Displaying 151 - 200 of 21054 records found. Return to search page.
Search results: Formulary Drugs
Brand Name/Generic Name NDC PDL Class FFS Clinical Prior Auth Required PDL Prior Auth Required Programs
ACETYLCYSTEINE 6 GRAM/30 ML VL
acetylcysteine
00574080530 No No Medicaid, CHIP, CSHCN
ACID GONE ANTACID LIQUID
mag carb/aluminum hydrox/algin
00904772714 No No Medicaid, CSHCN
ACID REDUCER 20 MG TABLET
famotidine
37205086163 No No Medicaid, CSHCN
ACIPHEX DR 20 MG TABLET
rabeprazole sodium
62856024330 PROTON PUMP INHIBITORS No Yes Medicaid, CHIP, CSHCN
ACIPHEX SPRINKLE DR 10 MG CAP
rabeprazole sodium
13551021001 PROTON PUMP INHIBITORS No Yes Medicaid, CHIP, CSHCN
ACIPHEX SPRINKLE DR 10 MG CAP
rabeprazole sodium
23594021001 PROTON PUMP INHIBITORS No Yes Medicaid, CHIP, CSHCN
ACIPHEX SPRINKLE DR 5 MG CAP
rabeprazole sodium
13551020501 PROTON PUMP INHIBITORS No Yes Medicaid, CHIP, CSHCN
ACIPHEX SPRINKLE DR 5 MG CAP
rabeprazole sodium
23594020501 PROTON PUMP INHIBITORS No Yes Medicaid, CHIP, CSHCN
ACITRETIN 10 MG CAPSULE
acitretin
00093113556 No No Medicaid, CHIP, CSHCN
ACITRETIN 10 MG CAPSULE
acitretin
00115175008 No No Medicaid, CHIP, CSHCN
ACITRETIN 10 MG CAPSULE
acitretin
00378702093 No No Medicaid, CHIP, CSHCN
ACITRETIN 10 MG CAPSULE
acitretin
42794008008 No No Medicaid, CHIP, CSHCN
ACITRETIN 10 MG CAPSULE
acitretin
66993089430 No No Medicaid, CHIP, CSHCN
ACITRETIN 17.5 MG CAPSULE
acitretin
00093113856 No No Medicaid, CHIP, CSHCN
ACITRETIN 17.5 MG CAPSULE
acitretin
00115166808 No No Medicaid, CHIP, CSHCN
ACITRETIN 17.5 MG CAPSULE
acitretin
42794008108 No No Medicaid, CHIP, CSHCN
ACITRETIN 25 MG CAPSULE
acitretin
00093113656 No No Medicaid, CHIP, CSHCN
ACITRETIN 25 MG CAPSULE
acitretin
00115166908 No No Medicaid, CHIP, CSHCN
ACITRETIN 25 MG CAPSULE
acitretin
00115175308 No No Medicaid, CHIP, CSHCN
ACITRETIN 25 MG CAPSULE
acitretin
00378702393 No No Medicaid, CHIP, CSHCN
ACITRETIN 25 MG CAPSULE
acitretin
42794008308 No No Medicaid, CHIP, CSHCN
ACITRETIN 25 MG CAPSULE
acitretin
66993089630 No No Medicaid, CHIP, CSHCN
ACNE MEDICATION 10% GEL
benzoyl peroxide
00536105656 No No Medicaid, CSHCN
ACNE MEDICATION 10% LOTION
benzoyl peroxide
00536105875 No No Medicaid, CSHCN
ACNE MEDICATION 5% GEL
benzoyl peroxide
00536105556 No No Medicaid, CSHCN
ACNE MEDICATION 5% LOTION
benzoyl peroxide
00536105775 No No Medicaid, CSHCN
ACTEMRA 162 MG/0.9 ML SYRINGE
tocilizumab
50242013801 CYTOKINE AND CAM ANTAGONISTS Yes Yes Medicaid, CHIP, CSHCN
ACTIDOSE 50 GM LIQUID
charcoal/sorbitol solution
00574012008 No No Medicaid, CSHCN
ACTIGALL 300 MG CAPSULE
ursodiol
52544093001 BILE SALTS No Yes Medicaid, CHIP, CSHCN
ACTIMMUNE 100 MCG/0.5 ML VIAL
interferon gamma-1b,recomb.
42238011101 No No Medicaid, CHIP, CSHCN
ACTIMMUNE 100 MCG/0.5 ML VIAL
interferon gamma-1b,recomb.
42238011112 No No Medicaid, CHIP, CSHCN
ACTIMMUNE 100 MCG/0.5 ML VIAL
interferon gamma-1b,recomb.
75987011110 No No Medicaid, CHIP, CSHCN
ACTIMMUNE 100 MCG/0.5 ML VIAL
interferon gamma-1b,recomb.
75987011111 No No Medicaid, CHIP, CSHCN
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
ACTONEL 150 MG TABLET
risedronate sodium
00430047801 BONE RESORPTION SUPPRESSION AND RELATED AGENTS No Yes Medicaid, CHIP, CSHCN
ACTONEL 150 MG TABLET
risedronate sodium
00430047802 BONE RESORPTION SUPPRESSION AND RELATED AGENTS No Yes Medicaid, CHIP, CSHCN
ACTONEL 30 MG TABLET
risedronate sodium
00430047015 BONE RESORPTION SUPPRESSION AND RELATED AGENTS No Yes Medicaid, CHIP, CSHCN
ACTONEL 35 MG TABLET
risedronate sodium
00430047203 BONE RESORPTION SUPPRESSION AND RELATED AGENTS No Yes Medicaid, CHIP, CSHCN
ACTONEL 5 MG TABLET
risedronate sodium
00430047115 BONE RESORPTION SUPPRESSION AND RELATED AGENTS No Yes Medicaid, CHIP, CSHCN
ACTOPLUS MET XR 15-1,000 MG TB
pioglitazone HCl/metformin HCl
64764051030 HYPOGLYCEMICS: TZD Yes Yes Medicaid, CHIP, CSHCN
ACTOPLUS MET XR 30-1,000 MG TB
pioglitazone HCl/metformin HCl
64764031030 HYPOGLYCEMICS: TZD Yes Yes Medicaid, CHIP, CSHCN
ACULAR 0.5% EYE DROPS
ketorolac tromethamine
00023218105 OPHTHALMICS: ANTI-INFLAMMATORIES No Yes Medicaid, CHIP, CSHCN
ACULAR LS 0.4% OPHTH SOL
ketorolac tromethamine
00023927705 OPHTHALMICS: ANTI-INFLAMMATORIES No Yes Medicaid, CHIP, CSHCN
ACUVAIL 0.45% OPHTH SOLUTION
ketorolac tromethamine/PF
00023350730 OPHTHALMICS: ANTI-INFLAMMATORIES Yes Yes Medicaid, CHIP, CSHCN
ACYCLOVIR 200 MG CAPSULE
acyclovir
00093894001 ANTIVIRALS: ORAL No No Medicaid, CHIP, CSHCN, KHC, HTW