OPHTHALMICS: GLAUCOMA AGENTS
Displaying 11 - 20 of 169 records found.| Brand Name/Generic Name | NDC/Manufacturer | FFS Clinical Prior Auth Required | PDL Prior Auth Required | Programs |
|---|---|---|---|---|
| BRIMONIDINE 0.2% EYE DROP brimonidine tartrate |
24208041105 BAUSCH & LOMB I |
No | No | Medicaid CHIP CSHCN |
| BRIMONIDINE 0.2% EYE DROP brimonidine tartrate |
24208041110 BAUSCH & LOMB I |
No | No | Medicaid CHIP CSHCN |
| BRIMONIDINE 0.2% EYE DROP brimonidine tartrate |
24208041115 BAUSCH & LOMB I |
No | No | Medicaid CHIP CSHCN |
| CARTEOLOL HCL 1% EYE DROPS carteolol HCl |
61314023805 SANDOZ |
No | No | Medicaid CHIP CSHCN |
| CARTEOLOL HCL 1% EYE DROPS carteolol HCl |
61314023810 SANDOZ |
No | No | Medicaid CHIP CSHCN |
| CARTEOLOL HCL 1% EYE DROPS carteolol HCl |
61314023815 SANDOZ |
No | No | Medicaid CHIP CSHCN |
| COMBIGAN 0.2%-0.5% EYE DROPS brimonidine tartrate/timolol |
00023921105 ALLERGAN INC. |
No | No | Medicaid CHIP CSHCN |
| COMBIGAN 0.2%-0.5% EYE DROPS brimonidine tartrate/timolol |
00023921110 ALLERGAN INC. |
No | No | Medicaid CHIP CSHCN |
| COMBIGAN 0.2%-0.5% EYE DROPS brimonidine tartrate/timolol |
00023921115 ALLERGAN INC. |
No | No | Medicaid CHIP CSHCN |
| DORZOLAMIDE HCL 2% EYE DROPS dorzolamide HCl |
24208048510 BAUSCH & LOMB I |
No | No | Medicaid CHIP CSHCN |