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You searched for Subvenite Starter (Blue) Kit Tablets In A Dose Pack.

Subvenite Starter (Blue) Kit At a Glance
Covered:	No
Your Cost*:	$$$$
Notices?:	No
* Your cost reflects copayment amount for drug. Individuals with high deductible plans may pay full cost of drug until deductible is met.

Strength:

Subvenite Starter (Blue) Kit 25 mg (35) tablets in a dose pack

Subvenite Starter (Blue) Kit 25 mg (35) tablets in a dose pack

Subvenite Starter (Blue) Kit is not included in this formulary. Member pays full cost.

Drug Name	Drug Form	Covered	Type	Your Cost*	Notices?
Fosphenytoin	Fosphenytoin Injection Solution	Yes	Generic	$$$$	No
Gabapentin	Gabapentin Tablet	Yes	Generic	$$$$	Yes
Roweepra	Roweepra Tablet	Yes	Brand	$$$$	No
Roweepra XR	Roweepra XR Tablet,Extended Release	Yes	Brand	$$$$	No
Topiragen	Topiragen Tablet	Yes	Brand	$$$$	Yes
Carbamazepine	Carbamazepine Chewable Tablet	Yes	Generic	$$$$	No
Carbamazepine	Carbamazepine Tablet	Yes	Generic	$$$$	No
Divalproex	Divalproex Tablet,Delayed Release	Yes	Generic	$$$$	No
Divalproex	Divalproex ER Tablet,Extended Release 24 Hr	Yes	Generic	$$$$	No
Epitol	Epitol Tablet	Yes	Brand	$$$$	No
Gabapentin	Gabapentin Capsule	Yes	Generic	$$$$	Yes
Lamotrigine	Lamotrigine Tablet	Yes	Generic	$$$$	No
Levetiracetam	Levetiracetam Tablet	Yes	Generic	$$$$	No
Levetiracetam	Levetiracetam Oral Solution	Yes	Generic	$$$$	No
Levetiracetam	Levetiracetam ER Tablet,Extended Release 24 Hr	Yes	Generic	$$$$	No
Oxcarbazepine	Oxcarbazepine Tablet	Yes	Generic	$$$$	No
Phenytoin	Phenytoin Oral Suspension	Yes	Generic	$$$$	No
Phenytoin	Phenytoin Chewable Tablet	Yes	Generic	$$$$	No
Phenytoin Sodium Extended	Phenytoin Sodium Extended Capsule	Yes	Generic	$$$$	No
Pregabalin	Pregabalin Capsule	Yes	Generic	$$$$	Yes
Primidone	Primidone Tablet	Yes	Generic	$$$$	No
Subvenite	Subvenite Tablet	Yes	Brand	$$$$	No
Topiramate	Topiramate Tablet	Yes	Generic	$$$$	No
Valproic Acid (As Sodium Salt)	Valproic Acid (As Sodium Salt) Oral Solution	Yes	Generic	$$$$	No
Valproic Acid	Valproic Acid Capsule	Yes	Generic	$$$$	No
Zonisamide	Zonisamide Capsule	Yes	Generic	$$$$	No
Carbamazepine	Carbamazepine Oral Suspension	Yes	Generic	$$$$	No
Celontin	Celontin Capsule	Yes	Brand	$$$$	Yes
Dilantin	Dilantin Capsule	Yes	Brand	$$$$	No
Gabapentin	Gabapentin Oral Solution	Yes	Generic	$$$$	Yes
Potiga	Potiga Tablet	Yes	Brand	$$$$	Yes
Carbamazepine	Carbamazepine ER Capsule,Extended Release Mphase12hr	Yes	Generic	$$$$	No
Carbamazepine	Carbamazepine ER Tablet,Extended Release,12 Hr	Yes	Generic	$$$$	No
Divalproex	Divalproex Capsule,Delayed Release Sprinkle	Yes	Generic	$$$$	No
Ethosuximide	Ethosuximide Capsule	Yes	Generic	$$$$	No
Ethosuximide	Ethosuximide Oral Solution	Yes	Generic	$$$$	No
Lacosamide	Lacosamide Oral Solution	Yes	Generic	$$$$	Yes
Lacosamide	Lacosamide Tablet	Yes	Generic	$$$$	Yes
Lamotrigine	Lamotrigine Chewable Dispersible Tablet	Yes	Generic	$$$$	Yes
Lamotrigine	Lamotrigine ER Tablet,Extended Release 24 Hr	Yes	Generic	$$$$	Yes
Oxcarbazepine	Oxcarbazepine Oral Suspension	Yes	Generic	$$$$	No
Peganone	Peganone Tablet	Yes	Brand	$$$$	Yes
Pregabalin	Pregabalin Oral Solution	Yes	Generic	$$$$	Yes
Rufinamide	Rufinamide Oral Suspension	Yes	Generic	$$$$	Yes
Topiramate	Topiramate Sprinkle Capsule	Yes	Generic	$$$$	No
Xcopri Maintenance Pack	Xcopri Maintenance Pack Tablet	Yes	Brand	$$$$	Yes
Briviact	Briviact Tablet	Yes	Brand	$$$$	Yes
Briviact	Briviact Oral Solution	Yes	Brand	$$$$	Yes
Diacomit	Diacomit Capsule	Yes	Brand	$$$$	Yes
Diacomit	Diacomit Oral Powder Packet	Yes	Brand	$$$$	Yes
Eslicarbazepine	Eslicarbazepine Tablet	Yes	Generic	$$$$	Yes
Fintepla	Fintepla Oral Solution	Yes	Brand	$$$$	Yes
Fycompa	Fycompa Oral Suspension	Yes	Brand	$$$$	Yes
Rufinamide	Rufinamide Tablet	Yes	Generic	$$$$	Yes
Vigabatrin	Vigabatrin Oral Powder Packet	Yes	Generic	$$$$	Yes
Vigabatrin	Vigabatrin Tablet	Yes	Generic	$$$$	Yes
Vigadrone	Vigadrone Oral Powder Packet	Yes	Brand	$$$$	Yes
Vigadrone	Vigadrone Tablet	Yes	Brand	$$$$	Yes
Vigpoder	Vigpoder Oral Powder Packet	Yes	Brand	$$$$	Yes
Xcopri	Xcopri Tablet	Yes	Brand	$$$$	Yes
Xcopri Titration Pack	Xcopri Titration Pack Tablets In A Dose Pack	Yes	Brand	$$$$	Yes

Drug Name	Drug Form	Covered	Type	Your Cost*	Notices?
Active-Pac	Active-Pac Kit,Capsule And Gel	No	Brand	$$$$	No
Aptiom	Aptiom Tablet	No	Brand	$$$$	No
Banzel	Banzel Tablet	No	Brand	$$$$	No
Banzel	Banzel Oral Suspension	No	Brand	$$$$	No
Carbatrol	Carbatrol Capsule, Extended Release	No	Brand	$$$$	No
Depacon	Depacon Intravenous Solution	No	Brand	$$$$	No
Depakene	Depakene Capsule	No	Brand	$$$$	No
Depakene	Depakene Oral Solution	No	Brand	$$$$	No
Depakote	Depakote Tablet,Delayed Release	No	Brand	$$$$	No
Depakote ER	Depakote ER Tablet,Extended Release	No	Brand	$$$$	No
Depakote Sprinkles	Depakote Sprinkles Capsule,Delayed Release	No	Brand	$$$$	No
Dilantin Extended	Dilantin Extended Capsule	No	Brand	$$$$	No
Dilantin Infatabs	Dilantin Infatabs Chewable Tablet	No	Brand	$$$$	No
Dilantin-125	Dilantin-125 Oral Suspension	No	Brand	$$$$	No
Elepsia XR	Elepsia XR Tablet,Extended Release	No	Brand	$$$$	No
Eprontia	Eprontia Oral Solution	No	Brand	$$$$	No
Felbamate	Felbamate Tablet	No	Generic	$$$$	No
Felbamate	Felbamate Oral Suspension	No	Generic	$$$$	No
Felbatol	Felbatol Tablet	No	Brand	$$$$	No
Felbatol	Felbatol Oral Suspension	No	Brand	$$$$	No
Fycompa	Fycompa Tablet	No	Brand	$$$$	No
Gabacaine	Gabacaine Oral Capsule And Topical Patch Kit	No	Brand	$$$$	No
Gabapal	Gabapal Kit, Topical Cream And Oral Capsule	No	Brand	$$$$	No
Gabarone	Gabarone Tablet	No	Brand	$$$$	No
Gabitril	Gabitril Tablet	No	Brand	$$$$	No
Keppra	Keppra Tablet	No	Brand	$$$$	No
Keppra	Keppra Oral Solution	No	Brand	$$$$	No
Keppra XR	Keppra XR Tablet,Extended Release	No	Brand	$$$$	No
Lamictal	Lamictal Tablet	No	Brand	$$$$	No
Lamictal	Lamictal Chewable Dispersible Tablet	No	Brand	$$$$	No
Lamictal ODT	Lamictal ODT Disintegrating Tablet	No	Brand	$$$$	No
Lamictal ODT Starter (Orange)	Lamictal ODT Starter (Orange) Tablet,Disintegrating	No	Brand	$$$$	No
Lamictal Starter (Blue) Kit	Lamictal Starter (Blue) Kit Tablets In A Dose Pack	No	Brand	$$$$	No
Lamictal Starter (Green) Kit	Lamictal Starter (Green) Kit Tablets, Dose Pack	No	Brand	$$$$	No
Lamictal Starter (Orange) Kit	Lamictal Starter (Orange) Kit Tablets, Dose Pack	No	Brand	$$$$	No
Lamictal XR	Lamictal XR Tablet,Extended Release	No	Brand	$$$$	No
Lamictal XR Starter (Blue)	Lamictal XR Starter (Blue) Tablet,Extend Release	No	Brand	$$$$	No
Lamotrigine	Lamotrigine Disintegrating Tablet	No	Generic	$$$$	No
Lamotrigine	Lamotrigine Tablet,Disintegrating, Pack	No	Generic	$$$$	No
Lamotrigine	Lamotrigine Tablets In A Dose Pack	No	Generic	$$$$	No
Lidotin	Lidotin Kit, Cream And Capsule	No	Brand	$$$$	No
Lipritin	Lipritin Oral Capsule And Topical Cream, Dressing Kit	No	Brand	$$$$	No
Lipritin II	Lipritin II Oral And Topical Kit	No	Brand	$$$$	No
Lyrica	Lyrica Capsule	No	Brand	$$$$	No
Lyrica	Lyrica Oral Solution	No	Brand	$$$$	No
Motpoly XR	Motpoly XR Capsule,Extended Release	No	Brand	$$$$	No
Mysoline	Mysoline Tablet	No	Brand	$$$$	No
Neurontin	Neurontin Capsule	No	Brand	$$$$	No
Neurontin	Neurontin Oral Solution	No	Brand	$$$$	No
Neurontin	Neurontin Tablet	No	Brand	$$$$	No
Oxcarbazepine	Oxcarbazepine ER Tablet,Extended Release 24 Hr	No	Generic	$$$$	No
Oxtellar XR	Oxtellar XR Tablet,Extended Release	No	Brand	$$$$	No
Pentican	Pentican Oral And Topical Kit	No	Brand	$$$$	No
Phenytek	Phenytek Capsule	No	Brand	$$$$	No
Qudexy XR	Qudexy XR Capsule Sprinkle,Extended Release	No	Brand	$$$$	No
Sabril	Sabril Oral Powder Packet	No	Brand	$$$$	No
Sabril	Sabril Tablet	No	Brand	$$$$	No
Smartrx Gaba-V Kit	Smartrx Gaba-V Kit Kit, Cream And Capsule	No	Brand	$$$$	No
Smartrx Gabakit	Smartrx Gabakit Kit, Cream And Capsule	No	Brand	$$$$	No
Spritam	Spritam Tablet For Oral Suspension	No	Brand	$$$$	No
Subvenite Starter (Blue) Kit	Subvenite Starter (Blue) Kit Tablets In A Dose Pack	No	Brand	$$$$	No
Subvenite Starter (Green) Kit	Subvenite Starter (Green) Kit Tablets In A Dose Pack	No	Brand	$$$$	No
Subvenite Starter (Orange) Kit	Subvenite Starter (Orange) Kit Tablets In A Dose Pack	No	Brand	$$$$	No
Tegretol	Tegretol Oral Suspension	No	Brand	$$$$	No
Tegretol	Tegretol Tablet	No	Brand	$$$$	No
Tegretol XR	Tegretol XR Tablet,Extended Release	No	Brand	$$$$	No
Tiagabine	Tiagabine Tablet	No	Generic	$$$$	No
Topamax	Topamax Tablet	No	Brand	$$$$	No
Topamax	Topamax Sprinkle Capsule	No	Brand	$$$$	No
Topiramate	Topiramate XR Capsule Sprinkle,Ext.Release 24 Hr	No	Generic	$$$$	No
Topiramate	Topiramate XR Capsule,Extended Release 24 Hr	No	Generic	$$$$	No
Trileptal	Trileptal Tablet	No	Brand	$$$$	No
Trileptal	Trileptal Oral Suspension	No	Brand	$$$$	No
Trokendi XR	Trokendi XR Capsule,Extended Release	No	Brand	$$$$	No
Vigafyde	Vigafyde Oral Solution	No	Brand	$$$$	No
Vimpat	Vimpat Oral Solution	No	Brand	$$$$	No
Vimpat	Vimpat Tablet	No	Brand	$$$$	No
Zarontin	Zarontin Capsule	No	Brand	$$$$	No
Zarontin	Zarontin Oral Solution	No	Brand	$$$$	No
Zonegran	Zonegran Capsule	No	Brand	$$$$	No
Zonisade	Zonisade Oral Suspension	No	Brand	$$$$	No

Alternative Drug Information

Discover the value of UPMC Health Plan:

As a member, you will have all the resources you need to manage your health:

Access to care to help you stay healthy.

	$0 preventive care that covers many health services for adults and children at 100 percent.¹
	No-cost preventive medications²
	Access to top-ranked doctors and hospitals and an extended network.³⁴

Care for your mental and physical health

	Six free counseling sessions through LifeSolutions®.⁵
	Free health coaching to help you make healthy changes in your life.

Support you when you need it

	24/7 video visits for treatment that fits your schedule and is covered at 100 percent by most plans.⁶
	The UPMC Health Plan app for easy access to your health insurance information.
	Our exceptional Health Care Concierge team for help navigating your benefits through an online chat or phone call.

¹Preventive care will be covered at 100 percent only when it is received from a participating provider and it is billed as preventive. A separate cost share may apply if additional medical services are received during the same visit or if your preventive care appointment becomes diagnostic in nature.

²Preventive medications on UPMC Health Plan’s Advantage Choice formulary will be covered with no cost share for members who meet certain criteria in accordance with the Patient Protection and Affordable Care Act of 2010.

³Go to www.upmchealthplan.com/BEST for award information.

⁴For details, visit upmchp.us/networkaccess.

⁵UPMC virtual counseling is available to UPMC Health Plan members who are located in Pennsylvania at the time of the visit. The service is available to members of your household who are 18 years old and older. If further counseling is needed, the counselor may refer you or your household members to relevant community resources.

⁶UPMC Health Plan members who are in Pennsylvania at the time of a virtual visit may select a UPMC-employed provider, subject to availability and discretion of the provider. Members located outside of Pennsylvania at the time of service or those who select Talk Therapy or Psychiatry services will receive care from a provider employed or contracted by Online Care Network II PC (OCN), also known as Amwell Medical Group. OCN is not an affiliate of UPMC. Limitations may apply for members of ASO plans that have opted out of coverage. Providers are not available to treat members who are in Puerto Rico.

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You searched for Subvenite Starter (Blue) Kit Tablets In A Dose Pack.

Alternative drugs to Subvenite Starter (Blue) Kit may be available. Review this list with your doctor.

These alternative drugs are not covered.