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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
paclitaxel injectable suspensiondrugId:1468 CHEMOTHERAPY MB
paclitaxel injectiondrugId:1467 CHEMOTHERAPY
pacritinibdrugId:8308 PA CHEMOTHERAPY
Padcev (enfortumab vedotin-ejfv)drugId:7351 PA CHEMOTHERAPY MB
palbociclibdrugId:4940 PA CHEMOTHERAPY PD
Palforzia (peanut allergen powder-dnfp)drugId:7373 PA ALLERGENS
palifermin ANTIDOTES MB
paliperidone extended-release 1-month injection; See Table 24drugId:1470; See Table 71drugId:4281 PA < 6 years, PA > 2 injections/28 days within the first 28 days of therapy and PA > 1 injection/28 days after 28 days of therapy ANTIPSYCHOTIC PD
paliperidone extended-release 3-month injection; See Table 24drugId:5121; See Table 71drugId:5122 PA < 6 years and PA > 1 injection/84 days ANTIPSYCHOTIC PD
paliperidone extended-release 6-month injection; See Table 24drugId:8113; See Table 71drugId:8114 PA < 6 years and PA > 1 injection/168 days ANTIPSYCHOTIC PD
paliperidone tablet; See Table 24drugId:1471; See Table 71drugId:4280 PA ANTIPSYCHOTIC A90
palivizumabdrugId:1472 PA ANTIVIRALS
palonosetron 0.25 mg/2 mL injectiondrugId:6614 PA > 2 units/28 days ANTIEMETICS A90
palonosetron 0.25 mg/5 mL injectiondrugId:1473 PA > 2 units/28 days ANTIEMETICS #
Palynziq (pegvaliase-pqpz)drugId:6923 PA ENZYMES
Pamelor (nortriptyline); See Table 17drugId:1262; See Table 71drugId:4120 PA < 6 years ANTIDEPRESSANTS A90, #
pancrelipase-Creon DRdrugId:1082 ENZYMES
pancrelipase-Pertzye DRdrugId:2730 ENZYMES
pancrelipase-ViokacedrugId:2597 ENZYMES
pancrelipase-Zenpep DRdrugId:1084 ENZYMES
Pandel (hydrocortisone probutate cream)drugId:732 GLUCOCORTICOIDS
panitumumabdrugId:1475 CHEMOTHERAPY MB
Panretin (alitretinoin)drugId:8411 PA ANTINEOPLASTICS
pantoprazole 40 mg suspensiondrugId:2702 PA PROTON PUMP INHIBITORS BP, M90
pantoprazole IVdrugId:1477 PROTON PUMP INHIBITORS #
pantoprazole tabletdrugId:1476 PA > 4 units/day PROTON PUMP INHIBITORS M90, #
Panzyga (immune globulin IV, human-ifas)drugId:7104 PA BIOLOGICAL
Paragard (copper IUD) CONTRACEPTIVES
parathyroid hormonedrugId:5107 PA HORMONE AGENTS
paricalcitol capsuledrugId:1481 PA ELECTROLYTES AND NUTRIENTS M90
paricalcitol injectiondrugId:5781 ELECTROLYTES AND NUTRIENTS MB
ParlodeldrugId:377 (bromocriptine 2.5 mg, 5 mg)drugId:377 ANTIPARKINSON A90, #
paromomycindrugId:1482 ANTIPARASITICS A90
paroxetine controlled-release; See Table 17drugId:1485; See Table 71drugId:3800 PA ANTIDEPRESSANTS A90
paroxetine hydrochloride; See Table 17drugId:1484; See Table 71drugId:3801 PA < 6 years ANTIDEPRESSANTS A90, #
paroxetine mesylate capsuledrugId:2839 PA UNCLASSIFIED DRUG PRODUCTS A90
paroxetine mesylate tablet; See Table 17drugId:1483; See Table 71drugId:3802 PA ANTIDEPRESSANTS
Parsabiv (etelcalcetide) CALCIMIMETIC MB
Paser (aminosalicylic acid)drugId:2500 TB PREPARATIONS
pasireotide injectable suspensiondrugId:4912 PA ENDOCRINE/METABOLIC AGENTS MB
Patanase (olopatadine nasal spray)drugId:1283 PA NASAL PREPARATIONS A90
patiromerdrugId:5320 PA > 1 unit/day CHELATING AGENT
Paxil (paroxetine hydrochloride); See Table 17drugId:1484; See Table 71drugId:3801 PA < 6 years ANTIDEPRESSANTS A90, #
Paxil CR (paroxetine controlled-release); See Table 17drugId:1485; See Table 71drugId:3800 PA ANTIDEPRESSANTS A90
Paxlovid (nirmatrelvir/ritonavir COVID EUA – December 22, 2021)drugId:8127 COVID - 19 related Treatments and Vaccines
Paxlovid (nirmatrelvir / ritonavir for members ≥ 18 years of age)drugId:8581 COVID - 19 related Treatments and Vaccines
pazopanibdrugId:1486 PA CHEMOTHERAPY BP, A90
peanut allergen powder-dnfpdrugId:7373 PA ALLERGENS
PediapreddrugId:1578 (prednisolone 5 mg/5 mL oral solution)drugId:1578 GLUCOCORTICOIDS A90, #
Pediarix (diphtheria / tetanus toxoids / acellular pertussis / hepatitis B, recombinant / poliovirus, inactivated vaccine)drugId:700 BIOLOGICAL 1
pediatric multivitaminsdrugId:1487 ELECTROLYTES AND NUTRIENTS *, M90
Pedmark (sodium thiosulfate)drugId:8576 PA ANTIDOTES MB
Pedvaxhib (haemophilus B conjugate vaccine-Pedvaxhib)drugId:694 BIOLOGICAL 1
pegaspargasedrugId:2430 CHEMOTHERAPY MB
Pegasys (peginterferon alfa-2a)drugId:2059 PA ANTIVIRALS
pegcetacoplan 1,080 mg/20 mL vialdrugId:7919 PA BIOLOGICAL
pegcetacoplan 150 mg/mL vialdrugId:8606 PA BIOLOGICAL MB
pegfilgrastimdrugId:1489 HEMATINIC AGENT
pegfilgrastim-apgfdrugId:7617 HEMATINIC AGENT
pegfilgrastim-bmezdrugId:7337 HEMATINIC AGENT
pegfilgrastim-cbqvdrugId:7012 HEMATINIC AGENT
pegfilgrastim-fpgkdrugId:8541 HEMATINICS & BLOOD CELL STIMULATORS
pegfilgrastim-jmdbdrugId:6903 HEMATINIC AGENT
pegfilgrastim-pbbkdrugId:8527 HEMATINICS & BLOOD CELL STIMULATORS
peginterferon alfa-2adrugId:2059 PA ANTIVIRALS
peginterferon alfa-2bdrugId:1490 PA ANTIVIRALS
peginterferon beta-1adrugId:4631 PA MULTIPLE SCLEROSIS AGENTS
Pegintron (peginterferon alfa-2b)drugId:1490 PA ANTIVIRALS
pegloticasedrugId:6294 PA GOUT AGENTS MB
pegunigalsidase alfa-iwxjdrugId:8655 PA ENZYMES
pegvaliase-pqpzdrugId:6923 PA ENZYMES
pegvisomantdrugId:1491 PA HORMONE AGENTS
Pemazyre (pemigatinib)drugId:7455 PA CHEMOTHERAPY
pembrolizumabdrugId:4780 PA CHEMOTHERAPY MB
pemetrexed disodiumdrugId:1492 CHEMOTHERAPY MB
pemetrexeddrugId:8267 CHEMOTHERAPY MB
pemetrexed-PemfexydrugId:8300 PA CHEMOTHERAPY MB
Pemfexy (pemetrexed-Pemfexy)drugId:8300 PA CHEMOTHERAPY MB
pemigatinibdrugId:7455 PA CHEMOTHERAPY
penciclovirdrugId:1495 PA ANTIVIRALS A90
penicillamine capsuledrugId:1496 CHELATING AGENT BP, A90
penicillamine tabletdrugId:1497 CHELATING AGENT A90, #
penicillin G 0.6 million, 1.2 million, 2.4 million unitsdrugId:2625 ANTIBIOTICS
penicillin G 5 million, 20 million unitsdrugId:1499 ANTIBIOTICS #
penicillin G benzathine / penicillin G procainedrugId:2624 ANTIBIOTICS
penicillin VdrugId:1500 ANTIBIOTICS A90
Pennsaid (diclofenac topical solution)drugId:1944 NONSTEROIDAL ANTI-INFLAMMATORY BP, A90
Pentacel (diphtheria / tetanus / acellular pertussis / poliovirus inactivated / haemophilus B conjugate vaccine)drugId:581 BIOLOGICAL 1
pentamidine ANTIPARASITICS A90, #
Pentasa (mesalamine controlled-release)drugId:1154 GI ANTI-INFLAMMATORY BP, A90
pentazocine / naloxonedrugId:1504 PA OPIOID ANALGESICS
pentostatindrugId:2692 CHEMOTHERAPY MB
pentoxifylline CARDIOVASCULAR A90
PepciddrugId:461 (famotidine tablet)drugId:461 H2 ANTAGONISTS *, M90, #
perampaneldrugId:7566 PA ANTICONVULSANTS
PercocetdrugId:1323 (oxycodone / acetaminophen-Percocet)drugId:1323 PA > 80 mg/day oxycodone and PA > 4 g/day acetaminophen OPIOID ANALGESICS #
perfluorohexyloctanedrugId:8714 PA OPHTHALMIC PREPARATIONS
Perforomist (formoterol)drugId:906 PA BRONCHODILATORS
perindoprildrugId:1509 CARDIOVASCULAR M90
Perjeta (pertuzumab)drugId:2583 PA CHEMOTHERAPY MB
permethrindrugId:1510 ANTIPARASITICS *, A90
permethrin creamdrugId:4700 ANTIPARASITICS A90
perphenazine; See Table 24drugId:6326; See Table 71drugId:1511 PA < 6 years ANTIPSYCHOTIC A90
Perseris (risperidone 90 mg, 120 mg extended-release subcutaneous injection); See Table 24drugId:7007; See Table 71drugId:7009 PA < 6 years and > 1 injection/28 days ANTIPSYCHOTIC PD
pertuzumab / trastuzumab / hyaluronidase-zzxfdrugId:7618 PA CHEMOTHERAPY MB
pertuzumabdrugId:2583 PA CHEMOTHERAPY MB
Pertzye DR (pancrelipase-Pertzye DR)drugId:2730 ENZYMES
petrolatumdrugId:1513 DERMATOLOGICAL *, A90
Pexeva (paroxetine mesylate tablet); See Table 17drugId:1483; See Table 71drugId:3802 PA ANTIDEPRESSANTS
pexidartinibdrugId:7279 PA CHEMOTHERAPY
PfizerpendrugId:1499 (penicillin G 5 million, 20 million units)drugId:1499 ANTIBIOTICS #
Pheburane (sodium phenylbutyrate granules)drugId:8369 PA ENZYMES
phenazopyridine ANALGESICS A90
phendimetrazine extended-releasedrugId:8668 PA ANTI-OBESITY AGENTS
phendimetrazinedrugId:8667 PA ANTI-OBESITY AGENTS
phenelzine; See Table 17drugId:1515; See Table 71drugId:3580 PA < 6 years ANTIDEPRESSANTS A90, #
phenobarbital 100 mg vialdrugId:8725 BARBITURATES MB
phenobarbital tablet, solution, injectiondrugId:1516 BARBITURATES
phenoxybenzaminedrugId:5123 PA CARDIOVASCULAR M90
phentermine 15 mg, 30 mg capsuledrugId:8669 PA ANTI-OBESITY AGENTS
phentermine 37.5 mg capsule, tabletdrugId:8662 PA ANTI-OBESITY AGENTS
phentermine 8 mg tabletdrugId:8666 PA ANTI-OBESITY AGENTS
phenylephrine / ketorolac OPHTHALMIC PREPARATIONS MB
phenylephrine / promethazine DECONGESTANT A90
phenylephrine ophthalmic solution ADRENERGICS
phenytoin chewable tabletdrugId:1523 ANTICONVULSANTS A90, #
phenytoin extended 200 mg and 300 mg capsuledrugId:1526 ANTICONVULSANTS A90
phenytoin extended 30 mg and 100 mg capsuledrugId:1525 ANTICONVULSANTS A90, #
phenytoin injectiondrugId:2661 ANTICONVULSANTS MB
phenytoin suspensiondrugId:2938 ANTICONVULSANTS A90, #
Phesgo (pertuzumab / trastuzumab / hyaluronidase-zzxf)drugId:7618 PA CHEMOTHERAPY MB
Phexxi (lactic acid / citric acid / potassium bitartrate vaginal gel) CONTRACEPTIVES
Phos-Flur (sodium fluoride oral rinse) ELECTROLYTES AND NUTRIENTS A90
Phoslyra (calcium acetate) ELECTROLYTES AND NUTRIENTS
Phospholine Iodide (echothiophate iodide)drugId:8582 OPHTHALMIC PREPARATIONS
Pifeltro (doravirine)drugId:6986 ANTIVIRALS PD
pilocarpine 1.2% ophthalmic solutiondrugId:8164 PA OPHTHALMIC PREPARATIONS
pilocarpine 1%, 2%, 4% ophthalmic solutiondrugId:2635 OPHTHALMIC PREPARATIONS M90, #
pilocarpine tablet PARASYMPATHETIC AGENTS A90
pimavanserindrugId:5588 PA ANTIPSYCHOTIC
pimecrolimusdrugId:1531 DERMATOLOGICAL BP, A90
pimozide; See Table 24drugId:6327; See Table 71drugId:1532 PA < 6 years ANTIPSYCHOTIC A90, #
pindololdrugId:1533 CARDIOVASCULAR M90
pioglitazone / metformindrugId:1536 DIABETIC AGENTS M90, #
pioglitazonedrugId:1534 DIABETIC AGENTS M90, #
piperacillin / tazobactamdrugId:1537 ANTIBIOTICS #
piperonyl butoxide / pyrethrinsdrugId:1538 ANTIPARASITICS *, A90
Piqray (alpelisib-Piqray)drugId:7225 PA CHEMOTHERAPY
pirfenidonedrugId:4767 PA PULMONARY FIBROSIS AGENTS A90
pirtobrutinibdrugId:8657 PA CHEMOTHERAPY
pitavastatin calciumdrugId:1962 PA LIPID LOWERING AGENTS M90
pitavastatin magnesiumdrugId:7109 PA LIPID LOWERING AGENTS
pitolisantdrugId:7356 PA NARCOLEPSY AGENTS
plasminogen, human-tvmhdrugId:8540 PA HEMOSTATICS
PlavixdrugId:277 (clopidogrel)drugId:277 ANTIPLATELET AGENT A90, #
plazomicindrugId:7014 PA ANTIBIOTICS
plecanatidedrugId:6043 PA CONSTIPATION AGENTS
Plegridy (peginterferon beta-1a)drugId:4631 PA MULTIPLE SCLEROSIS AGENTS
Plenvu (polyethylene glycol-electrolyte solution-Plenvu)drugId:7137 LAXATIVES
plerixafor HEMATINIC AGENT #
pneumococcal 13-valent conjugate vaccinedrugId:1542 BIOLOGICAL 1
pneumococcal 15-valent conjugate vaccinedrugId:7983 BIOLOGICAL
pneumococcal 20-valent conjugate vaccinedrugId:7924 BIOLOGICALS
pneumococcal 23-valent polysaccharide vaccinedrugId:1544 BIOLOGICAL 1
Pneumovax (pneumococcal 23-valent polysaccharide vaccine)drugId:1544 BIOLOGICAL 1
podofiloxdrugId:2261 DERMATOLOGICAL A90, #
polatuzumab vedotin-piiqdrugId:7263 PA CHEMOTHERAPY MB
polidocanoldrugId:2934 PA CARDIOVASCULAR MB
poliovirus vaccine, inactivateddrugId:1546 BIOLOGICAL 1
Polivy (polatuzumab vedotin-piiq)drugId:7263 PA CHEMOTHERAPY MB
polyethylene glycol 3350drugId:1547 LAXATIVES *, A90
polyethylene glycol-electrolyte solutiondrugId:1552 LAXATIVES A90
polyethylene glycol-electrolyte solution-GolytelydrugId:1549 LAXATIVES A90, #
polyethylene glycol-electrolyte solution-MoviprepdrugId:1551 LAXATIVES BP, A90
polyethylene glycol-electrolyte solution-PlenvudrugId:7137 LAXATIVES
PolytrimdrugId:2060 (trimethoprim / polymyxin B ophthalmic solution)drugId:2060 OPHTHALMIC PREPARATIONS A90, #
pomalidomidedrugId:2787 PA CHEMOTHERAPY
Pomalyst (pomalidomide)drugId:2787 PA CHEMOTHERAPY
ponatinibdrugId:2724 PA CHEMOTHERAPY
Portrazza (necitumumab)drugId:5420 PA CHEMOTHERAPY
posaconazole injection, suspensiondrugId:8099 PA FUNGICIDES BP, A90
posaconazole powder for oral suspensiondrugId:8533 PA ANTIFUNGALS
posaconazole tabletdrugId:2928 FUNGICIDES A90, #
potassium bicarbonate ELECTROLYTES AND NUTRIENTS A90
potassium chloride injection ELECTROLYTES AND NUTRIENTS
potassium chloride-Kaochlor ELECTROLYTES AND NUTRIENTS A90
potassium chloride-Kaon-CL ELECTROLYTES AND NUTRIENTS A90
potassium chloride-Klor-Con ELECTROLYTES AND NUTRIENTS A90, #
potassium chloride-K-Tab ELECTROLYTES AND NUTRIENTS A90
potassium chloride-Micro-K ELECTROLYTES AND NUTRIENTS A90, #
potassium citrate / citric acid ELECTROLYTES AND NUTRIENTS A90
potassium citrate / sodium citrate / citric acid ELECTROLYTES AND NUTRIENTS A90
potassium citrate ELECTROLYTES AND NUTRIENTS A90, #
potassium iodidedrugId:8421 PA > 1 mL/day IODINE THERAPY
potassium phosphate / dibasic sodium phosphate / monobasic sodium phosphate ELECTROLYTES AND NUTRIENTS A90
potassium phosphate / sodium phosphate / phosphorus ELECTROLYTES AND NUTRIENTS
potassium phosphate ELECTROLYTES AND NUTRIENTS *
Poteligeo (mogamulizumab-kpkc)drugId:6924 PA CHEMOTHERAPY MB
povidonedrugId:1567 ANTISEPTICS *, A90
Pradaxa (dabigatran capsule)drugId:5286 ANTICOAGULANTS BP, M90
Pradaxa (dabigatran oral pellet)drugId:8575 PA ANTICOAGULANTS
pralatrexatedrugId:1568 CHEMOTHERAPY MB
pralsetinibdrugId:7660 PA CHEMOTHERAPY
Praluent (alirocumab)drugId:5119 PA LIPID LOWERING AGENTS
pramipexoledrugId:1569 ANTIPARKINSON A90, #
pramipexole extended-releasedrugId:1943 PA ANTIPARKINSON A90
pramlintidedrugId:1570 DIABETIC AGENTS
prasugreldrugId:1571 ANTIPLATELET AGENT A90, #
pravastatin 10 mg, 20 mg, 40 mgdrugId:2736 PA > 1.5 units/day LIPID LOWERING AGENTS M90
pravastatin 80 mgdrugId:1572 PA > 1 unit/day LIPID LOWERING AGENTS M90
praziquanteldrugId:2358 ANTIPARASITICS BP, A90
prazosin; See Table 18drugId:1573; See Table 19drugId:5164 CARDIOVASCULAR M90, #
PrecosedrugId:143 (acarbose)drugId:143 DIABETIC AGENTS M90, #
Pred FortedrugId:1580 (prednisolone acetate 1% ophthalmic suspension)drugId:1580 OPHTHALMIC PREPARATIONS A90, #
Pred-G (gentamicin / prednisolone ophthalmic ointment)drugId:7963 PA OPHTHALMIC PREPARATIONS
Pred-G (gentamicin / prednisolone ophthalmic suspension)drugId:929 OPHTHALMIC PREPARATIONS
Pred Mild (prednisolone acetate 0.12% ophthalmic suspension)drugId:5001 OPHTHALMIC PREPARATIONS
prednicarbate cream, ointmentdrugId:1574 GLUCOCORTICOIDS A90
prednisolone 10 mg/5 mL oral solutiondrugId:1575 PA GLUCOCORTICOIDS A90
prednisolone 15 mg/5 mL, 25 mg/5 mL oral solutiondrugId:1576 GLUCOCORTICOIDS A90
prednisolone 20 mg/5 mL oral solutiondrugId:1579 PA GLUCOCORTICOIDS A90
prednisolone 5 mg/5 mL oral solutiondrugId:1578 GLUCOCORTICOIDS A90, #
prednisolone acetate 0.12% ophthalmic suspensiondrugId:5001 OPHTHALMIC PREPARATIONS
prednisolone acetate 1% ophthalmic suspensiondrugId:1580 OPHTHALMIC PREPARATIONS A90, #
prednisolone orally disintegrating tabletdrugId:1577 PA GLUCOCORTICOIDS A90
prednisolone sodium phosphate ophthalmic solutiondrugId:2618 OPHTHALMIC PREPARATIONS A90
prednisolone tabletdrugId:2199 PA GLUCOCORTICOIDS A90
prednisonedrugId:1581 GLUCOCORTICOIDS A90
prednisone delayed-releasedrugId:2645 PA GLUCOCORTICOIDS
Prefest (estradiol / norgestimate) HORMONE REPLACEMENT THERAPY
pregabalin extended-release; See Table 71drugId:6609; See Table 72drugId:6608 PA GABA ANALOGS BP
pregabalin; See Table 20drugId:1582; See Table 71drugId:4460 PA ANTICONVULSANTS
Prehevbrio (hepatitis B recombinant vaccine)drugId:8157 BIOLOGICALS 1
Premarin (estrogens, conjugated) HORMONE REPLACEMENT THERAPY
Premphase (medroxyprogesterone / estrogens, conjugated-Premphase) HORMONE REPLACEMENT THERAPY
Prempro (medroxyprogesterone / estrogens, conjugated-Prempro) HORMONE REPLACEMENT THERAPY
prenatal vitaminsdrugId:1583 ELECTROLYTES AND NUTRIENTS *, M90
pretomaniddrugId:7568 TB PREPARATIONS A90
PrevaciddrugId:1021 (lansoprazole capsule)drugId:1021 PA > 1 unit/day PROTON PUMP INHIBITORS M90, #
Prevacid Solutab (lansoprazole orally disintegrating tablet)drugId:1022 PA ≥ 2 years PROTON PUMP INHIBITORS BP, M90
Prevnar 13 (pneumococcal 13-valent conjugate vaccine)drugId:1542 BIOLOGICAL 1
Prevnar 20 (pneumococcal 20-valent conjugate vaccine)drugId:7924 BIOLOGICALS
Prevymis (letermovir)drugId:6615 PA ANTIVIRALS
Prezcobix (darunavir / cobicistat)drugId:4792 ANTIVIRALS PD
Prezista (darunavir)drugId:330 ANTIVIRALS BP, A90
Priftin (rifapentine)drugId:2501 TB PREPARATIONS
Prilosec (omeprazole suspension)drugId:2054 PA PROTON PUMP INHIBITORS
primaquine ANTIMALARIALS A90
PrimaxindrugId:781 (imipenem / cilastatin)drugId:781 ANTIBIOTICS #
primidonedrugId:1586 ANTICONVULSANTS A90, #
Priorix (measles / mumps / rubella vaccine)drugId:8257 BIOLOGICAL
Pristiq (desvenlafaxine succinate extended-release); See Table 17drugId:490; See Table 71drugId:3940 PA < 6 years and PA > 1 unit/day ANTIDEPRESSANTS BP, A90
Privigen (immune globulin IV, human-Privigen)drugId:2197 PA BIOLOGICAL
Proair Digihaler (albuterol inhalation powder-Proair Digihaler)drugId:7352 PA BRONCHODILATORS
Proair HFA (albuterol inhaler-Proair HFA)drugId:1 BRONCHODILATORS BP, A90
Proair Respiclick (albuterol inhalation powder-Proair Respiclick)drugId:5109 BRONCHODILATORS
probenecid / colchicinedrugId:287 GOUT AGENTS M90
probeneciddrugId:1587 GOUT AGENTS M90
procarbazinedrugId:1589 CHEMOTHERAPY
Procardia XLdrugId:1215 (nifedipine extended-release)drugId:1215 CARDIOVASCULAR M90, #
prochlorperazine ANTIEMETICS A90
Procrit (epoetin alfa-Procrit)drugId:611 PA HEMATINIC AGENT
Procysbi (cysteamine delayed-release capsule)drugId:2861 PA ENZYMES
Procysbi (cysteamine delayed-release granule)drugId:7374 PA ENZYMES
Profilnine SD (factor IX complex human-Profilnine SD)drugId:457 ANTI-HEMOPHILIA AGENTS
progesterone capsule HORMONE REPLACEMENT THERAPY A90, #
progesterone geldrugId:2587 PA HORMONE REPLACEMENT THERAPY
progesterone injection PROGESTERONE
progesterone vaginal insertdrugId:8361 PA PROGESTERONE
Proglycem (diazoxide) DIABETIC AGENTS BP, A90
Prograf (tacrolimus granules)drugId:7264 PA IMMUNOMODULATOR
Prograf (tacrolimus injection)drugId:2741 IMMUNOMODULATOR MB
PrografdrugId:1918 (tacrolimus immediate-release capsule)drugId:1918 IMMUNOMODULATOR A90, #
Prolastin-C (alpha-1-proteinase inhibitor, human-Prolastin-C) ENZYMES MB
Prolensa (bromfenac 0.07%)drugId:2788 OPHTHALMIC PREPARATIONS BP, A90
Proleukin (aldesleukin)drugId:8406 PA ANTINEOPLASTICS
Prolia (denosumab-Prolia)drugId:1967 PA BIOLOGICAL
Promacta (eltrombopag)drugId:594 PA HEMATINIC AGENT
promethazinedrugId:1593 ANTIHISTAMINES A90
Prometrium (progesterone capsule) HORMONE REPLACEMENT THERAPY A90, #
propafenone extended-releasedrugId:7637 CARDIOVASCULAR M90, #
propafenone immediate-releasedrugId:1594 CARDIOVASCULAR M90
proparacainedrugId:6366 OPHTHALMIC PREPARATIONS A90
propranolol / hydrochlorothiazidedrugId:1603 CARDIOVASCULAR M90
propranolol extended-releasedrugId:1601 CARDIOVASCULAR M90, #
propranolol immediate-releasedrugId:1600 CARDIOVASCULAR M90
propranolol long-acting capsuledrugId:6562 PA CARDIOVASCULAR
propranolol solutiondrugId:2959 PA CARDIOVASCULAR M90
propylthiouracil THYROID PREPARATIONS M90
Proquad (measles / mumps / rubella / varicella virus vaccine)drugId:1122 BIOLOGICAL 1
ProscardrugId:857 (finasteride)drugId:857 BENIGN PROSTATIC HYPERPLASIA AGENTS M90, #
protein C concentratedrugId:1605 PA HEMATINIC AGENT MB
prothrombin complex concentrate, human HEMOSTATICS
Protonix (pantoprazole 40 mg suspension)drugId:2702 PA PROTON PUMP INHIBITORS BP, M90
ProtonixdrugId:1476 (pantoprazole tablet)drugId:1476 PA > 4 units/day PROTON PUMP INHIBITORS M90, #
Protonix IVdrugId:1477 (pantoprazole IV)drugId:1477 PROTON PUMP INHIBITORS #
ProtopicdrugId:1919 (tacrolimus topical)drugId:1919 DERMATOLOGICAL A90, #
protriptyline; See Table 17drugId:1606; See Table 71drugId:4140 PA ANTIDEPRESSANTS A90
Provenge (sipuleucel-T)drugId:2288 PA CHEMOTHERAPY MB
Proventil (albuterol inhaler-Proventil)drugId:2 BRONCHODILATORS BP, A90
Provera (medroxyprogesterone tablet) HORMONE REPLACEMENT THERAPY A90, #
Provigil (modafinil 100 mg); See Table 50drugId:1373; See Table 71drugId:7451 PA < 6 years and PA > 1.5 units/day NARCOLEPSY AGENTS #
Provigil (modafinil 200 mg); See Table 50drugId:7450; See Table 71drugId:7452 PA < 6 years and PA > 2 units/day NARCOLEPSY AGENTS #
Prozac (fluoxetine 10 mg, 20 mg, 40 mg capsule, solution); See Table 17drugId:879; See Table 71drugId:3721 PA < 6 years ANTIDEPRESSANTS A90, #
prucalopridedrugId:7136 PA CONSTIPATION AGENTS
Prudoxin (doxepin cream-Prudoxin)drugId:568 PA DERMATOLOGICAL
pseudoephedrinedrugId:1607 PA > 240 mg/day DECONGESTANT *
psyllium capsuledrugId:8224 CONSTIPATION AGENTS *, M90
psyllium powderdrugId:1610 CONSTIPATION AGENTS *, A90
Pulmicort (budesonide inhalation powder)drugId:380 BRONCHODILATORS
PulmicortdrugId:381 (budesonide inhalation suspension)drugId:381 PA ≥ 13 years BRONCHODILATORS A90, #
Pulmosal (sodium chloride 7% for inhalation) - Non-Drug Product NON-DRUG PRODUCT
Pulmozyme (dornase alfa)drugId:562 ENZYMES
Purixan (mercaptopurine oral suspension)drugId:4632 PA CHEMOTHERAPY
Pylera (bismuth subcitrate / metronidazole / tetracycline)drugId:367 H. PYLORI AGENTS BP, A90
pyrantel pamoatedrugId:6217 ANTIPARASITICS
pyrazinamidedrugId:1611 ANTIBIOTICS A90
pyridostigmine bromide 30 mg tabletdrugId:7226 PA PARASYMPATHETIC AGENTS A90
pyridostigmine bromide 60 mg tablet, 180 mg extended-release tabletdrugId:1612 PARASYMPATHETIC AGENTS A90, #
pyridostigmine bromide solutiondrugId:8269 PARASYMPATHETIC AGENTS BP, A90
pyridoxinedrugId:1613 ELECTROLYTES AND NUTRIENTS *, M90
pyrimethaminedrugId:1614 PA ANTIMALARIALS BP, A90
Pyrukynd (mitapivat)drugId:8258 PA UNCLASSIFIED DRUG PRODUCTS

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

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Last updated 04/01/24