Displaying 1 - 50 of 104 records found.
| 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 |