Pulmonary Arterial Hypertension Oral and Inhaled Drugs

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PDL Reference Documents

Drug Use Review Documents

PDL Status Values

Y = preferred
N = non-preferred. Non-preferred drugs listed as N but without clinical drug use criteria are subject to the Non-Preferred Drugs in Select PDL Classes prior authorization criteria. New drugs will be listed as N until reviewed by the P&T Committee and are subject to the New Drug Policy.
V = voluntary non-preferred. Non-preferred mental health drugs are listed as V and prior authorization is not required.
Null (i.e. blank) = indicates the class or specific drug has not been reviewed for PDL placement.

To request a Prior Authorization, please use this form.

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NDC Brand Name Generic Name Form Strength PDL
Status		 Rebate Current Drug Use Criteria
00378427193 AMBRISENTAN ambrisentan TABLET 10 mg N Y PA Document
00591240630 AMBRISENTAN ambrisentan TABLET 10 mg N Y PA Document
42794005208 AMBRISENTAN ambrisentan TABLET 10 mg N Y PA Document
47335023783 AMBRISENTAN ambrisentan TABLET 10 mg N Y PA Document
59651049530 AMBRISENTAN ambrisentan TABLET 10 mg N Y PA Document
60505455303 AMBRISENTAN ambrisentan TABLET 10 mg N Y PA Document
69097038702 AMBRISENTAN ambrisentan TABLET 10 mg N Y PA Document
70710118003 AMBRISENTAN ambrisentan TABLET 10 mg N Y PA Document
82009014230 AMBRISENTAN ambrisentan TABLET 10 mg N Y PA Document
61958080201 LETAIRIS ambrisentan TABLET 10 mg N Y PA Document
61958080205 LETAIRIS ambrisentan TABLET 10 mg N Y PA Document
00378427093 AMBRISENTAN ambrisentan TABLET 5 mg N Y PA Document
00591240530 AMBRISENTAN ambrisentan TABLET 5 mg N Y PA Document
42794005108 AMBRISENTAN ambrisentan TABLET 5 mg N Y PA Document
47335023683 AMBRISENTAN ambrisentan TABLET 5 mg N Y PA Document
59651049430 AMBRISENTAN ambrisentan TABLET 5 mg N Y PA Document
60505455203 AMBRISENTAN ambrisentan TABLET 5 mg N Y PA Document
69097038602 AMBRISENTAN ambrisentan TABLET 5 mg N Y PA Document
70710117903 AMBRISENTAN ambrisentan TABLET 5 mg N Y PA Document
82009014130 AMBRISENTAN ambrisentan TABLET 5 mg N Y PA Document
61958080101 LETAIRIS ambrisentan TABLET 5 mg N Y PA Document
61958080105 LETAIRIS ambrisentan TABLET 5 mg N Y PA Document
68180034011 BOSENTAN bosentan TAB SUSP 32 mg N Y PA Document
68180034013 BOSENTAN bosentan TAB SUSP 32 mg N Y PA Document
66215023214 TRACLEER bosentan TAB SUSP 32 mg N Y PA Document
66215023256 TRACLEER bosentan TAB SUSP 32 mg N Y PA Document
00591251260 BOSENTAN bosentan TABLET 125 mg Y Y  
47335003986 BOSENTAN bosentan TABLET 125 mg Y Y  
68382044714 BOSENTAN bosentan TABLET 125 mg Y Y  
66215010203 TRACLEER bosentan TABLET 125 mg Y Y  
66215010206 TRACLEER bosentan TABLET 125 mg Y Y  
00591251160 BOSENTAN bosentan TABLET 62.5 mg Y Y  
47335003886 BOSENTAN bosentan TABLET 62.5 mg Y Y  
68382044614 BOSENTAN bosentan TABLET 62.5 mg Y Y  
66215010103 TRACLEER bosentan TABLET 62.5 mg Y Y  
66215010106 TRACLEER bosentan TABLET 62.5 mg Y Y  
66215030200 VENTAVIS iloprost tromethamine AMPUL-NEB 10 mcg/mL N Y PA Document
66215030230 VENTAVIS iloprost tromethamine AMPUL-NEB 10 mcg/mL N Y PA Document
66215030300 VENTAVIS iloprost tromethamine AMPUL-NEB 20 mcg/mL N Y PA Document
66215030330 VENTAVIS iloprost tromethamine AMPUL-NEB 20 mcg/mL N Y PA Document
66215050115 OPSUMIT macitentan TABLET 10 mg N Y PA Document
66215050130 OPSUMIT macitentan TABLET 10 mg N Y PA Document
50419025001 ADEMPAS riociguat TABLET 0.5 mg N Y PA Document
50419025091 ADEMPAS riociguat TABLET 0.5 mg N Y PA Document
50419025101 ADEMPAS riociguat TABLET 1 mg N Y PA Document
50419025191 ADEMPAS riociguat TABLET 1 mg N Y PA Document
50419025201 ADEMPAS riociguat TABLET 1.5 mg N Y PA Document
50419025291 ADEMPAS riociguat TABLET 1.5 mg N Y PA Document
50419025301 ADEMPAS riociguat TABLET 2 mg N Y PA Document
50419025391 ADEMPAS riociguat TABLET 2 mg N Y PA Document
50419025401 ADEMPAS riociguat TABLET 2.5 mg N Y PA Document
50419025491 ADEMPAS riociguat TABLET 2.5 mg N Y PA Document
66215062820 UPTRAVI selexipag TAB DS PK 200 mcg (140)-800 mcg (60) N Y PA Document
66215061006 UPTRAVI selexipag TABLET 1,000 mcg N Y PA Document
66215061206 UPTRAVI selexipag TABLET 1,200 mcg N Y PA Document
66215061406 UPTRAVI selexipag TABLET 1,400 mcg N Y PA Document
66215061606 UPTRAVI selexipag TABLET 1,600 mcg N Y PA Document
66215060206 UPTRAVI selexipag TABLET 200 mcg N Y PA Document
66215060214 UPTRAVI selexipag TABLET 200 mcg N Y PA Document
66215060406 UPTRAVI selexipag TABLET 400 mcg N Y PA Document
66215060606 UPTRAVI selexipag TABLET 600 mcg N Y PA Document
66215060806 UPTRAVI selexipag TABLET 800 mcg N Y PA Document
00069033621 REVATIO sildenafil citrate SUSP RECON 10 mg/mL N Y PA Document
00591405094 SILDENAFIL CITRATE sildenafil citrate SUSP RECON 10 mg/mL N Y PA Document
27241017529 SILDENAFIL CITRATE sildenafil citrate SUSP RECON 10 mg/mL N Y PA Document
31722013631 SILDENAFIL CITRATE sildenafil citrate SUSP RECON 10 mg/mL N Y PA Document
51672423108 SILDENAFIL CITRATE sildenafil citrate SUSP RECON 10 mg/mL N Y PA Document
59651042011 SILDENAFIL CITRATE sildenafil citrate SUSP RECON 10 mg/mL N Y PA Document
60219265101 SILDENAFIL CITRATE sildenafil citrate SUSP RECON 10 mg/mL N Y PA Document
69238157401 SILDENAFIL CITRATE sildenafil citrate SUSP RECON 10 mg/mL N Y PA Document
70710171604 SILDENAFIL CITRATE sildenafil citrate SUSP RECON 10 mg/mL N Y PA Document
70954016810 SILDENAFIL CITRATE sildenafil citrate SUSP RECON 10 mg/mL N Y PA Document
72205003576 SILDENAFIL CITRATE sildenafil citrate SUSP RECON 10 mg/mL N Y PA Document
72205005976 SILDENAFIL CITRATE sildenafil citrate SUSP RECON 10 mg/mL N Y PA Document
00093534301 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
00093534356 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
00378166093 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
13668018801 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
13668018830 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
27241006903 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
27241006905 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
27241006910 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
31722071101 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
31722071105 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
31722071130 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
33342004307 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
33342004311 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
33342004344 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
59762003602 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
60219175303 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
65862069101 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
65862069105 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
65862069130 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
72241007105 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
72241007111 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
72241007122 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
72888001700 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
75834024100 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
75834024101 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
75834024130 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
76282064501 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
76282064530 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
82009009301 SILDENAFIL CITRATE sildenafil citrate TABLET 100 mg N Y PA Document
00069422030 VIAGRA sildenafil citrate TABLET 100 mg N Y PA Document
00069422066 VIAGRA sildenafil citrate TABLET 100 mg N Y PA Document
58151042893 VIAGRA sildenafil citrate TABLET 100 mg N Y PA Document
00069419068 REVATIO sildenafil citrate TABLET 20 mg Y Y PA Document
00093551798 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
00904667104 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
00904667106 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
13668018590 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
27241012403 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
27241012405 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
31722077605 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
31722077690 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
33342012110 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
33342053610 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
50268071711 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
50268071715 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
52817029590 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
59762003301 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
59762003303 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
60687078811 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
60687078821 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
62135037290 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
63739007233 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
65162035109 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
65162035111 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
65862068890 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
65862068899 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
68001036305 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
68001059705 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
72888001800 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
72888001890 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
82009009490 SILDENAFIL CITRATE sildenafil citrate TABLET 20 mg Y Y PA Document
00093534156 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
13668018630 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
27241006703 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
27241006705 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
31722070930 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
33342004107 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
33342004144 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
59762003401 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
60219175103 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
65862068930 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
65862068999 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
70748013106 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
72241006911 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
72241006922 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
72888001505 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
75834027200 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
76282064330 SILDENAFIL CITRATE sildenafil citrate TABLET 25 mg N Y PA Document
00069420030 VIAGRA sildenafil citrate TABLET 25 mg N Y PA Document
58151042693 VIAGRA sildenafil citrate TABLET 25 mg N Y PA Document
00093534201 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
00093534256 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
13668018701 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
13668018730 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
27241006803 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
27241006805 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
31722071001 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
31722071030 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
33342004207 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
33342004211 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
33342004244 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
59762003501 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
59762003502 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
60219175203 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
65862069001 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
65862069030 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
65862069099 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
70748013201 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
70748013206 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
72241007005 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
72241007011 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
72241007022 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
72888001600 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
75834024000 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
75834024001 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
75834024030 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
76282064401 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
76282064430 SILDENAFIL CITRATE sildenafil citrate TABLET 50 mg N Y PA Document
00069421030 VIAGRA sildenafil citrate TABLET 50 mg N Y PA Document
00069421066 VIAGRA sildenafil citrate TABLET 50 mg N Y PA Document
58151042701 VIAGRA sildenafil citrate TABLET 50 mg N Y PA Document
46287004515 TADLIQ tadalafil ORAL SUSP 20 mg/5 mL (4 mg/mL) N Y PA Document
00480231056 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
13668056730 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
16714007601 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
16729037110 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
16729037116 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
24979072906 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
24979072969 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
27241011303 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
27241011305 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
29300028805 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
29300028813 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
31722064530 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
33342026707 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
35573046230 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
43547003203 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
43547005003 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
43547005050 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
43598057430 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
47335001183 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
62332017930 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
62332017991 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
65862085230 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
68180092106 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
68382089806 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
68382089810 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
69238134803 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
75834024901 TADALAFIL tadalafil TABLET 10 mg N Y PA Document
00093301630 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
00093301665 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
00480230830 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
00480230865 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
13668056530 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
16714007401 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
16714007402 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
16729036910 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
24979072702 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
24979072706 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
27241011103 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
27241011105 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
29300028605 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
29300028613 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
31722064330 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
33342026507 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
35573046038 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
35573046056 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
43547003003 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
43547004703 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
43547004750 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
43598057630 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
47335000964 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
47335000972 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
62332017715 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
62332017730 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
62332017791 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
68180091906 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
68382089606 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
68382089610 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
69238134603 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
75834024701 TADALAFIL tadalafil TABLET 2.5 mg N Y PA Document
66302046760 ADCIRCA tadalafil TABLET 20 mg Y Y PA Document
00480927706 ALYQ tadalafil TABLET 20 mg Y Y PA Document
00480231156 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
13668056830 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
13668058130 TADALAFIL tadalafil TABLET 20 mg Y Y PA Document
16714007701 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
16729037210 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
16729037216 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
24979073006 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
24979073044 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
27241011403 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
27241011405 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
27241012302 TADALAFIL tadalafil TABLET 20 mg Y Y PA Document
29300028905 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
29300028913 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
31722064630 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
31722064730 TADALAFIL tadalafil TABLET 20 mg Y Y PA Document
33342026807 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
33342027809 TADALAFIL tadalafil TABLET 20 mg Y Y PA Document
35573046330 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
43547003303 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
43547005103 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
43547005150 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
43547099006 TADALAFIL tadalafil TABLET 20 mg Y Y PA Document
43598057330 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
43598057331 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
43598057379 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
43598057860 TADALAFIL tadalafil TABLET 20 mg Y Y PA Document
47335001283 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
50268073911 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
50268073913 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
62332018030 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
62332018091 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
65862085330 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
65862088060 TADALAFIL tadalafil TABLET 20 mg Y Y PA Document
68180092206 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
68382089906 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
68382089910 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
69097052603 TADALAFIL tadalafil TABLET 20 mg Y Y PA Document
69238134903 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
75834025001 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
82009007905 TADALAFIL tadalafil TABLET 20 mg N Y PA Document
82009008060 TADALAFIL tadalafil TABLET 20 mg Y Y PA Document
00093301730 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
00093301765 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
00480230930 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
00480230956 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
00480230965 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
13668056630 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
16714007501 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
16729037010 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
16729037016 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
24979072802 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
24979072806 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
27241011203 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
27241011205 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
29300028705 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
29300028713 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
29300028751 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
31722064430 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
33342026607 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
35573046130 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
43547003103 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
43547004903 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
43547004950 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
43598057530 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
43598057531 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
43598057579 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
47335001083 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
50268073811 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
50268073813 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
62332017815 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
62332017830 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
62332017891 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
65862085130 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
68180092006 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
68382089706 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
68382089710 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
69238134703 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
75834024801 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
82009007705 TADALAFIL tadalafil TABLET 5 mg N Y PA Document
66302020603 TYVASO treprostinil AMPUL-NEB 1.74 mg/2.9 mL (0.6 mg/mL) N Y PA Document
66302061601 TYVASO DPI treprostinil CART INHAL 16 mcg N Y PA Document
66302061603 TYVASO DPI treprostinil CART INHAL 16 mcg N Y PA Document
66302071604 TYVASO DPI treprostinil CART INHAL 16 mcg N Y PA Document
66302061002 TYVASO DPI treprostinil CART INHAL 16 mcg(112)-32 mcg(112)-48 mcg(28) N Y PA Document
66302063201 TYVASO DPI treprostinil CART INHAL 32 mcg N Y PA Document
66302063203 TYVASO DPI treprostinil CART INHAL 32 mcg N Y PA Document
66302073204 TYVASO DPI treprostinil CART INHAL 32 mcg N Y PA Document
66302062003 TYVASO DPI treprostinil CART INHAL 32 mcg-48 mcg N Y PA Document
66302064801 TYVASO DPI treprostinil CART INHAL 48 mcg N Y PA Document
66302064803 TYVASO DPI treprostinil CART INHAL 48 mcg N Y PA Document
66302074804 TYVASO DPI treprostinil CART INHAL 48 mcg N Y PA Document
66302066401 TYVASO DPI treprostinil CART INHAL 64 mcg N Y PA Document
66302066403 TYVASO DPI treprostinil CART INHAL 64 mcg N Y PA Document
66302076404 TYVASO DPI treprostinil CART INHAL 64 mcg N Y PA Document
66302030001 ORENITRAM ER treprostinil diolamine TABLET ER 0.125 mg N Y PA Document
66302030002 ORENITRAM ER treprostinil diolamine TABLET ER 0.125 mg N Y PA Document
66302030201 ORENITRAM ER treprostinil diolamine TABLET ER 0.25 mg N Y PA Document
66302030202 ORENITRAM ER treprostinil diolamine TABLET ER 0.25 mg N Y PA Document
66302031001 ORENITRAM ER treprostinil diolamine TABLET ER 1 mg N Y PA Document
66302031002 ORENITRAM ER treprostinil diolamine TABLET ER 1 mg N Y PA Document
66302032501 ORENITRAM ER treprostinil diolamine TABLET ER 2.5 mg N Y PA Document
66302032502 ORENITRAM ER treprostinil diolamine TABLET ER 2.5 mg N Y PA Document
66302035001 ORENITRAM ER treprostinil diolamine TABLET ER 5 mg N Y PA Document
66302035002 ORENITRAM ER treprostinil diolamine TABLET ER 5 mg N Y PA Document
66302036256 ORENITRAM MONTH 2 TITRATION KT treprostinil diolamine TB ER DSPK 0.125 mg (126)-0.25 mg (210) N Y PA Document
66302036128 ORENITRAM MONTH 1 TITRATION KT treprostinil diolamine TB ER DSPK 0.125 mg (126)-0.25 mg (42) N Y PA Document
66302036384 ORENITRAM MONTH 3 TITRATION KT treprostinil diolamine TB ER DSPK 0.125 mg (126)-0.25 mg (42)-1 mg (84) N Y PA Document
72964001401 YUTREPIA treprostinil sodium CAP W/DEV 106 mcg N Y PA Document
72964001101 YUTREPIA treprostinil sodium CAP W/DEV 26.5 mcg N Y PA Document
72964001201 YUTREPIA treprostinil sodium CAP W/DEV 53 mcg N Y PA Document
72964001301 YUTREPIA treprostinil sodium CAP W/DEV 79.5 mcg N Y PA Document
66302020602 TYVASO REFILL KIT treprostinil/neb accessories AMPUL-NEB 1.74 mg/2.9 mL (0.6 mg/mL) N Y PA Document
66302020604 TYVASO INSTITUTIONAL START KIT treprostinil/nebulizer/accesor AMPUL-NEB 1.74 mg/2.9 mL (0.6 mg/mL) N Y PA Document
66302020601 TYVASO STARTER KIT treprostinil/nebulizer/accesor AMPUL-NEB 1.74 mg/2.9 mL (0.6 mg/mL) N Y PA Document
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