Search Tips:
Select the field you wish to use, then enter your search term in the "Value" field. Enter only one value at a time, using letters and/or numbers. Instead of using an asterisk ("*") character as a wildcard to search for multiple values, simply include only the partial string for which you are searching. Finally, select the field you would like to use when sorting your matches and click "Search" to begin searching. If you have questions or need assistance, please
let us know.
Example: To find all drugs whose NDC code contains "1234", sorted by description, you would start by selecting "NDC Code" as the field to use. Enter "1234" as the "Value", and select "Description" as the "Sort By" field. When you search, your matches are displayed, sorted by the description.
National Drug Code (NDC):
The 3 segments of the 11-digit NDC identify: the labeler (5-digit), the product (4-digit), and the commercial package size (2-digit). Partial search will yield results. Users may enter only the first 5-digits to display a manufacturer's drug catalogue.
Drug Types:
- GENERIC
- BRAND
- GENERIC UPPER LIMIT
- BRAND UPPER LIMIT
- GENERIC COPAY EXCLUDED
- BRAND COPAY EXCLUDED
- GENERIC UPPER LIMIT COPAY EXCL
- BRAND UPPER LIMIT COPAY EXCLUD
Generic Name:
Represents the active ingredient of the drug.
Maximum Reimbursable Amount (MRA):
Unique for each drug. Displays the maximum total reimbursement per drug unit. A drug unit is defined by the "Basis of MRA."
Basis of MRA:
- Each - Tablets, Kits, etc.
- Grams - Solids
- Milliliters - Liquids
PA Code Field Values:
- PA code "0" = PA not required
- PA code "N" = PA required
- PA code "G" = PA required / may be required
PA may be required if drug is non-preferred OR clinical criteria including Frequency/Quantity/Duration (FQD) limits, or step therapy requirements are not met. Details regarding these limitations can be found by accessing the Preferred Drug List
Labeler:
Manufactures (including repackers or relabelers), or distributers of the drug.
Covered Outpatient Drug (COD) / Over-the-Counter (OTC) Indicator*
- "Y" (Covered) Identifies an OTC product that are both covered by Medicaid and meet the definition of a Covered Outpatient Drug under § 1927(k)(4) of the Social Security Act.
- "N" (Not Covered) Identifies an OTC products that are both covered by Medicaid, but do not meet the definition of a Covered Outpatient Drug under § 1927(k)(4) of the Social Security Act.
*Only applies to OTC drugs.
Preferred Drug Code:
- PREFERRED DRUG - PDL Drug
- NOT PREFERRED DRUG - PDL Drug
- OTHER - Covered non-PDL Drug
RX Types:
- OTC Drugs and Supplies Billed by NDC
- Class II Controlled Substance
- Class III Controlled Substance
- Class IV Controlled Substance
- Class V Controlled Substance
- Rx Legend
Maximum Quantities
- Maximum allowable unit amount per claim. Please note, criteria such as dose-optimization, FQD, or duration of treatment considerations may apply for PA Code types "G" or "N." Please consult the Preferred Drug List for more information, as additional criteria may apply. Providers should dose-optimize when possible.
- Maximum quantities represent amounts up to a 90-day supply for maintenance mediations or course of therapy.
- Nothing listed in this resource should be used to bypass FDA-labeled dosing limits.
Age Range
Lists the required age minimum and maximum per drug. Additional criteria may apply for PA Code types "G" or "N." If the range is unavailable, please consult the Preferred Drug List for additional information.
Refills Allowed
Number of refills allowed per prescription. Please consult the Preferred Drug List for additional information.
