Search Results: Formulary Products

Displaying 1 - 25 of 4672 records found. Return to search page.

Name NDC/Manufacturer Package Size HCPCS Description Program(s)
HYPER-SAL 3.5% VIAL 83490023560
PARI RESPIRATOR
4ML Hypertonic Saline Medicaid CHIP CSHCN
HYPER-SAL 7% VIAL 83490020760
PARI RESPIRATOR
4ML Hypertonic Saline Medicaid CHIP CSHCN
SODIUM CHLORIDE 0.9% INHAL VL 76204030003
RITEDOSE PHARMA
3ML Hypertonic Saline Medicaid CHIP CSHCN
FLOWFLEX COVID-19 AG HOME TEST 82607066026
ACON LABORATORI
1EA Medicaid CHIP CSHCN KHC
INTELISWAB COVID-19 RAPID TEST 08337000158
ORASURE TECHNOL
2EA Medicaid CHIP CSHCN KHC
EVERLYWELL COVID19 HOM COLLECT 51044000842
EVERLYWELL INC.
1EA Medicaid CHIP CSHCN KHC
QUICKVUE AT-HOME COVID-19 TEST 14613033972
QUIDEL CORPORAT
2EA Medicaid CHIP CSHCN KHC
QUICKVUE SARS ANTIGEN TEST 14613033937
QUIDEL CORPORAT
1EA Medicaid CHIP CSHCN KHC
BINAXNOW COVID-19 AG SELF TEST 11877001140
ALERE/ABBOTT DI
2EA Medicaid CHIP CSHCN KHC
BINAXNOW COVD AG CARD HOME TST 11877001133
ALERE/ABBOTT DI
1EA Medicaid CHIP CSHCN KHC
BINAXNOW COVID-19 AG CARD 11877001129
ALERE/ABBOTT DI
1EA Medicaid CHIP CSHCN KHC
PFIZER COVID (12Y UP) VAC-GRAY 59267102504
PFIZER MANUFACT
1.8ML Medicaid CHIP
PFIZER COVID (12Y UP) VAC-GRAY 59267102503
PFIZER MANUFACT
1.8ML Medicaid CHIP
PFIZER COVID (12Y UP) VAC-GRAY 59267102501
PFIZER MANUFACT
1.8ML Medicaid CHIP
UNIFINE ULTRA PEN NDL 31G 6MM 08470419001
OWEN MUMFORD US
100EA Insulin Needles Medicaid CHIP CSHCN KHC
UNIFINE ULTRA PEN NDL 31G 5MM 08470415001
OWEN MUMFORD US
100EA Insulin Needles Medicaid CHIP CSHCN KHC
UNIFINE ULTRA PEN NDL 31G 8MM 08470413001
OWEN MUMFORD US
100EA Insulin Needles Medicaid CHIP CSHCN KHC
UNIFINE ULTRA PEN NDL 32G 4MM 08470414001
OWEN MUMFORD US
100EA Insulin Needles Medicaid CHIP CSHCN KHC
CVS SPECTRAVITE WOMEN 50 PLUS 50428034187
CVS
200EA VITAMIN AND MINERAL-under 20yrs of age Medicaid, C Medicaid CSHCN
CVS SPECTRAVITE WOMEN TABLET 50428030503
CVS
200EA VITAMIN AND MINERAL-under 20yrs of age Medicaid, C Medicaid CSHCN
PFIZER COVID (5-11Y) VAC-ORANG 59267105504
PFIZER MANUFACT
2ML Medicaid CHIP
PFIZER COVID (5-11Y) VAC-ORANG 59267105502
PFIZER MANUFACT
2ML Medicaid CHIP
PFIZER COVID (5-11Y) VAC-ORANG 59267105501
PFIZER MANUFACT
2ML Medicaid CHIP
EASY TALK PLUS II TEST STRIP 50027049422
HOME AIDE DIAGN
50EA Diabetic Test Strips Medicaid CHIP CSHCN KHC
GNP TRUETRACK GLUCOSE TEST STR 87701040542
AMERISOURCE-GNP
50EA Diabetic Test Strips Medicaid CHIP CSHCN KHC