Drug - Brand Name (Generic Name) PA Status Class Drug Notes "famotidine tablet *, M90" H2 ANTAGONISTS "*, M90, #" "ferrous fumarate *, M90" HEMATINIC AGENT "*, M90" "ferrous gluconate *, M90" HEMATINIC AGENT "*, M90" "ferrous sulfate *, M90" HEMATINIC AGENT "*, M90" "fexofenadine tablet *, M90" ANTIHISTAMINES "*, M90" "folic acid *, M90" ELECTROLYTES AND NUTRIENTS "*, M90" "fexofenadine / pseudoephedrine *, A90" ANTIHISTAMINES "*, A90" "Fluad (influenza virus vaccine, adjuvanted) 1 - PA < 65 years" PA BIOLOGICAL 1 "Fluzone (influenza virus vaccine, high dose) 1 - PA < 65 years " PA BIOLOGICAL 1 Fluarix (influenza virus vaccine-Fluarix) 1 BIOLOGICAL 1 Flublok (influenza virus vaccine-Flublok) 1 BIOLOGICAL 1 Flucelvax (influenza virus vaccine-Flucelvax) 1 BIOLOGICAL 1 Flulaval (influenza virus vaccine-Flulaval) 1 BIOLOGICAL 1 Flumist (influenza virus vaccine-Flumist) 1 BIOLOGICAL 1 Fluzone (influenza virus vaccine-Fluzone) 1 BIOLOGICAL 1 fam-trastuzumab deruxtecan-nxki MB - PA PA CHEMOTHERAPY MB faricimab-svoa MB OPHTHALMIC PREPARATIONS MB ferric carboxymaltose injection MB - PA PA HEMATINIC AGENT MB ferric pyrophosphate citrate MB HEMATINIC AGENT MB floxuridine MB CHEMOTHERAPY MB fluocinolone ophthalmic implant-Iluvien MB OPHTHALMIC PREPARATIONS MB fluocinolone ophthalmic implant-Retisert MB OPHTHALMIC PREPARATIONS MB fluocinolone ophthalmic implant-Yutiq MB OPHTHALMIC PREPARATIONS MB fluorouracil injection MB CHEMOTHERAPY MB foscarnet MB ANTIVIRALS MB fosdenopterin MB - PA PA ENZYMES MB fulvestrant MB - PA PA CHEMOTHERAPY MB Faslodex (fulvestrant) MB - PA PA CHEMOTHERAPY MB Folotyn (pralatrexate) MB CHEMOTHERAPY MB Focalin # (dexmethylphenidate) - PA 3 units/day; See Table 31; See Table 71 PA 3 units/day CEREBRAL STIMULANTS # Flolan # (epoprostenol-Flolan) CARDIOVASCULAR # "fat emulsions, intravenous-liposyn" ELECTROLYTES AND NUTRIENTS # fondaparinux ANTICOAGULANTS # fosaprepitant injection - PA > 2 vials/28 days PA > 2 vials/28 days ANTIEMETICS # fosphenytoin ANTICONVULSANTS # Ferrlecit # (sodium ferric gluconate complex) HEMATINIC AGENT # "fesoterodine BP, A90" URINARY ANTISPASMODICS "BP, A90" "flucytosine BP, A90" ANTIBIOTICS "BP, A90" "fluocinolone oil, otic drops BP, A90" OTIC PREPARATIONS "BP, A90" "fluorouracil 0.5% cream BP, A90" CHEMOTHERAPY "BP, A90" "fluorouracil 5% cream BP, A90" CHEMOTHERAPY "BP, A90" "fluticasone / salmeterol inhalation powder-Airduo Respiclick BP, A90 - PA" PA BRONCHODILATORS "BP, A90" "fluticasone / salmeterol inhalation-Advair BP, A90" BRONCHODILATORS "BP, A90" "fluticasone / vilanterol BP, A90" BRONCHODILATORS "BP, A90" "fosamprenavir BP, A90" ANTIVIRALS "BP, A90" "frovatriptan BP, A90 - PA" PA TRIPTAN "BP, A90" "Frova (frovatriptan) BP, A90 - PA" PA TRIPTAN "BP, A90" "Firvanq (vancomycin oral solution) BP, A90" ANTIBIOTICS "BP, A90" Focalin XR (dexmethylphenidate extended-release) BP - PA 2 units/day; See Table 31; See Table 71 PA 2 units/day CEREBRAL STIMULANTS BP Forteo (teriparatide-Forteo) BP - PA PA HORMONE AGENTS BP Fortesta (testosterone 2% gel pump) BP - PA PA HORMONE REPLACEMENT THERAPY BP factor IX human recombinant-Benefix PD ANTI-HEMOPHILIA AGENTS PD fostemsavir PD - PA PA ANTIVIRALS PD fremanezumab-vfrm for migraine prophylaxis PD - PA PA CALCITONIN GENE-RELATED PEPTIDE INHIBITOR PD Fosamax # (alendronate tablet) M90 ELECTROLYTES AND NUTRIENTS "M90, #" Femhrt # (ethinyl estradiol 2.5 mcg / norethindrone 0.5 mg-Femhrt) M90 HORMONE REPLACEMENT THERAPY "M90, #" "fenofibrate 48 mg, 145 mg tablet M90" LIPID LOWERING AGENTS "M90, #" fenofibric acid M90 LIPID LOWERING AGENTS "M90, #" finasteride M90 BENIGN PROSTATIC HYPERPLASIA AGENTS "M90, #" "furosemide tablet, solution, injection M90" CARDIOVASCULAR "M90, #" Flomax # (tamsulosin) M90 BENIGN PROSTATIC HYPERPLASIA AGENTS "M90, #" febuxostat M90 - PA PA GOUT AGENTS M90 felodipine extended-release M90 CARDIOVASCULAR M90 "fenofibrate 30 mg, 90 mg capsule M90" LIPID LOWERING AGENTS M90 "fenofibrate 40 mg, 120 mg tablet M90 - PA" PA LIPID LOWERING AGENTS M90 "Fenoglide (fenofibrate 40 mg, 120 mg tablet) M90 - PA" PA LIPID LOWERING AGENTS M90 "fenofibrate 43 mg, 67 mg, 130 mg, 134 mg, 200 mg capsule M90" LIPID LOWERING AGENTS M90 "fenofibrate 50 mg, 150 mg capsule M90" LIPID LOWERING AGENTS M90 "fenofibrate 54 mg, 160 mg tablet M90" LIPID LOWERING AGENTS M90 fenofibric acid tablet M90 LIPID LOWERING AGENTS M90 flecainide M90 CARDIOVASCULAR M90 flunisolide nasal spray M90 - PA PA NASAL PREPARATIONS M90 fluticasone propionate 50 mcg nasal spray M90 - PA > 1 inhaler/30 days PA > 1 inhaler/30 days NASAL PREPARATIONS M90 fluvastatin M90 - PA PA LIPID LOWERING AGENTS M90 fluvastatin extended-release M90 - PA PA LIPID LOWERING AGENTS M90 fosinopril M90 CARDIOVASCULAR M90 fosinopril / hydrochlorothiazide M90 CARDIOVASCULAR M90 felbamate A90 ANTICONVULSANTS "A90, #" Felbatol # (felbamate) A90 ANTICONVULSANTS "A90, #" fingolimod capsule A90 - PA > 1 unit/day PA > 1 unit/day SPHINGOSINE 1-PHOSPHATE RECEPTOR MODULATOR "A90, #" fluconazole A90 FUNGICIDES "A90, #" fluocinolone 0.025% cream A90 GLUCOCORTICOIDS "A90, #" "fluocinolone body oil, scalp oil A90" GLUCOCORTICOIDS "A90, #" fluocinolone ointment A90 GLUCOCORTICOIDS "A90, #" fluocinolone solution A90 GLUCOCORTICOIDS "A90, #" fluocinonide 0.1% cream A90 GLUCOCORTICOIDS "A90, #" fluorometholone A90 OPHTHALMIC PREPARATIONS "A90, #" FML # (fluorometholone) A90 OPHTHALMIC PREPARATIONS "A90, #" "fluoxetine 10 mg, 20 mg, 40 mg capsule, solution A90 - PA < 6 years; See Table 17; See Table 71" PA ANTIDEPRESSANTS "A90, #" fosfomycin A90 ANTIBIOTICS "A90, #" Fosrenol # (lanthanum) A90 ELECTROLYTES AND NUTRIENTS "A90, #" Femara # (letrozole) A90 CHEMOTHERAPY "A90, #" Feldene # (piroxicam) A90 NONSTEROIDAL ANTI-INFLAMMATORY "A90, #" Fareston # (toremifene) A90 CHEMOTHERAPY "A90, #" Finacea (azelaic acid gel) A90 - PA PA DERMATOLOGICAL A90 Fleqsuvy (baclofen suspension) A90 - PA PA MUSCLE RELAXANT A90 Forfivo XL (bupropion hydrochloride extended-release 450 mg tablet) A90 - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS A90 Ferriprox (deferiprone) A90 - PA PA CHELATING AGENT A90 Flector (diclofenac topical patch-Flector) A90 - PA PA NONSTEROIDAL ANTI-INFLAMMATORY A90 famciclovir A90 ANTIVIRALS A90 famotidine suspension A90 H2 ANTAGONISTS A90 fenoprofen capsule A90 - PA PA NONSTEROIDAL ANTI-INFLAMMATORY A90 fenoprofen tablet A90 - PA PA NONSTEROIDAL ANTI-INFLAMMATORY A90 flavoxate A90 URINARY ANTISPASMODICS A90 fludrocortisone A90 GLUCOCORTICOIDS A90 fluocinolone 0.01% cream A90 GLUCOCORTICOIDS A90 fluocinonide / emollient A90 GLUCOCORTICOIDS A90 "fluocinonide cream, gel, ointment, solution A90" GLUCOCORTICOIDS A90 fluorescein / benoxinate A90 OPHTHALMIC PREPARATIONS A90 fluorouracil solution A90 CHEMOTHERAPY A90 "fluoxetine 10 mg, 20 mg tablet for premenstrual dysphoric disorder A90 - PA < 6 years; See Table 17; See Table 71" PA ANTIDEPRESSANTS A90 fluoxetine 60 mg tablet A90 - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS A90 fluoxetine 90 mg delayed-release capsule A90 - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS A90 fluphenazine A90 - PA < 6 years; See Table 24; See Table 71 PA ANTIPSYCHOTIC A90 "flurandrenolide cream, lotion A90 - PA" PA GLUCOCORTICOIDS A90 flurandrenolide ointment A90 - PA PA GLUCOCORTICOIDS A90 flurbiprofen A90 NONSTEROIDAL ANTI-INFLAMMATORY A90 flurbiprofen ophthalmic solution A90 OPHTHALMIC PREPARATIONS A90 flutamide A90 CHEMOTHERAPY A90 fluticasone cream A90 GLUCOCORTICOIDS A90 fluticasone lotion A90 - PA PA GLUCOCORTICOIDS A90 fluticasone ointment A90 GLUCOCORTICOIDS A90 fluticasone propionate inhalation aerosol A90 - PA ≥ 5 years PA ≥ 5 years BRONCHODILATORS A90 fluticasone propionate inhalation powder A90 - PA PA BRONCHODILATORS A90 fluvoxamine extended-release A90 - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS A90 fluvoxamine immediate-release A90 - PA < 6 years; See Table 17; See Table 71 PA ANTIDEPRESSANTS A90 Flagyl (metronidazole 375 mg capsule) A90 - PA PA ANTIBIOTICS A90 Furadantin (nitrofurantoin 25 mg/5 mL suspension) A90 - PA PA ANTIBIOTICS A90 Fabrazyme (agalsidase beta) - PA PA ENZYMES Fosamax Plus D (alendronate / cholecalciferol) - PA PA ELECTROLYTES AND NUTRIENTS Firdapse (amifampridine) - PA PA POTASSIUM CHANNEL BLOCKER Feiba NF (anti-inhibitor coagulant complex-Feiba NF) ANTI-HEMOPHILIA AGENTS Finacea (azelaic acid foam) - PA PA DERMATOLOGICAL Fasenra (benralizumab) - PA PA BIOLOGICAL Fetroja (cefiderocol) - PA PA ANTIBIOTICS Flowflex (COVID-19 antigen self-test) - PA > 2 tests/28 days; Non-Drug Product PA > 2 tests/28 days DIAGNOSTICS Foltrate (cyanocobalamin / folic acid) - PA PA ELECTROLYTES AND NUTRIENTS Fragmin (dalteparin) ANTICOAGULANTS Farxiga (dapagliflozin) DIABETIC AGENTS Firmagon (degarelix) - PA PA CHEMOTHERAPY Fuzeon (enfuvirtide) ANTIVIRALS Femring (estradiol-Femring) HORMONE REPLACEMENT THERAPY factor IX ANTI-HEMOPHILIA AGENTS factor IX complex human-Profilnine SD ANTI-HEMOPHILIA AGENTS factor IX human recombinant-Ixinity ANTI-HEMOPHILIA AGENTS "factor IX recombinant, albumin fusion protein" ANTI-HEMOPHILIA AGENTS "factor IX recombinant, Fc fusion protein" ANTI-HEMOPHILIA AGENTS "factor IX, human" ANTI-HEMOPHILIA AGENTS "factor VIII recombinant, Fc fusion protein" ANTI-HEMOPHILIA AGENTS "factor VIII recombinant, glycopegylated-exei" ANTI-HEMOPHILIA AGENTS factor XIII A-subunit recombinant ANTI-HEMOPHILIA AGENTS "factor XIII concentrate, human" ANTI-HEMOPHILIA AGENTS famotidine injection H2 ANTAGONISTS "fat emulsions, intravenous- intralipid" ELECTROLYTES AND NUTRIENTS "fecal microbiota spores, live-brpk - PA" PA GASTROINTESTINAL AGENT "fecal microbiota, live-jslm - PA" PA MISCELLANEOUS fedratinib - PA PA CHEMOTHERAPY fenfluramine - PA PA ANTICONVULSANTS Fintepla (fenfluramine) - PA PA ANTICONVULSANTS "fentanyl 12, 25, 50 mcg/hr transdermal system - PA > 50 mcg/hr and PA > 10 patches/30 days" PA > 50 mcg/hr and PA > 10 patches/30 days OPIOID ANALGESICS "fentanyl 37.5, 62.5, 87.5 mcg/hr transdermal system - PA" PA OPIOID ANALGESICS "fentanyl 75, 100 mcg/hr transdermal system - PA" PA OPIOID ANALGESICS fentanyl buccal tablet - PA PA OPIOID ANALGESICS Fentora (fentanyl buccal tablet) - PA PA OPIOID ANALGESICS fentanyl injection OPIOID ANALGESICS fentanyl transmucosal system - PA PA OPIOID ANALGESICS ferric citrate - PA PA HEMATINIC AGENT ferric derisomaltose - PA PA HEMATINIC AGENT ferric maltol - PA PA HEMATINIC AGENT ferumoxytol - PA PA HEMATINIC AGENT Feraheme (ferumoxytol) - PA PA HEMATINIC AGENT fezolinetant - PA PA UNCLASSIFIED DRUG PRODUCTS fibrinogen ANTI-HEMOPHILIA AGENTS Fibryga (fibrinogen) ANTI-HEMOPHILIA AGENTS fibrinogen concentrate ANTI-HEMOPHILIA AGENTS fidaxomicin - PA PA ANTIBIOTICS filgrastim HEMATINIC AGENT filgrastim-aafi HEMATINIC AGENT filgrastim-ayow HEMATINIC AGENT filgrastim-sndz HEMATINIC AGENT finasteride / tadalafil - PA PA BENIGN PROSTATIC HYPERPLASIA AGENTS finerenone - PA PA ALDOSTERONE ANTAGONISTS fingolimod orally disintegrating tablet - PA PA SPHINGOSINE 1-PHOSPHATE RECEPTOR MODULATOR fludarabine CHEMOTHERAPY fluocinolone cream kit - PA PA GLUCOCORTICOIDS fluocinolone ointment kit - PA PA GLUCOCORTICOIDS fluocinolone solution kit - PA PA GLUCOCORTICOIDS fluorometholone acetate OPHTHALMIC PREPARATIONS Flarex (fluorometholone acetate) OPHTHALMIC PREPARATIONS flurazepam - PA 1 unit/day; See Table 69; See Table 71 PA 1 unit/day BENZODIAZEPINES fluticasone / salmeterol inhalation powder-Airduo Digihaler - PA PA BRONCHODILATORS fluticasone furoate / umeclidinium / vilanterol - PA PA BRONCHODILATORS fluticasone furoate inhalation powder BRONCHODILATORS fluticasone propionate 93 mcg nasal spray - PA PA NASAL PREPARATIONS fluticasone propionate inhalation powder-Armonair Digihaler - PA PA BRONCHODILATORS formoterol - PA PA BRONCHODILATORS fosnetupitant / palonosetron injection - PA > 2 vials/28 days PA > 2 vials/28 days ANTIEMETICS fostamatinib - PA PA HEMATOLOGIC furosemide on-body infusor - PA PA CARDIOVASCULAR Furoscix (furosemide on-body infusor) - PA PA CARDIOVASCULAR futibatinib - PA PA ANTINEOPLASTICS Firazyr (icatibant) - PA PA ENZYMES Fanapt (iloperidone) - PA; See Table 24; See Table 71 PA ANTIPSYCHOTIC "Flebogamma (immune globulin IV, human-Flebogamma) - PA" PA BIOLOGICAL Fiasp (insulin aspart-Fiasp) - PA PA DIABETIC AGENTS Fensolvi (leuprolide) - PA PA HORMONE AGENTS Fusilev (levoleucovorin powder for injection) - PA PA ANTIDOTES Fetzima (levomilnacipran) - PA; See Table 17; See Table 71 PA ANTIDEPRESSANTS First-Omeprazole (omeprazole suspension compounding kit) - PA PA PROTON PUMP INHIBITORS Fulphila (pegfilgrastim-jmdb) HEMATINIC AGENT Fylnetra (pegfilgrastim-pbbk) HEMATINICS & BLOOD CELL STIMULATORS Fycompa (perampanel) - PA PA ANTICONVULSANTS Florastor (saccharomyces boulardii) - PA ≥ 22 years PA ≥ 22 years GASTROINTESTINAL AGENT Fyarro (sirolimus injection) - PA PA IMMUNOMODULATOR Filspari (sparsentan) - PA PA OTHER ANTIHYPERTENSIVES Fabior (tazarotene foam) - PA PA DERMATOLOGICAL Fotivda (tivozanib) - PA PA CHEMOTHERAPY