Search Results: Formulary Drugs

Displaying 1 - 25 of 7584 records found. Return to search page.
Brand Name/Generic Name/Package Size NDC/Manufacturer PDL Class FFS Clinical Prior Auth Required PDL Prior Auth Required Programs
24HR ALLERGY(LEVOCETIRZN) 5 MG
levocetirizine dihydrochloride
10 EA
70000036201
LEADER
ANTIHISTAMINES: MINIMALLY SEDATING Yes Yes Medicaid CSHCN
24HR ALLERGY(LEVOCETIRZN) 5 MG
levocetirizine dihydrochloride
35 EA
70000036202
LEADER
ANTIHISTAMINES: MINIMALLY SEDATING Yes Yes Medicaid CSHCN
ABILIFY 10 MG TABLET
aripiprazole
30 EA
59148000813
OTSUKA AMERICA
ANTIPSYCHOTICS Yes Yes Medicaid CHIP CSHCN
ABILIFY 15 MG TABLET
aripiprazole
30 EA
59148000913
OTSUKA AMERICA
ANTIPSYCHOTICS Yes Yes Medicaid CHIP CSHCN
ABILIFY 2 MG TABLET
aripiprazole
30 EA
59148000613
OTSUKA AMERICA
ANTIPSYCHOTICS Yes Yes Medicaid CHIP CSHCN
ABILIFY 20 MG TABLET
aripiprazole
30 EA
59148001013
OTSUKA AMERICA
ANTIPSYCHOTICS Yes Yes Medicaid CHIP CSHCN
ABILIFY 30 MG TABLET
aripiprazole
30 EA
59148001113
OTSUKA AMERICA
ANTIPSYCHOTICS Yes Yes Medicaid CHIP CSHCN
ABILIFY 5 MG TABLET
aripiprazole
30 EA
59148000713
OTSUKA AMERICA
ANTIPSYCHOTICS Yes Yes Medicaid CHIP CSHCN
ABILIFY MAINTENA ER 300 MG SYR
aripiprazole
1 EA
59148004580
OTSUKA AMERICA
ANTIPSYCHOTICS Yes No Medicaid CHIP CSHCN
ABILIFY MAINTENA ER 300 MG VL
aripiprazole
1 EA
59148001871
OTSUKA AMERICA
ANTIPSYCHOTICS Yes No Medicaid CHIP CSHCN
ABILIFY MAINTENA ER 400 MG SYR
aripiprazole
1 EA
59148007280
OTSUKA AMERICA
ANTIPSYCHOTICS Yes No Medicaid CHIP CSHCN
ABILIFY MAINTENA ER 400 MG VL
aripiprazole
1 EA
59148001971
OTSUKA AMERICA
ANTIPSYCHOTICS Yes No Medicaid CHIP CSHCN
ACCURETIC 20-25 MG TABLET
quinapril/hydrochlorothiazide
90 EA
00071022323
PFIZER US PHARM
ANGIOTENSIN MODULATORS Yes Yes Medicaid CHIP CSHCN KHC
ACETAMINOP-CODEINE 120-12 MG/5
acetaminophen with codeine
118 ML
00121050404
PHARM ASSOC INC
ANALGESICS: NARCOTICS SHORT Yes No Medicaid CHIP CSHCN KHC
ACETAMINOP-CODEINE 120-12 MG/5
acetaminophen with codeine
473 ML
50383007916
HI-TECH/AKORN C
ANALGESICS: NARCOTICS SHORT Yes No Medicaid CHIP CSHCN
ACETAMINOP-CODEINE 120-12 MG/5
acetaminophen with codeine
473 ML
00121050416
PHARM ASSOC INC
ANALGESICS: NARCOTICS SHORT Yes No Medicaid CHIP CSHCN KHC
ACETAMINOP-CODEINE 120-12 MG/5
acetaminophen with codeine
473 ML
60432024516
MORTON GROVE PH
ANALGESICS: NARCOTICS SHORT Yes No Medicaid CHIP CSHCN KHC
ACETAMINOPHEN-COD #2 TABLET
acetaminophen with codeine
100 EA
71930005412
EYWA PHARMA INC
ANALGESICS: NARCOTICS SHORT Yes No Medicaid CHIP CSHCN
ACETAMINOPHEN-COD #2 TABLET
acetaminophen with codeine
500 EA
71930005452
EYWA PHARMA INC
ANALGESICS: NARCOTICS SHORT Yes No Medicaid CHIP CSHCN
ACETAMINOPHEN-COD #2 TABLET
acetaminophen with codeine
100 EA
13107005801
AUROBINDO PHARM
ANALGESICS: NARCOTICS SHORT Yes No Medicaid CHIP CSHCN KHC
ACETAMINOPHEN-COD #2 TABLET
acetaminophen with codeine
100 EA
00406048301
MALLINCKRODT PH
ANALGESICS: NARCOTICS SHORT Yes No Medicaid CHIP CSHCN KHC
ACETAMINOPHEN-COD #2 TABLET
acetaminophen with codeine
100 EA
00603233721
QUALITEST/PAR P
ANALGESICS: NARCOTICS SHORT Yes No Medicaid CHIP CSHCN KHC
ACETAMINOPHEN-COD #3 TABLET
acetaminophen with codeine
100 EA
71930005512
EYWA PHARMA INC
ANALGESICS: NARCOTICS SHORT Yes No Medicaid CHIP CSHCN
ACETAMINOPHEN-COD #3 TABLET
acetaminophen with codeine
500 EA
71930005552
EYWA PHARMA INC
ANALGESICS: NARCOTICS SHORT Yes No Medicaid CHIP CSHCN
ACETAMINOPHEN-COD #3 TABLET
acetaminophen with codeine
100 EA
00093015001
TEVA USA
ANALGESICS: NARCOTICS SHORT Yes No Medicaid CHIP CSHCN KHC