KYUA Biologic Drug Lists

653619

NDC Biosim Name “Trade Name” if applicable SaveON SP 7/1/2026 Custom $0 Copay Overreide
00597-0545-22 ADALIMUMAB-ADBM ADALIMUMAB-ADBM Yes (Excluding Quallent) No, saveon in play
00597-0555-80 ADALIMUMAB-ADBM ADALIMUMAB-ADBM Yes (Excluding Quallent) No, saveon in play
00597-0565-20 ADALIMUMAB-ADBM ADALIMUMAB-ADBM Yes (Excluding Quallent) No, saveon in play
00597-0575-50 ADALIMUMAB-ADBM ADALIMUMAB-ADBM Yes (Excluding Quallent) No, saveon in play
00597-0585-89 ADALIMUMAB-ADBM ADALIMUMAB-ADBM Yes (Excluding Quallent) No, saveon in play
00597-0595-20 ADALIMUMAB-ADBM ADALIMUMAB-ADBM Yes (Excluding Quallent) No, saveon in play
55513-0399-01 ADALIMUMAB-ATTO AMJEVITA No No, $0 pt copay card still available
55513-0413-01 ADALIMUMAB-ATTO AMJEVITA No No, $0 pt copay card still available
55513-0479-02 ADALIMUMAB-ATTO AMJEVITA No No, $0 pt copay card still available
55513-0481-01 ADALIMUMAB-ATTO AMJEVITA No No, $0 pt copay card still available
55513-0481-02 ADALIMUMAB-ATTO AMJEVITA No No, $0 pt copay card still available
55513-0482-01 ADALIMUMAB-ATTO AMJEVITA No No, $0 pt copay card still available
55513-0482-02 ADALIMUMAB-ATTO AMJEVITA No No, $0 pt copay card still available
00597-0370-82 ADALIMUMAB-ADBM CYLTEZO No No, $0 pt copay card still available, getting reports it may stop
00597-0400-89 ADALIMUMAB-ADBM CYLTEZO No No, $0 pt copay card still available, getting reports it may stop
00597-0405-80 ADALIMUMAB-ADBM CYLTEZO No No, $0 pt copay card still available, getting reports it may stop
00597-0485-20 ADALIMUMAB-ADBM CYLTEZO No No, $0 pt copay card still available, getting reports it may stop
00597-0495-50 ADALIMUMAB-ADBM CYLTEZO No No, $0 pt copay card still available, getting reports it may stop
00597-0375-97 ADALIMUMAB-ADBM CYLTEZO PEN No No, $0 pt copay card still available, getting reports it may stop
00074-4339-02 ADALIMUMAB HUMIRA PEN Yes No, saveon in play
00074-3799-02 ADALIMUMAB HUMIRA PEN PSRS/UVT Yes No, saveon in play
51759-0274-17 ADALIMUMAB-RYVK SIMLANDI Yes No, saveon in play

669182

NDC Biosim Name “Trade Name” if applicable SaveON SP 7/1/2026 Custom $0 Copay Overreide
51759-0607-32 USTEKINUMAB-AEKN SELARSDI Being Removed 7/1/2026 Still a copay card, if it doesn’t work, place $0 override
83257-0023-41 USTEKINUMAB-KFCE Yesintek Yes No, saveon in play