OPHTHALMICS: GLAUCOMA AGENTS

Displaying 1 - 10 of 171 records found.

Brand Name/Generic Name	NDC/Manufacturer	FFS Clinical Prior Auth Required	PDL Prior Auth Required	Programs
AZOPT 1% EYE DROPS brinzolamide	00065027515 ALCON/NOVARTIS	No	No	Medicaid CHIP CSHCN
AZOPT 1% EYE DROPS brinzolamide	00078072210 NOVARTIS	No	No	Medicaid CHIP CSHCN
BRIMONIDINE 0.2% EYE DROP brimonidine tartrate	17478071510 AKORN INC.	No	No	Medicaid CHIP CSHCN
BRIMONIDINE 0.2% EYE DROP brimonidine tartrate	70069023101 SOMERSET THERAP	No	No	Medicaid CHIP CSHCN
BRIMONIDINE 0.2% EYE DROP brimonidine tartrate	70069023201 SOMERSET THERAP	No	No	Medicaid CHIP CSHCN
BRIMONIDINE 0.2% EYE DROP brimonidine tartrate	70069023301 SOMERSET THERAP	No	No	Medicaid CHIP CSHCN
BRIMONIDINE 0.2% EYE DROP brimonidine tartrate	61314014305 SANDOZ	No	No	Medicaid CHIP CSHCN
BRIMONIDINE 0.2% EYE DROP brimonidine tartrate	24208041105 BAUSCH & LOMB I	No	No	Medicaid CHIP CSHCN
BRIMONIDINE 0.2% EYE DROP brimonidine tartrate	61314014310 SANDOZ	No	No	Medicaid CHIP CSHCN
BRIMONIDINE 0.2% EYE DROP brimonidine tartrate	24208041110 BAUSCH & LOMB I	No	No	Medicaid CHIP CSHCN