OPHTHALMICS: GLAUCOMA AGENTS
Displaying 1 - 10 of 169 records found.| Brand Name/Generic Name | NDC/Manufacturer | FFS Clinical Prior Auth Required | PDL Prior Auth Required | Programs |
|---|---|---|---|---|
| AZOPT 1% EYE DROPS brinzolamide |
00078072210 NOVARTIS/SANDOZ |
No | No | Medicaid CHIP CSHCN |
| BRIMONIDINE 0.2% EYE DROP brimonidine tartrate |
71921018505 FLORIDA PHARMAC |
No | No | Medicaid CHIP CSHCN |
| BRIMONIDINE 0.2% EYE DROP brimonidine tartrate |
71921018510 FLORIDA PHARMAC |
No | No | Medicaid CHIP CSHCN |
| BRIMONIDINE 0.2% EYE DROP brimonidine tartrate |
71921018515 FLORIDA PHARMAC |
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 |
61314014310 SANDOZ |
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 |
61314014315 SANDOZ |
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 |