BRONCHODILATORS: BETA AGONIST
Displaying 1 - 10 of 89 records found.| Brand Name/Generic Name | NDC/Manufacturer | FFS Clinical Prior Auth Required | PDL Prior Auth Required | Programs |
|---|---|---|---|---|
| ALBUTEROL 2.5 MG/0.5 ML SOL albuterol sulfate |
00487990130 NEPHRON CORP |
Yes | No | Medicaid CHIP CSHCN HTWPlus |
| ALBUTEROL SUL 0.63 MG/3 ML SOL albuterol sulfate |
00487030101 NEPHRON CORP |
Yes | No | Medicaid CHIP CSHCN HTWPlus |
| ALBUTEROL SUL 0.63 MG/3 ML SOL albuterol sulfate |
76204001055 RITEDOSE PHARMA |
Yes | No | Medicaid CHIP CSHCN |
| ALBUTEROL SUL 0.63 MG/3 ML SOL albuterol sulfate |
00378705752 MYLAN |
Yes | No | Medicaid CHIP CSHCN |
| ALBUTEROL SUL 0.63 MG/3 ML SOL albuterol sulfate |
00591346753 ACTAVIS/TEVA |
Yes | No | Medicaid CHIP CSHCN HTWPlus |
| ALBUTEROL SUL 1.25 MG/3 ML SOL albuterol sulfate |
00378705852 MYLAN |
Yes | No | Medicaid CHIP CSHCN |
| ALBUTEROL SUL 1.25 MG/3 ML SOL albuterol sulfate |
00591346853 ACTAVIS/TEVA |
Yes | No | Medicaid CHIP CSHCN HTWPlus |
| ALBUTEROL SUL 1.25 MG/3 ML SOL albuterol sulfate |
76204001155 RITEDOSE PHARMA |
Yes | No | Medicaid CHIP CSHCN |
| ALBUTEROL SUL 1.25 MG/3 ML SOL albuterol sulfate |
00487990401 NEPHRON CORP |
Yes | No | Medicaid CHIP CSHCN HTWPlus |
| ALBUTEROL SUL 1.25 MG/3 ML SOL albuterol sulfate |
00487990425 NEPHRON CORP |
Yes | No | Medicaid CHIP CSHCN HTWPlus |