ANTICONVULSANTS
Displaying 11 - 20 of 1059 records found.| Brand Name/Generic Name | NDC/Manufacturer | FFS Clinical Prior Auth Required | PDL Prior Auth Required | Programs |
|---|---|---|---|---|
| BRIVIACT 100 MG TABLET brivaracetam |
50474077066 UCB PHARMA |
No | No | Medicaid CHIP CSHCN |
| BRIVIACT 25 MG TABLET brivaracetam |
50474047009 UCB PHARMA |
No | No | Medicaid CHIP CSHCN |
| BRIVIACT 25 MG TABLET brivaracetam |
50474047066 UCB PHARMA |
No | No | Medicaid CHIP CSHCN |
| BRIVIACT 50 MG TABLET brivaracetam |
50474057009 UCB PHARMA |
No | No | Medicaid CHIP CSHCN |
| BRIVIACT 50 MG TABLET brivaracetam |
50474057066 UCB PHARMA |
No | No | Medicaid CHIP CSHCN |
| BRIVIACT 75 MG TABLET brivaracetam |
50474067066 UCB PHARMA |
No | No | Medicaid CHIP CSHCN |
| CARBAMAZEPINE 100 MG TAB CHEW carbamazepine |
13668027101 TORRENT PHARMAC |
No | No | Medicaid CHIP CSHCN |
| CARBAMAZEPINE 100 MG TAB CHEW carbamazepine |
13668027105 TORRENT PHARMAC |
No | No | Medicaid CHIP CSHCN |
| CARBAMAZEPINE 100 MG TAB CHEW carbamazepine |
51672404101 TARO PHARM USA |
No | No | Medicaid CHIP CSHCN KHC |
| CARBAMAZEPINE 100 MG TAB CHEW carbamazepine |
51672404102 TARO PHARM USA |
No | No | Medicaid CHIP CSHCN KHC |