Displaying 1 - 50 of 1435 records found. Return to search page.
Brand Name/Generic Name | NDC | PDL Class | FFS Clinical Prior Auth Required | PDL Prior Auth Required | Programs |
---|---|---|---|---|---|
ACETAMIN-CAFF-DIHYDROCOD 320.5 acetaminophen/caff/dihydrocod |
42195084010 | ANALGESICS: NARCOTICS SHORT | Yes | Yes | Medicaid, CHIP, CSHCN |
ACETAMIN-CAFF-DIHYDROCOD 325 acetaminophen/caff/dihydrocod |
68047072001 | ANALGESICS: NARCOTICS SHORT | No | Yes | Medicaid, CHIP, CSHCN |
ACETAMINOP-CODEINE 120-12 MG/5 acetaminophen with codeine |
00121050404 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOP-CODEINE 120-12 MG/5 acetaminophen with codeine |
00121050416 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOP-CODEINE 120-12 MG/5 acetaminophen with codeine |
50383007916 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN |
ACETAMINOP-CODEINE 120-12 MG/5 acetaminophen with codeine |
60432024516 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #2 TABLET acetaminophen with codeine |
00603233721 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #2 TABLET acetaminophen with codeine |
00406048301 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #2 TABLET acetaminophen with codeine |
00093005001 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #2 TABLET acetaminophen with codeine |
13107005801 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #3 TABLET acetaminophen with codeine |
65162003310 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #3 TABLET acetaminophen with codeine |
65162003311 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #3 TABLET acetaminophen with codeine |
51079016120 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN |
ACETAMINOPHEN-COD #3 TABLET acetaminophen with codeine |
00603233821 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #3 TABLET acetaminophen with codeine |
00406048401 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #3 TABLET acetaminophen with codeine |
00603233832 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #3 TABLET acetaminophen with codeine |
00406048410 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #3 TABLET acetaminophen with codeine |
00406048462 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #3 TABLET acetaminophen with codeine |
00093015001 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #3 TABLET acetaminophen with codeine |
00093015010 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #3 TABLET acetaminophen with codeine |
13107005901 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #3 TABLET acetaminophen with codeine |
13107005999 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #4 TABLET acetaminophen with codeine |
00603233921 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #4 TABLET acetaminophen with codeine |
00603233928 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #4 TABLET acetaminophen with codeine |
00406048501 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #4 TABLET acetaminophen with codeine |
00406048505 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #4 TABLET acetaminophen with codeine |
00093035001 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #4 TABLET acetaminophen with codeine |
00093035005 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #4 TABLET acetaminophen with codeine |
00093035010 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #4 TABLET acetaminophen with codeine |
13107006001 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #4 TABLET acetaminophen with codeine |
13107006005 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACETAMINOPHEN-COD #4 TABLET acetaminophen with codeine |
13107006099 | ANALGESICS: NARCOTICS SHORT | Yes | No | Medicaid, CHIP, CSHCN, KHC |
ACTIQ 1,200 MCG LOZENGE fentanyl citrate |
63459051230 | ANALGESICS: NARCOTICS SHORT | Yes | Yes | Medicaid, CHIP, CSHCN |
ACTIQ 1,600 MCG LOZENGE fentanyl citrate |
63459051630 | ANALGESICS: NARCOTICS SHORT | Yes | Yes | Medicaid, CHIP, CSHCN |
ACTIQ 200 MCG LOZENGE fentanyl citrate |
63459050230 | ANALGESICS: NARCOTICS SHORT | Yes | Yes | Medicaid, CHIP, CSHCN |
ACTIQ 400 MCG LOZENGE fentanyl citrate |
63459050430 | ANALGESICS: NARCOTICS SHORT | Yes | Yes | Medicaid, CHIP, CSHCN |
ACTIQ 600 MCG LOZENGE fentanyl citrate |
63459050630 | ANALGESICS: NARCOTICS SHORT | Yes | Yes | Medicaid, CHIP, CSHCN |
ACTIQ 800 MCG LOZENGE fentanyl citrate |
63459050830 | ANALGESICS: NARCOTICS SHORT | Yes | Yes | Medicaid, CHIP, CSHCN |
ALPRAZOLAM 0.25 MG TABLET alprazolam |
00228202796 | Yes | No | Medicaid, CHIP, CSHCN | |
ALPRAZOLAM 0.25 MG TABLET alprazolam |
51991070401 | Yes | No | Medicaid, CHIP, CSHCN | |
ALPRAZOLAM 0.25 MG TABLET alprazolam |
51991070405 | Yes | No | Medicaid, CHIP, CSHCN | |
ALPRAZOLAM 0.25 MG TABLET alprazolam |
47335060313 | Yes | No | Medicaid, CHIP, CSHCN | |
ALPRAZOLAM 0.25 MG TABLET alprazolam |
69452011020 | Yes | No | Medicaid, CHIP, CSHCN | |
ALPRAZOLAM 0.25 MG TABLET alprazolam |
51991070410 | Yes | No | Medicaid, CHIP, CSHCN | |
ALPRAZOLAM 0.25 MG TABLET alprazolam |
47335060318 | Yes | No | Medicaid, CHIP, CSHCN | |
ALPRAZOLAM 0.25 MG TABLET alprazolam |
47335060388 | Yes | No | Medicaid, CHIP, CSHCN | |
ALPRAZOLAM 0.25 MG TABLET alprazolam |
65862067699 | Yes | No | Medicaid, CHIP, CSHCN | |
ALPRAZOLAM 0.25 MG TABLET alprazolam |
69452011030 | Yes | No | Medicaid, CHIP, CSHCN | |
ALPRAZOLAM 0.25 MG TABLET alprazolam |
69452011032 | Yes | No | Medicaid, CHIP, CSHCN | |
ALPRAZOLAM 0.25 MG TABLET alprazolam |
59762371901 | Yes | No | Medicaid, CHIP, CSHCN |