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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.


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MassHealth Drug List table
Drug - Brand Name (Generic Name) Class
Calquence (acalabrutinib)drugId:6483 - PA CHEMOTHERAPY
Combivent (albuterol / ipratropium inhalation spray)drugId:2557 BRONCHODILATORS
Campath (alemtuzumab 30 mg)drugId:6110 CHEMOTHERAPY
Cordarone # (amiodarone) CARDIOVASCULAR
Caduet (amlodipine / atorvastatin) - PA; See Table 13drugId:42; See Table 18drugId:43 CARDIOVASCULAR/STATIN
Cinvanti (aprepitant injectable emulsion)drugId:6604 ANTIEMETICS
Coartem (artemether / lumefantrine)drugId:95 - PA > 24 units/365 days ANTIMALARIALS
Cayston (aztreonam) ANTIBIOTICS
ColazaldrugId:126 # (balsalazide)drugId:126 GI ANTI-INFLAMMATORY
Cystadane (betaine) ELECTROLYTES AND NUTRIENTS
CelestonedrugId:357 # (betamethasone injection)drugId:357 GLUCOCORTICOIDS
CasodexdrugId:362 # (bicalutamide)drugId:362 CHEMOTHERAPY
Combigan (brimonidine / timolol, ophthalmic)drugId:374 OPHTHALMIC PREPARATIONS
Cycloset (bromocriptine 0.8 mg tablet)drugId:2984 - PA DIABETIC AGENTS
Crysvita (burosumab-twza)drugId:6740 - PA BIOLOGICAL
c1 esterase inhibitor, human-BerinertdrugId:1938 - PA ENZYMES
c1 esterase inhibitor, human-CinryzedrugId:416 - PA ENZYMES
Cinryze (c1 esterase inhibitor, human-Cinryze)drugId:416 - PA ENZYMES
c1 esterase inhibitor, human-HaegardadrugId:6283 - PA ENZYMES
c1 esterase inhibitor, recombinant-RuconestdrugId:4794 - PA ENZYMES
cabazitaxeldrugId:1961 - PA CHEMOTHERAPY
cabergoline HORMONE AGENTS
cabozantinib capsuledrugId:2719 - PA CHEMOTHERAPY
Cometriq (cabozantinib capsule)drugId:2719 - PA CHEMOTHERAPY
cabozantinib tabletdrugId:5585 - PA CHEMOTHERAPY
Cabometyx (cabozantinib tablet)drugId:5585 - PA CHEMOTHERAPY
caffeine BRONCHODILATORS
Cafcit # (caffeine) BRONCHODILATORS
calamine lotion * DERMATOLOGICAL
calcifedioldrugId:5765 - PA ELECTROLYTES AND NUTRIENTS
calcipotriene creamdrugId:420 - PA > 60 grams/month DERMATOLOGICAL
calcipotriene foamdrugId:2560 - PA DERMATOLOGICAL
calcipotriene ointmentdrugId:2563 - PA > 60 grams/month DERMATOLOGICAL
calcipotriene scalp solutiondrugId:2562 DERMATOLOGICAL
calcitonin salmon injectiondrugId:4960 - PA HORMONE AGENTS
calcitonin salmon nasal spray-ForticaldrugId:422 HORMONE AGENTS
calcitonin salmon nasal spray-MiacalcindrugId:423 HORMONE AGENTS
calcitrioldrugId:426 ELECTROLYTES AND NUTRIENTS
calcitriol injectiondrugId:425 ELECTROLYTES AND NUTRIENTS
calcitriol ointmentdrugId:424 - PA DERMATOLOGICAL
calcium acetate ELECTROLYTES AND NUTRIENTS
calcium replacementdrugId:428 * ELECTROLYTES AND NUTRIENTS
canagliflozindrugId:2780 DIABETIC AGENTS
canagliflozin / metformindrugId:4775 DIABETIC AGENTS
canagliflozin / metformin extended-releasedrugId:5723 - PA DIABETIC AGENTS
canakinumabdrugId:432 - PA IMMUNOMODULATOR
candesartandrugId:433 - PA CARDIOVASCULAR
candesartan / hydrochlorothiazidedrugId:434 - PA CARDIOVASCULAR
cannabidiol - PA; See Table 20drugId:6901; See Table 71drugId:6902 ANTICONVULSANTS
capecitabinedrugId:435 CHEMOTHERAPY
caplacizumab-yhdpdrugId:7180 - PA BIOLOGICAL
Cablivi (caplacizumab-yhdp)drugId:7180 - PA BIOLOGICAL
capreomycindrugId:2490 TB PREPARATIONS
Capastat (capreomycin)drugId:2490 TB PREPARATIONS
capsaicin * DERMATOLOGICAL
capsaicin high dose patchdrugId:1946 ^ - PA ANALGESICS
captoprildrugId:437 - PA CARDIOVASCULAR
captopril / hydrochlorothiazidedrugId:438 - PA CARDIOVASCULAR
carbachol 0.01%drugId:1984 OPHTHALMIC PREPARATIONS
carbamazepine extended-release-Carbatrol - PA < 6 years; See Table 20drugId:439; See Table 71drugId:3240 ANTICONVULSANTS
Carbatrol # (carbamazepine extended-release-Carbatrol) - PA < 6 years; See Table 20drugId:439; See Table 71drugId:3240 ANTICONVULSANTS
carbamazepine extended-release-Equetro - PA; See Table 20drugId:171; See Table 71drugId:3260 ANTICONVULSANTS
carbamazepine extended-release-Tegretol XR - PA < 6 years; See Table 20drugId:2192; See Table 71drugId:3220 ANTICONVULSANTS
carbamazepine-Tegretol - PA < 6 years; See Table 20drugId:170; See Table 71drugId:3280 ANTICONVULSANTS
carbamide peroxide * OTIC PREPARATIONS
carbidopadrugId:173 ANTIPARKINSON
carbidopa / levodopa / entacaponedrugId:176 - PA ANTIPARKINSON
carbidopa / levodopa enteral suspensiondrugId:5104 - PA ANTIPARKINSON
carbidopa / levodopa extended-release capsuledrugId:4950 - PA ANTIPARKINSON
carbidopa / levodopa extended-release tabletdrugId:1997 ANTIPARKINSON
carbidopa / levodopa orally disintegrating tabletdrugId:174 - PA ANTIPARKINSON
carbidopa / levodopa tabletdrugId:175 ANTIPARKINSON
carbinoxamine 4 mg/5 mL solution, 4 mg tabletdrugId:2267 ANTIHISTAMINES
carbinoxamine 6 mg tabletdrugId:7229 - PA ANTIHISTAMINES
carbinoxamine extended-releasedrugId:2962 - PA ANTIHISTAMINES
carboplatindrugId:179 CHEMOTHERAPY
carfilzomibdrugId:2581 - PA CHEMOTHERAPY
carglumic aciddrugId:2161 - PA ENZYMES
Carbaglu (carglumic acid)drugId:2161 - PA ENZYMES
cariprazine - PA; See Table 24drugId:5405; See Table 71drugId:5406 ANTIPSYCHOTIC
carisoprodoldrugId:180 - PA MUSCLE RELAXANT
carisoprodol / aspirindrugId:181 - PA MUSCLE RELAXANT
carisoprodol / aspirin / codeinedrugId:182 - PA OPIOID ANALGESICS/MUSCLE RELAXANTS
carmustinedrugId:183 CHEMOTHERAPY
carteololdrugId:184 OPHTHALMIC PREPARATIONS
carvediloldrugId:185 CARDIOVASCULAR
CoregdrugId:185 # (carvedilol)drugId:185 CARDIOVASCULAR
carvedilol extended-releasedrugId:186 - PA CARDIOVASCULAR
Coreg CR (carvedilol extended-release)drugId:186 - PA CARDIOVASCULAR
caspofungin ANTIBIOTICS
Cancidas # (caspofungin) ANTIBIOTICS
cefaclordrugId:189 ANTIBIOTICS
cefaclor extended-releasedrugId:190 - PA ANTIBIOTICS
cefadroxil capsule, suspensiondrugId:191 ANTIBIOTICS
cefadroxil tabletdrugId:1986 - PA ANTIBIOTICS
cefazolindrugId:192 ANTIBIOTICS
cefdinirdrugId:193 ANTIBIOTICS
cefepimedrugId:195 ANTIBIOTICS
cefiximedrugId:196 - PA ANTIBIOTICS
cefotaximedrugId:197 ANTIBIOTICS
ClaforandrugId:197 # (cefotaxime)drugId:197 ANTIBIOTICS
cefotetandrugId:5200 ANTIBIOTICS
CefotandrugId:5200 # (cefotetan)drugId:5200 ANTIBIOTICS
cefoxitindrugId:198 ANTIBIOTICS
cefpodoximedrugId:199 ANTIBIOTICS
cefprozildrugId:200 ANTIBIOTICS
ceftarolinedrugId:2179 - PA ANTIBIOTICS
ceftazidimedrugId:202 ANTIBIOTICS
ceftazidime / avibactamdrugId:4902 - PA ANTIBIOTICS
ceftolozane / tazobactamdrugId:4842 - PA ANTIBIOTICS
ceftriaxonedrugId:204 ANTIBIOTICS
cefuroxime axetildrugId:205 ANTIBIOTICS
cefuroxime sodiumdrugId:206 ANTIBIOTICS
celecoxibdrugId:207 NONSTEROIDAL ANTI-INFLAMMATORY
CelebrexdrugId:207 # (celecoxib)drugId:207 NONSTEROIDAL ANTI-INFLAMMATORY
cemiplimab-rwlcdrugId:7005 - PA CHEMOTHERAPY
cenegermin-bkbjdrugId:7103 - PA OPHTHALMIC PREPARATIONS
centruroides immune F(ab’)2, equine ^ ANTIDOTES
cephalexin 250 mg, 500 mg capsule, suspensiondrugId:208 ANTIBIOTICS
cephalexin 333 mg capsuledrugId:6484 - PA ANTIBIOTICS
cephalexin 750 mg capsuledrugId:209 - PA ANTIBIOTICS
ceritinibdrugId:2951 - PA CHEMOTHERAPY
certolizumabdrugId:210 - PA IMMUNOMODULATOR
Cimzia (certolizumab)drugId:210 - PA IMMUNOMODULATOR
cetirizine / pseudoephedrinedrugId:2265 * ANTIHISTAMINES
cetirizine syrup, tabletdrugId:211 * ANTIHISTAMINES
cetuximabdrugId:212 CHEMOTHERAPY
cevimeline PARASYMPATHETIC AGENTS
chenodioldrugId:1956 - PA BILE THERAPY
cherry syrup * COMPOUNDING AGENT
chlorambucildrugId:216 CHEMOTHERAPY
chloramphenicoldrugId:217 ANTIBIOTICS
chlordiazepoxide - PA < 6 years; See Table 69drugId:218; See Table 71drugId:4361 BENZODIAZEPINES
chlordiazepoxide / clidiniumdrugId:6843 - PA ANTISPASMODICS,ANTICHOLINERGIC
chlorhexidine gluconatedrugId:1990 * ANTISEPTICS
chloroprocaine ^ ANESTHETICS
chloroquine phosphate tablet ANTIMALARIALS
chlorothiazidedrugId:221 CARDIOVASCULAR
chlorpheniraminedrugId:222 * ANTIHISTAMINES
chlorpromazine - PA < 6 years; See Table 24drugId:6321; See Table 71drugId:223 ANTIPSYCHOTIC
chlorpropamidedrugId:224 DIABETIC AGENTS
chlorthalidonedrugId:225 CARDIOVASCULAR
chlorzoxazone 250 mg, 375 mg, 750 mgdrugId:2360 - PA MUSCLE RELAXANT
chlorzoxazone 500 mgdrugId:226 - PA < 18 years MUSCLE RELAXANT
cholera vaccine, live, oraldrugId:5594 1 BIOLOGICAL
cholestyramine / aspartame-PrevalitedrugId:228 LIPID LOWERING AGENTS
cholestyramine / aspartame-Questran LightdrugId:2431 LIPID LOWERING AGENTS
cholestyramine / sucrosedrugId:229 LIPID LOWERING AGENTS
cholestyramine resin powderdrugId:7110 - PA LIPID LOWERING AGENTS
cholic aciddrugId:4907 - PA BILE THERAPY
Cholbam (cholic acid)drugId:4907 - PA BILE THERAPY
ciclesonidedrugId:230 BRONCHODILATORS
ciclesonide nasal aerosol, 37 mcgdrugId:2561 - PA NASAL PREPARATIONS
ciclesonide nasal spray, 50 mcgdrugId:231 - PA NASAL PREPARATIONS
ciclopirox 0.77% cream, suspensiondrugId:5625 FUNGICIDES
ciclopirox 0.77% geldrugId:232 - PA FUNGICIDES
ciclopirox 1% shampoodrugId:5128 - PA FUNGICIDES
ciclopirox 8% nail lacquerdrugId:233 FUNGICIDES
cidofovir ANTIVIRALS
cilostazoldrugId:235 ANTIPLATELET AGENT
cimetidinedrugId:236 * H2 ANTAGONISTS
cinacalcet BP CALCIMIMETIC
ciprofloxacin; See Table 35drugId:241; See Table 66drugId:5663 ANTIBIOTICS
Cipro # (ciprofloxacin); See Table 35drugId:241; See Table 66drugId:5663 ANTIBIOTICS
ciprofloxacin / dexamethasonedrugId:245 OTIC PREPARATIONS
Ciprodex (ciprofloxacin / dexamethasone)drugId:245 OTIC PREPARATIONS
ciprofloxacin / fluocinolonedrugId:5683 - PA OTIC PREPARATIONS
ciprofloxacin / hydrocortisonedrugId:246 OTIC PREPARATIONS
Cipro HC (ciprofloxacin / hydrocortisone)drugId:246 OTIC PREPARATIONS
ciprofloxacin 0.2% otic solutiondrugId:2895 - PA OTIC PREPARATIONS
ciprofloxacin extended-releasedrugId:238 - PA ANTIBIOTICS
Cipro XR (ciprofloxacin extended-release)drugId:238 - PA ANTIBIOTICS
ciprofloxacin ophthalmic ointmentdrugId:243 - PA OPHTHALMIC PREPARATIONS
Ciloxan (ciprofloxacin ophthalmic ointment)drugId:243 - PA OPHTHALMIC PREPARATIONS
ciprofloxacin ophthalmic solutiondrugId:244 OPHTHALMIC PREPARATIONS
CiloxandrugId:244 # (ciprofloxacin ophthalmic solution)drugId:244 OPHTHALMIC PREPARATIONS
ciprofloxacin otic suspensiondrugId:5390 ^ OTIC PREPARATIONS
cisplatindrugId:247 CHEMOTHERAPY
citalopram - PA < 6 years; See Table 17drugId:248; See Table 71drugId:3700 ANTIDEPRESSANTS
Celexa # (citalopram) - PA < 6 years; See Table 17drugId:248; See Table 71drugId:3700 ANTIDEPRESSANTS
citric acid / potassium citrate ELECTROLYTES AND NUTRIENTS
citric acid / sodium citrate / potassium citrate ELECTROLYTES AND NUTRIENTS
cladribine injectiondrugId:2673 CHEMOTHERAPY
cladribine tabletdrugId:7224 - PA MULTIPLE SCLEROSIS AGENTS
clarithromycindrugId:252 ANTIBIOTICS
clarithromycin extended-releasedrugId:253 - PA ANTIBIOTICS
clemastinedrugId:254 ANTIHISTAMINES
clevidipinedrugId:2896 CARDIOVASCULAR
Cleviprex (clevidipine)drugId:2896 CARDIOVASCULAR
clindamycin / benzoyl peroxide-AcanyadrugId:262 - PA DERMATOLOGICAL
clindamycin / benzoyl peroxide-BenzaclindrugId:263 - PA DERMATOLOGICAL
clindamycin / benzoyl peroxide-DuacdrugId:264 - PA DERMATOLOGICAL
clindamycin / benzoyl peroxide-OnextondrugId:4788 - PA DERMATOLOGICAL
clindamycin / tretinoin-VeltindrugId:1970 - PA DERMATOLOGICAL
clindamycin / tretinoin-ZianadrugId:265 - PA DERMATOLOGICAL
clindamycin capsule, injection, oral solution; See Table 35drugId:255; See Table 66drugId:2626 ANTIBIOTICS
Cleocin # (clindamycin capsule, injection, oral solution); See Table 35drugId:255; See Table 66drugId:2626 ANTIBIOTICS
clindamycin foamdrugId:261 - PA ANTIBIOTICS
clindamycin gel, lotion, solutiondrugId:257 - PA ≥ 22 years ANTIBIOTICS
Cleocin TdrugId:257 # (clindamycin gel, lotion, solution)drugId:257 - PA ≥ 22 years ANTIBIOTICS
clindamycin gel-ClindageldrugId:258 - PA ANTIBIOTICS
Clindagel (clindamycin gel-Clindagel)drugId:258 - PA ANTIBIOTICS
clindamycin pledgetsdrugId:256 - PA ANTIBIOTICS
Cleocin T (clindamycin pledgets)drugId:256 - PA ANTIBIOTICS
clindamycin vaginal cream-CleocindrugId:5000 ANTIBIOTICS
CleocindrugId:5000 # (clindamycin vaginal cream-Cleocin)drugId:5000 ANTIBIOTICS
clindamycin vaginal cream-ClindessedrugId:260 - PA ANTIBIOTICS
Clindesse (clindamycin vaginal cream-Clindesse)drugId:260 - PA ANTIBIOTICS
clindamycin vaginal suppositorydrugId:4915 - PA ANTIBIOTICS
Cleocin Vaginal Ovule (clindamycin vaginal suppository)drugId:4915 - PA ANTIBIOTICS
clobazam film - PA; See Table 20drugId:7106; See Table 71drugId:7107 ANTICONVULSANTS
clobazam suspension, tablet - PA; See Table 20drugId:2419; See Table 71drugId:3300 ANTICONVULSANTS
clobetasol propionate / emollientdrugId:5035 GLUCOCORTICOIDS
clobetasol propionate cream, ointmentdrugId:269 GLUCOCORTICOIDS
clobetasol propionate foamdrugId:268 - PA GLUCOCORTICOIDS
clobetasol propionate foam / emollientdrugId:2532 - PA GLUCOCORTICOIDS
clobetasol propionate gel, shampoo kitdrugId:5033 - PA GLUCOCORTICOIDS
clobetasol propionate lotion, shampoo, spraydrugId:266 - PA GLUCOCORTICOIDS
Clobex (clobetasol propionate lotion, shampoo, spray)drugId:266 - PA GLUCOCORTICOIDS
clobetasol propionate powderdrugId:7160 - PA GLUCOCORTICOIDS
clobetasol propionate solutiondrugId:5080 GLUCOCORTICOIDS
clocortolone creamdrugId:270 - PA GLUCOCORTICOIDS
Cloderm (clocortolone cream)drugId:270 - PA GLUCOCORTICOIDS
clofarabinedrugId:271 CHEMOTHERAPY
ClolardrugId:271 # (clofarabine)drugId:271 CHEMOTHERAPY
clomipramine - PA; See Table 17drugId:272; See Table 71drugId:4002 ANTIDEPRESSANTS
clonazepam 0.125 mg, 0.25 mg, 0.5 mg, 1 mg orally disintegrating tablet - PA < 6 years and PA > 90 units/month; See Table 69drugId:273; See Table 71drugId:4362 BENZODIAZEPINES
clonazepam 2 mg orally disintegrating tablet - PA; See Table 69drugId:2909; See Table 71drugId:4364 BENZODIAZEPINES
clonazepam powder - PA; See Table 69drugId:7022; See Table 71drugId:7023 BENZODIAZEPINES
clonazepam tablet - PA < 6 years; See Table 69drugId:274; See Table 71drugId:4363 BENZODIAZEPINES
clonidine / chlorthalidonedrugId:276 CARDIOVASCULAR
clonidine extended-release tablet - PA; See Table 31drugId:2170; See Table 71drugId:3081 NONSTIMULANT ADHD AGENTS
clonidine injectiondrugId:2750 ANALGESICS
clonidine patch BP - PA; See Table 18drugId:5160; See Table 71drugId:2194 CARDIOVASCULAR
Catapres-TTS (clonidine patch) BP - PA; See Table 18drugId:5160; See Table 71drugId:2194 CARDIOVASCULAR
clonidine powder - PA; See Table 18drugId:6370; See Table 71drugId:6371 CARDIOVASCULAR
clonidine tablet - PA < 3 years; See Table 18drugId:5161; See Table 71drugId:2105 CARDIOVASCULAR
Catapres # (clonidine tablet) - PA < 3 years; See Table 18drugId:5161; See Table 71drugId:2105 CARDIOVASCULAR
clopidogreldrugId:277 ANTIPLATELET AGENT
clorazepate - PA < 6 years; See Table 69drugId:278; See Table 71drugId:4380 BENZODIAZEPINES
clotrimazoledrugId:279 * FUNGICIDES
clotrimazole / betamethasone creamdrugId:280 FUNGICIDES
clotrimazole / betamethasone lotiondrugId:2856 - PA FUNGICIDES
clotrimazole trochedrugId:1995 FUNGICIDES
clozapine orally disintegrating tablet - PA; See Table 24drugId:282; See Table 71drugId:4262 ANTIPSYCHOTIC
clozapine suspension - PA; See Table 24drugId:2930; See Table 71drugId:4263 ANTIPSYCHOTIC
clozapine tablet - PA < 6 years; See Table 24drugId:281; See Table 71drugId:4261 ANTIPSYCHOTIC
Clozaril # (clozapine tablet) - PA < 6 years; See Table 24drugId:281; See Table 71drugId:4261 ANTIPSYCHOTIC
coagulation factor IX recombinant, glycopegylated-Rebinyn ANTI-HEMOPHILIA AGENTS
coagulation factor IX, recombinant ANTI-HEMOPHILIA AGENTS
coagulation factor VIIa, recombinant ANTI-HEMOPHILIA AGENTS
coagulation factor X, human ANTI-HEMOPHILIA AGENTS
Coagadex (coagulation factor X, human) ANTI-HEMOPHILIA AGENTS
cobicistatdrugId:4816 ANTIVIRALS
cobimetinibdrugId:5243 - PA CHEMOTHERAPY
Cotellic (cobimetinib)drugId:5243 - PA CHEMOTHERAPY
cod liver oil * ELECTROLYTES AND NUTRIENTS
codeinedrugId:285 - PA < 12 years and PA > 360 mg/day OPIOID ANALGESICS
codeine powderdrugId:286 - PA OPIOID ANALGESICS
coenzyme Q10drugId:6202 - PA ≥ 19 years ELECTROLYTES AND NUTRIENTS
colchicine capsuledrugId:4765 - PA GOUT AGENTS
colchicine tabletdrugId:2162 - PA GOUT AGENTS
Colcrys (colchicine tablet)drugId:2162 - PA GOUT AGENTS
colesevelam BP; See Table 13drugId:288; See Table 26drugId:289 LIPID LOWERING AGENTS
colestipoldrugId:290 LIPID LOWERING AGENTS
ColestiddrugId:290 # (colestipol)drugId:290 LIPID LOWERING AGENTS
colistimethate sodium injectiondrugId:291 ANTIBIOTICS
Coly-Mycin MdrugId:291 # (colistimethate sodium injection)drugId:291 ANTIBIOTICS
colistin / neomycin / thonzonium / hydrocortisonedrugId:2108 BP OTIC PREPARATIONS
Coly-Mycin S (colistin / neomycin / thonzonium / hydrocortisone)drugId:2108 BP OTIC PREPARATIONS
collagenase ENZYMES
collagenase clostridium histolyticumdrugId:1951 - PA ENZYMES
colloidal oatmeal * DERMATOLOGICAL
copanlisibdrugId:6500 - PA CHEMOTHERAPY
copper IUD CONTRACEPTIVES
corticotropindrugId:294 - PA HORMONE AGENTS
cortisonedrugId:295 GLUCOCORTICOIDS
cosyntropin DIAGNOSTICS
Cortrosyn # (cosyntropin) DIAGNOSTICS
crisaboroledrugId:6041 - PA DERMATOLOGICAL
crizotinibdrugId:2376 - PA CHEMOTHERAPY
crofelemerdrugId:5684 - PA ANTIDIARRHEALS
cromolyn inhalationdrugId:298 BRONCHODILATORS
cromolyn ophthalmicdrugId:299 OPHTHALMIC PREPARATIONS
cromolyn oral BRONCHODILATORS
crossed-linked hyaluronatedrugId:4802 - PA; Non-Drug Product NON-DRUG PRODUCT
crotamitondrugId:300 - PA ANTIPARASITICS
cyanocobalamindrugId:302 o ELECTROLYTES AND NUTRIENTS
cyanocobalamin / folic aciddrugId:303 - PA ELECTROLYTES AND NUTRIENTS
cyanocobalamin-NascobaldrugId:301 - PA ELECTROLYTES AND NUTRIENTS
cyclobenzaprine 5 mg, 10 mgdrugId:305 - PA < 15 years MUSCLE RELAXANT
cyclobenzaprine 7.5 mgdrugId:306 - PA MUSCLE RELAXANT
cyclobenzaprine extended-releasedrugId:304 - PA MUSCLE RELAXANT
cyclopentolate OPHTHALMIC PREPARATIONS
cyclopentolate / phenylephrine OPHTHALMIC PREPARATIONS
cyclophosphamidedrugId:310 CHEMOTHERAPY
cycloserinedrugId:2498 TB PREPARATIONS
cyclosporinedrugId:2092 IMMUNOMODULATOR
cyclosporine modifieddrugId:314 IMMUNOMODULATOR
cyclosporine ophthalmicdrugId:311 - PA OPHTHALMIC PREPARATIONS
cyproheptadinedrugId:315 ANTIHISTAMINES
cysteamine delayed-release capsuledrugId:2861 - PA ENZYMES
cysteamine immediate-release capsuledrugId:316 ENZYMES
Cystagon (cysteamine immediate-release capsule)drugId:316 ENZYMES
cysteamine ophthalmicdrugId:2818 - PA OPHTHALMIC PREPARATIONS
Cystaran (cysteamine ophthalmic)drugId:2818 - PA OPHTHALMIC PREPARATIONS
cytarabinedrugId:317 CHEMOTHERAPY
cytomegalovirus immune globulin IV, humandrugId:318 BIOLOGICAL
Cytogam (cytomegalovirus immune globulin IV, human)drugId:318 BIOLOGICAL
CosmegendrugId:2674 # (dactinomycin)drugId:2674 CHEMOTHERAPY
Cubicin (daptomycin)drugId:326 - PA ANTIBIOTICS
Clarinex-D (desloratadine / pseudoephedrine)drugId:474 - PA ANTIHISTAMINES
ClarinexdrugId:339 # (desloratadine syrup, tablet)drugId:339 ANTIHISTAMINES
Cambia (diclofenac powder for solution)drugId:1953 - PA NONSTEROIDAL ANTI-INFLAMMATORY
Cardizem CDdrugId:531 # (diltiazem 120 mg, 180 mg, 240 mg, 300 mg-Cardizem CD)drugId:531 CARDIOVASCULAR
Cardizem CD (diltiazem 360 mg-Cardizem CD)drugId:2299 - PA CARDIOVASCULAR
Cardizem LAdrugId:529 # (diltiazem extended-release tablet)drugId:529 CARDIOVASCULAR
CardizemdrugId:528 # (diltiazem-Cardizem)drugId:528 CARDIOVASCULAR
CosoptdrugId:564 # (dorzolamide / timolol)drugId:564 OPHTHALMIC PREPARATIONS
Cosopt PF (dorzolamide / timolol, preservative free)drugId:2517 - PA OPHTHALMIC PREPARATIONS
Cardura XL (doxazosin extended-release)drugId:566 - PA BENIGN PROSTATIC HYPERPLASIA AGENTS
Cardura # (doxazosin immediate-release); See Table 18drugId:565; See Table 19drugId:5163 CARDIOVASCULAR
Cymbalta # (duloxetine 20 mg, 30 mg, 60 mg) - PA < 6 years; See Table 17drugId:585; See Table 71drugId:3960 ANTIDEPRESSANTS
Copiktra (duvelisib)drugId:7002 - PA CHEMOTHERAPY
Cerdelga (eliglustat)drugId:4764 - PA ENZYMES
Complera (emtricitabine / rilpivirine / tenofovir disoproxil fumarate)drugId:2361 ANTIVIRALS
Comtan (entacapone)drugId:602 - PA ANTIPARKINSON
Combipatch (estradiol / norethindrone-Combipatch) HORMONE REPLACEMENT THERAPY
Climara # (estradiol-Climara) HORMONE REPLACEMENT THERAPY
Cyclessa # (ethinyl estradiol / desogestrel-Cyclessa) CONTRACEPTIVES
Corifact (factor XIII concentrate, human) ANTI-HEMOPHILIA AGENTS
Capex (fluocinolone shampoo)drugId:868 - PA GLUCOCORTICOIDS
Carac (fluorouracil 0.5% cream)drugId:876 - PA CHEMOTHERAPY
Cordran (flurandrenolide tape)drugId:884 - PA GLUCOCORTICOIDS
CutivatedrugId:5065 # (fluticasone cream)drugId:5065 GLUCOCORTICOIDS
Cutivate (fluticasone lotion)drugId:892 - PA GLUCOCORTICOIDS
CerebyxdrugId:2681 # (fosphenytoin)drugId:2681 ANTICONVULSANTS
CytovenedrugId:922 # (ganciclovir injection)drugId:922 ANTIVIRALS
Copaxone (glatiramer)drugId:930 BP MULTIPLE SCLEROSIS AGENTS
Cuvposa (glycopyrrolate oral solution)drugId:2163 - PA ANTISPASMODICS,ANTICHOLINERGIC
CortenemadrugId:2983 # (hydrocortisone enema)drugId:2983 GLUCOCORTICOIDS
Cortifoam (hydrocortisone foam)drugId:731 GLUCOCORTICOIDS
CortefdrugId:736 # (hydrocortisone tablet)drugId:736 GLUCOCORTICOIDS
Cyanokit (hydroxocobalamin) ANTIDOTES
Cerezyme (imiglucerase)drugId:780 - PA ENZYMES
Carimune NF (immune globulin IV, human-Carimune NF)drugId:785 - PA BIOLOGICAL
Cuvitru (immune globulin subcutaneous injection, human-Cuvitru)drugId:5720 - PA BIOLOGICAL
Cutaquig (immune globulin subcutaneous injection, human-hipp)drugId:7131 - PA BIOLOGICAL
Crixivan (indinavir)drugId:791 ANTIVIRALS
CamptosardrugId:970 # (irinotecan)drugId:970 CHEMOTHERAPY
Cresemba (isavuconazonium)drugId:4909 - PA FUNGICIDES
Corlanor (ivabradine)drugId:5124 - PA CARDIOVASCULAR
Culturelle (lactobacillus rhamnosus GG)drugId:6204 - PA ≥ 19 years GASTROINTESTINAL AGENT
Cimduo (lamivudine / tenofovir disoproxil fumarate)drugId:6780 - PA ANTIVIRALS
CombivirdrugId:1012 # (lamivudine / zidovudine)drugId:1012 ANTIVIRALS
Carnitor # (levocarnitine) ELECTROLYTES AND NUTRIENTS
Cytomel # (liothyronine) THYROID PREPARATIONS
CozaardrugId:1103 # (losartan)drugId:1103 CARDIOVASCULAR
Cantil (mepenzolate) ANTISPASMODICS,ANTICHOLINERGIC
Carbocaine (mepivacaine) ^ ANESTHETICS
CanasadrugId:2095 # (mesalamine suppository)drugId:2095 GI ANTI-INFLAMMATORY
Celontin (methsuximide); See Table 20drugId:948; See Table 71drugId:4441 ANTICONVULSANTS
Cotempla XR-ODT (methylphenidate extended-release orally disintegrating tablet) - PA; See Table 31drugId:6281; See Table 71drugId:6282 CEREBRAL STIMULANTS
Concerta (methylphenidate extended-release-Concerta) BP - PA < 3 years and PA > 60 units/month; See Table 31drugId:2662; See Table 71drugId:3041 CEREBRAL STIMULANTS
Cytotec # (misoprostol) ANTACIDS
Centany (mupirocin ointment)drugId:2564 ANTIBIOTICS
CellceptdrugId:1410 # (mycophenolate mofetil)drugId:1410 IMMUNOMODULATOR
Cesamet (nabilone)drugId:1414 - PA ANTIEMETICS
Corgard (nadolol)drugId:1416 - PA CARDIOVASCULAR
CorzidedrugId:1418 # (nadolol / bendroflumethiazide)drugId:1418 CARDIOVASCULAR
Cortisporin (neomycin / bacitracin / polymyxin B / hydrocortisone topical ointment)drugId:5502 ANTIBIOTICS
Cortisporin (neomycin / polymyxin B / hydrocortisone cream)drugId:1184 ANTIBIOTICS
Creon DR (pancrelipase-Creon DR)drugId:1082 ENZYMES
Cuprimine (penicillamine-Cuprimine) BP CHELATING AGENT
Condylox Gel (podofilox gel)drugId:2261 - PA DERMATOLOGICAL
Condylox SolutiondrugId:1545 # (podofilox solution)drugId:1545 DERMATOLOGICAL
ColytedrugId:2539 # (polyethylene glycol-electrolyte solution-Colyte)drugId:2539 LAXATIVES
Cytra-K (potassium citrate / citric acid) ELECTROLYTES AND NUTRIENTS
Cytra-3 (potassium citrate / sodium citrate / citric acid) ELECTROLYTES AND NUTRIENTS
Crinone (progesterone gel)drugId:2587 - PA HORMONE REPLACEMENT THERAPY
Ceprotin (protein C concentrate)drugId:1605 - PA HEMATINIC AGENT
Cyramza (ramucirumab)drugId:2955 - PA CHEMOTHERAPY
Cinqair (reslizumab)drugId:5586 - PA BIOLOGICAL
CopegusdrugId:1651 # (ribavirin tablet)drugId:1651 ANTIVIRALS
CrestordrugId:5601 # (rosuvastatin 40 mg)drugId:5601 - PA > 30 units/month LIPID LOWERING AGENTS
CrestordrugId:1459 # (rosuvastatin 5 mg, 10 mg, 20 mg)drugId:1459 - PA > 45 units/month LIPID LOWERING AGENTS
Cosentyx (secukinumab)drugId:4908 - PA IMMUNOMODULATOR
Cytra-2 (sodium citrate / citric acid) ELECTROLYTES AND NUTRIENTS
Clenpiq (sodium picosulfate / magnesium oxide / anhydrous citric acid-Clenpiq)drugId:6380 - PA LAXATIVES
Carospir (spironolactone suspension)drugId:6280 - PA ALDOSTERONE ANTAGONISTS
Chemet (succimer) CHELATING AGENT
Carafate (sucralfate suspension) BP ANTACIDS
Carafate # (sucralfate tablet) ANTACIDS
Cialis (tadalafil-Cialis)drugId:2373 - PA BENIGN PROSTATIC HYPERPLASIA AGENTS
Conzip (tramadol extended-release capsule)drugId:2362 - PA ANALGESICS
Caprelsa (vandetanib)drugId:2281 - PA CHEMOTHERAPY
Chantix (varenicline) SMOKING CESSATION
Calan SRdrugId:2742 # (verapamil sustained-release)drugId:2742 CARDIOVASCULAR
CalandrugId:1800 # (verapamil tablet)drugId:1800 CARDIOVASCULAR
CoumadindrugId:1812 # (warfarin)drugId:1812 ANTICOAGULANTS

MassHealth Drug List Footnotes
PA Prior authorization is required. The prescriber must obtain prior authorization for the drug in order for the pharmacy to receive payment. Note: Prior authorization applies to both the brand-name and the FDA "A"-rated generic equivalent of listed product.
 
# This designates a brand-name drug with FDA “A”-rated generic equivalents. Prior authorization is required for the brand, unless a particular form of that drug (for example, tablet, capsule, or liquid) does not have an FDA “A”-rated generic equivalent.
 
BP Brand Preferred over generic equivalents. In general, MassHealth requires a trial of the preferred drug or clinical rationale for prescribing the non-preferred drug generic equivalent.
 
CO Carve-Out. This agent is listed on the Acute Hospital Carve-Out Drugs List and is subject to additional monitoring and billing requirements.
 
PD Preferred Drug. In general, MassHealth requires a trial of the preferred drug or clinical rationale for prescribing a non-preferred drug within a therapeutic class.
 
* The generic OTC and, if any, generic prescription versions of the drug are payable under MassHealth without prior authorization.
 
o Prior-authorization status depends on the drug's formulation.
 
^ This drug is available through the health care professional who administers the drug. MassHealth does not pay for this drug to be dispensed through a retail pharmacy.
 
1 Product may be available through the Massachusetts Department of Public Health (DPH). Please check with DPH for availability. MassHealth does not pay for immunizing biologicals (i.e., vaccines) and tubercular (TB) drugs that are available free of charge through local boards of public health or through the Massachusetts Department of Public Health without prior authorization (130 CMR 406.413(C)). In cases where free vaccines are available to providers for specific populations (e.g. children, high risk, etc.), MassHealth will reimburse the provider only for individuals not eligible for the free vaccines. Notwithstanding the above, MassHealth will pay pharmacies for seasonal flu vaccine serum without prior authorization, if the vaccine is administered in the pharmacy.
 
2 Prior authorization status is gender specific.
 

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


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Last updated 10/09/19