Displaying 51 - 66 of 66 records found.

Items in this class
Brand Name/Generic Name NDC code Clinical Prior Auth Required PDL Prior Auth Required
VITAFOL NANO TABLET
prenatal no.75/iron/folate no1
00642009430 No No
VITAFOL ULTRA SOFTGEL
PNV 67/iron ps/folate no.1/dha
00642009330 No No
VITAFOL-OB CAPLET
prenatal vit 10/iron fum/folic
00642007912 No Yes
VITAFOL-OB+DHA COMBO PACK
prenatal vit 10/iron/folic/dha
00642007630 No No
VITAFOL-ONE CAPSULE
prenatal 26/iron ps/folic/dha
00642007030 No No
VOL-NATE TABLET
multivit-mins no.64/iron/folic
13811051410 No Yes
VOL-PLUS TABLET
multivit-mins60/iron fum/folic
13811051910 No No
VOL-PLUS TABLET
multivit-mins60/iron fum/folic
13811051950 No No
VOL-TAB RX TABLET
mv-mins no.50/iron,carb/folic
13811051690 No Yes
VP-CH-PNV PRENATAL SOFTGEL
prenatal 34/iron/folic/dss/dha
69543022430 No Yes
VP-GGR-B6 TABLET
PNV/folic ac/B6/calcium/ginger
76439023360 No Yes
VP-HEME OB TABLET
PNV 21/iron ps,heme ppep/folic
69543023790 No Yes
VP-HEME ONE SOFTGEL
PNV 19/iron ps,heme/folic/dha
69543024030 No Yes
VP-PNV-DHA SOFTGEL
prenatal no.52/iron/FA/dha
69543022330 No Yes
ZATEAN-PN DHA CAPSULE
prenatal 47/iron/folate 1/dha
13811058030 No Yes
ZATEAN-PN PLUS SOFTGEL
prenatal 68/iron/folic no1/dha
13811058230 No Yes