Search Results: Formulary Products

Name/Package Size	NDC/Manufacturer	Product Group	Program(s)
KINDERLYTE ELECTROLYTE SOLN 1000 ML	50001080580 KINDERFARMS, LL	Oral Electrolyte	Medicaid CHIP CSHCN
ORALYTE SOLUTION 1000 ML	80681001300 RUGBY	Oral Electrolyte	Medicaid CHIP CSHCN
CVS PEDIATRIC ELECTROLYTE SOLN 1000 ML	50428038805 CVS	Oral Electrolyte	Medicaid CHIP CSHCN
EQ SPACE CHAMBER-LARGE MASK 1 EA	81131024070 WAL-MART STORES	Aerosol Chamber	Medicaid CHIP CSHCN
KINDERLYTE ELECTROLYTE SOLN 1000 ML	50001080559 KINDERFARMS, LL	Oral Electrolyte	Medicaid CHIP CSHCN
HYDRALYTE ELECTROLYTE PWDR PKT 3 EA	50015072311 HYDRALYTE LLC	Oral Electrolyte	Medicaid CHIP CSHCN
FERROUS FUMARATE 324 MG TABLET 100 EA	69367025920 WESTMINSTER PHA		Medicaid CSHCN
EASY TOUCH 0.5 ML SYR 29GX1/2" 100 EA	08496011601 MHC MEDICAL PRO	Insulin Syringes	Medicaid CHIP CSHCN KHC
EASY TOUCH 0.5 ML SYR 30GX5/16 100 EA	08496011801 MHC MEDICAL PRO	Insulin Syringes	Medicaid CHIP CSHCN KHC
PRO COMFORT SPACER-INFANT MASK 1 EA	50632000756 HOME AIDE DIAGN	Aerosol Chamber	Medicaid CHIP CSHCN
CVS PEDIATRIC ELECTROLYTE SOLN 1000 ML	50428036825 CVS	Oral Electrolyte	Medicaid CHIP CSHCN
CLEVER CHOICE CHAMBER-LRG MASK 1 EA	50002086047 SDI USA, INC.	Aerosol Chamber	Medicaid CHIP CSHCN
PROCARE SPACER WITH CHILD MASK 1 EA	72217003902 ARISE MEDICAL L	Aerosol Chamber	Medicaid CHIP CSHCN
VORTEX VHC LADYBUG TODDLER MSK 1 EA	83490051037 PARI RESPIRATOR	Aerosol Chamber	Medicaid CHIP CSHCN
PEDIALYTE SOLUTION 1000 ML	70074000240 ABBOTT NUTRITIO	Oral Electrolyte	Medicaid CHIP CSHCN
PROCARE SPACER WITH ADULT MASK 1 EA	72217003901 ARISE MEDICAL L	Aerosol Chamber	Medicaid CHIP CSHCN
KINDERLYTE ELECTROLYTE SOLN 1000 ML	50001080560 KINDERFARMS, LL	Oral Electrolyte	Medicaid CHIP CSHCN
ORALYTE SOLUTION 1000 ML	80681001600 RUGBY	Oral Electrolyte	Medicaid CHIP CSHCN
EQ SPACE CHAMBER-SMALL MASK 1 EA	81131024068 WAL-MART STORES	Aerosol Chamber	Medicaid CHIP CSHCN
BD SAFTYGLD INS 0.5ML 29G 13MM 100 EA	08290593201 BD DIABETES	Insulin Syringes	Medicaid CHIP CSHCN KHC
ORALYTE SOLUTION 1000 ML	80681001500 RUGBY	Oral Electrolyte	Medicaid CHIP CSHCN
PEDIATRIC ELECTROLYTE SOLUTION 1000 ML	96295013816 LEADER	Oral Electrolyte	Medicaid CHIP CSHCN
PEDIATRIC ELECTROLYTE SOLUTION 1000 ML	96295013815 LEADER	Oral Electrolyte	Medicaid CHIP CSHCN
CVS PEDIATRIC ELECTROLYTE SOLN 1000 ML	50428029627 CVS	Oral Electrolyte	Medicaid CHIP CSHCN
CLEVER CHOICE CHAMBER-SM MASK 1 EA	50002086045 SDI USA, INC.	Aerosol Chamber	Medicaid CHIP CSHCN