Displaying 1 - 50 of 159 records found.

Items in this class
Brand Name/Generic Name NDC code Clinical Prior Auth Required PDL Prior Auth Required
ANCOBON 250 MG CAPSULE
flucytosine
00187355410 No Yes
ANCOBON 500 MG CAPSULE
flucytosine
00187355510 No Yes
CLOTRIMAZOLE 10 MG TROCHE
clotrimazole
00054414622 No No
CLOTRIMAZOLE 10 MG TROCHE
clotrimazole
00054414623 No No
CLOTRIMAZOLE 10 MG TROCHE
clotrimazole
00574010714 No No
CLOTRIMAZOLE 10 MG TROCHE
clotrimazole
00574010770 No No
CLOTRIMAZOLE 10 MG TROCHE
clotrimazole
00054814622 No No
CRESEMBA 186 MG CAPSULE
isavuconazonium sulfate
00469052014 No Yes
DIFLUCAN 10 MG/ML SUSPENSION
fluconazole
00049344019 No Yes
DIFLUCAN 100 MG TABLET
fluconazole
00049342030 No Yes
DIFLUCAN 150 MG TABLET
fluconazole
00049350079 No Yes
DIFLUCAN 200 MG TABLET
fluconazole
00049343030 No Yes
DIFLUCAN 40 MG/ML SUSPENSION
fluconazole
00049345019 No Yes
DIFLUCAN 50 MG TABLET
fluconazole
00049341030 No Yes
FLUCONAZOLE 10 MG/ML SUSP
fluconazole
57237014935 No No
FLUCONAZOLE 10 MG/ML SUSP
fluconazole
59762502901 No No
FLUCONAZOLE 10 MG/ML SUSP
fluconazole
00054000285 No No
FLUCONAZOLE 10 MG/ML SUSP
fluconazole
16714069501 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
70710113803 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
68001025204 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
59762501601 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
68462010230 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
16714069101 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
16714069102 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
00172541146 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
00172541160 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
55111014401 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
55111014430 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
00904650061 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
67405060203 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
70710113801 No No
FLUCONAZOLE 100 MG TABLET
fluconazole
57237000430 No No
FLUCONAZOLE 150 MG TABLET
fluconazole
57237000511 No No
FLUCONAZOLE 150 MG TABLET
fluconazole
70710113908 No No
FLUCONAZOLE 150 MG TABLET
fluconazole
68001025320 No No
FLUCONAZOLE 150 MG TABLET
fluconazole
59762501701 No No
FLUCONAZOLE 150 MG TABLET
fluconazole
68462010340 No No
FLUCONAZOLE 150 MG TABLET
fluconazole
16714069210 No No
FLUCONAZOLE 150 MG TABLET
fluconazole
16714069211 No No
FLUCONAZOLE 150 MG TABLET
fluconazole
00172541211 No No
FLUCONAZOLE 150 MG TABLET
fluconazole
55111014512 No No
FLUCONAZOLE 150 MG TABLET
fluconazole
67405060301 No No
FLUCONAZOLE 200 MG TABLET
fluconazole
67405060403 No No
FLUCONAZOLE 200 MG TABLET
fluconazole
57237000630 No No
FLUCONAZOLE 200 MG TABLET
fluconazole
70710114001 No No
FLUCONAZOLE 200 MG TABLET
fluconazole
70710114003 No No
FLUCONAZOLE 200 MG TABLET
fluconazole
68001025404 No No
FLUCONAZOLE 200 MG TABLET
fluconazole
59762501801 No No
FLUCONAZOLE 200 MG TABLET
fluconazole
68462010430 No No
FLUCONAZOLE 200 MG TABLET
fluconazole
16714069301 No No