Search Results: Formulary Products

Displaying 1 - 25 of 4843 products found. Return to search page.
A product with a termination date will appear on the search for 90 days following the termination date.

Name/Package Size	NDC/Manufacturer	Product Group	Program(s)
MODERNA COVID 23-24(6M-11Y)EUA .25 ML	80777028792 MODERNA US, INC		Medicaid CHIP CSHCN
MODERNA COVID 23-24(6M-11Y)EUA .25 ML	80777028707 MODERNA US, INC		Medicaid CHIP CSHCN
SPIKEVAX 2023-24 (12Y UP) SYRG .5 ML	80777010296 MODERNA US, INC		Medicaid CHIP CSHCN
SPIKEVAX 2023-24 (12Y UP) VIAL .5 ML	80777010295 MODERNA US, INC		Medicaid CHIP CSHCN
SPIKEVAX 2023-24 (12Y UP) SYRG .5 ML	80777010293 MODERNA US, INC		Medicaid CHIP CSHCN
SPIKEVAX 2023-24 (12Y UP) VIAL .5 ML	80777010204 MODERNA US, INC		Medicaid CHIP CSHCN
SPIKEVAX 2023-24 (12Y UP) SYRG .5 ML	80777010201 MODERNA US, INC		Medicaid CHIP CSHCN
NOVAVAX COVID 2023-24 VL (EUA) 2.5 ML	80631010502 NOVAVAX INC.		Medicaid CHIP CSHCN
NOVAVAX COVID 2023-24 VL (EUA) 2.5 ML	80631010501 NOVAVAX INC.		Medicaid CHIP CSHCN
PFIZER COVID 2023-24(5-11Y)EUA .3 ML	59267433102 PFIZER MANUFACT		Medicaid CHIP CSHCN
PFIZER COVID 2023-24(5-11Y)EUA .3 ML	59267433101 PFIZER MANUFACT		Medicaid CHIP CSHCN
PFIZER COVID 2023-24(6M-4Y)EUA .9 ML	59267431502 PFIZER MANUFACT		Medicaid CHIP CSHCN
PFIZER COVID 2023-24(6M-4Y)EUA .9 ML	59267431501 PFIZER MANUFACT		Medicaid CHIP CSHCN
COMIRNATY 2023-24(12Y UP) SYRG .3 ML	00069239210 PFIZER US PHARM		Medicaid CHIP CSHCN
COMIRNATY 2023-24(12Y UP) SYRG .3 ML	00069239201 PFIZER US PHARM		Medicaid CHIP CSHCN
COMIRNATY 2023-24(12Y UP) SYRG .3 ML	00069237710 PFIZER US PHARM		Medicaid CHIP CSHCN
COMIRNATY 2023-24(12Y UP) SYRG .3 ML	00069237701 PFIZER US PHARM		Medicaid CHIP CSHCN
COMIRNATY 2023-24(12Y UP) VIAL .3 ML	00069236210 PFIZER US PHARM		Medicaid CHIP CSHCN
COMIRNATY 2023-24(12Y UP) VIAL .3 ML	00069236201 PFIZER US PHARM		Medicaid CHIP CSHCN
FERROUS SULF 220 MG/5 ML ELIX 473 ML	71321080116 BRANDYWINE PHAR		Medicaid CSHCN
FERROUS SULF 300 MG/5 ML CUP 5 ML	58526000559 AHP		Medicaid CSHCN
VERIFINE IN SYR 0.5ML 29G 12MM 100 EA	50011083385 PROMISEMED	Insulin Syringes	Medicaid CHIP CSHCN KHC
VERIFINE INS SYR 1 ML 31G 8MM 100 EA	50011083384 PROMISEMED	Insulin Syringes	Medicaid CHIP CSHCN KHC
VERIFINE INS SYR 1 ML 29G 12MM 100 EA	50011083358 PROMISEMED	Insulin Syringes	Medicaid CHIP CSHCN KHC
VERIFINE INS SYR 0.5ML 31G 8MM 100 EA	50011083357 PROMISEMED	Insulin Syringes	Medicaid CHIP CSHCN KHC