NEUROPATHIC PAIN | Vendor Drug Program

Brand Name/Generic Name	NDC/Manufacturer	FFS Clinical Prior Auth Required	PDL Prior Auth Required	Programs
CAPSAICIN 0.025% CREAM capsaicin	00536252525 RUGBY	No	No	Medicaid CSHCN
DULOXETINE HCL DR 20 MG CAP duloxetine HCl	68180029407 LUPIN PHARMACEU	No	No	Medicaid CHIP CSHCN
DULOXETINE HCL DR 20 MG CAP duloxetine HCl	57237001760 RISING PHARM	No	No	Medicaid CHIP CSHCN
DULOXETINE HCL DR 20 MG CAP duloxetine HCl	47335038188 SUN PHARMA GLOB	No	No	Medicaid CHIP CSHCN
DULOXETINE HCL DR 20 MG CAP duloxetine HCl	51991074605 BRECKENRIDGE	No	No	Medicaid CHIP CSHCN
DULOXETINE HCL DR 20 MG CAP duloxetine HCl	51991074690 BRECKENRIDGE	No	No	Medicaid CHIP CSHCN
DULOXETINE HCL DR 20 MG CAP duloxetine HCl	31722058160 CAMBER PHARMACE	No	No	Medicaid CHIP CSHCN
DULOXETINE HCL DR 20 MG CAP duloxetine HCl	27241009706 AJANTA PHARMA L	No	No	Medicaid CHIP CSHCN
DULOXETINE HCL DR 20 MG CAP duloxetine HCl	82009002905 QUALLENT PHARMA	No	No	Medicaid CHIP CSHCN
DULOXETINE HCL DR 20 MG CAP duloxetine HCl	50268026915 AVPAK	No	No	Medicaid CHIP CSHCN