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Clinician-Administered Drugs
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Prior Authorization
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By NDC code:
Brand Name
Generic Name
PDL Class
- Any -
ACNE AGENTS: ORAL
ACNE AGENTS: TOPICAL
ALZHEIMER'S AGENTS
ANALGESICS: NARCOTICS LONG
ANALGESICS: NARCOTICS SHORT
ANDROGENIC AGENTS
ANGIOTENSIN MODULATOR COMBINATIONS
ANGIOTENSIN MODULATORS
ANTI-ALLERGENS: ORAL
ANTIBIOTICS: GI
ANTIBIOTICS: INHALED
ANTIBIOTICS: TOPICAL
ANTIBIOTICS: VAGINAL
ANTICOAGULANTS
ANTIDEPRESSANTS: OTHER
ANTIDEPRESSANTS: SSRIs
ANTIEMETIC/ANTIVERTIGO AGENTS
ANTIFUNGALS: ORAL
ANTIFUNGALS: TOPICAL
ANTIHISTAMINES: MINIMALLY SEDATING
ANTIHYPERTENSIVES: SYMPATHOLYTICS
ANTIHYPERURICEMICS
ANTIMIGRAINE AGENTS: OTHER
ANTIMIGRAINE AGENTS: TRIPTANS
ANTIPARASITICS: TOPICAL
ANTIPARKINSON'S AGENTS
ANTIPSYCHOTICS
ANTIVIRALS: ORAL
ANTIVIRALS: TOPICAL
BETA-BLOCKERS
BILE SALTS
BLADDER RELAXANT PREPARATIONS
BONE RESORPTION SUPPRESSION AND RELATED AGENTS
BPH TREATMENTS
BRONCHODILATORS: BETA AGONIST
CALCIUM CHANNEL BLOCKERS
CEPHALOSPORINS AND RELATED ANTIBIOTICS
COLONY STIMULATING FACTORS
COPD AGENTS
COUGH AND COLD: COLD
COUGH AND COLD: NARCOTIC
COUGH AND COLD: NON-NARCOTIC
CYTOKINE AND CAM ANTAGONISTS
EPINEPHRINE: SELF-INJECTED
ERYTHROPOIESIS STIMULATING PROTEINS
FLUOROQUINOLONES: ORAL
GI MOTILITY: CHRONIC
GLUCOCORTICOIDS: INHALED
GLUCOCORTICOIDS: ORAL
GROWTH HORMONE
H. PYLORI TREATMENT
HAE TREATMENTS
HEPATITIS C AGENTS
HYPOGLYCEMICS: INCRETIN MIMETICS/ENHANCERS
HYPOGLYCEMICS: INSULIN AND RELATED AGENTS
HYPOGLYCEMICS: MEGLITINIDES
HYPOGLYCEMICS: SGLT2
HYPOGLYCEMICS: TZD
IMMUNE GLOBULINS
IMMUNOMODULATORS: ATOPIC DERMATITIS
IMMUNOSUPPRESSIVES: ORAL
INTRANASAL RHINITIS AGENTS
IRON: ORAL
LEUKOTRIENE MODIFIERS
LINCOSAMIDES/OXAZOLIDINONES/STREPTOGRAMINS
LIPOTROPICS: OTHER
LIPOTROPICS: STATINS
MACROLIDES/KETOLIDES
NEUROPATHIC PAIN
NOT ASSIGNED
NSAIDS
OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS
OPHTHALMIC ANTIBIOTICS
OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS
OPHTHALMICS: ANTI-INFLAMMATORIES
OPHTHALMICS: GLAUCOMA AGENTS
OPIATE DEPENDENCE TREATMENTS
OTIC ANTI-INFECTIVES & ANESTHETICS
OTIC ANTIBIOTICS
PAH AGENTS: ORAL AND INHALED
PANCREATIC ENZYMES
PEDIATRIC VITAMIN PREPARATIONS
PENICILLINS
PHOSPHATE BINDERS
PLATELET AGGREGATION INHIBITORS
PRENATAL VITAMINS
PROGESTINS FOR CACHEXIA
PROTON PUMP INHIBITORS
SEDATIVE HYPNOTICS
SKELETAL MUSCLE RELAXANTS
SMOKING CESSATION
STEROIDS: TOPICAL HIGH
STEROIDS: TOPICAL LOW
STEROIDS: TOPICAL MEDIUM
STEROIDS: TOPICAL VERY HIGH
STIMULANTS AND RELATED AGENTS
TETRACYCLINES
ULCERATIVE COLITIS AGENTS
Manufacturer
Medicaid
CHIP
CSHCN
HTW
HTWPlus
KHC
PDL PA Required
Clinical PA Required
90% Utilization
Family Planning
Injectable
LARC
OTC
Product Search
NDC
Brand Name
Generic Name
HCPCS Description
- Any -
Aerosol Holding Chamber
Diabetic Lancets
Diabetic Monitor & Test Strips
Diabetic Monitor (talking)
Diabetic Test Strips
Hypertonic Saline
Insulin Needles
Insulin Syringes
Oral Electrolyte
Spring Powered Device for Lancet
Vitamin and Mineral
Manufacturer
Medicaid
CHIP
CSHCN
KHC
Diabetic Supply
Flu vaccine
Mosquito repellent
The above data is available for
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Other Resources
Epocrates
Enhanced Texas Medicaid Drug and Clinical Prior Authorization Search
