Displaying 1 - 50 of 104 records found.

Items in this class
Brand Name/Generic Name NDC code Clinical Prior Auth Required PDL Prior Auth Required
ACTONEL 150 MG TABLET
risedronate sodium
00430047801 No Yes
ACTONEL 150 MG TABLET
risedronate sodium
00430047802 No Yes
ACTONEL 30 MG TABLET
risedronate sodium
00430047015 No Yes
ACTONEL 35 MG TABLET
risedronate sodium
00430047203 No Yes
ACTONEL 5 MG TABLET
risedronate sodium
00430047115 No Yes
ALENDRONATE SOD 70 MG/75 ML
alendronate sodium
51224030110 No Yes
ALENDRONATE SODIUM 10 MG TAB
alendronate sodium
16714063101 No No
ALENDRONATE SODIUM 10 MG TAB
alendronate sodium
16714063102 No No
ALENDRONATE SODIUM 10 MG TAB
alendronate sodium
00115167801 No No
ALENDRONATE SODIUM 10 MG TAB
alendronate sodium
00115167808 No No
ALENDRONATE SODIUM 35 MG TAB
alendronate sodium
59746024202 No No
ALENDRONATE SODIUM 35 MG TAB
alendronate sodium
69543013004 No No
ALENDRONATE SODIUM 35 MG TAB
alendronate sodium
69543013012 No No
ALENDRONATE SODIUM 35 MG TAB
alendronate sodium
16252059902 No No
ALENDRONATE SODIUM 35 MG TAB
alendronate sodium
16252059944 No No
ALENDRONATE SODIUM 35 MG TAB
alendronate sodium
16714063201 No No
ALENDRONATE SODIUM 35 MG TAB
alendronate sodium
16714063202 No No
ALENDRONATE SODIUM 35 MG TAB
alendronate sodium
69097022316 No No
ALENDRONATE SODIUM 35 MG TAB
alendronate sodium
00115167926 No No
ALENDRONATE SODIUM 35 MG TAB
alendronate sodium
69097022376 No No
ALENDRONATE SODIUM 35 MG TAB
alendronate sodium
00115167934 No No
ALENDRONATE SODIUM 40 MG TAB
alendronate sodium
00115168008 No No
ALENDRONATE SODIUM 5 MG TABLET
alendronate sodium
00115167601 No No
ALENDRONATE SODIUM 5 MG TABLET
alendronate sodium
00115167608 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
00115168134 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
69543013104 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
69543013112 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
69543013120 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
59746024402 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
65862032904 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
16252060102 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
16252060144 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
16714063301 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
16714063302 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
69097022416 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
69097022476 No No
ALENDRONATE SODIUM 70 MG TAB
alendronate sodium
00115168126 No No
ATELVIA DR 35 MG TABLET
risedronate sodium
00430097903 No Yes
BINOSTO 70 MG TABLET EFF
alendronate sodium
00178010102 No Yes
BONIVA 150 MG TABLET
ibandronate sodium
00004018682 No Yes
BONIVA 150 MG TABLET
ibandronate sodium
00004018683 No Yes
CALCITONIN-SALMON 200 UNITS SP
calcitonin,salmon,synthetic
49884016111 No Yes
CALCITONIN-SALMON 200 UNITS SP
calcitonin,salmon,synthetic
60505082306 No Yes
ETIDRONATE DISODIUM 200 MG TAB
etidronate disodium
00378328691 No Yes
ETIDRONATE DISODIUM 400 MG TAB
etidronate disodium
00378328891 No Yes
EVISTA 60 MG TABLET
raloxifene HCl
00002418402 Yes Yes
EVISTA 60 MG TABLET
raloxifene HCl
00002418407 Yes Yes
EVISTA 60 MG TABLET
raloxifene HCl
00002418430 Yes Yes
FORTEO 600 MCG/2.4 ML PEN INJ
teriparatide
00002840001 No Yes
FOSAMAX 70 MG TABLET
alendronate sodium
00006003144 No Yes