Displaying 51 - 100 of 21288 records found.
Search results: Formulary Drugs
Brand Name/Generic Name NDC PDL Class FFS Clinical Prior Auth Required PDL Prior Auth Required Programs
ACARBOSE 25 MG TABLET
acarbose
23155014701 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 25 MG TABLET
acarbose
23155014710 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 25 MG TABLET
acarbose
47781034001 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 25 MG TABLET
acarbose
64380075806 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 25 MG TABLET
acarbose
69543012010 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 25 MG TABLET
acarbose
69543012011 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 50 MG TABLET
acarbose
00054014125 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 50 MG TABLET
acarbose
00115115101 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 50 MG TABLET
acarbose
00115115102 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 50 MG TABLET
acarbose
16252052401 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 50 MG TABLET
acarbose
23155014801 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 50 MG TABLET
acarbose
23155014805 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 50 MG TABLET
acarbose
23155014810 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 50 MG TABLET
acarbose
47781034101 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 50 MG TABLET
acarbose
64380075906 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 50 MG TABLET
acarbose
69543012110 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACARBOSE 50 MG TABLET
acarbose
69543012111 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACCUPRIL 10 MG TABLET
quinapril HCl
00071053023 ANGIOTENSIN MODULATORS No Yes Medicaid, CHIP, CSHCN, KHC
ACCUPRIL 10 MG TABLET
quinapril HCl
00071053040 ANGIOTENSIN MODULATORS No Yes Medicaid, CHIP, CSHCN, KHC
ACCUPRIL 20 MG TABLET
quinapril HCl
00071053223 ANGIOTENSIN MODULATORS No Yes Medicaid, CHIP, CSHCN, KHC
ACCUPRIL 20 MG TABLET
quinapril HCl
00071053240 ANGIOTENSIN MODULATORS No Yes Medicaid, CHIP, CSHCN, KHC
ACCUPRIL 40 MG TABLET
quinapril HCl
00071053523 ANGIOTENSIN MODULATORS No Yes Medicaid, CHIP, CSHCN, KHC
ACCUPRIL 5 MG TABLET
quinapril HCl
00071052723 ANGIOTENSIN MODULATORS No Yes Medicaid, CHIP, CSHCN, KHC
ACCURETIC 10-12.5 MG TABLET
quinapril/hydrochlorothiazide
00071022223 ANGIOTENSIN MODULATORS Yes Yes Medicaid, CHIP, CSHCN
ACCURETIC 20-12.5 MG TABLET
quinapril/hydrochlorothiazide
00071022023 ANGIOTENSIN MODULATORS Yes Yes Medicaid, CHIP, CSHCN
ACCURETIC 20-25 MG TABLET
quinapril/hydrochlorothiazide
00071022323 ANGIOTENSIN MODULATORS Yes Yes Medicaid, CHIP, CSHCN
ACEBUTOLOL 200 MG CAPSULE
acebutolol HCl
00378120001 BETA-BLOCKERS No No Medicaid, CHIP, CSHCN, KHC
ACEBUTOLOL 200 MG CAPSULE
acebutolol HCl
65162066910 BETA-BLOCKERS No No Medicaid, CHIP, CSHCN, KHC
ACEBUTOLOL 200 MG CAPSULE
acebutolol HCl
53746066901 BETA-BLOCKERS No No Medicaid, CHIP, CSHCN
ACEBUTOLOL 400 MG CAPSULE
acebutolol HCl
00378140001 BETA-BLOCKERS No No Medicaid, CHIP, CSHCN, KHC
ACEBUTOLOL 400 MG CAPSULE
acebutolol HCl
65162067010 BETA-BLOCKERS No No Medicaid, CHIP, CSHCN, KHC
ACEPHEN 120 MG SUPPOSITORY
acetaminophen
00713011801 NOT ASSIGNED No No Medicaid, CSHCN
ACEPHEN 120 MG SUPPOSITORY
acetaminophen
00713011812 NOT ASSIGNED No No Medicaid, CSHCN
ACEPHEN 120 MG SUPPOSITORY
acetaminophen
00713011850 NOT ASSIGNED No No Medicaid, CSHCN
ACEPHEN 325 MG SUPPOSITORY
acetaminophen
00713016401 NOT ASSIGNED No No Medicaid, CSHCN
ACEPHEN 325 MG SUPPOSITORY
acetaminophen
00713016412 NOT ASSIGNED No No Medicaid, CSHCN
ACEPHEN 325 MG SUPPOSITORY
acetaminophen
00713016450 NOT ASSIGNED No No Medicaid, CSHCN
ACEPHEN 650 MG SUPPOSITORY
acetaminophen
00713016501 NOT ASSIGNED No No Medicaid, CSHCN
ACEPHEN 650 MG SUPPOSITORY
acetaminophen
00713016512 NOT ASSIGNED No No Medicaid, CSHCN
ACEPHEN 650 MG SUPPOSITORY
acetaminophen
00713016550 NOT ASSIGNED No No Medicaid, CSHCN
ACETA-GESIC 325-12.5 MG TABLET
acetaminophen/diphenhydramine
00536100301 NOT ASSIGNED Yes No Medicaid, CSHCN
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 325 MG TABLET
acetaminophen
63739044001 NOT ASSIGNED No No Medicaid, CSHCN
ACETAMINOPHEN-COD #2 TABLET
acetaminophen with codeine
00093005001 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