Displaying 1 - 47 of 47 records found.
Brand Name/Generic Name | NDC code | Clinical Prior Auth Required | PDL Prior Auth Required |
---|---|---|---|
AURYXIA 210 MG TABLET ferric citrate |
59922063101 | Yes | Yes |
CALCIUM ACETATE 667 MG CAPSULE calcium acetate |
69097086283 | Yes | No |
CALCIUM ACETATE 667 MG CAPSULE calcium acetate |
00904666825 | Yes | No |
CALCIUM ACETATE 667 MG CAPSULE calcium acetate |
00054008813 | Yes | No |
CALCIUM ACETATE 667 MG CAPSULE calcium acetate |
00054008826 | Yes | No |
CALCIUM ACETATE 667 MG CAPSULE calcium acetate |
23155053102 | Yes | No |
CALCIUM ACETATE 667 MG CAPSULE calcium acetate |
29033002602 | Yes | No |
CALCIUM ACETATE 667 MG CAPSULE calcium acetate |
76282037702 | Yes | No |
CALCIUM ACETATE 667 MG CAPSULE calcium acetate |
62135019122 | Yes | No |
CALCIUM ACETATE 667 MG CAPSULE calcium acetate |
65162059020 | Yes | No |
CALCIUM ACETATE 667 MG CAPSULE calcium acetate |
68180013415 | Yes | No |
CALCIUM ACETATE 667 MG GELCAP calcium acetate |
00781208102 | Yes | No |
CALCIUM ACETATE 667 MG TABLET calcium acetate |
23155062102 | Yes | No |
CALCIUM ACETATE 667 MG TABLET calcium acetate |
62135019222 | Yes | No |
FOSRENOL 1,000 MG POWDER PACK lanthanum carbonate |
54092025702 | Yes | Yes |
FOSRENOL 1,000 MG TABLET CHEW lanthanum carbonate |
54092025490 | Yes | Yes |
FOSRENOL 500 MG TABLET CHEW lanthanum carbonate |
54092025290 | Yes | Yes |
FOSRENOL 750 MG POWDER PACKET lanthanum carbonate |
54092025602 | Yes | Yes |
FOSRENOL 750 MG TABLET CHEW lanthanum carbonate |
54092025390 | Yes | Yes |
LANTHANUM CARB 1,000 MG TB CHW lanthanum carbonate |
68180082147 | Yes | Yes |
LANTHANUM CARB 1,000 MG TB CHW lanthanum carbonate |
66993042485 | Yes | Yes |
LANTHANUM CARB 500 MG TAB CHEW lanthanum carbonate |
68180081942 | Yes | Yes |
LANTHANUM CARB 500 MG TAB CHEW lanthanum carbonate |
66993042285 | Yes | Yes |
LANTHANUM CARB 750 MG TAB CHEW lanthanum carbonate |
68180082046 | Yes | Yes |
LANTHANUM CARB 750 MG TAB CHEW lanthanum carbonate |
66993042385 | Yes | Yes |
PHOSLYRA 667 MG/5 ML SOLUTION calcium acetate |
49230064331 | Yes | Yes |
RENAGEL 800 MG TABLET sevelamer HCl |
58468002101 | No | No |
RENVELA 2.4 GM POWDER PACKET sevelamer carbonate |
58468013102 | No | Yes |
RENVELA 800 MG TABLET sevelamer carbonate |
58468013001 | No | Yes |
SEVELAMER 0.8 GM POWDER PACKET sevelamer carbonate |
43598047890 | No | Yes |
SEVELAMER 0.8 GM POWDER PACKET sevelamer carbonate |
00955105290 | No | Yes |
SEVELAMER 0.8 GM POWDER PACKET sevelamer carbonate |
65862093090 | No | Yes |
SEVELAMER 2.4 GM POWDER PACKET sevelamer carbonate |
43598047990 | No | Yes |
SEVELAMER 2.4 GM POWDER PACKET sevelamer carbonate |
00955105490 | No | Yes |
SEVELAMER 2.4 GM POWDER PACKET sevelamer carbonate |
65862093190 | No | Yes |
SEVELAMER CARBONATE 800 MG TAB sevelamer carbonate |
69097096793 | No | Yes |
SEVELAMER CARBONATE 800 MG TAB sevelamer carbonate |
00955105027 | No | Yes |
SEVELAMER CARBONATE 800 MG TAB sevelamer carbonate |
55111078911 | No | Yes |
SEVELAMER CARBONATE 800 MG TAB sevelamer carbonate |
55111078927 | No | Yes |
SEVELAMER CARBONATE 800 MG TAB sevelamer carbonate |
24979018646 | No | Yes |
SEVELAMER CARBONATE 800 MG TAB sevelamer carbonate |
76282040727 | No | Yes |
SEVELAMER CARBONATE 800 MG TAB sevelamer carbonate |
65162005827 | No | Yes |
SEVELAMER CARBONATE 800 MG TAB sevelamer carbonate |
65862092127 | No | Yes |
SEVELAMER HCL 400 MG TABLET sevelamer HCl |
68462044626 | No | Yes |
SEVELAMER HCL 800 MG TABLET sevelamer HCl |
68462044718 | No | Yes |
SEVELAMER HCL 800 MG TABLET sevelamer HCl |
00955104818 | No | Yes |
VELPHORO 500 MG CHEWABLE TAB sucroferric oxyhydroxide |
49230064551 | Yes | Yes |