Displaying 51 - 100 of 21959 records found. Return to search page.
Search results: Formulary Drugs
Brand Name/Generic Name NDC/Manufacturer PDL Class FFS Clinical Prior Auth Requiredsort descending PDL Prior Auth Required Programs
PREGABALIN 150 MG CAPSULE
pregabalin
76282057290
EXELAN PHARMACE
NEUROPATHIC PAIN No No Medicaid, CHIP, CSHCN
ANDROGEL 1% (25 MG/2.5 G) PKT
testosterone
00051842530
ABBVIE US LLC
ANDROGENIC AGENTS No Yes Medicaid, CHIP, CSHCN
VIREAD 150 MG TABLET
tenofovir disoproxil fumarate
61958040401
GILEAD SCIENCES
No No Medicaid, CHIP, CSHCN
LANSOPRAZOLE DR 30 MG CAPSULE
lansoprazole
00781214892
SANDOZ
PROTON PUMP INHIBITORS No Yes Medicaid, CHIP, CSHCN
RIZATRIPTAN 5 MG TABLET
rizatriptan benzoate
67877026118
ASCEND LABORATO
ANTIMIGRAINE AGENTS: TRIPTANS No No Medicaid, CHIP, CSHCN
METFORMIN HCL 1,000 MG TABLET
metformin HCl
65862001099
AUROBINDO PHARM
No No Medicaid, CHIP, CSHCN, HTW
DULOXETINE HCL DR 60 MG CAP
duloxetine HCl
57237001990
RISING PHARM
NEUROPATHIC PAIN No No Medicaid, CHIP, CSHCN
MERCAPTOPURINE 50 MG TABLET
mercaptopurine
69076091302
QUINN PHARMACEU
No No Medicaid, CHIP, CSHCN
LEVOTHYROXINE 25 MCG TABLET
levothyroxine sodium
68180096501
LUPIN PHARMACEU
No No Medicaid, CHIP, CSHCN
ANAGRELIDE HCL 1 MG CAPSULE
anagrelide HCl
13668046201
TORRENT PHARMAC
No No Medicaid, CHIP, CSHCN
PRAZOSIN 5 MG CAPSULE
prazosin HCl
70954002120
NOVITIUM PHARMA
No No Medicaid, CHIP, CSHCN
CLOBETASOL 0.05% CREAM
clobetasol propionate
50383026715
HI-TECH/AKORN C
STEROIDS: TOPICAL VERY HIGH No No Medicaid, CHIP, CSHCN
GLIMEPIRIDE 2 MG TABLET
glimepiride
16729000216
ACCORD HEALTHCA
No No Medicaid, CHIP, CSHCN, HTW
CEFEPIME HCL 1 GM VIAL
cefepime HCl
25021012120
SAGENT PHARMACE
No No Medicaid, CHIP, CSHCN
ADAPALENE-BNZYL PEROX 0.1-2.5%
adapalene/benzoyl peroxide
00781718270
SANDOZ
ACNE AGENTS: TOPICAL No Yes Medicaid, CHIP, CSHCN
HEMOFIL M 250 UNIT NOMINAL
antihemophilic factor, human
00944394002
BAXALTA US INC.
No No Medicaid, CHIP
BUPROPION HCL SR 150 MG TABLET
bupropion HCl
00185041501
SANDOZ
ANTIDEPRESSANTS: OTHER No No Medicaid, CHIP, CSHCN, HTW
POTASSIUM CL 20 MEQ PACKET
potassium chloride
00603155416
QUALITEST/PAR P
No No Medicaid, CHIP, CSHCN
CITALOPRAM HBR 40 MG TABLET
citalopram hydrobromide
60505252008
APOTEX CORP
ANTIDEPRESSANTS: SSRIs No No Medicaid, CHIP, CSHCN, HTW
TRACLEER 32 MG TABLET FOR SUSP
bosentan
66215010356
ACTELION PHARMA
PAH AGENTS: ORAL AND INHALED No Yes Medicaid, CHIP, CSHCN
ONDANSETRON ODT 4 MG TABLET
ondansetron
68001024617
BLUEPOINT LABOR
ANTIEMETIC/ANTIVERTIGO AGENTS No No Medicaid, CHIP, CSHCN
FENOFIBRATE 54 MG TABLET
fenofibrate
62332053890
ALEMBIC PHARMAC
LIPOTROPICS: OTHER No No Medicaid, CHIP, CSHCN
MOTEGRITY 1 MG TABLET
prucalopride succinate
54092054601
SHIRE US INC.
GI MOTILITY: CHRONIC No Yes Medicaid, CHIP, CSHCN
ONDANSETRON HCL 4 MG TABLET
ondansetron HCl
63304045830
RANBAXY/SUN PHA
ANTIEMETIC/ANTIVERTIGO AGENTS No No Medicaid, CHIP, CSHCN
PREGABALIN 225 MG CAPSULE
pregabalin
64980041609
RISING PHARM
NEUROPATHIC PAIN No No Medicaid, CHIP, CSHCN
SYMTUZA 800-150-200-10 MG TAB
darunavir/cob/emtri/tenof alaf
59676080030
JANSSEN PRODUCT
No No Medicaid, CHIP, CSHCN
GS ANTACID PLUS ANTI-GAS LIQ
mag hydrox/aluminum hyd/simeth
00113035740
PERRIGO/GOODSEN
No No Medicaid, CSHCN
NITROGLYCERIN 400 MCG SPRAY
nitroglycerin
70003030065
JACKSONVILLE PH
No No Medicaid, CHIP, CSHCN
AMOXICILLIN 400 MG/5 ML SUSP
amoxicillin
00143988775
WEST-WARD/HIKMA
PENICILLINS No No Medicaid, CHIP, CSHCN, KHC
ATOVAQUONE 750 MG/5 ML SUSP
atovaquone
68180028201
LUPIN PHARMACEU
No No Medicaid, CHIP, CSHCN
SPIRONOLACTONE 50 MG TABLET
spironolactone
68382066101
ZYDUS PHARMACEU
No No Medicaid, CHIP, CSHCN
ENALAPRIL MALEATE 20 MG TAB
enalapril maleate
16714044501
NORTHSTAR RX LL
ANGIOTENSIN MODULATORS No No Medicaid, CHIP, CSHCN, HTW
METRONIDAZOLE 500 MG TABLET
metronidazole
29300022746
UNICHEM PHARMAC
ANTIBIOTICS: GI No No Medicaid, CHIP, CSHCN, KHC, HTW
KLOR-CON M10 TABLET
potassium chloride
00245531711
UPSHER-SMITH LA
No No Medicaid, CHIP, CSHCN, KHC
VALACYCLOVIR HCL 1 GRAM TABLET
valacyclovir HCl
00378427677
MYLAN
ANTIVIRALS: ORAL No No Medicaid, CHIP, CSHCN, KHC, HTW
CLOBETASOL 0.05% TOPICAL LOTN
clobetasol propionate
00472040492
ACTAVIS/TEVA
STEROIDS: TOPICAL VERY HIGH No Yes Medicaid, CHIP, CSHCN
GLIPIZIDE 10 MG TABLET
glipizide
00591046101
ACTAVIS/TEVA
No No Medicaid, CHIP, CSHCN, KHC, HTW
INF GAS REL 20 MG/0.3 ML DROP
simethicone
00904589430
MAJOR PHARMACEU
No No Medicaid, CSHCN
CIPROFLOX-DEXAMETH OTIC SUSP
ciprofloxacin HCl/dexameth
43598032675
DR.REDDY'S LAB
OTIC ANTIBIOTICS No Yes Medicaid, CHIP, CSHCN
CEFACLOR 500 MG CAPSULE
cefaclor
61442017230
CARLSBAD TECH
CEPHALOSPORINS AND RELATED ANTIBIOTICS No Yes Medicaid, CHIP, CSHCN
ALUNBRIG 30 MG TABLET
brigatinib
63020011330
MILLENNIUM PHAR
No No Medicaid, CHIP, CSHCN
DESVENLAFAXINE SUCCNT ER 25 MG
desvenlafaxine succinate
59762121003
GREENSTONE LLC.
ANTIDEPRESSANTS: OTHER No Yes Medicaid, CHIP, CSHCN
AMMONIUM LACTATE 12% LOTION
ammonium lactate
51672130009
TARO PHARM USA
No No Medicaid, CHIP, CSHCN
CLOPIDOGREL 75 MG TABLET
clopidogrel bisulfate
65862035730
AUROBINDO PHARM
PLATELET AGGREGATION INHIBITORS No No Medicaid, CHIP, CSHCN, KHC
MEDROXYPROGESTERONE 150 MG/ML
medroxyprogesterone acetate
67457088701
MYLAN INSTITUTI
No No Medicaid, CSHCN, HTW
PRAZOSIN 1 MG CAPSULE
prazosin HCl
00093406701
TEVA USA
No No Medicaid, CHIP, CSHCN, KHC
LAMOTRIGINE ER 300 MG TABLET
lamotrigine
65162099003
AMNEAL PHARMACE
No No Medicaid, CHIP, CSHCN
SENSIPAR 30 MG TABLET
cinacalcet HCl
55513007330
AMGEN
No No Medicaid, CHIP, CSHCN
PROPRANOLOL ER 60 MG CAPSULE
propranolol HCl
51991081701
BRECKENRIDGE
BETA-BLOCKERS No Yes Medicaid, CHIP, CSHCN
ENALAPRIL MALEATE 5 MG TABLET
enalapril maleate
68682071110
OCEANSIDE PHARM
ANGIOTENSIN MODULATORS No No Medicaid, CHIP, CSHCN