Displaying 201 - 250 of 1026 records found.

Items in this class
Brand Name/Generic Name NDC code Clinical Prior Auth Required PDL Prior Auth Required
CLOZAPINE 100 MG TABLET
clozapine
00378086001 Yes No
CLOZAPINE 100 MG TABLET
clozapine
00378086005 Yes No
CLOZAPINE 200 MG TABLET
clozapine
00378097301 Yes No
CLOZAPINE 200 MG TABLET
clozapine
65862084701 Yes No
CLOZAPINE 200 MG TABLET
clozapine
51079074920 Yes No
CLOZAPINE 200 MG TABLET
clozapine
00093440505 Yes No
CLOZAPINE 200 MG TABLET
clozapine
00093440593 Yes No
CLOZAPINE 200 MG TABLET
clozapine
51862027401 Yes No
CLOZAPINE 200 MG TABLET
clozapine
51862027405 Yes No
CLOZAPINE 25 MG TABLET
clozapine
00093435901 Yes No
CLOZAPINE 25 MG TABLET
clozapine
00781598901 Yes No
CLOZAPINE 25 MG TABLET
clozapine
00093435905 Yes No
CLOZAPINE 25 MG TABLET
clozapine
00093435993 Yes No
CLOZAPINE 25 MG TABLET
clozapine
57664034588 Yes No
CLOZAPINE 25 MG TABLET
clozapine
51079092120 Yes No
CLOZAPINE 25 MG TABLET
clozapine
51862027101 Yes No
CLOZAPINE 25 MG TABLET
clozapine
51862027105 Yes No
CLOZAPINE 25 MG TABLET
clozapine
16729014101 Yes No
CLOZAPINE 25 MG TABLET
clozapine
16729014116 Yes No
CLOZAPINE 25 MG TABLET
clozapine
00378082501 Yes No
CLOZAPINE 25 MG TABLET
clozapine
65862084401 Yes No
CLOZAPINE 50 MG TABLET
clozapine
57664024188 Yes No
CLOZAPINE 50 MG TABLET
clozapine
00093440401 Yes No
CLOZAPINE 50 MG TABLET
clozapine
00093440405 Yes No
CLOZAPINE 50 MG TABLET
clozapine
51862027201 Yes No
CLOZAPINE 50 MG TABLET
clozapine
51862027205 Yes No
CLOZAPINE 50 MG TABLET
clozapine
00378097201 Yes No
CLOZAPINE 50 MG TABLET
clozapine
65862084501 Yes No
CLOZAPINE ODT 100 MG TABLET
clozapine
51079028804 Yes Yes
CLOZAPINE ODT 100 MG TABLET
clozapine
00093541901 Yes Yes
CLOZAPINE ODT 100 MG TABLET
clozapine
00093541984 Yes Yes
CLOZAPINE ODT 12.5 MG TABLET
clozapine
00093541601 Yes Yes
CLOZAPINE ODT 12.5 MG TABLET
clozapine
00093301101 Yes Yes
CLOZAPINE ODT 150 MG TABLET
clozapine
00093308601 Yes Yes
CLOZAPINE ODT 150 MG TABLET
clozapine
00093308684 Yes Yes
CLOZAPINE ODT 200 MG TABLET
clozapine
00093308701 Yes Yes
CLOZAPINE ODT 200 MG TABLET
clozapine
00093308784 Yes Yes
CLOZAPINE ODT 25 MG TABLET
clozapine
00093541701 Yes Yes
CLOZAPINE ODT 25 MG TABLET
clozapine
00093541784 Yes Yes
CLOZARIL 100 MG TABLET
clozapine
69809012705 Yes Yes
CLOZARIL 25 MG TABLET
clozapine
69809012605 Yes Yes
FANAPT 1 MG TABLET
iloperidone
43068010102 Yes Yes
FANAPT 10 MG TABLET
iloperidone
43068011002 Yes Yes
FANAPT 12 MG TABLET
iloperidone
43068011202 Yes Yes
FANAPT 2 MG TABLET
iloperidone
43068010202 Yes Yes
FANAPT 4 MG TABLET
iloperidone
43068010402 Yes Yes
FANAPT 6 MG TABLET
iloperidone
43068010602 Yes Yes
FANAPT 8 MG TABLET
iloperidone
43068010802 Yes Yes
FANAPT TITRATION PACK
iloperidone
43068011304 Yes Yes
FAZACLO 100 MG ODT
clozapine
18860010401 Yes Yes