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Search results: Formulary Drugs
Brand Name/Generic Name NDC/Manufacturer PDL Class FFS Clinical Prior Auth Required PDL Prior Auth Requiredsort descending Programs
FELODIPINE ER 10 MG TABLET
felodipine
00603358328
QUALITEST/PAR P
CALCIUM CHANNEL BLOCKERS No No Medicaid, CHIP, CSHCN, HTW
ATORVASTATIN 10 MG TABLET
atorvastatin calcium
16729004417
ACCORD HEALTHCA
LIPOTROPICS: STATINS Yes No Medicaid, CHIP, CSHCN, KHC, HTW
TRIENTINE HCL 250 MG CAPSULE
trientine HCl
72205000891
NOVADOZ PHARMAC
No No Medicaid, CHIP, CSHCN
TRIAMCINOLONE 0.1% OINTMENT
triamcinolone acetonide
45802005536
PERRIGO CO.
STEROIDS: TOPICAL HIGH No No Medicaid, CHIP, CSHCN
SPIRONOLACTONE 25 MG TABLET
spironolactone
53489014305
MUTUAL PHARM CO
No No Medicaid, CHIP, CSHCN
ROSUVASTATIN CALCIUM 40 MG TAB
rosuvastatin calcium
57237017105
RISING PHARM
LIPOTROPICS: STATINS Yes No Medicaid, CHIP, CSHCN
IRBESARTAN 75 MG TABLET
irbesartan
59746044790
JUBILANT CADIST
ANGIOTENSIN MODULATORS Yes No Medicaid, CHIP, CSHCN, HTW
MIRTAZAPINE 30 MG TABLET
mirtazapine
63739035610
MCKESSON PACKAG
ANTIDEPRESSANTS: OTHER No No Medicaid, CHIP, CSHCN
WARFARIN SODIUM 10 MG TABLET
warfarin sodium
65162076910
AMNEAL PHARMACE
ANTICOAGULANTS Yes No Medicaid, CHIP, CSHCN, KHC, HTWPlus
IPRATROPIUM BR 0.02% SOLN
ipratropium bromide
65862090530
AUROBINDO PHARM
COPD AGENTS No No Medicaid, CHIP, CSHCN
MYCOPHENOLATE 250 MG CAPSULE
mycophenolate mofetil
00093733405
TEVA USA
IMMUNOSUPPRESSIVES: ORAL No No Medicaid, CHIP, CSHCN, KHC
NIKKI 3 MG-0.02 MG TABLET
ethinyl estradiol/drospirenone
68180088613
LUPIN PHARMACEU
No No Medicaid, CHIP, CSHCN, HTW
DOXEPIN 25 MG CAPSULE
doxepin HCl
69238117009
AMNEAL PHARMACE
No No Medicaid, CHIP, CSHCN
POLY BACITRACIN OINTMENT
bacitracin zinc/polymyxin B
70000047101
LEADER
No No Medicaid, CSHCN
AMOXICILLIN 875 MG TABLET
amoxicillin
00143928501
WEST-WARD/HIKMA
PENICILLINS No No Medicaid, CHIP, CSHCN, KHC
FERROUS SULF EC 325 MG TABLET
ferrous sulfate
00245010810
UPSHER-SMITH LA
No No KHC
ACYCLOVIR 200 MG/5 ML SUSP
acyclovir
00472008216
ACTAVIS/TEVA
ANTIVIRALS: ORAL No No Medicaid, CHIP, CSHCN, KHC
AMOX-CLAV ER 1,000-62.5 MG TAB
amoxicillin/potassium clav
00781194339
SANDOZ
CEPHALOSPORINS AND RELATED ANTIBIOTICS No No Medicaid, CHIP, CSHCN, KHC
OLANZAPINE 20 MG TABLET
olanzapine
00904628761
MAJOR PHARMACEU
ANTIPSYCHOTICS Yes No Medicaid, CHIP, CSHCN
PAROXETINE HCL 10 MG TABLET
paroxetine HCl
13107015405
AUROBINDO PHARM
ANTIDEPRESSANTS: SSRIs Yes No Medicaid, CHIP, CSHCN
BUSPIRONE HCL 30 MG TABLET
buspirone HCl
23155009705
HERITAGE PHARMA
No No Medicaid, CHIP, CSHCN
HYDROCHLOROTHIAZIDE 50 MG TAB
hydrochlorothiazide
43547039810
SOLCO HEALTHCAR
Yes No Medicaid, CHIP, CSHCN
MEMANTINE HCL 5 MG TABLET
memantine HCl
47335032186
SUN PHARMA GLOB
ALZHEIMER'S AGENTS No No Medicaid, CHIP, CSHCN
ACETAZOLAMIDE ER 500 MG CAP
acetazolamide
50742023301
INGENUS PHARMAC
No No Medicaid, CHIP, CSHCN
GLIMEPIRIDE 4 MG TABLET
glimepiride
55111032201
DR.REDDY'S LAB
No No Medicaid, CHIP, CSHCN, HTW
M-PAP 160 MG/5 ML LIQUID
acetaminophen
58657052516
METHOD PHARMACE
No No Medicaid, CSHCN
MYORISAN 30 MG CAPSULE
isotretinoin
61748030313
VERSAPHARM/AKOR
ACNE AGENTS: ORAL No No Medicaid, CHIP, CSHCN
LETROZOLE 2.5 MG TABLET
letrozole
62756051183
SUN PHARMACEUTI
No No Medicaid, CHIP, CSHCN
NALOXONE 0.4 MG/ML VIAL
naloxone HCl
67457029200
MYLAN INSTITUTI
OPIATE DEPENDENCE TREATMENTS No No Medicaid, CHIP, CSHCN
GLIMEPIRIDE 2 MG TABLET
glimepiride
69452012920
BIONPHARMA INC.
No No Medicaid, CHIP, CSHCN
GAMMAGARD LIQUID 10% VIAL
immun glob G(IgG)/gly/IgA ov50
00944270004
BAXALTA US INC.
IMMUNE GLOBULINS No No Medicaid, CHIP, CSHCN
LAMOTRIGINE ER 200 MG TABLET
lamotrigine
13668034230
TORRENT PHARMAC
No No Medicaid, CHIP, CSHCN
CARBIDOPA-LEVO ER 50-200 TAB
carbidopa/levodopa
00378009401
MYLAN
ANTIPARKINSON'S AGENTS No No Medicaid, CHIP, CSHCN
GENOTROPIN MINIQUICK 1.4 MG
somatropin
00013265502
PHARMACI/PFIZER
GROWTH HORMONE Yes No Medicaid, CHIP, CSHCN
ANTACID EX-STR 750 MG TAB CHEW
calcium carbonate
00536105022
RUGBY
No No Medicaid, CSHCN
PROPANTHELINE 15 MG TABLET
propantheline bromide
00054472125
WEST-WARD/HIKMA
No No Medicaid, CHIP, CSHCN
OLANZAPINE ODT 10 MG TABLET
olanzapine
33342008407
MACLEODS PHARMA
ANTIPSYCHOTICS Yes No Medicaid, CHIP, CSHCN
HIZENTRA 4 GRAM/20 ML VIAL
immun glob G(IgG)/pro/IgA 0-50
44206045404
CSL BEHRING LLC
IMMUNE GLOBULINS No No Medicaid, CHIP, CSHCN
SELZENTRY 25 MG TABLET
maraviroc
49702023308
VIIV HEALTHCARE
No No Medicaid, CHIP, CSHCN
FLUOXETINE HCL 20 MG CAPSULE
fluoxetine HCl
50228011430
SCIEGEN PHARMAC
ANTIDEPRESSANTS: SSRIs No No Medicaid, CHIP, CSHCN, HTW
VENLAFAXINE HCL 75 MG TABLET
venlafaxine HCl
52817013310
TRUPHARMA, LLC.
ANTIDEPRESSANTS: OTHER No No Medicaid, CHIP, CSHCN
RIZATRIPTAN 10 MG ODT
rizatriptan benzoate
57237008663
RISING PHARM
ANTIMIGRAINE AGENTS: TRIPTANS No No Medicaid, CHIP, CSHCN
PREDNISONE 20 MG TABLET
prednisone
59746017509
JUBILANT CADIST
GLUCOCORTICOIDS: ORAL Yes No Medicaid, CHIP, CSHCN, HTWPlus
IRBESARTAN-HCTZ 150-12.5 MG TB
irbesartan/hydrochlorothiazide
60505360309
APOTEX CORP
ANGIOTENSIN MODULATORS Yes No Medicaid, CHIP, CSHCN, KHC, HTW
ATOMOXETINE HCL 100 MG CAPSULE
atomoxetine HCl
00093354856
TEVA USA
STIMULANTS AND RELATED AGENTS Yes No Medicaid, CHIP, CSHCN
CALCIUM ACETATE 667 MG CAPSULE
calcium acetate
65162059020
AMNEAL PHARMACE
PHOSPHATE BINDERS Yes No Medicaid, CHIP, CSHCN, KHC
EFAVIRENZ 600 MG TABLET
efavirenz
65862077430
AUROBINDO PHARM
No No Medicaid, CHIP, CSHCN
METHYLPREDNISOLONE 4 MG DOSEPK
methylprednisolone
68001000501
BLUEPOINT LABOR
GLUCOCORTICOIDS: ORAL Yes No Medicaid, CHIP, CSHCN
AMLODIPINE BESYLATE 10 MG TAB
amlodipine besylate
68180072103
LUPIN PHARMACEU
CALCIUM CHANNEL BLOCKERS No No Medicaid, CHIP, CSHCN, KHC, HTW
GLYBURIDE 2.5 MG TABLET
glyburide
00093943305
TEVA USA
No No Medicaid, CHIP, CSHCN, KHC, HTW