HIV / AIDS | Vendor Drug Program

Brand Name/Generic Name	NDC/Manufacturer	FFS Clinical Prior Auth Required	PDL Prior Auth Required	Programs
ABACAVIR 20 MG/ML SOLUTION abacavir sulfate	31722056224 CAMBER PHARMACE	No	No	Medicaid CHIP CSHCN
ABACAVIR 20 MG/ML SOLUTION abacavir sulfate	64980040524 RISING PHARM	No	No	Medicaid CHIP CSHCN
ABACAVIR 300 MG TABLET abacavir sulfate	51079020406 MYLAN INSTITUTI	No	No	Medicaid CHIP CSHCN
ABACAVIR 300 MG TABLET abacavir sulfate	69097051403 CIPLA USA, INC.	No	No	Medicaid CHIP CSHCN
ABACAVIR 300 MG TABLET abacavir sulfate	00378410591 MYLAN	No	No	Medicaid CHIP CSHCN
ABACAVIR 300 MG TABLET abacavir sulfate	64380071703 STRIDES PHARMA	No	No	Medicaid CHIP CSHCN
ABACAVIR 300 MG TABLET abacavir sulfate	65862007360 AUROBINDO PHARM	No	No	Medicaid CHIP CSHCN
ABACAVIR 300 MG TABLET abacavir sulfate	31722055760 CAMBER PHARMACE	No	No	Medicaid CHIP CSHCN
ABACAVIR-LAMIVUDINE 600-300 MG abacavir sulfate/lamivudine	68180028806 LUPIN PHARMACEU	No	No	Medicaid CHIP CSHCN
ABACAVIR-LAMIVUDINE 600-300 MG abacavir sulfate/lamivudine	65862033530 AUROBINDO PHARM	No	No	Medicaid CHIP CSHCN