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Medicaid Drug Prior Authorization
BRAND NAME
GENERIC NAME
Abilify
Aripiprazole
Accutane
Isotretinoin
Actimmune
Interferon gamma-1b
Alferon N
Interferon alfa-n3
Aricept
Donepezil
Avonex
Interferon beta-1a
Compound
Compound
Copaxone
Glatiramer acetate
Cough and Cold Medications in Children Less than 4 Years of Age
Cough and Cold Medications in Children Less than 4 Years of Age
Elidel
Pimecrolimus
Enbrel
Entanercept
Epogen
Epoetin alfa
Exelon
Rivastigmine
Forteo
Teriparatide rDNA
Geodon
Ziprasidone
Gleevec
Imatinib
Humira
Adalimumab
Infergen
Interferon alfacon-1
Intron-A
Interferon alfa-2b
Leukine
Sargramostim
1
2
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Last Updated:
1/29/2008