Formulary Drug Search
Search Results
Displaying 1 - 25 of 6487 drugs found. Return to search page.
A drug with a termination date will appear on the search for 90 days following the termination date.
| Brand Name/Generic Name/Package Size | NDC/Manufacturer/Class | Medicaid PA Required | Programs/Coverage Dates |
|---|---|---|---|
| 24HR ALLERGY(LEVOCETIRZN) 5 MG - 10EA levocetirizine dihydrochloride 10 EA |
70000036201 LEADER ANTIHISTAMINES, MINIMALLY SEDATING |
FFS Clinical: Yes PDL: Yes |
Medicaid start: 11/13/2019 CSHCN start: 11/13/2019 |
| 24HR ALLERGY(LEVOCETIRZN) 5 MG - 35EA levocetirizine dihydrochloride 35 EA |
70000036202 LEADER ANTIHISTAMINES, MINIMALLY SEDATING |
FFS Clinical: Yes PDL: Yes |
Medicaid start: 11/13/2019 CSHCN start: 11/13/2019 |
| 24HR ALLERGY-CONGST 180-240 MG - 10EA fexofenadine/pseudoephedrine 10 EA |
70000060701 LEADER ANTIHISTAMINES, MINIMALLY SEDATING |
FFS Clinical: No PDL: Yes |
Medicaid start: 06/06/2023 Medicaid end: 10/15/2025 CSHCN start: 06/06/2023 CSHCN end: 10/15/2025 |
| ABILIFY 10 MG TABLET - 30EA aripiprazole 30 EA |
59148000813 OTSUKA AMERICA ANTIPSYCHOTICS |
FFS Clinical: Yes PDL: Yes |
Medicaid start: 11/22/2002 CHIP start: 11/22/2002 CSHCN start: 11/22/2002 |
| ABILIFY 15 MG TABLET - 30EA aripiprazole 30 EA |
59148000913 OTSUKA AMERICA ANTIPSYCHOTICS |
FFS Clinical: Yes PDL: Yes |
Medicaid start: 11/22/2002 CHIP start: 11/22/2002 CSHCN start: 11/22/2002 |
| ABILIFY 2 MG TABLET - 30EA aripiprazole 30 EA |
59148000613 OTSUKA AMERICA ANTIPSYCHOTICS |
FFS Clinical: Yes PDL: Yes |
Medicaid start: 02/09/2006 CHIP start: 02/09/2006 CSHCN start: 02/09/2006 |
| ABILIFY 20 MG TABLET - 30EA aripiprazole 30 EA |
59148001013 OTSUKA AMERICA ANTIPSYCHOTICS |
FFS Clinical: Yes PDL: Yes |
Medicaid start: 11/22/2002 CHIP start: 11/22/2002 CSHCN start: 11/22/2002 |
| ABILIFY 30 MG TABLET - 30EA aripiprazole 30 EA |
59148001113 OTSUKA AMERICA ANTIPSYCHOTICS |
FFS Clinical: Yes PDL: Yes |
Medicaid start: 11/22/2002 CHIP start: 11/22/2002 CSHCN start: 11/22/2002 |
| ABILIFY 5 MG TABLET - 30EA aripiprazole 30 EA |
59148000713 OTSUKA AMERICA ANTIPSYCHOTICS |
FFS Clinical: Yes PDL: Yes |
Medicaid start: 09/08/2003 CHIP start: 09/08/2003 CSHCN start: 09/08/2003 |
| ABSORICA 10 MG CAPSULE - 30EA isotretinoin 30 EA |
10631011531 SUN PHARMACEUTI ACNE AGENTS, ORAL |
FFS Clinical: No PDL: Yes |
Medicaid start: 01/09/2013 CHIP start: 01/09/2013 CSHCN start: 01/09/2013 |
| ABSORICA 20 MG CAPSULE - 30EA isotretinoin 30 EA |
10631011631 SUN PHARMACEUTI ACNE AGENTS, ORAL |
FFS Clinical: No PDL: Yes |
Medicaid start: 01/09/2013 CHIP start: 01/09/2013 CSHCN start: 01/09/2013 |
| ABSORICA 30 MG CAPSULE - 30EA isotretinoin 30 EA |
10631011731 SUN PHARMACEUTI ACNE AGENTS, ORAL |
FFS Clinical: No PDL: Yes |
Medicaid start: 01/09/2013 CHIP start: 01/09/2013 CSHCN start: 01/09/2013 |
| ABSORICA 40 MG CAPSULE - 30EA isotretinoin 30 EA |
10631011831 SUN PHARMACEUTI ACNE AGENTS, ORAL |
FFS Clinical: No PDL: Yes |
Medicaid start: 01/09/2013 CHIP start: 01/09/2013 CSHCN start: 01/09/2013 |
| ACCRUFER 30 MG CAPSULE - 60EA ferric maltol 60 EA |
73059000160 SHIELD THERAPEU IRON, ORAL |
FFS Clinical: No PDL: Yes |
Medicaid start: 02/10/2022 CHIP start: 02/10/2022 CSHCN start: 02/10/2022 |
| ACCUPRIL 10 MG TABLET - 90EA quinapril HCl 90 EA |
00071053023 PFIZER US PHARM ANGIOTENSIN MODULATORS |
FFS Clinical: No PDL: Yes |
Medicaid start: 03/01/2002 CHIP start: 03/01/2002 CSHCN start: 03/01/2002 KHC start: 03/01/2002 |
| ACCUPRIL 20 MG TABLET - 90EA quinapril HCl 90 EA |
00071053223 PFIZER US PHARM ANGIOTENSIN MODULATORS |
FFS Clinical: No PDL: Yes |
Medicaid start: 03/01/2002 CHIP start: 03/01/2002 CSHCN start: 03/01/2002 KHC start: 03/01/2002 |
| ACCUPRIL 40 MG TABLET - 90EA quinapril HCl 90 EA |
00071053523 PFIZER US PHARM ANGIOTENSIN MODULATORS |
FFS Clinical: No PDL: Yes |
Medicaid start: 03/01/2002 CHIP start: 03/01/2002 CSHCN start: 03/01/2002 KHC start: 03/01/2002 |
| ACCUPRIL 5 MG TABLET - 90EA quinapril HCl 90 EA |
00071052723 PFIZER US PHARM ANGIOTENSIN MODULATORS |
FFS Clinical: No PDL: Yes |
Medicaid start: 03/01/2002 CHIP start: 03/01/2002 CSHCN start: 03/01/2002 KHC start: 03/01/2002 |
| ACCURETIC 20-25 MG TABLET - 90EA quinapril/hydrochlorothiazide 90 EA |
00071022323 PFIZER US PHARM ANGIOTENSIN MODULATORS |
FFS Clinical: Yes PDL: Yes |
Medicaid start: 10/07/2002 CHIP start: 10/07/2002 CSHCN start: 10/07/2002 KHC start: 10/07/2002 |
| ACETAMN-CAF-DIHYDRCODEIN 320.5 - 100EA acetaminophen/caff/dihydrocod 100 EA |
42195084010 XSPIRE PHARMA ANALGESICS, NARCOTICS SHORT |
FFS Clinical: Yes PDL: Yes |
Medicaid start: 08/11/2015 Medicaid end: 08/15/2045 CHIP start: 08/11/2015 CHIP end: 08/15/2045 CSHCN start: 08/11/2015 CSHCN end: 08/15/2045 |
| ACID REDUCER DR 20 MG CAP - 14EA omeprazole magnesium 14 EA |
70000023201 LEADER PROTON PUMP INHIBITORS |
FFS Clinical: No PDL: Yes |
Medicaid start: 02/13/2020 CSHCN start: 02/13/2020 |
| ACID REDUCER DR 20 MG CAP - 28EA omeprazole magnesium 28 EA |
70000023202 LEADER PROTON PUMP INHIBITORS |
FFS Clinical: No PDL: Yes |
Medicaid start: 02/13/2020 CSHCN start: 02/13/2020 |
| ACID REDUCER DR 20 MG CAP - 42EA omeprazole magnesium 42 EA |
70000023203 LEADER PROTON PUMP INHIBITORS |
FFS Clinical: No PDL: Yes |
Medicaid start: 02/13/2020 CSHCN start: 02/13/2020 |
| ACTEMRA 162 MG/0.9 ML SYRINGE - 0.9ML tocilizumab 0.9 ML |
50242013801 GENENTECH, INC. CYTOKINE AND CAM ANTAGONISTS |
FFS Clinical: Yes PDL: Yes |
Medicaid start: 11/12/2013 CHIP start: 11/12/2013 CSHCN start: 11/12/2013 |
| ACTEMRA ACTPEN 162 MG/0.9 ML - 0.9ML tocilizumab 0.9 ML |
50242014301 GENENTECH, INC. CYTOKINE AND CAM ANTAGONISTS |
FFS Clinical: Yes PDL: Yes |
Medicaid start: 05/23/2019 CHIP start: 05/23/2019 CSHCN start: 05/23/2019 |