Displaying 1 - 50 of 260 records found.

Items in this class
Brand Name/Generic Name NDC code Clinical Prior Auth Required PDL Prior Auth Required
AMCINONIDE 0.1% CREAM
amcinonide
00168027860 No Yes
AMCINONIDE 0.1% CREAM
amcinonide
00168027815 No Yes
AMCINONIDE 0.1% CREAM
amcinonide
00168027830 No Yes
AMCINONIDE 0.1% LOTION
amcinonide
00168028060 No Yes
BETAMETHASONE DP 0.05% CRM
betamethasone dipropionate
70710123301 No Yes
BETAMETHASONE DP 0.05% CRM
betamethasone dipropionate
70710123304 No Yes
BETAMETHASONE DP 0.05% CRM
betamethasone dipropionate
00472038015 No Yes
BETAMETHASONE DP 0.05% CRM
betamethasone dipropionate
00168005515 No Yes
BETAMETHASONE DP 0.05% CRM
betamethasone dipropionate
00472038045 No Yes
BETAMETHASONE DP 0.05% CRM
betamethasone dipropionate
00168005546 No Yes
BETAMETHASONE DP 0.05% CRM
betamethasone dipropionate
16714099601 No Yes
BETAMETHASONE DP 0.05% CRM
betamethasone dipropionate
16714099602 No Yes
BETAMETHASONE DP 0.05% CRM
betamethasone dipropionate
51672127401 No Yes
BETAMETHASONE DP 0.05% CRM
betamethasone dipropionate
51672127406 No Yes
BETAMETHASONE DP 0.05% LOT
betamethasone dipropionate
45802002146 No No
BETAMETHASONE DP 0.05% LOT
betamethasone dipropionate
00713080753 No No
BETAMETHASONE DP 0.05% LOT
betamethasone dipropionate
00168005760 No No
BETAMETHASONE DP 0.05% LOT
betamethasone dipropionate
61748047560 No No
BETAMETHASONE DP 0.05% OINT
betamethasone dipropionate
00472038115 No Yes
BETAMETHASONE DP 0.05% OINT
betamethasone dipropionate
00168005615 No Yes
BETAMETHASONE DP 0.05% OINT
betamethasone dipropionate
00472038145 No Yes
BETAMETHASONE DP 0.05% OINT
betamethasone dipropionate
00168005646 No Yes
BETAMETHASONE DP AUG 0.05% CRM
betamethasone/propylene glyc
51672131001 No No
BETAMETHASONE DP AUG 0.05% CRM
betamethasone/propylene glyc
51672131003 No No
BETAMETHASONE DP AUG 0.05% CRM
betamethasone/propylene glyc
45802037632 No No
BETAMETHASONE DP AUG 0.05% CRM
betamethasone/propylene glyc
45802037635 No No
BETAMETHASONE DP AUG 0.05% CRM
betamethasone/propylene glyc
00168026515 No No
BETAMETHASONE DP AUG 0.05% CRM
betamethasone/propylene glyc
00168026550 No No
BETAMETHASONE DP AUG 0.05% CRM
betamethasone/propylene glyc
68462029052 No No
BETAMETHASONE DP AUG 0.05% GEL
betamethasone dipropionate
51672130901 No Yes
BETAMETHASONE DP AUG 0.05% GEL
betamethasone dipropionate
51672130903 No Yes
BETAMETHASONE DP AUG 0.05% LOT
betamethasone/propylene glyc
52565002359 No Yes
BETAMETHASONE DP AUG 0.05% LOT
betamethasone/propylene glyc
51672134003 No Yes
BETAMETHASONE DP AUG 0.05% LOT
betamethasone/propylene glyc
51672134004 No Yes
BETAMETHASONE DP AUG 0.05% LOT
betamethasone/propylene glyc
00168026730 No Yes
BETAMETHASONE DP AUG 0.05% LOT
betamethasone/propylene glyc
00168026760 No Yes
BETAMETHASONE DP AUG 0.05% LOT
betamethasone/propylene glyc
52565002329 No Yes
BETAMETHASONE DP AUG 0.05% OIN
betamethasone/propylene glyc
66993089715 No Yes
BETAMETHASONE DP AUG 0.05% OIN
betamethasone/propylene glyc
66993089749 No Yes
BETAMETHASONE DP AUG 0.05% OIN
betamethasone/propylene glyc
68180094701 No Yes
BETAMETHASONE DP AUG 0.05% OIN
betamethasone/propylene glyc
68180094702 No Yes
BETAMETHASONE DP AUG 0.05% OIN
betamethasone/propylene glyc
00472038215 No Yes
BETAMETHASONE DP AUG 0.05% OIN
betamethasone/propylene glyc
00472038245 No Yes
BETAMETHASONE DP AUG 0.05% OIN
betamethasone/propylene glyc
00168026815 No Yes
BETAMETHASONE DP AUG 0.05% OIN
betamethasone/propylene glyc
00168026850 No Yes
BETAMETHASONE VA 0.1% CREAM
betamethasone valerate
00713032615 No No
BETAMETHASONE VA 0.1% CREAM
betamethasone valerate
00713032637 No No
BETAMETHASONE VA 0.1% CREAM
betamethasone valerate
00472037015 No No
BETAMETHASONE VA 0.1% CREAM
betamethasone valerate
00472037045 No No
BETAMETHASONE VA 0.1% CREAM
betamethasone valerate
00168004015 No No