Displaying 201 - 250 of 1011 records found.

Items in this class
Brand Name/Generic Name NDC code Clinical Prior Auth Required PDL Prior Auth Required
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
65862084501 Yes No
CLOZAPINE 50 MG TABLET
clozapine
57664024188 Yes No
CLOZAPINE ODT 100 MG TABLET
clozapine
00093541901 Yes Yes
CLOZAPINE ODT 100 MG TABLET
clozapine
00093541984 Yes Yes
CLOZAPINE ODT 100 MG TABLET
clozapine
51079028804 Yes Yes
CLOZAPINE ODT 100 MG TABLET
clozapine
00093301001 Yes Yes
CLOZAPINE ODT 100 MG TABLET
clozapine
00093301084 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
CLOZAPINE ODT 25 MG TABLET
clozapine
00093301201 Yes Yes
CLOZAPINE ODT 25 MG TABLET
clozapine
00093301284 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
FAZACLO 100 MG ODT
clozapine
18860010410 Yes Yes
FAZACLO 12.5 MG ODT
clozapine
18860010110 Yes Yes
FAZACLO 150 MG ODT
clozapine
18860010501 Yes Yes
FAZACLO 150 MG ODT
clozapine
18860010510 Yes Yes
FAZACLO 200 MG ODT
clozapine
18860010601 Yes Yes
FAZACLO 200 MG ODT
clozapine
18860010610 Yes Yes
FAZACLO 25 MG ODT
clozapine
18860010201 Yes Yes
FAZACLO 25 MG ODT
clozapine
18860010210 Yes Yes
FLUPHENAZINE 1 MG TABLET
fluphenazine HCl
00378600401 Yes No
FLUPHENAZINE 1 MG TABLET
fluphenazine HCl
00378600405 Yes No
FLUPHENAZINE 1 MG TABLET
fluphenazine HCl
00527178801 Yes No
FLUPHENAZINE 10 MG TABLET
fluphenazine HCl
00527179105 Yes No
FLUPHENAZINE 10 MG TABLET
fluphenazine HCl
00378609701 Yes No
FLUPHENAZINE 10 MG TABLET
fluphenazine HCl
00378609705 Yes No
FLUPHENAZINE 10 MG TABLET
fluphenazine HCl
51079048820 Yes No
FLUPHENAZINE 10 MG TABLET
fluphenazine HCl
00527179101 Yes No
FLUPHENAZINE 2.5 MG TABLET
fluphenazine HCl
00378600901 Yes No
FLUPHENAZINE 2.5 MG TABLET
fluphenazine HCl
00378600905 Yes No
FLUPHENAZINE 2.5 MG TABLET
fluphenazine HCl
00527178901 Yes No
FLUPHENAZINE 2.5 MG TABLET
fluphenazine HCl
51079048620 Yes No