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MassHealth Drug List table

Drug - Brand Name (Generic Name)	Class
Tyvaso (treprostinil inhalation solution)drugId:1746 - PA	CARDIOVASCULAR
Tysabri (natalizumab)drugId:1177	MULTIPLE SCLEROSIS AGENTS
typhoid vaccine injectiondrugId:1771	BIOLOGICAL
typhoid vaccine capsuledrugId:2628	BIOLOGICAL
Typhim VI (typhoid vaccine injection)drugId:1771	BIOLOGICAL
Tymlos (abaloparatide)drugId:6362 - PA	HORMONE AGENTS
Tylenol / CodeinedrugId:146 # (acetaminophen / codeine)drugId:146 - PA < 12 years and PA > 4 g/day acetaminophen and PA > 360 mg/day codeine	OPIOID ANALGESICS
Tykerb (lapatinib)drugId:1025	CHEMOTHERAPY
Tygacil (tigecycline)drugId:1701 - PA	ANTIBIOTICS
Tybost (cobicistat)drugId:4816	ANTIVIRALS
Twynsta (amlodipine / telmisartan)drugId:1661 - PA	CARDIOVASCULAR
Twinrix (hepatitis A, inactivated / hepatitis B recombinant)drugId:2627 1	BIOLOGICAL
Tudorza (aclidinium)drugId:2649 - PA > 1 inhaler/month	BRONCHODILATORS
Truvada (emtricitabine / tenofovir disoproxil fumarate)drugId:597	ANTIVIRALS
TrusoptdrugId:563 # (dorzolamide)drugId:563	OPHTHALMIC PREPARATIONS
Trumenba (meningococcal group B vaccine-Trumenba)drugId:4815 1	BIOLOGICAL
Trulicity (dulaglutide)drugId:4814 - PA	DIABETIC AGENTS
Trulance (plecanatide)drugId:6043 - PA	CONSTIPATION AGENTS
trospium immediate-releasedrugId:1770	URINARY ANTISPASMODICS
trospium extended-releasedrugId:1769 - PA	URINARY ANTISPASMODICS
tropicamide	OPHTHALMIC PREPARATIONS
Trokendi XR (topiramate extended-release capsule-Trokendi XR) - PA; See Table 20drugId:2859; See Table 71drugId:4505	ANTICONVULSANTS
Trogarzo (ibalizumab-uiyk)drugId:6687 - PA	ANTIVIRALS
TrizivirdrugId:139 # (abacavir / lamivudine / zidovudine)drugId:139	ANTIVIRALS
Trivisc (hyaluronate-Trivisc)drugId:6926 - PA; Non-Drug Product	NON-DRUG PRODUCT
Triumeq (abacavir / dolutegravir / lamivudine)drugId:4642 PD	ANTIVIRALS
TrisenoxdrugId:2697 # (arsenic trioxide)drugId:2697	CHEMOTHERAPY
triptorelindrugId:1766 - PA	CHEMOTHERAPY
Triptodur (triptorelin)drugId:6486 - PA	HORMONE AGENTS
triple antibiotic ointment (neomycin / bacitracin / polymyxin B topical ointment)drugId:1994 *	ANTIBIOTICS
Trintellix (vortioxetine) - PA; See Table 17drugId:2885; See Table 71drugId:3881	ANTIDEPRESSANTS
Tri-Norinyl # (ethinyl estradiol / norethindrone-Tri-Norinyl)	CONTRACEPTIVES
trimipramine - PA < 6 years; See Table 17drugId:1765; See Table 71drugId:4160	ANTIDEPRESSANTS
trimethoprim tabletdrugId:4886	ANTIBIOTICS
trimethoprim / polymyxin B ophthalmic solutiondrugId:2060	OPHTHALMIC PREPARATIONS
trimethobenzamide	ANTIEMETICS
Triluron (hyaluronate-Triluron)drugId:7268 - PA; Non-Drug Product	NON-DRUG PRODUCT
TrilipixdrugId:837 # (fenofibric acid)drugId:837	LIPID LOWERING AGENTS
Trileptal # (oxcarbazepine) - PA < 6 years; See Table 20drugId:1311; See Table 71drugId:4442	ANTICONVULSANTS
trihexyphenidyldrugId:1762	ANTIPARKINSON
Triglide (fenofibrate 160 mg tablet)drugId:472	LIPID LOWERING AGENTS
trifluridine / tipiracildrugId:5261 - PA	CHEMOTHERAPY
trifluridine	OPHTHALMIC PREPARATIONS
trifluoperazine - PA < 6 years; See Table 24drugId:6330; See Table 71drugId:1760	ANTIPSYCHOTIC
Triferic (ferric pyrophosphate citrate)drugId:6021 ^	ELECTROLYTES AND NUTRIENTS
Triesence (triamcinolone ophthalmic suspension) ^	OPHTHALMIC PREPARATIONS
trientine BP	CHELATING AGENT
TricordrugId:467 # (fenofibrate 48 mg, 145 mg tablet)drugId:467	LIPID LOWERING AGENTS
Tribenzor (amlodipine / olmesartan / hydrochlorothiazide)drugId:1969 - PA	CARDIOVASCULAR
triazolam - PA < 6 years and PA > 30 units/month; See Table 69drugId:1757; See Table 71drugId:4353	BENZODIAZEPINES
triamterenedrugId:5247 - PA	CARDIOVASCULAR
triamcinolone spraydrugId:2526 - PA	GLUCOCORTICOIDS
triamcinolone paste	GLUCOCORTICOIDS
triamcinolone OTC nasal spraydrugId:6241 - PA > 1 inhaler/month	NASAL PREPARATIONS
triamcinolone ophthalmic suspension ^	OPHTHALMIC PREPARATIONS
triamcinolone injectiondrugId:1750	GLUCOCORTICOIDS
triamcinolone extended-release injectable suspensiondrugId:6415 - PA	GLUCOCORTICOIDS
triamcinolone 0.5% ointmentdrugId:5032	GLUCOCORTICOIDS
triamcinolone 0.1% ointment, 0.5% creamdrugId:5030	GLUCOCORTICOIDS
triamcinolone 0.1% lotion, 0.025% ointmentdrugId:5028	GLUCOCORTICOIDS
triamcinolone 0.1% creamdrugId:5029	GLUCOCORTICOIDS
triamcinolone 0.05% ointmentdrugId:2527 - PA	GLUCOCORTICOIDS
triamcinolone 0.025% cream, lotiondrugId:1753	GLUCOCORTICOIDS
triamcinolone, oral	GLUCOCORTICOIDS
Treximet (sumatriptan / naproxen)drugId:1916 BP - PA	TRIPTAN/NON STEROIDAL ANTI-INFLAMMATORY
Tretten (factor XIII A-subunit recombinant)	ANTI-HEMOPHILIA AGENTS
tretinoin-Retin-AdrugId:1748 BP - PA ≥ 22 years	DERMATOLOGICAL
tretinoin microspheresdrugId:1749 - PA	DERMATOLOGICAL
tretinoin capsuledrugId:5135	CHEMOTHERAPY
tretinoin-AvitadrugId:1747 - PA ≥ 22 years	DERMATOLOGICAL
tretinoin 0.05% lotiondrugId:6900 - PA	DERMATOLOGICAL
tretinoin 0.05% geldrugId:2432 - PA	DERMATOLOGICAL
Tresiba (insulin degludec)drugId:5302	DIABETIC AGENTS
treprostinil tabletdrugId:2940 - PA	CARDIOVASCULAR
treprostinil injectiondrugId:1745 BP - PA	CARDIOVASCULAR
treprostinil inhalation solutiondrugId:1746 - PA	CARDIOVASCULAR
Tremfya (guselkumab)drugId:6289 - PA	IMMUNOMODULATOR
Trelstar (triptorelin)drugId:1766 - PA	CHEMOTHERAPY
Trelegy (fluticasone furoate / umeclidinium / vilanterol)drugId:6408 - PA	BRONCHODILATORS
Trecator (ethionamide)drugId:2499	TB PREPARATIONS
Treanda (bendamustine)drugId:134	CHEMOTHERAPY
trazodone 50 mg, 100 mg, 150 mg - PA < 6 years; See Table 17drugId:1744; See Table 71drugId:3861	ANTIDEPRESSANTS
trazodone 300 mg tablet - PA; See Table 17drugId:2062; See Table 71drugId:3862	ANTIDEPRESSANTS
travoprost 0.004% eye dropdrugId:1743	OPHTHALMIC PREPARATIONS
Travatan Z (travoprost 0.004% eye drop)drugId:1743	OPHTHALMIC PREPARATIONS
Travasol (amino acid and electrolyte IV infusion)	ELECTROLYTES AND NUTRIENTS
trastuzumabdrugId:1742	CHEMOTHERAPY
tranylcypromine - PA < 6 years; See Table 17drugId:1741; See Table 71drugId:3540	ANTIDEPRESSANTS
Tranxene # (clorazepate) - PA < 6 years; See Table 69drugId:278; See Table 71drugId:4380	BENZODIAZEPINES
Transderm-Scop (scopolamine transdermal patch)drugId:1835 BP - PA	ANTIEMETICS
tranexamic acid tablet	HEMOSTATICS
trandolapril / verapamildrugId:4812 - PA	CARDIOVASCULAR
trandolaprildrugId:1738	CARDIOVASCULAR
trametinibdrugId:2845 - PA	CHEMOTHERAPY
tramadoldrugId:1735 - PA < 12 years and PA > 400 mg/day	ANALGESICS
tramadol extended-release tabletdrugId:1736 - PA	ANALGESICS
tramadol extended-release capsuledrugId:2362 - PA	ANALGESICS
tramadol / acetaminophendrugId:1737 - PA	ANALGESICS
Tradjenta (linagliptin)drugId:2293	DIABETIC AGENTS
Tracleer (bosentan)drugId:372 BP - PA	CARDIOVASCULAR
Toviaz (fesoterodine)drugId:850 BP	URINARY ANTISPASMODICS
Toujeo (insulin glargine-Toujeo)drugId:4914	DIABETIC AGENTS
Totect (dexrazoxane)	ANTIDOTES
torsemidedrugId:1732	CARDIOVASCULAR
ToriseldrugId:1668 # (temsirolimus)drugId:1668	CHEMOTHERAPY
toremifenedrugId:1731	CHEMOTHERAPY
Toprol XLdrugId:1337 # (metoprolol extended-release tablet)drugId:1337	CARDIOVASCULAR
topotecandrugId:1730	CHEMOTHERAPY
topiramate sprinkle capsule - PA < 6 years; See Table 20drugId:2316; See Table 71drugId:4504	ANTICONVULSANTS
topiramate powder - PA; See Table 20drugId:7120; See Table 71drugId:7121	ANTICONVULSANTS
topiramate - PA < 6 years; See Table 20drugId:1729; See Table 71drugId:4503	ANTICONVULSANTS
topiramate extended-release capsule-Trokendi XR - PA; See Table 20drugId:2859; See Table 71drugId:4505	ANTICONVULSANTS
topiramate extended-release capsule-Qudexy XR - PA; See Table 20drugId:2943; See Table 71drugId:4502	ANTICONVULSANTS
Topicort (desoximetasone 0.25% cream, ointment, spray, 0.05% gel)drugId:488 - PA	GLUCOCORTICOIDS
Topicort (desoximetasone 0.05% cream, ointment)drugId:5021 - PA	GLUCOCORTICOIDS
Topamax # (topiramate sprinkle capsule) - PA < 6 years; See Table 20drugId:2316; See Table 71drugId:4504	ANTICONVULSANTS
Topamax # (topiramate) - PA < 6 years; See Table 20drugId:1729; See Table 71drugId:4503	ANTICONVULSANTS
tolvaptan-SamscadrugId:1728 - PA	VASOPRESSIN ANTAGONISTS
tolvaptan-JynarquedrugId:6801 - PA	VASOPRESSIN ANTAGONISTS
tolterodine immediate-releasedrugId:1726	URINARY ANTISPASMODICS
tolterodine extended-releasedrugId:1725	URINARY ANTISPASMODICS
Tolsura (itraconazole 65 mg capsule)drugId:7011 - PA	FUNGICIDES
tolnaftatedrugId:1724 *	FUNGICIDES
tolmetindrugId:1723 - PA	NONSTEROIDAL ANTI-INFLAMMATORY
tolcaponedrugId:1722 - PA	ANTIPARKINSON
tolbutamidedrugId:1721	DIABETIC AGENTS
tolazamidedrugId:1720	DIABETIC AGENTS
Tolak (fluorouracil 4% cream)drugId:5503 - PA	CHEMOTHERAPY
Tofranil-PM (imipramine pamoate) - PA; See Table 17drugId:2308; See Table 71drugId:4080	ANTIDEPRESSANTS
Tofranil # (imipramine hydrochloride) - PA < 6 years; See Table 17drugId:782; See Table 71drugId:4060	ANTIDEPRESSANTS
tofacitinibdrugId:2660 - PA	IMMUNOMODULATOR
tofacitinib extended-releasedrugId:5407 - PA	IMMUNOMODULATOR
tocilizumabdrugId:1719 - PA	IMMUNOMODULATOR
TobrexdrugId:1715 # (tobramycin ophthalmic solution)drugId:1715	OPHTHALMIC PREPARATIONS
Tobrex (tobramycin ophthalmic ointment)drugId:1716 - PA	OPHTHALMIC PREPARATIONS
tobramycin ophthalmic solutiondrugId:1715	OPHTHALMIC PREPARATIONS
tobramycin ophthalmic ointmentdrugId:1716 - PA	OPHTHALMIC PREPARATIONS
tobramycin injectiondrugId:2630	ANTIBIOTICS
tobramycin inhalation solution-TobidrugId:1713	ANTIBIOTICS
tobramycin inhalation solution-Kitabis PakdrugId:4781	ANTIBIOTICS
tobramycin inhalation solution-BethkisdrugId:2884 - PA	ANTIBIOTICS
tobramycin inhalation powderdrugId:2794 - PA	ANTIBIOTICS
tobramycin 0.3% / dexamethasone 0.1%, ophthalmic suspensiondrugId:1717	OPHTHALMIC PREPARATIONS
tobramycin 0.3% / dexamethasone 0.1%, ophthalmic ointmentdrugId:2275 - PA	OPHTHALMIC PREPARATIONS
tobramycin 0.3% / dexamethasone 0.05%, ophthalmic suspensiondrugId:2088 - PA	OPHTHALMIC PREPARATIONS
tobramycin / loteprednol ophthalmic suspensiondrugId:1718 - PA	OPHTHALMIC PREPARATIONS
Tobradex ST (tobramycin 0.3% / dexamethasone 0.05%, ophthalmic suspension)drugId:2088 - PA	OPHTHALMIC PREPARATIONS
TobradexdrugId:1717 # (tobramycin 0.3% / dexamethasone 0.1%, ophthalmic suspension)drugId:1717	OPHTHALMIC PREPARATIONS
Tobradex (tobramycin 0.3% / dexamethasone 0.1%, ophthalmic ointment)drugId:2275 - PA	OPHTHALMIC PREPARATIONS
Tobi Podhaler (tobramycin inhalation powder)drugId:2794 - PA	ANTIBIOTICS
TobidrugId:1713 # (tobramycin inhalation solution-Tobi)drugId:1713	ANTIBIOTICS
tizanidine tabletdrugId:1712	MUSCLE RELAXANT
tizanidine capsuledrugId:1711 - PA	MUSCLE RELAXANT
Tivorbex (indomethacin 20 mg, 40 mg)drugId:5115 - PA	NONSTEROIDAL ANTI-INFLAMMATORY
Tivicay (dolutegravir)drugId:2852 - PA > 30 units/month	ANTIVIRALS
tisagenlecleuceldrugId:6404 CO ^ - PA	CHEMOTHERAPY
Tirosint (levothyroxine-Tirosint)	THYROID PREPARATIONS
tipranavirdrugId:1709	ANTIVIRALS
tiotropium inhalation solutiondrugId:4640 - PA > 1 inhaler/month	BRONCHODILATORS
tiotropium inhalation powderdrugId:1708 - PA > 30 units/month	BRONCHODILATORS
tiotropium / olodateroldrugId:5112 - PA	BRONCHODILATORS
tiopronin	CHELATING AGENT
tinidazoledrugId:1706 - PA	ANTIPARASITICS
Tindamax (tinidazole)drugId:1706 - PA	ANTIPARASITICS
Timoptic-XE (timolol ophthalmic gel forming solution)drugId:2211 - PA	OPHTHALMIC PREPARATIONS
Timoptic Ocudose (timolol ophthalmic unit dose solution)drugId:2210 - PA	OPHTHALMIC PREPARATIONS
TimopticdrugId:1704 # (timolol-Timoptic)drugId:1704	OPHTHALMIC PREPARATIONS
timolol-TimopticdrugId:1704	OPHTHALMIC PREPARATIONS
timolol tabletdrugId:5020	CARDIOVASCULAR
timolol ophthalmic unit dose solutiondrugId:2210 - PA	OPHTHALMIC PREPARATIONS
timolol ophthalmic gel forming solutiondrugId:2211 - PA	OPHTHALMIC PREPARATIONS
timolol-IstaloldrugId:1703 BP	OPHTHALMIC PREPARATIONS
Timentin (ticarcillin / clavulanate)drugId:1699	ANTIBIOTICS
tildrakizumab-asmndrugId:7004 - PA	IMMUNOMODULATOR
Tikosyn # (dofetilide)	CARDIOVASCULAR
Tiglutik (riluzole suspension)drugId:7010 - PA	AMYOTROPHIC LATERAL SCLEROSIS AGENTS
tigecyclinedrugId:1701 - PA	ANTIBIOTICS
Tigan # (trimethobenzamide)	ANTIEMETICS
ticarcillin / clavulanatedrugId:1699	ANTIBIOTICS
ticagrelordrugId:2359 - PA	ANTIPLATELET AGENT
Tibsovo (ivosidenib)drugId:6925 - PA	CHEMOTHERAPY
Tiazac ERdrugId:533 # (diltiazem-Tiazac ER)drugId:533	CARDIOVASCULAR
tiagabine - PA; See Table 20drugId:2617; See Table 71drugId:4500	ANTICONVULSANTS
Thyrolar (liotrix)	THYROID PREPARATIONS
thyroid	THYROID PREPARATIONS
Thymoglobulin (antithymocyte globulin, rabbit)drugId:1111	BIOLOGICAL
thiothixene - PA < 6 years; See Table 24drugId:6329; See Table 71drugId:1696	ANTIPSYCHOTIC
thioridazine - PA < 6 years; See Table 24drugId:6328; See Table 71drugId:1694	ANTIPSYCHOTIC
Thiola (tiopronin)	CHELATING AGENT
thioguaninedrugId:1693	CHEMOTHERAPY
thiaminedrugId:1692 *	ELECTROLYTES AND NUTRIENTS
ThermazenedrugId:1852 # (silver sulfadiazine-Thermazene)drugId:1852	ANTIBIOTICS
Theracys (BCG live, intravesical)drugId:127	CHEMOTHERAPY
theophyllinedrugId:1691	BRONCHODILATORS
Thalomid (thalidomide)drugId:1690	IMMUNOMODULATOR
thalidomidedrugId:1690	IMMUNOMODULATOR
tezacaftor / ivacaftordrugId:6540 - PA	CYSTIC FIBROSIS AGENTS
tetradecyl sulfate injectiondrugId:2495 - PA	CARDIOVASCULAR
tetracyclinedrugId:1689	ANTIBIOTICS
tetracaine	OPHTHALMIC PREPARATIONS
tetrabenazinedrugId:1688 BP - PA	NEUROLOGIC AGENT
tetanus immune globulin IM, humandrugId:1687	BIOLOGICAL
testosterone undecanoatedrugId:2954 ^ - PA	HORMONE REPLACEMENT THERAPY
testosterone powderdrugId:2311 - PA	HORMONE REPLACEMENT THERAPY
testosterone patchdrugId:1682 - PA	HORMONE REPLACEMENT THERAPY
testosterone intramuscular pelletdrugId:1685 - PA	HORMONE REPLACEMENT THERAPY
testosterone enanthatedrugId:7050 - PA	HORMONE REPLACEMENT THERAPY
testosterone cypionatedrugId:1680 - PA	HORMONE REPLACEMENT THERAPY
testosterone buccal systemdrugId:2647 - PA	HORMONE REPLACEMENT THERAPY
testosterone 2% solutiondrugId:2237 - PA	HORMONE REPLACEMENT THERAPY
testosterone 2% gel pumpdrugId:2241 - PA	HORMONE REPLACEMENT THERAPY
testosterone 1% gel tubedrugId:1684 - PA	HORMONE REPLACEMENT THERAPY
testosterone 1% gel tube, packet, pumpdrugId:2948 - PA	HORMONE REPLACEMENT THERAPY
testosterone 1% gel packetdrugId:2248 BP - PA	HORMONE REPLACEMENT THERAPY
testosterone 1.62% gel packet, pumpdrugId:2280 - PA	HORMONE REPLACEMENT THERAPY
Testopel (testosterone intramuscular pellet)drugId:1685 - PA	HORMONE REPLACEMENT THERAPY
Testim (testosterone 1% gel tube)drugId:1684 - PA	HORMONE REPLACEMENT THERAPY
tesamorelindrugId:5626 - PA	OTHER HORMONES
teriparatidedrugId:1678 - PA	HORMONE AGENTS
teriflunomidedrugId:2657 - PA	MULTIPLE SCLEROSIS AGENTS
terconazole	ANTIBIOTICS
terbutaline	BRONCHODILATORS
terbinafine tabletdrugId:1672	FUNGICIDES
terazosin; See Table 18drugId:1670; See Table 19drugId:5165	CARDIOVASCULAR
Terazol # (terconazole)	ANTIBIOTICS
TenormindrugId:102 # (atenolol)drugId:102	CARDIOVASCULAR
TenoreticdrugId:103 # (atenolol / chlorthalidone)drugId:103	CARDIOVASCULAR
tenofovir disoproxil fumarate tablet - PA > 30 units/month; See Table 38drugId:1669; See Table 44drugId:5820	ANTIVIRALS
tenofovir disoproxil fumarate powder - PA ≥ 13 years; See Table 38drugId:2489; See Table 44drugId:5821	ANTIVIRALS
tenofovir alafenamidedrugId:5768 - PA	ANTIVIRALS
Tenivac (diphtheria / tetanus toxoid vaccine)drugId:1686 1	BIOLOGICAL
teniposidedrugId:2699	CHEMOTHERAPY
Tenex # (guanfacine) - PA < 3 years; See Table 18drugId:5162; See Table 71drugId:691	CARDIOVASCULAR
temsirolimusdrugId:1668	CHEMOTHERAPY
temozolomidedrugId:1667	CHEMOTHERAPY
Temovate EdrugId:5035 # (clobetasol propionate / emollient)drugId:5035	GLUCOCORTICOIDS
TemovatedrugId:269 # (clobetasol propionate cream, ointment)drugId:269	GLUCOCORTICOIDS
TemodardrugId:1667 # (temozolomide)drugId:1667	CHEMOTHERAPY
temazepam 7.5 mg, 15 mg, 30 mg - PA < 6 years and PA >30 units/month; See Table 69drugId:1665; See Table 71drugId:4352	BENZODIAZEPINES
temazepam 22.5 mg - PA; See Table 69drugId:1666; See Table 71drugId:4351	BENZODIAZEPINES
telotristat ethyldrugId:6108 - PA	ANTIDIARRHEALS
telmisartandrugId:1660 - PA	CARDIOVASCULAR
telmisartan / hydrochlorothiazidedrugId:1663 - PA	CARDIOVASCULAR
telavancindrugId:1949 - PA	ANTIBIOTICS
Tekturna HCT (aliskiren / hydrochlorothiazide)drugId:14 - PA	CARDIOVASCULAR
Tekturna (aliskiren)drugId:13 BP - PA	CARDIOVASCULAR
Tegsedi (inotersen)drugId:6988 - PA	OLIGONUCLEOTIDE AGENTS
Tegretol XR # (carbamazepine extended-release-Tegretol XR) - PA < 6 years; See Table 20drugId:2192; See Table 71drugId:3220	ANTICONVULSANTS
Tegretol # (carbamazepine-Tegretol) - PA < 6 years; See Table 20drugId:170; See Table 71drugId:3280	ANTICONVULSANTS
Teflaro (ceftaroline)drugId:2179 - PA	ANTIBIOTICS
teduglutide injectiondrugId:2722 - PA	GASTROINTESTINAL AGENT
tedizolid tabletdrugId:4635 - PA	ANTIBIOTICS
tedizolid injectiondrugId:4636 - PA	ANTIBIOTICS
Technivie (ombitasvir / paritaprevir / ritonavir)drugId:5114 - PA	ANTIVIRALS
Tecfidera (dimethyl fumarate)drugId:2793 - PA	MULTIPLE SCLEROSIS AGENTS
Tecentriq (atezolizumab)drugId:5593 - PA	CHEMOTHERAPY
TBO-filgrastimdrugId:2889 - PA	HEMATINIC AGENT
Tazorac (tazarotene)drugId:1657 - PA	DERMATOLOGICAL
tazarotenedrugId:1657 - PA	DERMATOLOGICAL
tazarotene foamdrugId:2841 - PA	DERMATOLOGICAL
Taytulla (ethinyl estradiol / norethindrone / ferrous fumarate)	CONTRACEPTIVES
TaxoteredrugId:553 # (docetaxel-Taxotere)drugId:553	CHEMOTHERAPY
Tavalisse (fostamatinib)drugId:6823 - PA	HEMATOLOGIC
tavaboroledrugId:4629 - PA	FUNGICIDES
Tasmar (tolcapone)drugId:1722 - PA	ANTIPARKINSON
tasimelteondrugId:2960 - PA	SEDATIVE, NON-BARBITURATE
Tasigna (nilotinib)drugId:1216	CHEMOTHERAPY
Tarka (trandolapril / verapamil)drugId:4812 - PA	CARDIOVASCULAR
TargretindrugId:361 # (bexarotene)drugId:361	CHEMOTHERAPY
Tarceva (erlotinib)drugId:619 BP - PA	CHEMOTHERAPY
tapentadoldrugId:1923 - PA	OPIOID ANALGESICS
tapentadol extended-releasedrugId:2369 - PA	OPIOID ANALGESICS
Tapazole # (methimazole)	THYROID PREPARATIONS
Tanzeum (albiglutide)drugId:2946 - PA	DIABETIC AGENTS
tamsulosindrugId:1922	BENIGN PROSTATIC HYPERPLASIA AGENTS
tamoxifen tabletdrugId:1921	CHEMOTHERAPY
tamoxifen solutiondrugId:4980 - PA	CHEMOTHERAPY
TamifludrugId:2314 # (oseltamivir suspension)drugId:2314 - PA > 180 mL/ claim and PA > 360 mL/ 365 days	ANTIVIRALS
TamifludrugId:1305 # (oseltamivir 45 mg and 75 mg)drugId:1305 - PA > 10 units/ claim and PA > 20 units/ 365 days	ANTIVIRALS
TamifludrugId:1303 # (oseltamivir 30mg)drugId:1303 - PA > 20 units/ claim and PA > 40 units/ 365 days	ANTIVIRALS
Tambocor # (flecainide)	CARDIOVASCULAR
Talzenna (talazoparib)drugId:7045 - PA	CHEMOTHERAPY
Talwin (pentazocine)drugId:1502	OPIOID ANALGESICS
Taltz (ixekizumab)drugId:5399 - PA	IMMUNOMODULATOR
talimogene laherparepvecdrugId:5440 ^ - PA	CHEMOTHERAPY
taliglucerase alfadrugId:2558 - PA	ENZYMES
talazoparibdrugId:7045 - PA	CHEMOTHERAPY
Takhzyro (lanadelumab-flyo)drugId:7008 - PA	BIOLOGICAL
Tagrisso (osimertinib)drugId:5301 - PA	CHEMOTHERAPY
tagraxofusp-erzsdrugId:7182 - PA	CHEMOTHERAPY
tafluprostdrugId:2524 - PA	OPHTHALMIC PREPARATIONS
Tafinlar (dabrafenib)drugId:2823 - PA	CHEMOTHERAPY
tafenoquinedrugId:7261	ANTIMALARIALS
tafamidisdrugId:7269 - PA	TRANSTHYRETIN STABILIZER
tadalafil-CialisdrugId:2373 - PA	BENIGN PROSTATIC HYPERPLASIA AGENTS
tadalafil-AdcircadrugId:1920 - PA	CARDIOVASCULAR
tacrolimus topicaldrugId:1919 BP	DERMATOLOGICAL
tacrolimus injectiondrugId:2741 ^	IMMUNOMODULATOR
tacrolimus immediate-release capsuledrugId:1918	IMMUNOMODULATOR
tacrolimus granulesdrugId:7264 - PA	IMMUNOMODULATOR
tacrolimus extended-release tabletdrugId:5249	IMMUNOMODULATOR
tacrolimus extended-release capsuledrugId:2838	IMMUNOMODULATOR
Taclonex (betamethasone / calcipotriene ointment, scalp suspension)drugId:421 - PA	GLUCOCORTICOIDS
Tabloid (thioguanine)drugId:1693	CHEMOTHERAPY

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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 11/25/19