Displaying 1 - 50 of 273 records found.

Items in this class
Brand Name/Generic Name NDC code Clinical Prior Auth Required PDL Prior Auth Required
AMOX-CLAV 200-28.5 MG TAB CHEW
amoxicillin/potassium clav
00093227034 No Yes
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
00143998101 No No
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
00143998150 No No
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
00143998175 No No
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
65862053301 No No
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
65862053350 No No
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
65862053375 No No
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
00781610246 No No
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
00093227773 No No
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
16714029201 No No
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
16714029202 No No
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
16714029203 No No
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
66685101100 No No
AMOX-CLAV 200-28.5 MG/5 ML SUS
amoxicillin/potassium clav
66685101101 No No
AMOX-CLAV 250-125 MG TABLET
amoxicillin/potassium clav
65862050130 No No
AMOX-CLAV 250-125 MG TABLET
amoxicillin/potassium clav
00781187431 No No
AMOX-CLAV 250-125 MG TABLET
amoxicillin/potassium clav
42571016030 No No
AMOX-CLAV 250-125 MG TABLET
amoxicillin/potassium clav
16714047601 No No
AMOX-CLAV 250-62.5 MG/5 ML SUS
amoxicillin/potassium clav
59651002601 No No
AMOX-CLAV 250-62.5 MG/5 ML SUS
amoxicillin/potassium clav
59651002655 No No
AMOX-CLAV 250-62.5 MG/5 ML SUS
amoxicillin/potassium clav
59651002675 No No
AMOX-CLAV 250-62.5 MG/5 ML SUS
amoxicillin/potassium clav
60432006500 No No
AMOX-CLAV 250-62.5 MG/5 ML SUS
amoxicillin/potassium clav
60432006547 No No
AMOX-CLAV 250-62.5 MG/5 ML SUS
amoxicillin/potassium clav
60432006575 No No
AMOX-CLAV 250-62.5 MG/5 ML SUS
amoxicillin/potassium clav
72508020407 No No
AMOX-CLAV 250-62.5 MG/5 ML SUS
amoxicillin/potassium clav
72508020410 No No
AMOX-CLAV 250-62.5 MG/5 ML SUS
amoxicillin/potassium clav
72508020415 No No
AMOX-CLAV 400-57 MG TAB CHEW
amoxicillin/potassium clav
00093227234 No Yes
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
00143998201 No No
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
00143998250 No No
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
00143998275 No No
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
65862053401 No No
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
65862053450 No No
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
65862053475 No No
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
00781610446 No No
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
00093227973 No No
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
16714029301 No No
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
16714029302 No No
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
16714029303 No No
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
66685101200 No No
AMOX-CLAV 400-57 MG/5 ML SUSP
amoxicillin/potassium clav
66685101201 No No
AMOX-CLAV 500-125 MG TABLET
amoxicillin/potassium clav
16714049401 No No
AMOX-CLAV 500-125 MG TABLET
amoxicillin/potassium clav
65862050220 No No
AMOX-CLAV 500-125 MG TABLET
amoxicillin/potassium clav
00093227434 No No
AMOX-CLAV 500-125 MG TABLET
amoxicillin/potassium clav
42571016101 No No
AMOX-CLAV 500-125 MG TABLET
amoxicillin/potassium clav
42571016142 No No
AMOX-CLAV 500-125 MG TABLET
amoxicillin/potassium clav
66685100200 No No
AMOX-CLAV 500-125 MG TABLET
amoxicillin/potassium clav
66685100202 No No
AMOX-CLAV 600-42.9 MG/5 ML SUS
amoxicillin/potassium clav
65862053502 No No
AMOX-CLAV 600-42.9 MG/5 ML SUS
amoxicillin/potassium clav
65862053513 No No