilled Syringe [Kinrix]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"830557"},{"drug_name":"doxycycline monohydrate 100 MG Oral Tablet [Avidoxy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"830605"},{"drug_name":"24 HR diltiazem hydrochloride 360 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"830795"},{"drug_name":"24 HR diltiazem hydrochloride 300 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"830801"},{"drug_name":"24 HR diltiazem hydrochloride 240 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"830837"},{"drug_name":"24 HR diltiazem hydrochloride 180 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"830845"},{"drug_name":"24 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"830861"},{"drug_name":"12 HR diltiazem hydrochloride 60 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"830865"},{"drug_name":"12 HR diltiazem hydrochloride 90 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"830869"},{"drug_name":"12 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"830872"},{"drug_name":"diltiazem hydrochloride 120 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831054"},{"drug_name":"diltiazem hydrochloride 90 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831102"},{"drug_name":"diltiazem hydrochloride 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831103"},{"drug_name":"cromolyn sodium 40 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"831109"},{"drug_name":"24 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule [Taztia]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831196"},{"drug_name":"24 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule [Dilt]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831215"},{"drug_name":"24 HR diltiazem hydrochloride 120 MG Extended Release Oral Capsule [Cartia]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831226"},{"drug_name":"cromolyn sodium 10 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831246"},{"drug_name":"24 HR diltiazem hydrochloride 180 MG Extended Release Oral Capsule [Taztia]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831248"},{"drug_name":"24 HR diltiazem hydrochloride 180 MG Extended Release Oral Capsule [Dilt]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831252"},{"drug_name":"24 HR diltiazem hydrochloride 180 MG Extended Release Oral Capsule [Cartia]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831255"},{"drug_name":"24 HR diltiazem hydrochloride 240 MG Extended Release Oral Capsule [Dilt]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831285"},{"drug_name":"24 HR diltiazem hydrochloride 240 MG Extended Release Oral Capsule [Taztia]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831300"},{"drug_name":"24 HR diltiazem hydrochloride 240 MG Extended Release Oral Capsule [Cartia]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831309"},{"drug_name":"24 HR diltiazem hydrochloride 300 MG Extended Release Oral Capsule [Taztia]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831325"},{"drug_name":"24 HR diltiazem hydrochloride 300 MG Extended Release Oral Capsule [Cartia]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831338"},{"drug_name":"24 HR diltiazem hydrochloride 360 MG Extended Release Oral Capsule [Taztia]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831349"},{"drug_name":"24 HR diltiazem hydrochloride 420 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"831359"},{"drug_name":"fibrinogen  human 1 MG Injection [RiaSTAP]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"831509"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Errin 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"831533"},{"drug_name":"darunavir 75 MG Oral Tablet [Prezista]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"831870"},{"drug_name":"{21 (desogestrel 0.15 MG \/ ethinyl estradiol 0.02 MG Oral Tablet) \/ 5 (ethinyl estradiol 0.01 MG Oral Tablet) \/ 2 (inert ingredients 1 MG Oral Tablet) } Pack [Azurette 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"831872"},{"drug_name":"Bacillus anthracis strain V770-NP1-R antigens 0.1 MG\/ML Injectable Suspension [Biothrax]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"832682"},{"drug_name":"potassium chloride 8 MEQ Extended Release Oral Tablet [Klor-Con]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"832718"},{"drug_name":"Microencapsulated potassium chloride 15 MEQ Extended Release Oral Tablet [Klor-Con]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"832731"},{"drug_name":"desmopressin acetate 0.2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"833008"},{"drug_name":"smallpox vaccine live  New York City Board of Health vaccinia strain 500000000 UNT\/ML Injectable Solution [ACAM2000]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"833086"},{"drug_name":"milnacipran hydrochloride 100 MG Oral Tablet [Savella]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"833139"},{"drug_name":"milnacipran hydrochloride 12.5 MG Oral Tablet [Savella]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"833143"},{"drug_name":"milnacipran hydrochloride 50 MG Oral Tablet [Savella]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"833146"},{"drug_name":"milnacipran hydrochloride 25 MG Oral Tablet [Savella]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"833149"},{"drug_name":"{5 (milnacipran hydrochloride 12.5 MG Oral Tablet [Savella]) \/ 8 (milnacipran hydrochloride 25 MG Oral Tablet [Savella]) \/ 42 (milnacipran hydrochloride 50 MG Oral Tablet [Savella]) } Pack [Savella 4-Week Titration]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"833151"},{"drug_name":"diltiazem hydrochloride 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"833217"},{"drug_name":"amiodarone hydrochloride 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"833528"},{"drug_name":"24 HR tramadol hydrochloride 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"833709"},{"drug_name":"24 HR tramadol hydrochloride 200 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"833711"},{"drug_name":"24 HR tramadol hydrochloride 300 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"833713"},{"drug_name":"ketorolac tromethamine 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"834022"},{"drug_name":"penicillin V potassium 50 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"834040"},{"drug_name":"penicillin V potassium 25 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"834046"},{"drug_name":"penicillin V potassium 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"834061"},{"drug_name":"penicillin V potassium 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"834102"},{"drug_name":"chlorhexidine gluconate 1.2 MG\/ML Mouthwash","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"834127"},{"drug_name":"chlorhexidine gluconate 1.2 MG\/ML Mouthwash [Periogard]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"834137"},{"drug_name":"amiodarone hydrochloride 200 MG Oral Tablet [Pacerone]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"834346"},{"drug_name":"imipramine hydrochloride 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835564"},{"drug_name":"imipramine hydrochloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835568"},{"drug_name":"imipramine pamoate 75 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835572"},{"drug_name":"imipramine pamoate 150 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835577"},{"drug_name":"imipramine pamoate 125 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835589"},{"drug_name":"imipramine pamoate 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835591"},{"drug_name":"imipramine hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835593"},{"drug_name":"tramadol hydrochloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835603"},{"drug_name":"acamprosate calcium 333 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835726"},{"drug_name":"cyclosporine  modified 100 MG Oral Capsule [Gengraf]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835835"},{"drug_name":"testosterone cypionate 200 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835840"},{"drug_name":"testosterone cypionate 200 MG\/ML Injectable Solution [Depo-testosterone]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835842"},{"drug_name":"cyclosporine  modified 100 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835886"},{"drug_name":"cyclosporine  modified 100 MG\/ML Oral Solution [Gengraf]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835892"},{"drug_name":"cyclosporine  modified 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835894"},{"drug_name":"cyclosporine  modified 25 MG Oral Capsule [Gengraf]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835896"},{"drug_name":"mefloquine hydrochloride 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835913"},{"drug_name":"cyclosporine  modified 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"835925"},{"drug_name":"temozolomide 100 MG Injection [Temodar]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"835948"},{"drug_name":"ipratropium bromide 0.2 MG\/ML Inhalation Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"836358"},{"drug_name":"200 ACTUAT ipratropium bromide 0.017 MG\/ACTUAT Metered Dose Inhaler [Atrovent]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"836368"},{"drug_name":"acetaminophen 325 MG \/ tramadol hydrochloride 37.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"836395"},{"drug_name":"1 ML hepatitis A virus strain CR 326F antigen  inactivated 50 UNT\/ML Prefilled Syringe [Vaqta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"836634"},{"drug_name":"0.5 ML hepatitis A virus strain CR 326F antigen  inactivated 50 UNT\/ML Prefilled Syringe [Vaqta]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"836636"},{"drug_name":"theophylline 100 MG Extended Release Oral Capsule [Theo-24]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"844590"},{"drug_name":"theophylline 300 MG Extended Release Oral Capsule [Theo-24]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"844591"},{"drug_name":"theophylline 200 MG Extended Release Oral Capsule [Theo-24]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"844813"},{"drug_name":"theophylline 400 MG Extended Release Oral Capsule [Theo-24]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"844829"},{"drug_name":"ramipril 1.25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"845488"},{"drug_name":"everolimus 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"845507"},{"drug_name":"everolimus 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"845515"},{"drug_name":"benzoyl peroxide 50 MG\/ML Medicated Liquid Soap [Benzac]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"845978"},{"drug_name":"24 HR levetiracetam 750 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"846378"},{"drug_name":"3 ML insulin isophane  human 70 UNT\/ML \/ insulin  regular  human 30 UNT\/ML Pen Injector [Humulin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"847189"},{"drug_name":"3 ML insulin aspart protamine  human 70 UNT\/ML \/ insulin aspart  human 30 UNT\/ML Pen Injector","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"847191"},{"drug_name":"3 ML insulin glargine 100 UNT\/ML Pen Injector [Lantus]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"847232"},{"drug_name":"1.5 ML somatropin 10 MG\/ML Pen Injector [Norditropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"847245"},{"drug_name":"1.5 ML somatropin 3.33 MG\/ML Pen Injector [Norditropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"847247"},{"drug_name":"3 ML insulin lispro 25 UNT\/ML \/ insulin lispro protamine  human 75 UNT\/ML Pen Injector","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"847252"},{"drug_name":"1.5 ML somatropin 6.67 MG\/ML Pen Injector [Norditropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"847348"},{"drug_name":"artemether 20 MG \/ lumefantrine 120 MG Oral Tablet [Coartem]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"847734"},{"drug_name":"lopinavir 200 MG \/ ritonavir 50 MG Oral Tablet [Kaletra]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"847741"},{"drug_name":"lopinavir 100 MG \/ ritonavir 25 MG Oral Tablet [Kaletra]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"847745"},{"drug_name":"lopinavir 80 MG\/ML \/ ritonavir 20 MG\/ML Oral Solution [Kaletra]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"847749"},{"drug_name":"60 ACTUAT exenatide 0.01 MG\/ACTUAT Pen Injector","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"847910"},{"drug_name":"60 ACTUAT exenatide 0.01 MG\/ACTUAT Pen Injector [Byetta]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"847913"},{"drug_name":"60 ACTUAT exenatide 0.005 MG\/ACTUAT Pen Injector","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"847915"},{"drug_name":"60 ACTUAT exenatide 0.005 MG\/ACTUAT Pen Injector [Byetta]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"847917"},{"drug_name":"amlodipine 10 MG \/ hydrochlorothiazide 12.5 MG \/ valsartan 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"848131"},{"drug_name":"amlodipine 10 MG \/ hydrochlorothiazide 25 MG \/ valsartan 320 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"848135"},{"drug_name":"amlodipine 5 MG \/ hydrochlorothiazide 12.5 MG \/ valsartan 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"848140"},{"drug_name":"amlodipine 5 MG \/ hydrochlorothiazide 25 MG \/ valsartan 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"848145"},{"drug_name":"amlodipine 10 MG \/ hydrochlorothiazide 25 MG \/ valsartan 160 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"848151"},{"drug_name":"Augmented betamethasone 0.5 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"848178"},{"drug_name":"24 HR ropinirole 6 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"848582"},{"drug_name":"cholestyramine resin 4000 MG Powder for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"848943"},{"drug_name":"Sugar-Free cholestyramine resin 4000 MG Powder for Oral Suspension [Prevalite]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"848951"},{"drug_name":"ciprofloxacin 2 MG\/ML Otic Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"848956"},{"drug_name":"ciprofloxacin 2 MG\/ML Otic Solution [Cetraxal]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"848960"},{"drug_name":"amantadine hydrochloride 10 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"849385"},{"drug_name":"amantadine hydrochloride 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"849389"},{"drug_name":"amantadine hydrochloride 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"849395"},{"drug_name":"naproxen sodium 275 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"849398"},{"drug_name":"naproxen sodium 550 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"849431"},{"drug_name":"desmopressin acetate 0.004 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"849501"},{"drug_name":"desmopressin acetate 0.01 MG\/ACTUAT Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"849506"},{"drug_name":"desmopressin acetate 0.1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"849515"},{"drug_name":"naproxen sodium 220 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"849574"},{"drug_name":"Hyponatremia tolvaptan 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"849827"},{"drug_name":"Hyponatremia tolvaptan 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"849833"},{"drug_name":"3 ML somatropin 10 MG\/ML Pen Injector [Norditropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"849851"},{"drug_name":"caffeine citrate 20 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"849928"},{"drug_name":"24 HR lamotrigine 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"850087"},{"drug_name":"24 HR lamotrigine 50 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"850091"},{"drug_name":"darunavir 150 MG Oral Tablet [Prezista]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"850457"},{"drug_name":"quinidine sulfate 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"852877"},{"drug_name":"quinidine sulfate 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"852913"},{"drug_name":"quinidine gluconate 324 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"852920"},{"drug_name":"24 HR quetiapine 50 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"853201"},{"drug_name":"dexamethasone 0.7 MG Drug Implant [Ozurdex]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"854181"},{"drug_name":"0.3 ML enoxaparin sodium 100 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854228"},{"drug_name":"0.4 ML enoxaparin sodium 100 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854235"},{"drug_name":"0.6 ML enoxaparin sodium 100 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854238"},{"drug_name":"0.8 ML enoxaparin sodium 100 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854241"},{"drug_name":"0.8 ML enoxaparin sodium 150 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854245"},{"drug_name":"1 ML enoxaparin sodium 100 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854248"},{"drug_name":"1 ML enoxaparin sodium 150 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854252"},{"drug_name":"enoxaparin sodium 100 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854255"},{"drug_name":"diclofenac sodium 1 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854801"},{"drug_name":"lisdexamfetamine dimesylate 20 MG Oral Capsule [Vyvanse]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"854832"},{"drug_name":"lisdexamfetamine dimesylate 30 MG Oral Capsule [Vyvanse]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"854836"},{"drug_name":"lisdexamfetamine dimesylate 40 MG Oral Capsule [Vyvanse]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"854840"},{"drug_name":"lisdexamfetamine dimesylate 70 MG Oral Capsule [Vyvanse]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"854844"},{"drug_name":"lisdexamfetamine dimesylate 60 MG Oral Capsule [Vyvanse]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"854848"},{"drug_name":"lisdexamfetamine dimesylate 50 MG Oral Capsule [Vyvanse]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"854852"},{"drug_name":"rabeprazole sodium 20 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854868"},{"drug_name":"zolpidem tartrate 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854873"},{"drug_name":"zolpidem tartrate 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854876"},{"drug_name":"zolpidem tartrate 12.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854880"},{"drug_name":"zolpidem tartrate 6.25 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854894"},{"drug_name":"bisoprolol fumarate 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854901"},{"drug_name":"bisoprolol fumarate 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854905"},{"drug_name":"bisoprolol fumarate 10 MG \/ hydrochlorothiazide 6.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854908"},{"drug_name":"bisoprolol fumarate 2.5 MG \/ hydrochlorothiazide 6.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854916"},{"drug_name":"bisoprolol fumarate 5 MG \/ hydrochlorothiazide 6.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"854919"},{"drug_name":"levocetirizine dihydrochloride 0.5 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855168"},{"drug_name":"levocetirizine dihydrochloride 0.5 MG\/ML Oral Solution [Xyzal]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"855170"},{"drug_name":"levocetirizine dihydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855172"},{"drug_name":"levocetirizine dihydrochloride 5 MG Oral Tablet [Xyzal]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855174"},{"drug_name":"tolterodine tartrate 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855178"},{"drug_name":"tolterodine tartrate 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855194"},{"drug_name":"warfarin sodium 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855288"},{"drug_name":"warfarin sodium 1 MG Oral Tablet [Jantoven]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855292"},{"drug_name":"warfarin sodium 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855296"},{"drug_name":"warfarin sodium 10 MG Oral Tablet [Jantoven]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855300"},{"drug_name":"warfarin sodium 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855302"},{"drug_name":"warfarin sodium 2 MG Oral Tablet [Jantoven]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855306"},{"drug_name":"warfarin sodium 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855312"},{"drug_name":"warfarin sodium 2.5 MG Oral Tablet [Jantoven]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855316"},{"drug_name":"warfarin sodium 3 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855318"},{"drug_name":"warfarin sodium 3 MG Oral Tablet [Jantoven]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855322"},{"drug_name":"warfarin sodium 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855324"},{"drug_name":"warfarin sodium 4 MG Oral Tablet [Jantoven]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855328"},{"drug_name":"warfarin sodium 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855332"},{"drug_name":"warfarin sodium 5 MG Oral Tablet [Jantoven]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855336"},{"drug_name":"warfarin sodium 6 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855338"},{"drug_name":"warfarin sodium 6 MG Oral Tablet [Jantoven]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855342"},{"drug_name":"warfarin sodium 7.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855344"},{"drug_name":"warfarin sodium 7.5 MG Oral Tablet [Jantoven]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855348"},{"drug_name":"alclometasone dipropionate 0.5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855474"},{"drug_name":"alclometasone dipropionate 0.0005 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"855480"},{"drug_name":"diclofenac sodium 0.01 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855633"},{"drug_name":"diclofenac sodium 0.01 MG\/MG Topical Gel [Voltaren]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855635"},{"drug_name":"24 HR diclofenac sodium 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855657"},{"drug_name":"diclofenac sodium 25 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855664"},{"drug_name":"phenytoin sodium 100 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855671"},{"drug_name":"prasugrel 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855812"},{"drug_name":"prasugrel 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855818"},{"drug_name":"3 ML apomorphine hydrochloride 10 MG\/ML Cartridge","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855856"},{"drug_name":"phenytoin sodium 200 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855861"},{"drug_name":"phenytoin sodium 300 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855873"},{"drug_name":"diclofenac sodium 50 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855906"},{"drug_name":"diclofenac sodium 75 MG Delayed Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855926"},{"drug_name":"diclofenac potassium 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"855942"},{"drug_name":"trazodone hydrochloride 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856364"},{"drug_name":"trazodone hydrochloride 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856369"},{"drug_name":"trazodone hydrochloride 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856373"},{"drug_name":"trazodone hydrochloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856377"},{"drug_name":"propranolol hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856448"},{"drug_name":"propranolol hydrochloride 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856457"},{"drug_name":"24 HR propranolol hydrochloride 120 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856460"},{"drug_name":"{7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.18 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.215 MG Oral Tablet) \/ 7 (ethinyl estradiol 0.025 MG \/ norgestimate 0.25 MG Oral Tablet) \/ 7 (inert ingredients 1 MG Oral Tablet) } Pack [Tri-Lo-Sprintec 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"856467"},{"drug_name":"24 HR propranolol hydrochloride 160 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856481"},{"drug_name":"propranolol hydrochloride 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856519"},{"drug_name":"24 HR propranolol hydrochloride 60 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856535"},{"drug_name":"propranolol hydrochloride 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856556"},{"drug_name":"24 HR propranolol hydrochloride 80 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856569"},{"drug_name":"propranolol hydrochloride 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856578"},{"drug_name":"amitriptyline hydrochloride 10 MG \/ perphenazine 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"856706"},{"drug_name":"amitriptyline hydrochloride 10 MG \/ perphenazine 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"856720"},{"drug_name":"propranolol hydrochloride 4 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"856724"},{"drug_name":"propranolol hydrochloride 8 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"856733"},{"drug_name":"amitriptyline hydrochloride 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856762"},{"drug_name":"amitriptyline hydrochloride 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856773"},{"drug_name":"amitriptyline hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856783"},{"drug_name":"amitriptyline hydrochloride 25 MG \/ perphenazine 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"856797"},{"drug_name":"amitriptyline hydrochloride 25 MG \/ perphenazine 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"856825"},{"drug_name":"amitriptyline hydrochloride 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856834"},{"drug_name":"amitriptyline hydrochloride 50 MG \/ perphenazine 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"856840"},{"drug_name":"amitriptyline hydrochloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856845"},{"drug_name":"amitriptyline hydrochloride 75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856853"},{"drug_name":"acetaminophen 21.7 MG\/ML \/ hydrocodone bitartrate 0.5 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856940"},{"drug_name":"acetaminophen 325 MG \/ hydrocodone bitartrate 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"856999"},{"drug_name":"acetaminophen 325 MG \/ hydrocodone bitartrate 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857002"},{"drug_name":"acetaminophen 325 MG \/ hydrocodone bitartrate 7.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857005"},{"drug_name":"fosinopril sodium 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857169"},{"drug_name":"fosinopril sodium 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857183"},{"drug_name":"fosinopril sodium 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857187"},{"drug_name":"sevelamer hydrochloride 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857216"},{"drug_name":"sevelamer hydrochloride 800 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857224"},{"drug_name":"clomipramine hydrochloride 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857297"},{"drug_name":"clomipramine hydrochloride 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857301"},{"drug_name":"clomipramine hydrochloride 75 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857305"},{"drug_name":"bethanechol chloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857321"},{"drug_name":"bethanechol chloride 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857328"},{"drug_name":"bethanechol chloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857336"},{"drug_name":"bethanechol chloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857340"},{"drug_name":"econazole nitrate 10 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857366"},{"drug_name":"trospium chloride 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857560"},{"drug_name":"terbutaline sulfate 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857677"},{"drug_name":"terbutaline sulfate 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"857683"},{"drug_name":"saxagliptin 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"858036"},{"drug_name":"saxagliptin 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"858042"},{"drug_name":"0.5 ML paliperidone palmitate 156 MG\/ML Prefilled Syringe [Invega]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"858051"},{"drug_name":"1.5 ML paliperidone palmitate 156 MG\/ML Prefilled Syringe [Invega]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"858053"},{"drug_name":"1 ML paliperidone palmitate 156 MG\/ML Prefilled Syringe [Invega]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"858055"},{"drug_name":"0.75 ML paliperidone palmitate 156 MG\/ML Prefilled Syringe [Invega]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"858057"},{"drug_name":"0.25 ML paliperidone palmitate 156 MG\/ML Prefilled Syringe [Invega]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"858074"},{"drug_name":"levonorgestrel 1.5 MG Oral Tablet [Plan B One-Step]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"858079"},{"drug_name":"degarelix 80 MG Injection [Firmagon]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"858125"},{"drug_name":"degarelix 120 MG Injection [Firmagon]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"858127"},{"drug_name":"pramipexole dihydrochloride 0.75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"858625"},{"drug_name":"ursodiol 300 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"858747"},{"drug_name":"ursodiol 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"858751"},{"drug_name":"enalapril maleate 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"858804"},{"drug_name":"enalapril maleate 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"858810"},{"drug_name":"enalapril maleate 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"858813"},{"drug_name":"enalapril maleate 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"858817"},{"drug_name":"enalapril maleate 5 MG \/ hydrochlorothiazide 12.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"858824"},{"drug_name":"enalapril maleate 10 MG \/ hydrochlorothiazide 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"858828"},{"drug_name":"pramipexole dihydrochloride 0.125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859033"},{"drug_name":"pramipexole dihydrochloride 0.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859040"},{"drug_name":"pramipexole dihydrochloride 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859044"},{"drug_name":"pramipexole dihydrochloride 1.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859048"},{"drug_name":"pramipexole dihydrochloride 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859052"},{"drug_name":"NDA020983 200 ACTUAT albuterol 0.09 MG\/ACTUAT Metered Dose Inhaler [Ventolin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"859088"},{"drug_name":"selegiline hydrochloride 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859186"},{"drug_name":"selegiline hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859193"},{"drug_name":"rosuvastatin calcium 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859419"},{"drug_name":"rosuvastatin calcium 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859424"},{"drug_name":"rosuvastatin calcium 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859747"},{"drug_name":"rosuvastatin calcium 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859751"},{"drug_name":"fluphenazine decanoate 25 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859824"},{"drug_name":"fluphenazine hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859841"},{"drug_name":"haloperidol decanoate 50 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859867"},{"drug_name":"haloperidol decanoate 100 MG\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859871"},{"drug_name":"asenapine 10 MG Sublingual Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859975"},{"drug_name":"asenapine 5 MG Sublingual Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"859981"},{"drug_name":"ketorolac tromethamine 4 MG\/ML Ophthalmic Solution [Acular]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"860105"},{"drug_name":"onabotulinumtoxinA 100 UNT Injection [Botox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"860195"},{"drug_name":"megestrol acetate 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"860215"},{"drug_name":"megestrol acetate 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"860221"},{"drug_name":"megestrol acetate 40 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"860225"},{"drug_name":"interferon beta-1b 0.3 MG Injection [Extavia]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"860244"},{"drug_name":"azelastine hydrochloride 0.5 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"860805"},{"drug_name":"vigabatrin 500 MG Oral Tablet [Sabril]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"860895"},{"drug_name":"vigabatrin 500 MG Powder for Oral Solution [Sabril]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"860898"},{"drug_name":"fluphenazine hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"860918"},{"drug_name":"24 HR metformin hydrochloride 500 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"860975"},{"drug_name":"24 HR metformin hydrochloride 750 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"860981"},{"drug_name":"metformin hydrochloride 1000 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861004"},{"drug_name":"metformin hydrochloride 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861007"},{"drug_name":"metformin hydrochloride 850 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861010"},{"drug_name":"metformin hydrochloride 100 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861025"},{"drug_name":"24 HR alfuzosin hydrochloride 10 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861132"},{"drug_name":"brimonidine tartrate 2 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861200"},{"drug_name":"brimonidine tartrate 1 MG\/ML Ophthalmic Solution [Alphagan]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"861206"},{"drug_name":"brimonidine tartrate 1.5 MG\/ML Ophthalmic Solution [Alphagan]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"861210"},{"drug_name":"24 HR amphetamine aspartate 2.5 MG \/ amphetamine sulfate 2.5 MG \/ dextroamphetamine saccharate 2.5 MG \/ dextroamphetamine sulfate 2.5 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861221"},{"drug_name":"24 HR amphetamine aspartate 3.75 MG \/ amphetamine sulfate 3.75 MG \/ dextroamphetamine saccharate 3.75 MG \/ dextroamphetamine sulfate 3.75 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861223"},{"drug_name":"24 HR amphetamine aspartate 5 MG \/ amphetamine sulfate 5 MG \/ dextroamphetamine saccharate 5 MG \/ dextroamphetamine sulfate 5 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861225"},{"drug_name":"24 HR amphetamine aspartate 6.25 MG \/ amphetamine sulfate 6.25 MG \/ dextroamphetamine saccharate 6.25 MG \/ dextroamphetamine sulfate 6.25 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861227"},{"drug_name":"24 HR amphetamine aspartate 7.5 MG \/ amphetamine sulfate 7.5 MG \/ dextroamphetamine saccharate 7.5 MG \/ dextroamphetamine sulfate 7.5 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861232"},{"drug_name":"24 HR amphetamine aspartate 1.25 MG \/ amphetamine sulfate 1.25 MG \/ dextroamphetamine saccharate 1.25 MG \/ dextroamphetamine sulfate 1.25 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861237"},{"drug_name":"clobetasol propionate 0.5 MG\/ML Topical Foam","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861353"},{"drug_name":"0.8 ML fondaparinux sodium 12.5 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861356"},{"drug_name":"0.5 ML fondaparinux sodium 5 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861360"},{"drug_name":"0.4 ML fondaparinux sodium 12.5 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861363"},{"drug_name":"0.6 ML fondaparinux sodium 12.5 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861365"},{"drug_name":"sevelamer carbonate 2400 MG Powder for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861370"},{"drug_name":"sevelamer carbonate 800 MG Powder for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861375"},{"drug_name":"propafenone hydrochloride 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861424"},{"drug_name":"propafenone hydrochloride 225 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861427"},{"drug_name":"propafenone hydrochloride 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861430"},{"drug_name":"clobetasol propionate 0.0005 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861434"},{"drug_name":"clobetasol propionate 0.0005 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861448"},{"drug_name":"meperidine hydrochloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861467"},{"drug_name":"meperidine hydrochloride 10 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"861479"},{"drug_name":"clobetasol propionate 0.5 MG\/ML Topical Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861487"},{"drug_name":"clobetasol propionate 0.5 MG\/ML Medicated Shampoo","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861490"},{"drug_name":"clobetasol propionate 0.5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861495"},{"drug_name":"clobetasol propionate 0.5 MG\/ML Topical Lotion","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861505"},{"drug_name":"clobetasol propionate 0.5 MG\/ML Topical Spray","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861512"},{"drug_name":"esomeprazole 10 MG Granules for Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861568"},{"drug_name":"brimonidine tartrate 2 MG\/ML \/ timolol 5 MG\/ML Ophthalmic Solution [Combigan]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"861637"},{"drug_name":"24 HR nitroglycerin 0.1 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861657"},{"drug_name":"dihydroergotamine mesylate 0.5 MG\/ACTUAT Metered Dose Nasal Spray","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861668"},{"drug_name":"1 ML dihydroergotamine mesylate 1 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861672"},{"drug_name":"glipizide 2.5 MG \/ metformin hydrochloride 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861731"},{"drug_name":"glipizide 2.5 MG \/ metformin hydrochloride 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861736"},{"drug_name":"glipizide 5 MG \/ metformin hydrochloride 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861740"},{"drug_name":"glyburide 1.25 MG \/ metformin hydrochloride 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861743"},{"drug_name":"glyburide 2.5 MG \/ metformin hydrochloride 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861748"},{"drug_name":"glyburide 5 MG \/ metformin hydrochloride 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861753"},{"drug_name":"metformin hydrochloride 1000 MG \/ sitagliptin phosphate 50 MG Oral Tablet [Janumet]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"861771"},{"drug_name":"metformin hydrochloride 500 MG \/ pioglitazone 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861783"},{"drug_name":"metformin hydrochloride 500 MG \/ sitagliptin phosphate 50 MG Oral Tablet [Janumet]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"861821"},{"drug_name":"metformin hydrochloride 850 MG \/ pioglitazone 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"861822"},{"drug_name":"24 HR guanfacine 1 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"862006"},{"drug_name":"24 HR guanfacine 2 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"862013"},{"drug_name":"24 HR guanfacine 3 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"862019"},{"drug_name":"24 HR guanfacine 4 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"862025"},{"drug_name":"oxybutynin chloride 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"863599"},{"drug_name":"erythromycin ethylsuccinate 400 MG Oral Tablet [E.E.S.]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"863606"},{"drug_name":"24 HR oxybutynin chloride 10 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"863619"},{"drug_name":"24 HR oxybutynin chloride 15 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"863628"},{"drug_name":"24 HR oxybutynin chloride 5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"863636"},{"drug_name":"oxybutynin chloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"863664"},{"drug_name":"tamsulosin hydrochloride 0.4 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"863669"},{"drug_name":"amylase 120000 UNT \/ lipase 24000 UNT \/ protease 76000 UNT Delayed Release Oral Capsule [Creon]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"863829"},{"drug_name":"amylase 30000 UNT \/ lipase 6000 UNT \/ protease 19000 UNT Delayed Release Oral Capsule [Creon]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"863836"},{"drug_name":"amylase 60000 UNT \/ lipase 12000 UNT \/ protease 38000 UNT Delayed Release Oral Capsule [Creon]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"863841"},{"drug_name":"efavirenz 600 MG \/ lamivudine 300 MG \/ tenofovir disoproxil fumarate 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"864661"},{"drug_name":"methadone hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"864706"},{"drug_name":"methadone hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"864718"},{"drug_name":"fluphenazine hydrochloride 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"865117"},{"drug_name":"fluphenazine hydrochloride 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"865123"},{"drug_name":"bisoprolol fumarate 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"865155"},{"drug_name":"buspirone hydrochloride 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866018"},{"drug_name":"cyproheptadine hydrochloride 0.4 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866021"},{"drug_name":"neomycin sulfate 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866042"},{"drug_name":"60 ACTUAT salmeterol 0.05 MG\/ACTUAT Dry Powder Inhaler [Serevent]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"866049"},{"drug_name":"buspirone hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866083"},{"drug_name":"buspirone hydrochloride 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866090"},{"drug_name":"buspirone hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866094"},{"drug_name":"24 HR paliperidone 1.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866103"},{"drug_name":"buspirone hydrochloride 7.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866111"},{"drug_name":"cyproheptadine hydrochloride 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866144"},{"drug_name":"12 HR carbamazepine 100 MG Extended Release Oral Tablet [Tegretol]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"866303"},{"drug_name":"12 HR carbamazepine 200 MG Extended Release Oral Tablet [Tegretol]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"866305"},{"drug_name":"12 HR carbamazepine 400 MG Extended Release Oral Tablet [Tegretol]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"866307"},{"drug_name":"24 HR metoprolol succinate 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866412"},{"drug_name":"24 HR metoprolol succinate 200 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866419"},{"drug_name":"24 HR metoprolol succinate 25 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866427"},{"drug_name":"24 HR metoprolol succinate 50 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866436"},{"drug_name":"metoprolol tartrate 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866511"},{"drug_name":"metoprolol tartrate 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866514"},{"drug_name":"metoprolol tartrate 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"866924"},{"drug_name":"C1 esterase inhibitor (human) 500 UNT Injection [Berinert]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"867381"},{"drug_name":"pazopanib 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"867502"},{"drug_name":"polyethylene glycol 3350 17000 MG Powder for Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"876193"},{"drug_name":"polyethylene glycol 3350 17000 MG Powder for Oral Solution [Miralax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"876195"},{"drug_name":"polyethylene glycol 3350 17000 MG Powder for Oral Solution [Gavilax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"876214"},{"drug_name":"amlodipine 10 MG \/ telmisartan 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"876514"},{"drug_name":"amlodipine 10 MG \/ telmisartan 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"876519"},{"drug_name":"amlodipine 5 MG \/ telmisartan 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"876524"},{"drug_name":"amlodipine 5 MG \/ telmisartan 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"876529"},{"drug_name":"ascorbic acid 35 MG\/ML \/ cholecalciferol 0.01 MG\/ML \/ niacin 8 MG\/ML \/ riboflavin 0.6 MG\/ML \/ thiamine 0.5 MG\/ML \/ vitamin A 0.45 MG\/ML \/ vitamin B12 0.002 MG\/ML \/ vitamin B6 0.4 MG\/ML \/ vitamin E 2.25 MG\/ML Oral Solution [Poly-Vi-Sol]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"876861"},{"drug_name":"chenodeoxycholate 250 MG Oral Tablet [Chenodal]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"877417"},{"drug_name":"romidepsin 10 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"877513"},{"drug_name":"polyethylene glycol 3350 17000 MG Powder for Oral Solution [ClearLax]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"880407"},{"drug_name":"psyllium 3400 MG Powder for Oral Suspension [Metamucil]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"880853"},{"drug_name":"12.5 ML sildenafil 0.8 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"882527"},{"drug_name":"clindamycin 20 MG\/ML Vaginal Cream [Cleocin]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"882536"},{"drug_name":"clindamycin phosphate 0.012 MG\/MG \/ tretinoin 0.00025 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"882548"},{"drug_name":"tranexamic acid 650 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"883826"},{"drug_name":"clonidine hydrochloride 0.1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884173"},{"drug_name":"clonidine hydrochloride 0.2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884185"},{"drug_name":"clonidine hydrochloride 0.3 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884189"},{"drug_name":"nystatin 100 UNT\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884308"},{"drug_name":"nonoxynol-9 100 MG Vaginal Insert [Encare]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"884378"},{"drug_name":"dextroamphetamine sulfate 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884385"},{"drug_name":"dextroamphetamine sulfate 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884386"},{"drug_name":"dextroamphetamine sulfate 10 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884520"},{"drug_name":"dextroamphetamine sulfate 1 MG\/ML Oral Solution [ProCentra]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"884526"},{"drug_name":"dextroamphetamine sulfate 15 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884532"},{"drug_name":"dextroamphetamine sulfate 5 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884535"},{"drug_name":"eltrombopag 75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884617"},{"drug_name":"amphetamine sulfate 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884655"},{"drug_name":"dextroamphetamine sulfate 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884684"},{"drug_name":"1 ML ecallantide 10 MG\/ML Injection [Kalbitor]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"884702"},{"drug_name":"estradiol 0.01 MG Vaginal Insert","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"884707"},{"drug_name":"benzoyl peroxide 0.025 MG\/MG \/ clindamycin phosphate 0.012 MG\/MG Topical Gel","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"885131"},{"drug_name":"benztropine mesylate 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"885209"},{"drug_name":"benztropine mesylate 1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"885213"},{"drug_name":"benztropine mesylate 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"885219"},{"drug_name":"cholecalciferol 0.125 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"885489"},{"drug_name":"balsalazide disodium 750 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"885857"},{"drug_name":"flecainide acetate 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"886662"},{"drug_name":"flecainide acetate 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"886666"},{"drug_name":"flecainide acetate 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"886671"},{"drug_name":"butoconazole nitrate 20 MG\/ML Vaginal Cream [Gynazole-1]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"890786"},{"drug_name":"ascorbic acid 100 MG \/ biotin 0.15 MG \/ calcium pantothenate 5 MG \/ folic acid 1 MG \/ niacin 20 MG \/ pyridoxine 10 MG \/ riboflavin 1.7 MG \/ thiamine mononitrate 1.5 MG \/ vitamin B12 0.006 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"891522"},{"drug_name":"cholecalciferol 0.357 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"891692"},{"drug_name":"ascorbic acid 200 MG \/ beta carotene 1000 UNT \/ cuprous oxide 2 MG \/ dl-alpha tocopheryl acetate 60 UNT \/ lutein 2 MG \/ sodium selenate 0.055 MG \/ zinc oxide 40 MG Oral Tablet [Ocuvite]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"891719"},{"drug_name":"ascorbic acid 113 MG \/ beta carotene 7160 MG \/ cuprous oxide 0.4 MG \/ dl-alpha tocopheryl acetate 100 UNT \/ zinc oxide 17.4 MG Oral Tablet [PreserVision]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"891815"},{"drug_name":"morphine sulfate 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"891874"},{"drug_name":"morphine sulfate 15 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"891881"},{"drug_name":"morphine sulfate 30 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"891888"},{"drug_name":"morphine sulfate 60 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"891893"},{"drug_name":"{14 (24 HR nicotine 0.292 MG\/HR Transdermal System) \/ 14 (24 HR nicotine 0.583 MG\/HR Transdermal System) \/ 28 (24 HR nicotine 0.875 MG\/HR Transdermal System) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"892244"},{"drug_name":"levothyroxine sodium 0.1 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"892246"},{"drug_name":"levothyroxine sodium 0.2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"892251"},{"drug_name":"levothyroxine sodium 0.3 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"892255"},{"drug_name":"morphine sulfate 30 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"892345"},{"drug_name":"morphine sulfate 60 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"892352"},{"drug_name":"morphine sulfate 10 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"892494"},{"drug_name":"morphine sulfate 10 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"892516"},{"drug_name":"morphine sulfate 100 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"892554"},{"drug_name":"morphine sulfate 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"892582"},{"drug_name":"morphine sulfate 2 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"892589"},{"drug_name":"morphine sulfate 20 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"892596"},{"drug_name":"morphine sulfate 20 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"892603"},{"drug_name":"morphine sulfate 20 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"892625"},{"drug_name":"morphine sulfate 200 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"892646"},{"drug_name":"morphine sulfate 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"892672"},{"drug_name":"morphine sulfate 30 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"892678"},{"drug_name":"morphine sulfate 4 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"894780"},{"drug_name":"morphine sulfate 50 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"894801"},{"drug_name":"morphine sulfate 5 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"894807"},{"drug_name":"morphine sulfate 80 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"894814"},{"drug_name":"fluticasone propionate 0.00005 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"895487"},{"drug_name":"diphenhydramine citrate 38 MG \/ ibuprofen 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"895664"},{"drug_name":"24 HR quetiapine 150 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"895670"},{"drug_name":"fluticasone propionate 0.5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"895987"},{"drug_name":"120 ACTUAT fluticasone propionate 0.044 MG\/ACTUAT Metered Dose Inhaler","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"895994"},{"drug_name":"120 ACTUAT fluticasone propionate 0.044 MG\/ACTUAT Metered Dose Inhaler [Flovent]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"895996"},{"drug_name":"120 ACTUAT fluticasone propionate 0.11 MG\/ACTUAT Metered Dose Inhaler","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"895999"},{"drug_name":"120 ACTUAT fluticasone propionate 0.11 MG\/ACTUAT Metered Dose Inhaler [Flovent]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896001"},{"drug_name":"120 ACTUAT fluticasone propionate 0.22 MG\/ACTUAT Metered Dose Inhaler","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896004"},{"drug_name":"120 ACTUAT fluticasone propionate 0.22 MG\/ACTUAT Metered Dose Inhaler [Flovent]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896006"},{"drug_name":"60 ACTUAT fluticasone propionate 0.05 MG\/ACTUAT Dry Powder Inhaler","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896018"},{"drug_name":"60 ACTUAT fluticasone propionate 0.1 MG\/ACTUAT Dry Powder Inhaler","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896021"},{"drug_name":"60 ACTUAT fluticasone propionate 0.25 MG\/ACTUAT Dry Powder Inhaler","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896025"},{"drug_name":"14 ACTUAT fluticasone propionate 0.1 MG\/ACTUAT \/ salmeterol 0.05 MG\/ACTUAT Dry Powder Inhaler [Advair]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896165"},{"drug_name":"60 ACTUAT fluticasone propionate 0.1 MG\/ACTUAT \/ salmeterol 0.05 MG\/ACTUAT Dry Powder Inhaler [Advair]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896185"},{"drug_name":"14 ACTUAT fluticasone propionate 0.25 MG\/ACTUAT \/ salmeterol 0.05 MG\/ACTUAT Dry Powder Inhaler [Advair]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896190"},{"drug_name":"60 ACTUAT fluticasone propionate 0.25 MG\/ACTUAT \/ salmeterol 0.05 MG\/ACTUAT Dry Powder Inhaler [Advair]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896212"},{"drug_name":"14 ACTUAT fluticasone propionate 0.5 MG\/ACTUAT \/ salmeterol 0.05 MG\/ACTUAT Dry Powder Inhaler [Advair]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896222"},{"drug_name":"60 ACTUAT fluticasone propionate 0.5 MG\/ACTUAT \/ salmeterol 0.05 MG\/ACTUAT Dry Powder Inhaler [Advair]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896229"},{"drug_name":"60 ACTUAT fluticasone propionate 0.045 MG\/ACTUAT \/ salmeterol 0.021 MG\/ACTUAT Metered Dose Inhaler [Advair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896235"},{"drug_name":"120 ACTUAT fluticasone propionate 0.045 MG\/ACTUAT \/ salmeterol 0.021 MG\/ACTUAT Metered Dose Inhaler [Advair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896237"},{"drug_name":"60 ACTUAT fluticasone propionate 0.115 MG\/ACTUAT \/ salmeterol 0.021 MG\/ACTUAT Metered Dose Inhaler [Advair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896243"},{"drug_name":"120 ACTUAT fluticasone propionate 0.115 MG\/ACTUAT \/ salmeterol 0.021 MG\/ACTUAT Metered Dose Inhaler [Advair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896245"},{"drug_name":"60 ACTUAT fluticasone propionate 0.23 MG\/ACTUAT \/ salmeterol 0.021 MG\/ACTUAT Metered Dose Inhaler [Advair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896271"},{"drug_name":"120 ACTUAT fluticasone propionate 0.23 MG\/ACTUAT \/ salmeterol 0.021 MG\/ACTUAT Metered Dose Inhaler [Advair]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896273"},{"drug_name":"labetalol hydrochloride 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"896758"},{"drug_name":"labetalol hydrochloride 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"896762"},{"drug_name":"labetalol hydrochloride 300 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"896766"},{"drug_name":"chorionic gonadotropin 10000 UNT\/ML Injectable Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896854"},{"drug_name":"chorionic gonadotropin 10000 UNT\/ML Injectable Solution [Pregnyl]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896856"},{"drug_name":"labetalol hydrochloride 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"896983"},{"drug_name":"12 HR dalfampridine 10 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"897021"},{"drug_name":"3 ML liraglutide 6 MG\/ML Pen Injector [Victoza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"897126"},{"drug_name":"onabotulinumtoxinA 200 UNT Injection [Botox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"897368"},{"drug_name":"verapamil hydrochloride 180 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"897640"},{"drug_name":"verapamil hydrochloride 240 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"897649"},{"drug_name":"verapamil hydrochloride 120 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"897659"},{"drug_name":"verapamil hydrochloride 120 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"897666"},{"drug_name":"verapamil hydrochloride 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"897683"},{"drug_name":"hydromorphone hydrochloride 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"897696"},{"drug_name":"hydromorphone hydrochloride 4 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"897702"},{"drug_name":"hydromorphone hydrochloride 8 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"897710"},{"drug_name":"verapamil hydrochloride 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"897722"},{"drug_name":"hydromorphone hydrochloride 3 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"897749"},{"drug_name":"amlodipine 10 MG \/ benazepril hydrochloride 20 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898342"},{"drug_name":"amlodipine 10 MG \/ benazepril hydrochloride 40 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898346"},{"drug_name":"amlodipine 2.5 MG \/ benazepril hydrochloride 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898350"},{"drug_name":"amlodipine 5 MG \/ benazepril hydrochloride 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898353"},{"drug_name":"amlodipine 5 MG \/ benazepril hydrochloride 20 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898356"},{"drug_name":"amlodipine 5 MG \/ benazepril hydrochloride 40 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898359"},{"drug_name":"benazepril hydrochloride 10 MG \/ hydrochlorothiazide 12.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898362"},{"drug_name":"benazepril hydrochloride 20 MG \/ hydrochlorothiazide 12.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898367"},{"drug_name":"benazepril hydrochloride 20 MG \/ hydrochlorothiazide 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898372"},{"drug_name":"benazepril hydrochloride 5 MG \/ hydrochlorothiazide 6.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898378"},{"drug_name":"collagenase Clostridium histolyticum 0.9 MG Injection [Xiaflex]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"898499"},{"drug_name":"Rho(D) immune globulin  human 250 UNT Prefilled Syringe [HyperRHO]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"898572"},{"drug_name":"Rho(D) immune globulin  human 1500 UNT Prefilled Syringe [HyperRHO]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"898578"},{"drug_name":"octreotide 20 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898589"},{"drug_name":"octreotide 30 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898601"},{"drug_name":"octreotide 10 MG Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898605"},{"drug_name":"benazepril hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898687"},{"drug_name":"benazepril hydrochloride 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898690"},{"drug_name":"pregabalin 20 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898715"},{"drug_name":"benazepril hydrochloride 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898719"},{"drug_name":"benazepril hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"898723"},{"drug_name":"24 HR dexmethylphenidate hydrochloride 10 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"899439"},{"drug_name":"24 HR dexmethylphenidate hydrochloride 15 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"899461"},{"drug_name":"24 HR dexmethylphenidate hydrochloride 20 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"899485"},{"drug_name":"24 HR dexmethylphenidate hydrochloride 30 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"899495"},{"drug_name":"24 HR dexmethylphenidate hydrochloride 5 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"899511"},{"drug_name":"dexmethylphenidate hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"899518"},{"drug_name":"dexmethylphenidate hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"899548"},{"drug_name":"dexmethylphenidate hydrochloride 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"899557"},{"drug_name":"24 HR lamotrigine 200 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"900156"},{"drug_name":"24 HR lamotrigine 25 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"900164"},{"drug_name":"ritonavir 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"900575"},{"drug_name":"ritonavir 100 MG Oral Tablet [Norvir]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"900577"},{"drug_name":"0.5 ML Neisseria meningitidis serogroup A oligosaccharide diphtheria CRM197 protein conjugate vaccine 0.02 MG\/ML \/ Neisseria meningitidis serogroup C oligosaccharide diphtheria CRM197 protein conjugate vaccine 0.01 MG\/ML \/ Neisseria meningitidis serogroup W-135 oligosaccharide diphtheria CRM197 protein conjugate vaccine 0.01 MG\/ML \/ Neisseria meningitidis serogroup Y oligosaccharide diphtheria CRM197 protein conjugate vaccine 0.01 MG\/ML Injection [Menveo]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"901518"},{"drug_name":"24 HR pramipexole dihydrochloride 4.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"901534"},{"drug_name":"24 HR pramipexole dihydrochloride 0.375 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"901541"},{"drug_name":"24 HR pramipexole dihydrochloride 0.75 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"901546"},{"drug_name":"24 HR pramipexole dihydrochloride 1.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"901550"},{"drug_name":"24 HR pramipexole dihydrochloride 3 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"901555"},{"drug_name":"0.5 ML Streptococcus pneumoniae serotype 1 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 14 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 18C capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 19A capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 19F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 23F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 3 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 4 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 5 capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 6A capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 6B capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0088 MG\/ML \/ Streptococcus pneumoniae serotype 7F capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML \/ Streptococcus pneumoniae serotype 9V capsular antigen diphtheria CRM197 protein conjugate vaccine 0.0044 MG\/ML Prefilled Syringe [Prevnar 13]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"901644"},{"drug_name":"velaglucerase alfa 400 UNT Injection [Vpriv]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"901812"},{"drug_name":"diphenhydramine hydrochloride 25 MG \/ ibuprofen 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"901814"},{"drug_name":"dexlansoprazole 30 MG Delayed Release Oral Capsule [Dexilant]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"902624"},{"drug_name":"dexlansoprazole 60 MG Delayed Release Oral Capsule [Dexilant]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"902626"},{"drug_name":"24 HR hydromorphone hydrochloride 12 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"902729"},{"drug_name":"24 HR hydromorphone hydrochloride 16 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"902736"},{"drug_name":"24 HR hydromorphone hydrochloride 8 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"902741"},{"drug_name":"liothyronine sodium 0.005 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"903456"},{"drug_name":"liothyronine sodium 0.025 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"903697"},{"drug_name":"liothyronine sodium 0.05 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"903703"},{"drug_name":"pyridostigmine bromide 180 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"903847"},{"drug_name":"pyridostigmine bromide 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"903857"},{"drug_name":"fluvoxamine maleate 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"903884"},{"drug_name":"fluvoxamine maleate 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"903887"},{"drug_name":"fluvoxamine maleate 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"903891"},{"drug_name":"alendronic acid 35 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904396"},{"drug_name":"alendronic acid 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904419"},{"drug_name":"alendronic acid 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"904425"},{"drug_name":"alendronic acid 70 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904431"},{"drug_name":"pravastatin sodium 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904458"},{"drug_name":"pravastatin sodium 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904467"},{"drug_name":"pravastatin sodium 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904475"},{"drug_name":"pravastatin sodium 80 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904481"},{"drug_name":"sotalol hydrochloride 240 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904589"},{"drug_name":"hydrocortisone acetate 10 MG\/ML \/ pramoxine hydrochloride 10 MG\/ML Topical Foam [Epifoam]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"904783"},{"drug_name":"168 HR buprenorphine 0.01 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904870"},{"drug_name":"168 HR buprenorphine 0.01 MG\/HR Transdermal System [BuTrans]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"904874"},{"drug_name":"168 HR buprenorphine 0.02 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904876"},{"drug_name":"168 HR buprenorphine 0.02 MG\/HR Transdermal System [BuTrans]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"904878"},{"drug_name":"168 HR buprenorphine 0.005 MG\/HR Transdermal System","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904880"},{"drug_name":"168 HR buprenorphine 0.005 MG\/HR Transdermal System [BuTrans]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"904882"},{"drug_name":"ibandronic acid 150 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904932"},{"drug_name":"3 ML ibandronic acid 1 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"904952"},{"drug_name":"triptorelin 22.5 MG Injection [Trelstar]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905057"},{"drug_name":"triptorelin 3.75 MG Injection [Trelstar]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905059"},{"drug_name":"triptorelin 11.25 MG Injection [Trelstar]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905064"},{"drug_name":"sirolimus 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"905158"},{"drug_name":"protriptyline hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"905168"},{"drug_name":"protriptyline hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"905172"},{"drug_name":"hydralazine hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"905199"},{"drug_name":"hydralazine hydrochloride 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"905222"},{"drug_name":"hydralazine hydrochloride 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"905225"},{"drug_name":"trihexyphenidyl hydrochloride 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"905269"},{"drug_name":"trihexyphenidyl hydrochloride 0.4 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905273"},{"drug_name":"trihexyphenidyl hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"905283"},{"drug_name":"chlordiazepoxide hydrochloride 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"905369"},{"drug_name":"carglumic acid 200 MG Tablet for Oral Suspension [Carbaglu]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905394"},{"drug_name":"hydralazine hydrochloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"905395"},{"drug_name":"levothyroxine sodium 0.112 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905451"},{"drug_name":"levothyroxine sodium 0.112 MG Oral Capsule [Tirosint]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905453"},{"drug_name":"levothyroxine sodium 0.137 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905455"},{"drug_name":"levothyroxine sodium 0.137 MG Oral Capsule [Tirosint]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905457"},{"drug_name":"levothyroxine sodium 0.075 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905458"},{"drug_name":"levothyroxine sodium 0.075 MG Oral Capsule [Tirosint]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905460"},{"drug_name":"levothyroxine sodium 0.088 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905462"},{"drug_name":"levothyroxine sodium 0.088 MG Oral Capsule [Tirosint]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"905464"},{"drug_name":"chlordiazepoxide hydrochloride 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"905495"},{"drug_name":"chlordiazepoxide hydrochloride 5 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"905516"},{"drug_name":"primidone 250 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"96304"},{"drug_name":"levothyroxine sodium 0.025 MG Oral Tablet [Euthyrox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966153"},{"drug_name":"levothyroxine sodium 0.025 MG Oral Tablet [Levo-T]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966154"},{"drug_name":"levothyroxine sodium 0.025 MG Oral Tablet [Levoxyl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966157"},{"drug_name":"levothyroxine sodium 0.025 MG Oral Tablet [Synthroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966158"},{"drug_name":"levothyroxine sodium 0.05 MG Oral Tablet [Euthyrox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966160"},{"drug_name":"levothyroxine sodium 0.05 MG Oral Tablet [Levo-T]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966161"},{"drug_name":"levothyroxine sodium 0.05 MG Oral Tablet [Levoxyl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966164"},{"drug_name":"levothyroxine sodium 0.075 MG Oral Tablet [Euthyrox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966166"},{"drug_name":"levothyroxine sodium 0.075 MG Oral Tablet [Levo-T]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966167"},{"drug_name":"levothyroxine sodium 0.075 MG Oral Tablet [Levoxyl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966170"},{"drug_name":"levothyroxine sodium 0.075 MG Oral Tablet [Synthroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966171"},{"drug_name":"levothyroxine sodium 0.088 MG Oral Tablet [Euthyrox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966173"},{"drug_name":"levothyroxine sodium 0.088 MG Oral Tablet [Levoxyl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966175"},{"drug_name":"levothyroxine sodium 0.1 MG Oral Tablet [Euthyrox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966177"},{"drug_name":"levothyroxine sodium 0.1 MG Oral Tablet [Levo-T]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966178"},{"drug_name":"levothyroxine sodium 0.112 MG Oral Tablet [Euthyrox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966182"},{"drug_name":"levothyroxine sodium 0.112 MG Oral Tablet [Levoxyl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966184"},{"drug_name":"levothyroxine sodium 0.112 MG Oral Tablet [Synthroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966185"},{"drug_name":"levothyroxine sodium 0.125 MG Oral Tablet [Euthyrox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966187"},{"drug_name":"levothyroxine sodium 0.125 MG Oral Tablet [Levo-T]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966188"},{"drug_name":"levothyroxine sodium 0.125 MG Oral Tablet [Levoxyl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966190"},{"drug_name":"levothyroxine sodium 0.125 MG Oral Tablet [Synthroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966191"},{"drug_name":"levothyroxine sodium 0.137 MG Oral Tablet [Levoxyl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966194"},{"drug_name":"levothyroxine sodium 0.15 MG Oral Tablet [Euthyrox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966196"},{"drug_name":"levothyroxine sodium 0.15 MG Oral Tablet [Levo-T]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966197"},{"drug_name":"levothyroxine sodium 0.15 MG Oral Tablet [Levoxyl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966200"},{"drug_name":"levothyroxine sodium 0.15 MG Oral Tablet [Synthroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966201"},{"drug_name":"levothyroxine sodium 0.175 MG Oral Tablet [Euthyrox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966202"},{"drug_name":"levothyroxine sodium 0.175 MG Oral Tablet [Levoxyl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966204"},{"drug_name":"levothyroxine sodium 0.175 MG Oral Tablet [Synthroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966205"},{"drug_name":"levothyroxine sodium 0.2 MG Oral Tablet [Euthyrox]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966207"},{"drug_name":"levothyroxine sodium 0.2 MG Oral Tablet [Levo-T]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966208"},{"drug_name":"levothyroxine sodium 0.2 MG Oral Tablet [Levoxyl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966211"},{"drug_name":"levothyroxine sodium 0.3 MG Oral Tablet [Levo-T]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966214"},{"drug_name":"levothyroxine sodium 0.3 MG Oral Tablet [Synthroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966218"},{"drug_name":"levothyroxine sodium 0.025 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966220"},{"drug_name":"levothyroxine sodium 0.05 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966221"},{"drug_name":"levothyroxine sodium 0.075 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966222"},{"drug_name":"levothyroxine sodium 0.125 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966224"},{"drug_name":"levothyroxine sodium 0.15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966225"},{"drug_name":"levothyroxine sodium 0.025 MG Oral Tablet [Unithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966228"},{"drug_name":"levothyroxine sodium 0.088 MG Oral Tablet [Unithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966232"},{"drug_name":"levothyroxine sodium 0.1 MG Oral Tablet [Unithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966233"},{"drug_name":"levothyroxine sodium 0.112 MG Oral Tablet [Unithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966235"},{"drug_name":"levothyroxine sodium 0.125 MG Oral Tablet [Unithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966237"},{"drug_name":"levothyroxine sodium 0.15 MG Oral Tablet [Unithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966238"},{"drug_name":"levothyroxine sodium 0.2 MG Oral Tablet [Unithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966241"},{"drug_name":"levothyroxine sodium 0.3 MG Oral Tablet [Unithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966243"},{"drug_name":"levothyroxine sodium 0.05 MG Oral Tablet [Unithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966244"},{"drug_name":"levothyroxine sodium 0.175 MG Oral Tablet [Unithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966246"},{"drug_name":"levothyroxine sodium 0.05 MG Oral Tablet [Synthroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966247"},{"drug_name":"levothyroxine sodium 0.112 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966248"},{"drug_name":"levothyroxine sodium 0.175 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966249"},{"drug_name":"levothyroxine sodium 0.1 MG Oral Tablet [Synthroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966250"},{"drug_name":"levothyroxine sodium 0.2 MG Oral Tablet [Synthroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966251"},{"drug_name":"levothyroxine sodium 0.088 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966253"},{"drug_name":"levothyroxine sodium 0.137 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966270"},{"drug_name":"levothyroxine sodium 0.137 MG Oral Tablet [Synthroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966271"},{"drug_name":"levothyroxine sodium 0.088 MG Oral Tablet [Synthroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966282"},{"drug_name":"levothyroxine sodium 0.1 MG Oral Tablet [Levoxyl]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966283"},{"drug_name":"levothyroxine sodium 0.075 MG Oral Tablet [Unithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966286"},{"drug_name":"levothyroxine sodium 0.112 MG Oral Tablet [Levo-T]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966397"},{"drug_name":"levothyroxine sodium 0.175 MG Oral Tablet [Levo-T]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966399"},{"drug_name":"levothyroxine sodium 0.088 MG Oral Tablet [Levo-T]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966401"},{"drug_name":"levothyroxine sodium 0.1 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966404"},{"drug_name":"levothyroxine sodium 0.125 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966405"},{"drug_name":"levothyroxine sodium 0.025 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966406"},{"drug_name":"levothyroxine sodium 0.05 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966407"},{"drug_name":"levothyroxine sodium 0.137 MG Oral Tablet [Levo-T]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966410"},{"drug_name":"levothyroxine sodium 0.013 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966412"},{"drug_name":"levothyroxine sodium 0.15 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966413"},{"drug_name":"levothyroxine sodium 0.1 MG Oral Capsule [Tirosint]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966415"},{"drug_name":"levothyroxine sodium 0.125 MG Oral Capsule [Tirosint]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966417"},{"drug_name":"levothyroxine sodium 0.15 MG Oral Capsule [Tirosint]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966420"},{"drug_name":"levothyroxine sodium 0.025 MG Oral Capsule [Tirosint]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966423"},{"drug_name":"levothyroxine sodium 0.05 MG Oral Capsule [Tirosint]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966426"},{"drug_name":"levothyroxine sodium 0.013 MG Oral Capsule [Tirosint]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966434"},{"drug_name":"levothyroxine sodium 0.137 MG Oral Tablet [Unithroid]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966436"},{"drug_name":"120 ACTUAT budesonide 0.18 MG\/ACTUAT Dry Powder Inhaler [Pulmicort]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966524"},{"drug_name":"60 ACTUAT budesonide 0.09 MG\/ACTUAT Dry Powder Inhaler [Pulmicort]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"966529"},{"drug_name":"doxepin 3 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966787"},{"drug_name":"doxepin 6 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966793"},{"drug_name":"polyethylene glycol 3350 236000 MG \/ potassium chloride 2970 MG \/ sodium bicarbonate 6740 MG \/ sodium chloride 5860 MG \/ sodium sulfate 22740 MG Powder for Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"966920"},{"drug_name":"polyethylene glycol 3350 236000 MG \/ potassium chloride 2970 MG \/ sodium bicarbonate 6740 MG \/ sodium chloride 5860 MG \/ sodium sulfate 22740 MG Powder for Oral Solution [Gavilyte-G]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"967012"},{"drug_name":"polyethylene glycol 3350 240000 MG \/ potassium chloride 2980 MG \/ sodium bicarbonate 6720 MG \/ sodium chloride 5840 MG \/ sodium sulfate 22720 MG Powder for Oral Solution [GaviLyte-C]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"967023"},{"drug_name":"nicotine 2 MG Oral Lozenge [Nicorette]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"968849"},{"drug_name":"nicotine 4 MG Oral Lozenge [Nicorette]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"968851"},{"drug_name":"everolimus 0.25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"977427"},{"drug_name":"everolimus 0.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"977434"},{"drug_name":"everolimus 0.75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"977438"},{"drug_name":"{28 (norethindrone 0.35 MG Oral Tablet) } Pack [Heather 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"977836"},{"drug_name":"methamphetamine hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"977860"},{"drug_name":"12 HR oxymorphone hydrochloride 10 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"977874"},{"drug_name":"amiloride hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"977880"},{"drug_name":"amiloride hydrochloride 5 MG \/ hydrochlorothiazide 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"977883"},{"drug_name":"12 HR oxymorphone hydrochloride 15 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"977894"},{"drug_name":"12 HR oxymorphone hydrochloride 20 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"977902"},{"drug_name":"12 HR oxymorphone hydrochloride 30 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"977909"},{"drug_name":"12 HR oxymorphone hydrochloride 40 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"977915"},{"drug_name":"12 HR oxymorphone hydrochloride 5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"977923"},{"drug_name":"12 HR oxymorphone hydrochloride 7.5 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"977929"},{"drug_name":"halobetasol propionate 0.0005 MG\/MG Topical Ointment","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"977978"},{"drug_name":"halobetasol propionate 0.5 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"977990"},{"drug_name":"loperamide hydrochloride 2 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"978006"},{"drug_name":"loperamide hydrochloride 2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"978010"},{"drug_name":"loperamide hydrochloride 2 MG Oral Tablet [Diamode]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"978012"},{"drug_name":"carteolol hydrochloride 10 MG\/ML Ophthalmic Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"978573"},{"drug_name":"{5 (dienogest 2 MG \/ estradiol valerate 2 MG Oral Tablet) \/ 17 (dienogest 3 MG \/ estradiol valerate 2 MG Oral Tablet) \/ 2 (estradiol valerate 1 MG Oral Tablet) \/ 2 (estradiol valerate 3 MG Oral Tablet) \/ 2 (inert ingredients 1 MG Oral Tablet) } Pack [Natazia 28 Day]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"978950"},{"drug_name":"polyethylene glycol 3350 420000 MG \/ potassium chloride 1480 MG \/ sodium bicarbonate 5720 MG \/ sodium chloride 11200 MG Powder for Oral Solution [GaviLyte-N]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"979099"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ losartan potassium 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"979464"},{"drug_name":"hydrochlorothiazide 12.5 MG \/ losartan potassium 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"979468"},{"drug_name":"hydrochlorothiazide 25 MG \/ losartan potassium 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"979471"},{"drug_name":"losartan potassium 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"979480"},{"drug_name":"losartan potassium 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"979485"},{"drug_name":"losartan potassium 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"979492"},{"drug_name":"sodium phenylbutyrate 0.94 MG\/MG Oral Powder [Buphenyl]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"984107"},{"drug_name":"chlorpromazine hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"991039"},{"drug_name":"chlorpromazine hydrochloride 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"991044"},{"drug_name":"dicyclomine hydrochloride 10 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"991061"},{"drug_name":"dicyclomine hydrochloride 2 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"991082"},{"drug_name":"dicyclomine hydrochloride 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"991086"},{"drug_name":"chlorpromazine hydrochloride 200 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"991188"},{"drug_name":"chlorpromazine hydrochloride 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"991194"},{"drug_name":"chlorpromazine hydrochloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"991336"},{"drug_name":"codeine phosphate 2 MG\/ML \/ promethazine hydrochloride 1.25 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"991486"},{"drug_name":"alpha 1-proteinase inhibitor  human 1 MG Injection [Zemaira]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"991722"},{"drug_name":"methenamine mandelate 1000 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"992153"},{"drug_name":"methenamine mandelate 500 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"992184"},{"drug_name":"promethazine hydrochloride 1.25 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992432"},{"drug_name":"promethazine hydrochloride 12.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992438"},{"drug_name":"promethazine hydrochloride 12.5 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992441"},{"drug_name":"promethazine hydrochloride 12.5 MG Rectal Suppository [Promethegan]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992445"},{"drug_name":"promethazine hydrochloride 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992447"},{"drug_name":"promethazine hydrochloride 25 MG Rectal Suppository","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992454"},{"drug_name":"promethazine hydrochloride 25 MG Rectal Suppository [Promethegan]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992459"},{"drug_name":"promethazine hydrochloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992475"},{"drug_name":"promethazine hydrochloride 50 MG Rectal Suppository [Promethegan]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"992481"},{"drug_name":"terbinafine hydrochloride 10 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992528"},{"drug_name":"homatropine methylbromide 0.3 MG\/ML \/ hydrocodone bitartrate 1 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992668"},{"drug_name":"homatropine methylbromide 0.3 MG\/ML \/ hydrocodone bitartrate 1 MG\/ML Oral Solution [Hydromet]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992675"},{"drug_name":"miconazole nitrate 200 MG Vaginal Insert","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"992765"},{"drug_name":"{1 (9000 MG) (miconazole nitrate 20 MG\/ML Vaginal Cream) \/ 3 (miconazole nitrate 200 MG Vaginal Insert) } Pack","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992766"},{"drug_name":"{1 (9000 MG) (miconazole nitrate 20 MG\/ML Vaginal Cream [Monistat]) \/ 3 (miconazole nitrate 200 MG Vaginal Insert [Monistat]) } Pack [Monistat 3 Day Ovule Combination Pack]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992771"},{"drug_name":"miconazole nitrate 100 MG Vaginal Insert","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"992780"},{"drug_name":"alglucosidase alfa 50 MG Injection [Lumizyme]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"993072"},{"drug_name":"1 ML denosumab 60 MG\/ML Prefilled Syringe [Prolia]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"993456"},{"drug_name":"midodrine hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993462"},{"drug_name":"midodrine hydrochloride 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993466"},{"drug_name":"midodrine hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993470"},{"drug_name":"12 HR bupropion hydrochloride 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993503"},{"drug_name":"12 HR bupropion hydrochloride 150 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993518"},{"drug_name":"12 HR bupropion hydrochloride 200 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993536"},{"drug_name":"24 HR bupropion hydrochloride 150 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993541"},{"drug_name":"24 HR bupropion hydrochloride 300 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993557"},{"drug_name":"bupropion hydrochloride 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993687"},{"drug_name":"bupropion hydrochloride 75 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993691"},{"drug_name":"acetaminophen 24 MG\/ML \/ codeine phosphate 2.4 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"993755"},{"drug_name":"acetaminophen 300 MG \/ codeine phosphate 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993770"},{"drug_name":"acetaminophen 300 MG \/ codeine phosphate 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993781"},{"drug_name":"lacosamide 10 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993856"},{"drug_name":"acetaminophen 300 MG \/ codeine phosphate 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993890"},{"drug_name":"acetaminophen 325 MG \/ butalbital 50 MG \/ caffeine 40 MG \/ codeine phosphate 30 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"993943"},{"drug_name":"aspirin 325 MG \/ butalbital 50 MG \/ caffeine 40 MG \/ codeine phosphate 30 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"994237"},{"drug_name":"aspirin 325 MG \/ butalbital 50 MG \/ caffeine 40 MG \/ codeine phosphate 30 MG Oral Capsule [Ascomp]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"994239"},{"drug_name":"12 HR orphenadrine citrate 100 MG Extended Release Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"994521"},{"drug_name":"hydroxyzine hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995218"},{"drug_name":"hydroxyzine pamoate 100 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"995232"},{"drug_name":"hydroxyzine hydrochloride 2 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995241"},{"drug_name":"hydroxyzine pamoate 25 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995253"},{"drug_name":"hydroxyzine hydrochloride 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995258"},{"drug_name":"1 ML hydroxyzine hydrochloride 25 MG\/ML Injection","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"995270"},{"drug_name":"hydroxyzine pamoate 50 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995278"},{"drug_name":"hydroxyzine hydrochloride 50 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995281"},{"drug_name":"ethambutol hydrochloride 100 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995599"},{"drug_name":"ethambutol hydrochloride 400 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995607"},{"drug_name":"ferrous sulfate 75 MG\/ML Oral Solution [Fer-in-Sol]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995613"},{"drug_name":"meclizine hydrochloride 12.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995624"},{"drug_name":"meclizine hydrochloride 25 MG Chewable Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995632"},{"drug_name":"meclizine hydrochloride 25 MG Chewable Tablet [Bonine]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995634"},{"drug_name":"meclizine hydrochloride 25 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995666"},{"drug_name":"meclizine hydrochloride 25 MG Oral Tablet [Dramamine Less Drowsy]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995726"},{"drug_name":"codeine phosphate 2 MG\/ML \/ guaifenesin 20 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"995868"},{"drug_name":"dextromethorphan hydrobromide 2 MG\/ML \/ guaifenesin 20 MG\/ML Oral Solution","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"996520"},{"drug_name":"1 ML somatropin 12 MG\/ML Cartridge [Genotropin]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"996559"},{"drug_name":"memantine hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"996561"},{"drug_name":"memantine hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"996571"},{"drug_name":"24 HR memantine hydrochloride 14 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"996594"},{"drug_name":"24 HR memantine hydrochloride 21 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"996603"},{"drug_name":"24 HR memantine hydrochloride 28 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"996609"},{"drug_name":"24 HR memantine hydrochloride 7 MG Extended Release Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"996615"},{"drug_name":"methylergonovine maleate 0.2 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"996824"},{"drug_name":"methylergonovine maleate 0.2 MG Oral Tablet [Methergine]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"996826"},{"drug_name":"clozapine 200 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREVENTIONTIER"}],"rxnorm_id":"996921"},{"drug_name":"codeine sulfate 15 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"997170"},{"drug_name":"donepezil hydrochloride 10 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"997220"},{"drug_name":"donepezil hydrochloride 10 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"997223"},{"drug_name":"donepezil hydrochloride 5 MG Disintegrating Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"997226"},{"drug_name":"donepezil hydrochloride 5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"997229"},{"drug_name":"250 ML sipuleucel-T 200000 CELLS\/ML Injection [Provenge]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"997267"},{"drug_name":"codeine sulfate 30 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"997287"},{"drug_name":"codeine sulfate 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDBRAND"}],"rxnorm_id":"997296"},{"drug_name":"fexofenadine hydrochloride 180 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"997420"},{"drug_name":"fexofenadine hydrochloride 180 MG Oral Tablet [Allegra]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"997422"},{"drug_name":"fexofenadine hydrochloride 6 MG\/ML Oral Suspension","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"997491"},{"drug_name":"fexofenadine hydrochloride 6 MG\/ML Oral Suspension [Allegra]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"997493"},{"drug_name":"fexofenadine hydrochloride 60 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"997501"},{"drug_name":"fexofenadine hydrochloride 60 MG Oral Tablet [Allegra]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"997502"},{"drug_name":"nilotinib 150 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"997653"},{"drug_name":"everolimus 2.5 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":true,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998189"},{"drug_name":"2 ML midazolam 1 MG\/ML Prefilled Syringe","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998211"},{"drug_name":"miconazole nitrate 20 MG\/ML Topical Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998483"},{"drug_name":"miconazole nitrate 20 MG\/ML Topical Cream [Baza]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998493"},{"drug_name":"miconazole nitrate 20 MG\/ML Topical Cream [Micaderm]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998501"},{"drug_name":"miconazole nitrate 20 MG\/ML Vaginal Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998540"},{"drug_name":"miconazole nitrate 20 MG\/ML Vaginal Cream [Monistat]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998541"},{"drug_name":"miconazole nitrate 40 MG\/ML Vaginal Cream","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998544"},{"drug_name":"miconazole nitrate 40 MG\/ML Vaginal Cream [Monistat]","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998546"},{"drug_name":"acebutolol 400 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998685"},{"drug_name":"acebutolol 200 MG Oral Capsule","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998689"},{"drug_name":"calcium carbonate 500 MG Chewable Tablet [Cal Gest]","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998704"},{"drug_name":"docusate sodium 50 MG \/ sennosides  USP 8.6 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":true,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"998740"},{"drug_name":"amlodipine 5 MG \/ hydrochlorothiazide 12.5 MG \/ olmesartan medoxomil 20 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"999967"},{"drug_name":"amlodipine 10 MG \/ hydrochlorothiazide 12.5 MG \/ olmesartan medoxomil 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"999986"},{"drug_name":"amlodipine 10 MG \/ hydrochlorothiazide 25 MG \/ olmesartan medoxomil 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"999991"},{"drug_name":"amlodipine 5 MG \/ hydrochlorothiazide 12.5 MG \/ olmesartan medoxomil 40 MG Oral Tablet","plans":[{"step_therapy":false,"quantity_limit":false,"plan_id_type":"HIOS-PLAN-ID","prior_authorization":false,"plan_id":"HEALTHYFAMILIE","years":[2022],"drug_tier":"PREFERREDGENERIC"}],"rxnorm_id":"999996"}]