Miscellaneous Pulmonary Agents

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Generic Name Brand Name Form PDL
Status
Current Drug Use Criteria Carveout
‐ Bill FFS
New Drug Evaluation & Updates
montelukast sodium MONTELUKAST SODIUM TAB CHEW Y    
montelukast sodium SINGULAIR TAB CHEW Y    
montelukast sodium MONTELUKAST SODIUM TABLET Y    
montelukast sodium SINGULAIR TABLET Y    
ensifentrine OHTUVAYRE AMPUL-NEB N Pharmacy PA  
montelukast sodium MONTELUKAST SODIUM GRAN PACK N    
nerandomilast JASCAYD TABLET N    
roflumilast ROFLUMILAST TABLET N Pharmacy PA  
roflumilast DALIRESP TABLET N Pharmacy PA Feb 23, 2012
zafirlukast ZAFIRLUKAST TABLET N    
zileuton ZYFLO TABLET N    
zileuton ZILEUTON ER TBMP 12HR N