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This is a listing of all of the drugs covered by Mass Health. please select a letter to see drugs listed by that letter, or enter the name of the drug you wish to search for.


    

 
MassHealth Drug List table
Drug - Brand Name (Generic Name) Class
labetaloldrugId:1001 CARDIOVASCULAR
Lac-Hydrin # (ammonium lactate-lac-hydrin) - PA DERMATOLOGICAL
LAClotion # (ammonium lactate-laclotion) - PA DERMATOLOGICAL
lacosamide injectiondrugId:1002 ANTICONVULSANTS
lacosamide solution - PA; See Table 20drugId:1972; See Table 71drugId:3500 ANTICONVULSANTS
lacosamide tablet - PA; See Table 20drugId:1003; See Table 71drugId:3520 ANTICONVULSANTS
Lacrisert (hydroxypropyl cellulose ophthalmic insert)drugId:2172 - PA OPHTHALMIC PREPARATIONS
lactic acid DERMATOLOGICAL
lactic acid / vitamin E DERMATOLOGICAL
Lactinol (lactic acid) DERMATOLOGICAL
lactulose packetdrugId:1007 - PA LAXATIVES
lactulose solutiondrugId:1008 GASTROINTESTINAL AGENT
Lamictal (lamotrigine tablet starter kit) - PA; See Table 20drugId:1016; See Table 71drugId:4284 ANTICONVULSANTS
Lamictal # (lamotrigine dispersible tablet) - PA < 6 years; See Table 20drugId:2216; See Table 71drugId:4288 ANTICONVULSANTS
Lamictal # (lamotrigine tablet) - PA < 6 years; See Table 20drugId:1013; See Table 71drugId:4289 ANTICONVULSANTS
Lamictal ODT (lamotrigine orally disintegrating tablet) - PA; See Table 20drugId:1014; See Table 71drugId:4291 ANTICONVULSANTS
Lamictal ODT (lamotrigine orally disintegrating tablet starter kit) - PA; See Table 20drugId:1015; See Table 71drugId:4292 ANTICONVULSANTS
Lamictal XR (lamotrigine extended-release tablet) - PA; See Table 20drugId:1017; See Table 71drugId:4297 ANTICONVULSANTS
Lamictal XR (lamotrigine extended-release tablet starter kit) - PA; See Table 20drugId:1018; See Table 71drugId:4300 ANTICONVULSANTS
Lamisil (terbinafine granules)drugId:1674 - PA ANTIBIOTICS
LamisildrugId:1672 # (terbinafine tablet)drugId:1672 ANTIBIOTICS
lamivudine / zidovudinedrugId:1012 ANTIVIRALS
lamivudine solutiondrugId:2541 ANTIVIRALS
lamivudine solutiondrugId:1011 - PA > 600 ml/month ANTIVIRALS
lamivudine tabletdrugId:1009 ANTIVIRALS
lamivudine tabletdrugId:1010 - PA > 30 units/month  ANTIVIRALS
lamotrigine dispersible tablet - PA < 6 years; See Table 20drugId:2216; See Table 71drugId:4288 ANTICONVULSANTS
lamotrigine extended-release tablet - PA; See Table 20drugId:1017; See Table 71drugId:4297 ANTICONVULSANTS
lamotrigine extended-release tablet starter kit - PA; See Table 20drugId:1018; See Table 71drugId:4300 ANTICONVULSANTS
lamotrigine orally disintegrating tablet - PA; See Table 20drugId:1014; See Table 71drugId:4291 ANTICONVULSANTS
lamotrigine orally disintegrating tablet starter kit - PA; See Table 20drugId:1015; See Table 71drugId:4292 ANTICONVULSANTS
lamotrigine tablet - PA < 6 years; See Table 20drugId:1013; See Table 71drugId:4289 ANTICONVULSANTS
lamotrigine tablet starter kit - PA; See Table 20drugId:1016; See Table 71drugId:4284 ANTICONVULSANTS
lanolin * COMPOUNDING AGENT
Lanoxin # (digoxin) CARDIOVASCULAR
lanreotide HORMONE AGENTS
lansoprazole / amoxicillin / clarithromycindrugId:1023 - PA H. PYLORI AGENTS
lansoprazole capsuledrugId:1021 - PA ≥ 2 years and PA > 30 units/month PROTON PUMP INHBITORS
lansoprazole orally disintegrating tabletdrugId:1022 - PA ≥ 2 years and PA > 30 units/month PROTON PUMP INHBITORS
lanthanum - PA ELECTROLYTES AND NUTRIENTS
Lantus (insulin glargine prefilled syringe)drugId:808 - PA DIABETIC AGENTS
Lantus (insulin glargine vial)drugId:807 DIABETIC AGENTS
lapatinibdrugId:1025 CHEMOTHERAPY
laronidasedrugId:1026 - PA ENZYMES
Lasix # (furosemide) CARDIOVASCULAR
Lastacaft (alcaftadine)drugId:2173 - PA ANTIHISTAMINES
latanoprostdrugId:1027 OPHTHALMIC PREPARATIONS
Latuda (lurasidone) - PA; See Table 24drugId:2174; See Table 71drugId:4266 ANTIPSYCHOTIC
Lazanda (fentanyl nasal spray)drugId:2963 - PA ANALGESICS, NARCOTIC
L-Carnitine (levocarnitine) ELECTROLYTES AND NUTRIENTS
ledipasvir / sofosbuvirdrugId:4600 - PA ANTIVIRALS
Leena (ethinyl estradiol / norethindrone-leena) CONTRACEPTIVES
leflunomide IMMUNOMODULATOR
lenalidomide 15 mg, 20 mg, 25 mgdrugId:2298 - PA > 21 units/28 days CHEMOTHERAPY
lenalidomide 2.5 mg, 5 mg, and 10 mgdrugId:1029 - PA > 30 units/month CHEMOTHERAPY
lepirudindrugId:1030 H ANTICOAGULANTS
Lescol (fluvastatin)drugId:899 - PA LIPID LOWERING AGENTS
Lescol XL (fluvastatin extended-release)drugId:898 - PA LIPID LOWERING AGENTS
Lessina (ethinyl estradiol / levonorgestrel-lessina) CONTRACEPTIVES
Letairis (ambrisentan)drugId:30 - PA CARDIOVASCULAR
letrozoledrugId:1031 CHEMOTHERAPY
leucovorin ANTIDOTES
Leukeran (chlorambucil)drugId:216 CHEMOTHERAPY
Leukine (sargramostim)drugId:1833 HEMATINIC AGENT
leuprolide / norethindronedrugId:2964 - PA OTHER HORMONES
leuprolidedrugId:1034 - PA CHEMOTHERAPY
levalbuterol, inhalerdrugId:1035 - PA BRONCHODIALATORS
levalbuterol inhalation solutiondrugId:1036 - PA BRONCHODIALATORS
LevaquindrugId:1044 # (levofloxacin oral, injectable)drugId:1044 ANTIBIOTICS
Levatol (penbutolol)drugId:1494 - PA CARDIOVASCULAR
Levemir (insulin detemir prefilled syringe)drugId:806 - PA DIABETIC AGENTS
Levemir (insulin detemir vial)drugId:805 DIABETIC AGENTS
levetiracetam extended-release - PA < 6 years; See Table 20drugId:1038; See Table 71drugId:4320 ANTICONVULSANTS
levetiracetam - PA < 6 years; See Table 20drugId:1037; See Table 71drugId:4302 ANTICONVULSANTS
Levlen # (ethinyl estradiol / levonorgestrel-levlen) CONTRACEPTIVES
levobunololdrugId:1040 OPHTHALMIC PREPARATIONS
levocarnitine ELECTROLYTES AND NUTRIENTS
levocetirizinedrugId:1043 - PA ANTIHISTAMINES
levofloxacin 0.5% ophthalmic solutiondrugId:1046 - PA OPHTHALMIC PREPARATIONS
levofloxacin oral, injectabledrugId:1044 ANTIBIOTICS
levoleucovorin - PA ANTIDOTES
levomilnacipran - PA; See Table 17drugId:2886; See Table 71drugId:3980 ANTIDEPRESSANTS
levonorgestrel / ethinyl estradiol-Amethia CONTRACEPTIVES
levonorgestrel / ethinyl estradiol-Aviane CONTRACEPTIVES
levonorgestrel / ethinyl estradiol-Enpresse CONTRACEPTIVES
levonorgestrel / ethinyl estradiol-Levora CONTRACEPTIVES
levonorgestrel / ethinyl estradiol-Loseasonique CONTRACEPTIVES
levonorgestrel / ethinyl estradiol-Lybrel CONTRACEPTIVES
levonorgestrel / ethinyl estradiol-Nordette CONTRACEPTIVES
levonorgestrel / ethinyl estradiol-Portia CONTRACEPTIVES
levonorgestrel / ethinyl estradiol-Quartette CONTRACEPTIVES
levonorgestrel / ethinyl estradiol-Seasonale CONTRACEPTIVES
levonorgestrel / ethinyl estradiol-Seasonique CONTRACEPTIVES
levonorgestrel IUD CONTRACEPTIVES
levonorgestrel-Plan B CONTRACEPTIVES
levonorgestrel-Plan B One Step CONTRACEPTIVES
levonorgestrel-releasing intrauterine system CONTRACEPTIVES
Levora # (levonorgestrel / ethinyl estradiol-Levora) CONTRACEPTIVES
levorphanol powderdrugId:1063 - PA OPIOID ANALGESICS
levorphanol tabletdrugId:1064 - PA > 8 mg/day OPIOID ANALGESICS
Levothroid # (levothyroxine-levothroid) THYROID PREPARATIONS
levothyroxine-levothroid THYROID PREPARATIONS
levothyroxine-levoxyl THYROID PREPARATIONS
levothyroxine-synthroid THYROID PREPARATIONS
levothyroxine-tirosint - PA THYROID PREPARATIONS
levothyroxine-unithroid THYROID PREPARATIONS
Levoxyl # (levothyroxine-levoxyl) THYROID PREPARATIONS
Lexapro # (escitalopram) - PA < 6 years; See Table 17drugId:630; See Table 71drugId:3701 ANTIDEPRESSANTS
Lexiva (fosamprenavir)drugId:908 ANTIVIRALS
l-glutamine - PA ELECTROLYTES AND NUTRIENTS
Lialda (mesalamine delayed-release) GI ANTI-INFLAMMATORY
lidocaine / prilocainedrugId:1074 ANESTHETICS
lidocaine / tetracainedrugId:1075 - PA > 4 patches / month ANESTHETICS
lidocaine ophthalmic gel OPHTHALMIC PREPARATIONS
lidocaine patchdrugId:1071 - PA ANESTHETICS
lidocaine-XylocainedrugId:1069 ANESTHETICS
lidocaine-Xylocaine-MPFdrugId:1073 ANESTHETICS
Lidoderm (lidocaine patch)drugId:1071 - PA ANESTHETICS
linaclotidedrugId:2658 - PA LAXATIVES
linagliptin / metformindrugId:2486 - PA DIABETIC AGENTS
linagliptindrugId:2293 - PA DIABETIC AGENTS
Lincocin (lincomycin)drugId:2634 ANTIBIOTICS
lincomycindrugId:2634 ANTIBIOTICS
lindane lotion, shampoodrugId:1076 - PA ANTIPARASITICS
linezolid, injectiondrugId:1079 - PA ANTIBIOTICS
linezolid solution, tabletdrugId:1078 - PA ANTIBIOTICS
Linzess (linaclotide)drugId:2658 - PA LAXATIVES
Lioresal Intrathecal (baclofen intrathecal injection)drugId:125 MUSCLE RELAXANT
liothyronine THYROID PREPARATIONS
liotrix THYROID PREPARATIONS
lipase / protease / amylase 3,000 unit, 10,000 unit, 15,000 unit, 20,000 unit, 25,000 unit capsuledrugId:1084 ENZYMES
lipase / protease / amylase 5,000 unit capsuledrugId:2911 ENZYMES
lipase / protease / amylase-Creon DRdrugId:1082 ENZYMES
lipase / protease / amylase-Pancreaze DRdrugId:2565 ENZYMES
lipase / protease / amylase-PancrelipasedrugId:1083 ENZYMES
lipase / protease / amylase-Pertzye DRdrugId:2730 ENZYMES
lipase / protease / amylase-Ultresa DRdrugId:2650 ENZYMES
lipase / protease / amylase-ViokacedrugId:2597 ENZYMES
LipitordrugId:105 # (atorvastatin 10 mg, 20 mg, 40 mg)drugId:105 - PA > 45 units/month LIPID LOWERING AGENTS
LipitordrugId:2933 # (atorvastatin 80 mg)drugId:2933 - PA > 30 units/month LIPID LOWERING AGENTS
Lipodox (doxorubicin liposomal injection)drugId:2689 CHEMOTHERAPY
Lipofen (fenofibrate capsule 50 mg and 150 mg)drugId:470 - PA LIPID LOWERING AGENTS
liposomal doxorubicindrugId:2678 CHEMOTHERAPY
Liposyn # (fat emulsions, intravenous-liposyn) ELECTROLYTES AND NUTRIENTS
Liptruzet (ezetimibe / atorvastatin)drugId:2786 - PA LIPID LOWERING AGENTS
liraglutidedrugId:1085 - PA DIABETIC AGENTS
lisdexamfetamine - PA < 3 years and PA > 60 units/month; See Table 31drugId:1086; See Table 71drugId:3021 CEREBRAL STIMULANTS
lisinopril / hydrochlorothiazidedrugId:1090 CARDIOVASCULAR
lisinopril-prinivildrugId:1087 CARDIOVASCULAR
lisinopril-zestrildrugId:1088 CARDIOVASCULAR
lithiumdrugId:1092 - PA < 6 years ANTIPSYCHOTIC
LithobiddrugId:1092 # (lithium)drugId:1092 - PA < 6 years ANTIPSYCHOTIC
Lithostat (acetohydroxamic acid) ANTIBIOTICS
Livalo (pitavastatin)drugId:1962 - PA LIPID LOWERING AGENTS
LodosyndrugId:173 # (carbidopa)drugId:173 ANTIPARKINSON
lodoxamidedrugId:1095 - PA OPHTHALMIC PREPARATIONS
Loestrin (ethinyl estradiol / norethindrone-Loestrin) CONTRACEPTIVES
LofibradrugId:471 # (fenofibrate capsule 67 mg, 134 mg and 200 mg and tablet 54 mg and 160 mg)drugId:471 LIPID LOWERING AGENTS
Lo Loestrin Fe (norethindrone / ethinyl estradiol / ferrous fumarate) CONTRACEPTIVES
lomitapidedrugId:2727 - PA LIPID LOWERING AGENTS
LomotildrugId:542 # (diphenoxylate / atropine)drugId:542 ANTIDIARRHEALS
lomustinedrugId:1096 CHEMOTHERAPY
loperamidedrugId:1097 * ANTIDIARRHEALS
LopiddrugId:927 # (gemfibrozil)drugId:927 LIPID LOWERING AGENTS
lopinavir / ritonavirdrugId:1098 ANTIVIRALS
LopressordrugId:1338 # (metoprolol)drugId:1338 CARDIOVASCULAR
Lopressor HCTdrugId:1339 # (metoprolol / hydrochlorothiazide)drugId:1339 CARDIOVASCULAR
Loprox (ciclopirox 1% shampoo, 0.77% gel)drugId:232 - PA ANTIBIOTICS
loratadinedrugId:1099 ANTIHISTAMINES
loratadine / pseudoephedrinedrugId:2264 ANTIHISTAMINES
lorazepam powder - PA; See Table 69drugId:1102; See Table 71drugId:4401 BENZODIAZEPINES
lorazepam solution, tablet - PA < 6 years; See Table 69drugId:1100; See Table 71drugId:4400 BENZODIAZEPINES
Loryna (ethinyl estradiol / drospirenone-loryna) CONTRACEPTIVES
losartandrugId:1103 CARDIOVASCULAR
losartan / hydrochlorothiazidedrugId:1104 CARDIOVASCULAR
Loseasonique (levonorgestrel / ethinyl estradiol-Loseasonique) CONTRACEPTIVES
Lotemax (loteprednol 0.5%)drugId:1106 - PA OPHTHALMIC PREPARATIONS
LotensindrugId:132 # (benazepril)drugId:132 CARDIOVASCULAR
Lotensin HCTdrugId:133 # (benazepril / hydrochlorothiazide)drugId:133 CARDIOVASCULAR
loteprednol 0.2% eye dropsdrugId:1105 - PA OPHTHALMIC PREPARATIONS
loteprednol 0.5%drugId:1106 - PA OPHTHALMIC PREPARATIONS
Lotrel (amlodipine / benazepril)drugId:44 - PA CARDIOVASCULAR
Lotrel (benazepril / amlodipine)drugId:45 - PA CARDIOVASCULAR
Lotrimin (clotrimazole)drugId:279 * ANTIBIOTICS
LotrisonedrugId:280 # (clotrimazole / betamethasone cream)drugId:280 ANTIBIOTICS
Lotronex (alosetron)drugId:19 - PA GASTROINTESTINAL AGENT
lovastatin / niacin extended-releasedrugId:1204 - PA LIPID LOWERING AGENTS
lovastatin 10 mg, 20 mgdrugId:1108 - PA > 45 units/month LIPID LOWERING AGENTS
lovastatin 40 mgdrugId:2735 - PA > 60 units/month LIPID LOWERING AGENTS
lovastatin extended-releasedrugId:1107 - PA LIPID LOWERING AGENTS
Lovaza (omega-3 acid ethyl esters)drugId:1288 - PA LIPID LOWERING AGENTS
LovenoxdrugId:601 # (enoxaparin)drugId:601 ANTICOAGULANTS
Low-Ogestrel # (ethinyl estradiol / norgestrel) CONTRACEPTIVES
loxapine capsuledrugId:1109 - PA < 6 years ANTIPSYCHOTIC
loxapine oral inhalation powder H ANTIPSYCHOTIC
LoxitanedrugId:1109 # (loxapine capsule)drugId:1109 - PA < 6 years ANTIPSYCHOTIC
lubiprostonedrugId:1110 - PA LAXATIVES
Lucentis (ranibizumab) ^ OPHTHALMIC PREPARATIONS
Lufyllin-GG (guaifenesin / dyphylline) BRONCHODIALATORS
luliconazoledrugId:2925 - PA ANTIBIOTICS
Lumigan (bimatoprost)drugId:363 - PA OPHTHALMIC PREPARATIONS
Lumizyme (alglucosidase alfa-Lumizyme)drugId:11 - PA ENZYMES
Lunesta (eszopiclone) - PA; See Table 15drugId:662; See Table 71drugId:4348 SEDATIVES
Lupaneta Pack (leuprolide / norethindrone)drugId:2964 - PA OTHER HORMONES
Lupron (leuprolide)drugId:1033 - PA HORMONE AGENTS
lurasidone - PA; See Table 24drugId:2174; See Table 71drugId:4266 ANTIPSYCHOTIC
Luvox CR (fluvoxamine extended-release) - PA; See Table 17drugId:901; See Table 71drugId:3780 ANTIDEPRESSANTS
Luxiq (betamethasone valerate foam)drugId:355 - PA DERMATOLOGICAL
Luzu (luliconazole)drugId:2925 - PA ANTIBIOTICS
Lybrel # (levonorgestrel / ethinyl estradiol-Lybrel) CONTRACEPTIVES
Lyrica (pregabalin) - PA; See Table 20drugId:1582; See Table 71drugId:4460 ANTICONVULSANTS
Lysteda # (tranexamic acid tablet) HEMOSTATICS

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.
 
* 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.
 
H This drug is available only in an inpatient hospital setting. MassHealth does not pay for this drug to be dispensed through the retail pharmacy or physician's office.
 
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 12/15/14