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MassHealth Drug List A - Z

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This is a listing of all of the drugs covered by MassHealth. Please select a letter to see drugs listed by that letter, or enter the name of the drug you wish to search for.

MassHealth Drug List table
Drug - Brand Name (Generic Name) PA Status Class Drug Notes
Levoxyl (levothyroxine-Levoxyl) THYROID PREPARATIONS #
levothyroxine-Unithroid THYROID PREPARATIONS #
levothyroxine-Tirosint THYROID PREPARATIONS BP
levothyroxine-Thyquidity THYROID PREPARATIONS
levothyroxine-Synthroid THYROID PREPARATIONS #
levothyroxine-Levoxyl THYROID PREPARATIONS #
levothyroxine-Levo-T THYROID PREPARATIONS #
levothyroxine-Euthyrox THYROID PREPARATIONS #
Levo-T (levothyroxine-Levo-T) THYROID PREPARATIONS #
Lunesta (eszopiclone); See Table 15drugId:662; See Table 71drugId:4348 PA < 6 years and PA > 1 unit/day SEDATIVES #
lemborexant; See Table 15drugId:7388; See Table 71drugId:7389 PA SEDATIVE NON-BARBITURATE
lansoprazole orally disintegrating tabletdrugId:1022 PA ≥ 2 years PROTON PUMP INHIBITORS BP
lansoprazole capsuledrugId:1021 PA > 1 unit/day PROTON PUMP INHIBITORS #
Lupaneta Pack (leuprolide / norethindrone)drugId:2964 PA OTHER HORMONES
leuprolide / norethindronedrugId:2964 PA OTHER HORMONES
levorphanol tabletdrugId:1064 PA OPIOID ANALGESICS
levorphanol powderdrugId:1063 PA OPIOID ANALGESICS
Luxturna (voretigene neparvovec)drugId:7497 PA OPHTHALMIC PREPARATIONS CO ^
Lumigan (bimatoprost 0.01% ophthalmic solution)drugId:363 OPHTHALMIC PREPARATIONS
Lucentis (ranibizumab) OPHTHALMIC PREPARATIONS ^
loteprednol 1% suspensiondrugId:7285 PA OPHTHALMIC PREPARATIONS
loteprednol 0.5%drugId:7304 OPHTHALMIC PREPARATIONS BP
loteprednol 0.38% geldrugId:7287 PA OPHTHALMIC PREPARATIONS
loteprednol 0.25% suspensiondrugId:7779 PA OPHTHALMIC PREPARATIONS
loteprednol 0.2%drugId:1105 OPHTHALMIC PREPARATIONS
Lotemax SM (loteprednol 0.38% gel)drugId:7287 PA OPHTHALMIC PREPARATIONS
Lotemax (loteprednol 0.5%)drugId:7304 OPHTHALMIC PREPARATIONS BP
lidocaine ophthalmic gel OPHTHALMIC PREPARATIONS
levofloxacin ophthalmic solutiondrugId:1046 PA OPHTHALMIC PREPARATIONS
levobunololdrugId:1040 OPHTHALMIC PREPARATIONS #
latanoprost solutiondrugId:1027 OPHTHALMIC PREPARATIONS #
latanoprostenedrugId:6487 PA OPHTHALMIC PREPARATIONS
latanoprost emulsiondrugId:7013 PA OPHTHALMIC PREPARATIONS
Lacrisert (hydroxypropyl cellulose ophthalmic insert)drugId:2172 OPHTHALMIC PREPARATIONS
Licart (diclofenac topical patch-Licart)drugId:7454 PA NONSTEROIDAL ANTI-INFLAMMATORY
Lioresal (baclofen intrathecal injection)drugId:125 MUSCLE RELAXANT
Lemtrada (alemtuzumab 12 mg)drugId:4782 PA MULTIPLE SCLEROSIS AGENTS ^
LovazadrugId:1288 (omega-3 acid ethyl esters)drugId:1288 LIPID LOWERING AGENTS #
lovastatin extended-releasedrugId:1107 PA LIPID LOWERING AGENTS
lovastatin 40 mgdrugId:2735 PA > 2 units/day LIPID LOWERING AGENTS
lovastatin 10 mg, 20 mgdrugId:1108 PA > 1.5 units/day LIPID LOWERING AGENTS
LopiddrugId:927 (gemfibrozil)drugId:927 LIPID LOWERING AGENTS #
lomitapidedrugId:2727 PA LIPID LOWERING AGENTS
Livalo (pitavastatin calcium)drugId:1962 PA LIPID LOWERING AGENTS
Lipofen (fenofibrate 50 mg, 150 mg capsule)drugId:5480 LIPID LOWERING AGENTS
LipitordrugId:2933 (atorvastatin 80 mg)drugId:2933 PA > 1 unit/day LIPID LOWERING AGENTS #
LipitordrugId:105 (atorvastatin 10 mg, 20 mg, 40 mg)drugId:105 PA > 1.5 units/day LIPID LOWERING AGENTS #
Lescol XL (fluvastatin extended-release)drugId:898 PA LIPID LOWERING AGENTS
Lescol (fluvastatin)drugId:899 PA LIPID LOWERING AGENTS
Lupkynis (voclosporin)drugId:7785 PA IMMUNOMODULATOR
Lupron (leuprolide)drugId:1033 PA HORMONE AGENTS
Lysteda (tranexamic acid tablet) HEMOSTATICS #
lusutrombopagdrugId:6991 PA HEMATOLOGIC
luspatercept-aamtdrugId:7334 PA HEMATOLOGIC
Leukine (sargramostim)drugId:1833 HEMATINIC AGENT
lansoprazole / amoxicillin / clarithromycindrugId:1023 PA H. PYLORI AGENTS
LuxiqdrugId:355 (betamethasone valerate foam)drugId:355 GLUCOCORTICOIDS #
Locoid Lipocream (hydrocortisone butyrate / emollient)drugId:5031 PA GLUCOCORTICOIDS
Locoid (hydrocortisone butyrate lotion)drugId:6561 PA GLUCOCORTICOIDS
Lexette (halobetasol foam)drugId:6983 PA GLUCOCORTICOIDS
Lialda (mesalamine delayed-release)drugId:1153 GI ANTI-INFLAMMATORY BP
Lotronex (alosetron)drugId:19 PA GASTROINTESTINAL AGENT
lactulose solutiondrugId:1008 GASTROINTESTINAL AGENT
lactobacillus rhamnosus GGdrugId:6204 PA ≥ 19 years GASTROINTESTINAL AGENT
Lyrica CR (pregabalin extended-release); See Table 71drugId:6609; See Table 72drugId:6608 PA GABA ANALOGS BP
Luzu (luliconazole)drugId:2925 PA FUNGICIDES
luliconazoledrugId:2925 PA FUNGICIDES
LoproxdrugId:5625 (ciclopirox 0.77% cream, suspension)drugId:5625 FUNGICIDES #
Loprox (ciclopirox 1% shampoo)drugId:5128 PA FUNGICIDES
LamisildrugId:1672 (terbinafine tablet)drugId:1672 FUNGICIDES #
Lumizyme (alglucosidase alfa)drugId:11 PA ENZYMES
laronidasedrugId:1026 PA ENZYMES
low molecular weight iron dextrandrugId:972 PA ELECTROLYTES AND NUTRIENTS
Liposyn (fat emulsions, intravenous-liposyn) ELECTROLYTES AND NUTRIENTS #
levocarnitine powderdrugId:7340 PA ELECTROLYTES AND NUTRIENTS
L-Carnitine (levocarnitine) ELECTROLYTES AND NUTRIENTS
Lyumjev (insulin lispro-Lyumjev)drugId:7491 PA DIABETIC AGENTS
lixisenatidedrugId:5760 PA DIABETIC AGENTS
liraglutidedrugId:1085 DIABETIC AGENTS
linagliptin / metformin extended-releasedrugId:5724 DIABETIC AGENTS
linagliptin / metformindrugId:2486 DIABETIC AGENTS
linagliptindrugId:2293 DIABETIC AGENTS
Levemir (insulin detemir)drugId:805 DIABETIC AGENTS
Lantus (insulin glargine-Lantus)drugId:807 DIABETIC AGENTS
Lactinol (lactic acid) DERMATOLOGICAL
lactic acid / vitamin E DERMATOLOGICAL
lumacaftor / ivacaftordrugId:5126 PA CYSTIC FIBROSIS AGENTS PD
Loseasonique (levonorgestrel / ethinyl estradiol-Loseasonique) CONTRACEPTIVES #
Lo Loestrin Fe (norethindrone / ethinyl estradiol / ferrous fumarate) CONTRACEPTIVES
Liletta (levonorgestrel-releasing intrauterine system 52 mg-Liletta) CONTRACEPTIVES
levonorgestrel-releasing intrauterine system 52 mg-Mirena CONTRACEPTIVES
levonorgestrel-releasing intrauterine system 52 mg-Liletta CONTRACEPTIVES
levonorgestrel-releasing intrauterine system 19.5 mg CONTRACEPTIVES
levonorgestrel-releasing intrauterine system 13.5 mg CONTRACEPTIVES
levonorgestrel 1.5 mg tablet CONTRACEPTIVES *
levonorgestrel / ethinyl estradiol triphasic CONTRACEPTIVES
levonorgestrel / ethinyl estradiol-Seasonique CONTRACEPTIVES #
levonorgestrel / ethinyl estradiol-Quartette CONTRACEPTIVES #
levonorgestrel / ethinyl estradiol patch CONTRACEPTIVES
levonorgestrel / ethinyl estradiol-Loseasonique CONTRACEPTIVES #
levonorgestrel / ethinyl estradiol 90/20 mcg CONTRACEPTIVES
levonorgestrel / ethinyl estradiol 0.15/0.03 mg CONTRACEPTIVES
levonorgestrel / ethinyl estradiol 0.10/0.02 mg CONTRACEPTIVES
levonorgestrel / ethinyl estradiol / ferrous bisglycinate CONTRACEPTIVES
levonorgestrel / ethinyl estradiol CONTRACEPTIVES
lactic acid / citric acid / potassium bitartrate vaginal gel CONTRACEPTIVES
lubiprostonedrugId:1110 PA CONSTIPATION AGENTS BP
Linzess (linaclotide)drugId:2658 PA CONSTIPATION AGENTS
linaclotidedrugId:2658 PA CONSTIPATION AGENTS
lactulose packetdrugId:1007 PA CONSTIPATION AGENTS
Lysodren (mitotane)drugId:4881 CHEMOTHERAPY
Lynparza (olaparib)drugId:4783 PA CHEMOTHERAPY
lurbinectedindrugId:7604 PA CHEMOTHERAPY
Lumoxiti (moxetumomab pasudotox-tdfk)drugId:7043 PA CHEMOTHERAPY
Lumakras (sotorasib)drugId:7980 PA CHEMOTHERAPY
lorlatinibdrugId:7042 PA CHEMOTHERAPY
Lorbrena (lorlatinib)drugId:7042 PA CHEMOTHERAPY
Lonsurf (trifluridine / tipiracil)drugId:5261 PA CHEMOTHERAPY
loncastuximab tesirine-lpyldrugId:8027 PA CHEMOTHERAPY
lisocabtagene maraleuceldrugId:7778 PA CHEMOTHERAPY CO ^
Libtayo (cemiplimab-rwlc)drugId:7005 PA CHEMOTHERAPY
Levulan (aminolevulinic acid) CHEMOTHERAPY ^
leuprolidedrugId:1034 PA CHEMOTHERAPY
Leukeran (chlorambucil)drugId:216 CHEMOTHERAPY
letrozoledrugId:1031 CHEMOTHERAPY #
Lenvima (lenvatinib)drugId:4943 PA CHEMOTHERAPY
lenvatinibdrugId:4943 PA CHEMOTHERAPY
lenalidomidedrugId:2298 PA CHEMOTHERAPY BP
larotrectinibdrugId:7047 PA CHEMOTHERAPY
lapatinibdrugId:1025 CHEMOTHERAPY BP
Lokelma (sodium zirconium cyclosilicate)drugId:6905 PA > 30 units/month CHELATING AGENT
lisdexamfetamine; See Table 31drugId:1086; See Table 71drugId:3021 PA < 3 years and PA > 2 units/day CEREBRAL STIMULANTS PD
LotreldrugId:44 (amlodipine / benazepril)drugId:44 CARDIOVASCULAR #
Lotensin HCTdrugId:133 (benazepril / hydrochlorothiazide)drugId:133 CARDIOVASCULAR #
LotensindrugId:132 (benazepril)drugId:132 CARDIOVASCULAR #
losartan / hydrochlorothiazidedrugId:1104 CARDIOVASCULAR #
losartandrugId:1103 CARDIOVASCULAR #
Lopressor HCTdrugId:1339 (metoprolol / hydrochlorothiazide)drugId:1339 CARDIOVASCULAR #
LopressordrugId:1338 (metoprolol)drugId:1338 CARDIOVASCULAR #
lisinopril solutiondrugId:5592 PA CARDIOVASCULAR
lisinopril / hydrochlorothiazidedrugId:1090 CARDIOVASCULAR #
lisinoprildrugId:1087 CARDIOVASCULAR #
Letairis (ambrisentan)drugId:30 PA CARDIOVASCULAR BP
LasixdrugId:916 (furosemide)drugId:916 CARDIOVASCULAR #
Lanoxin (digoxin) CARDIOVASCULAR #
labetaloldrugId:1001 CARDIOVASCULAR
Lonhala (glycopyrrolate inhalation solution)drugId:6742 PA BRONCHODILATORS
levalbuterol inhalerdrugId:1035 BRONCHODILATORS BP
levalbuterol inhalation solutiondrugId:1036 PA BRONCHODILATORS
lanadelumab-flyodrugId:7008 PA BIOLOGICAL
lorazepam solution, tablet; See Table 69drugId:1100; See Table 71drugId:4400 PA < 6 years BENZODIAZEPINES #
lorazepam powder; See Table 69drugId:1102; See Table 71drugId:4401 PA BENZODIAZEPINES
lorazepam injectiondrugId:7662 BENZODIAZEPINES #
lopinavir / ritonavirdrugId:1098 ANTIVIRALS #
Lexiva (fosamprenavir)drugId:908 ANTIVIRALS BP
letermovirdrugId:6615 PA ANTIVIRALS
ledipasvir / sofosbuvirdrugId:4600 PA ANTIVIRALS PD
lamivudine 5 mg/mL solutiondrugId:1011 PA > 20 mL/day ANTIVIRALS
lamivudine 150 mg, 300 mg tabletdrugId:1009 ANTIVIRALS #
lamivudine 10 mg/mL solutiondrugId:2541 ANTIVIRALS #
lamivudine 100 mg tabletdrugId:1010 PA > 1 unit/day ANTIVIRALS #
lamivudine / zidovudinedrugId:1012 ANTIVIRALS #
lamivudine / tenofovir disoproxil fumaratedrugId:6780 PA ANTIVIRALS
Librax (chlordiazepoxide / clidinium)drugId:6843 PA ANTISPASMODICS,ANTICHOLINERGIC
lurasidone; See Table 24drugId:2174; See Table 71drugId:4266 PA ANTIPSYCHOTIC
lumateperone; See Table 24drugId:7361; See Table 71drugId:7362 PA ANTIPSYCHOTIC
Loxitane (loxapine capsule); See Table 24drugId:6324; See Table 71drugId:1109 PA < 6 years ANTIPSYCHOTIC #
loxapine capsule; See Table 24drugId:6324; See Table 71drugId:1109 PA < 6 years ANTIPSYCHOTIC #
LithobiddrugId:1092 (lithium)drugId:1092 PA < 6 years ANTIPSYCHOTIC #
lithiumdrugId:1092 PA < 6 years ANTIPSYCHOTIC #
Latuda (lurasidone); See Table 24drugId:2174; See Table 71drugId:4266 PA ANTIPSYCHOTIC
LodosyndrugId:173 (carbidopa)drugId:173 ANTIPARKINSON #
levodopadrugId:7237 PA ANTIPARKINSON
lindane shampoodrugId:1076 PA ANTIPARASITICS
loratadine tablet, solutiondrugId:1099 ANTIHISTAMINES *
loratadine / pseudoephedrinedrugId:2264 ANTIHISTAMINES *
levocetirizine tabletdrugId:1043 ANTIHISTAMINES #
levocetirizine solutiondrugId:5960 PA ANTIHISTAMINES
Lastacaft (alcaftadine)drugId:2173 ANTIHISTAMINES
levoleucovorin powder for injectiondrugId:1047 PA ANTIDOTES
levoleucovorin injectiondrugId:4944 PA ANTIDOTES
leucovorindrugId:1032 ANTIDOTES
loperamidedrugId:1097 ANTIDIARRHEALS *
LomotildrugId:542 (diphenoxylate / atropine)drugId:542 ANTIDIARRHEALS #
Lexapro (escitalopram); See Table 17drugId:630; See Table 71drugId:3701 PA < 6 years ANTIDEPRESSANTS #
levomilnacipran; See Table 17drugId:2886; See Table 71drugId:3980 PA < 6 years and PA > 1 unit/day ANTIDEPRESSANTS
Lyrica (pregabalin); See Table 20drugId:1582; See Table 71drugId:4460 PA ANTICONVULSANTS
levetiracetam tablet for oral suspension; See Table 20drugId:5397; See Table 71drugId:5398 PA ANTICONVULSANTS
levetiracetam injection, solution, tablet; See Table 20drugId:1037; See Table 71drugId:4302 ANTICONVULSANTS #
levetiracetam extended-release; See Table 20drugId:1038; See Table 71drugId:4320 ANTICONVULSANTS #
lamotrigine tablet starter kit; See Table 20drugId:1016; See Table 71drugId:4284 PA ANTICONVULSANTS
lamotrigine tablet; See Table 20drugId:1013; See Table 71drugId:4289 PA < 6 years ANTICONVULSANTS #
lamotrigine powder; See Table 20drugId:7189; See Table 71drugId:7190 PA ANTICONVULSANTS
lamotrigine orally disintegrating tablet starter kit; See Table 20drugId:1015; See Table 71drugId:4292 PA ANTICONVULSANTS
lamotrigine orally disintegrating tablet; See Table 20drugId:1014; See Table 71drugId:4291 PA ANTICONVULSANTS
lamotrigine extended-release tablet starter kit; See Table 20drugId:1018; See Table 71drugId:4300 PA ANTICONVULSANTS
lamotrigine extended-release tablet; See Table 20drugId:1017; See Table 71drugId:4297 PA ANTICONVULSANTS
lamotrigine dispersible tablet; See Table 20drugId:2216; See Table 71drugId:4288 PA < 6 years ANTICONVULSANTS #
Lamictal XR (lamotrigine extended-release tablet starter kit); See Table 20drugId:1018; See Table 71drugId:4300 PA ANTICONVULSANTS
Lamictal XR (lamotrigine extended-release tablet); See Table 20drugId:1017; See Table 71drugId:4297 PA ANTICONVULSANTS
Lamictal ODT (lamotrigine orally disintegrating tablet starter kit); See Table 20drugId:1015; See Table 71drugId:4292 PA ANTICONVULSANTS
Lamictal ODT (lamotrigine orally disintegrating tablet); See Table 20drugId:1014; See Table 71drugId:4291 PA ANTICONVULSANTS
Lamictal (lamotrigine tablet); See Table 20drugId:1013; See Table 71drugId:4289 PA < 6 years ANTICONVULSANTS #
Lamictal (lamotrigine dispersible tablet); See Table 20drugId:2216; See Table 71drugId:4288 PA < 6 years ANTICONVULSANTS #
Lamictal (lamotrigine tablet starter kit); See Table 20drugId:1016; See Table 71drugId:4284 PA ANTICONVULSANTS
lacosamide tablet; See Table 20drugId:1003; See Table 71drugId:3520 PA ANTICONVULSANTS
lacosamide solution; See Table 20drugId:1972; See Table 71drugId:3500 PA ANTICONVULSANTS
lacosamide injectiondrugId:1002 ANTICONVULSANTS
LovenoxdrugId:601 (enoxaparin)drugId:601 ANTICOAGULANTS #
Lithostat (acetohydroxamic acid) ANTIBIOTICS
linezolid tabletdrugId:8038 ANTIBIOTICS #
linezolid suspensiondrugId:1078 PA ANTIBIOTICS
linezolid injectiondrugId:1079 PA ANTIBIOTICS
lincomycindrugId:2634 ANTIBIOTICS #
LincocindrugId:2634 (lincomycin)drugId:2634 ANTIBIOTICS #
levofloxacin powderdrugId:7053 PA ANTIBIOTICS
levofloxacin; See Table 35drugId:1044; See Table 66drugId:4720 ANTIBIOTICS
lefamulin tabletdrugId:7358 PA ANTIBIOTICS
lefamulin injectiondrugId:7357 PA ANTIBIOTICS
Lampit (nifurtimox)drugId:7598 PA ANTIBIOTICS
LidodermdrugId:1071 (lidocaine 5% patch)drugId:1071 PA > 3 patches/day ANESTHETICS #
lidocaine viscous solutiondrugId:5605 ANESTHETICS
lidocaine vial, preservative free ANESTHETICS #
lidocaine vial ANESTHETICS #
lidocaine topical jelly, solutiondrugId:7957 ANESTHETICS
lidocaine powderdrugId:6374 PA ANESTHETICS
lidocaine ointmentdrugId:5604 PA ANESTHETICS
lidocaine 5% patchdrugId:1071 PA > 3 patches/day ANESTHETICS #
lidocaine 1.8% patchdrugId:7015 PA ANESTHETICS
lidocaine / tetracainedrugId:1075 PA > 4 patches / month ANESTHETICS
lidocaine / prilocainedrugId:1074 ANESTHETICS
Lucemyra (lofexidine)drugId:6906 PA ALPHA-2 ADRENERGIC AGONIST
lofexidinedrugId:6906 PA ALPHA-2 ADRENERGIC AGONIST

Note: Any drug that does not appear on the List requires prior authorization.

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Last updated 01/14/22