OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS

Brand Name/Generic Name	NDC/Manufacturer	FFS Clinical Prior Auth Required	PDL Prior Auth Required	Programs
CROMOLYN 4% EYE DROPS cromolyn sodium	61314023710 SANDOZ	No	No	Medicaid CHIP CSHCN
EYE ALLERGY ITCH RLF 0.2% DROP olopatadine HCl	70000005301 LEADER	No	No	Medicaid CSHCN
EYE ALLERGY ITCH-RED 0.1% DROP olopatadine HCl	70000005401 LEADER	No	No	Medicaid CSHCN
OLOPATADINE HCL 0.1% EYE DROPS olopatadine HCl	00536130840 RUGBY	No	No	Medicaid CSHCN
OLOPATADINE HCL 0.2% EYE DROP olopatadine HCl	00536130723 RUGBY	No	No	Medicaid CSHCN
OLOPATADINE HCL 0.2% EYE DROP olopatadine HCl	68001053069 BLUEPOINT LABOR	No	No	Medicaid CSHCN
PATADAY ONCE DAILY 0.7% DROPS olopatadine HCl	00065081604 ALCON LABORATOR	No	No	Medicaid CSHCN
ALOCRIL 2% EYE DROPS nedocromil sodium	00023884205 ALLERGAN INC.	No	Yes	Medicaid CHIP CSHCN
ALREX 0.2% EYE DROPS loteprednol etabonate	24208035305 BAUSCH & LOMB I	No	Yes	Medicaid CHIP CSHCN
ALREX 0.2% EYE DROPS loteprednol etabonate	24208035310 BAUSCH & LOMB I	No	Yes	Medicaid CHIP CSHCN