Displaying 1 - 50 of 78 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 35 MG TABLET risedronate sodium |
00430047203 | No | Yes |
ALENDRONATE SOD 70 MG/75 ML alendronate sodium |
51224030110 | No | Yes |
ALENDRONATE SODIUM 10 MG TAB alendronate sodium |
00115167808 | No | No |
ALENDRONATE SODIUM 10 MG TAB alendronate sodium |
64980034001 | No | No |
ALENDRONATE SODIUM 10 MG TAB alendronate sodium |
64980034003 | No | No |
ALENDRONATE SODIUM 10 MG TAB alendronate sodium |
16714063101 | No | No |
ALENDRONATE SODIUM 10 MG TAB alendronate sodium |
16714063102 | 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 |
69097022376 | 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 |
64980034114 | No | No |
ALENDRONATE SODIUM 35 MG TAB alendronate sodium |
65862032804 | No | No |
ALENDRONATE SODIUM 40 MG TAB alendronate sodium |
00115168008 | 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 |
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 |
64980034214 | No | No |
ALENDRONATE SODIUM 70 MG TAB alendronate sodium |
65862032904 | 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 |
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 |
EVISTA 60 MG TABLET raloxifene HCl |
00002418402 | 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 |
FOSAMAX PLUS D 70 MG-2,800 IU alendronate sodium/vitamin D3 |
00006071044 | No | Yes |
FOSAMAX PLUS D 70 MG-5,600 IU alendronate sodium/vitamin D3 |
00006027044 | No | Yes |
IBANDRONATE SODIUM 150 MG TAB ibandronate sodium |
47781010333 | No | Yes |
IBANDRONATE SODIUM 150 MG TAB ibandronate sodium |
55111057503 | No | Yes |
IBANDRONATE SODIUM 150 MG TAB ibandronate sodium |
55111057511 | No | Yes |
IBANDRONATE SODIUM 150 MG TAB ibandronate sodium |
60505279500 | No | Yes |
IBANDRONATE SODIUM 150 MG TAB ibandronate sodium |
65862023703 | No | Yes |
IBANDRONATE SODIUM 150 MG TAB ibandronate sodium |
47781010307 | No | Yes |
RALOXIFENE HCL 60 MG TABLET raloxifene HCl |
66993066188 | Yes | Yes |
RALOXIFENE HCL 60 MG TABLET raloxifene HCl |
00093729001 | Yes | Yes |
RALOXIFENE HCL 60 MG TABLET raloxifene HCl |
00093729056 | Yes | Yes |
RALOXIFENE HCL 60 MG TABLET raloxifene HCl |
69097082502 | Yes | Yes |
RALOXIFENE HCL 60 MG TABLET raloxifene HCl |
69097082507 | Yes | Yes |
RALOXIFENE HCL 60 MG TABLET raloxifene HCl |
69097082515 | Yes | Yes |