Displaying 101 - 150 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
ACETAMINOPHEN-COD #2 TABLET
acetaminophen with codeine
00603233721 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
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
00406048401 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
00603233821 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
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 #3 TABLET
acetaminophen with codeine
51079016120 ANALGESICS: NARCOTICS SHORT Yes No Medicaid, CHIP, CSHCN
ACETAMINOPHEN-COD #3 TABLET
acetaminophen with codeine
63739000410 ANALGESICS: NARCOTICS SHORT Yes No Medicaid, CHIP, CSHCN
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 #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
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
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
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
ACETAMINOPHEN-DIPHENHYD 500-25
acetaminophen/diphenhydramine
00536101506 NOT ASSIGNED Yes No Medicaid, CSHCN
ACETAZOLAMIDE 125 MG TABLET
acetazolamide
23155028701 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETAZOLAMIDE 125 MG TABLET
acetazolamide
51672402201 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETAZOLAMIDE 125 MG TABLET
acetazolamide
64380083306 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETAZOLAMIDE 250 MG TABLET
acetazolamide
00527105001 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETAZOLAMIDE 250 MG TABLET
acetazolamide
23155028801 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETAZOLAMIDE 250 MG TABLET
acetazolamide
51672402301 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETAZOLAMIDE 250 MG TABLET
acetazolamide
64380083406 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETAZOLAMIDE ER 500 MG CAP
acetazolamide
00555051302 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETAZOLAMIDE ER 500 MG CAP
acetazolamide
23155012001 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETAZOLAMIDE ER 500 MG CAP
acetazolamide
29033003001 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETAZOLAMIDE ER 500 MG CAP
acetazolamide
68382026101 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETAZOLAMIDE ER 500 MG CAP
acetazolamide
50742023301 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETIC ACID 0.25% IRRIG SOLN
acetic acid
00264230400 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETIC ACID 0.25% IRRIG SOLN
acetic acid
00264230410 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETIC ACID 0.25% IRRIG SOLN
acetic acid
00409614309 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETIC ACID 2% EAR SOLUTION
acetic acid
50383088915 OTIC ANTI-INFECTIVES & ANESTHETICS No No Medicaid, CHIP, CSHCN
ACETIC ACID 2% EAR SOLUTION
acetic acid
60432074115 OTIC ANTI-INFECTIVES & ANESTHETICS No No Medicaid, CHIP, CSHCN
ACETIC ACID-ALUMINUM DROPS
acetic acid/aluminum acetate
24208061577 OTIC ANTI-INFECTIVES & ANESTHETICS No Yes Medicaid, CHIP, CSHCN
ACETYLCYSTEINE 10% VIAL
acetylcysteine
00409330703 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETYLCYSTEINE 10% VIAL
acetylcysteine
00517750425 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETYLCYSTEINE 10% VIAL
acetylcysteine
00517751003 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETYLCYSTEINE 20% VIAL
acetylcysteine
00409330803 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETYLCYSTEINE 20% VIAL
acetylcysteine
00517760425 NOT ASSIGNED No No Medicaid, CHIP, CSHCN
ACETYLCYSTEINE 6 GRAM/30 ML VL
acetylcysteine
00574080530 NOT ASSIGNED No No Medicaid, CHIP, CSHCN