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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
paclitaxel injectable suspensiondrugId:1468 CHEMOTHERAPY
paclitaxel injectiondrugId:1467 CHEMOTHERAPY
palbociclibdrugId:4940 - PA CHEMOTHERAPY
palifermin ANTIDOTES
paliperidone extended-release 1-month injection - PA < 6 years, PA > 2 units/month within the first 30 days of therapy and PA > 1 unit/month after 30 days of therapy; See Table 24drugId:1470; See Table 71drugId:4281 ANTIPSYCHOTIC
paliperidone extended-release 3-month injection - PA < 6 years and PA > 1 unit/3 months; See Table 24drugId:5121; See Table 71drugId:5122 ANTIPSYCHOTIC
paliperidone tablet - PA; See Table 24drugId:1471; See Table 71drugId:4280 ANTIPSYCHOTIC
palivizumabdrugId:1472 - PA ANTIVIRALS
palonosetron 0.25 mg/2 mL injectiondrugId:6614 - PA > 2 units/28 days ANTIEMETICS
palonosetron 0.25 mg/5 mL injectiondrugId:1473 - PA > 2 units/28 days ANTIEMETICS
Palynziq (pegvaliase-pqpz)drugId:6923 - PA ENZYMES
Pamelor # (nortriptyline) - PA < 6 years; See Table 17drugId:1262; See Table 71drugId:4120 ANTIDEPRESSANTS
Pancreaze DR (pancrelipase-Pancreaze DR)drugId:2565 ENZYMES
pancrelipase-Creon DRdrugId:1082 ENZYMES
pancrelipase-Pancreaze DRdrugId:2565 ENZYMES
pancrelipase-Pertzye DRdrugId:2730 ENZYMES
pancrelipase-ViokacedrugId:2597 ENZYMES
pancrelipase-Zenpep DRdrugId:1084 ENZYMES
Pandel (hydrocortisone probutate cream)drugId:732 - PA GLUCOCORTICOIDS
panitumumabdrugId:1475 CHEMOTHERAPY
panobinostatdrugId:5105 - PA CHEMOTHERAPY
Panretin (alitretinoin)drugId:16 - PA CHEMOTHERAPY
pantoprazole 40 mg suspensiondrugId:2702 - PA PROTON PUMP INHIBITORS
pantoprazole IVdrugId:1477 PROTON PUMP INHIBITORS
pantoprazole tabletdrugId:1476 - PA > 120 units/month PROTON PUMP INHIBITORS
Panzyga (immune globulin IV, human-ifas)drugId:7104 - PA BIOLOGICAL
Parafon Forte DSCdrugId:226 # (chlorzoxazone 500 mg)drugId:226 - PA < 18 years MUSCLE RELAXANT
Paragard (copper IUD) CONTRACEPTIVES
parathyroid hormonedrugId:5107 - PA HORMONE AGENTS
paricalcitol capsuledrugId:1481 - PA ELECTROLYTES AND NUTRIENTS
paricalcitol injectiondrugId:5781 ^ ELECTROLYTES AND NUTRIENTS
ParlodeldrugId:377 # (bromocriptine 2.5 mg, 5 mg)drugId:377 ANTIPARKINSON
Parnate # (tranylcypromine) - PA < 6 years; See Table 17drugId:1741; See Table 71drugId:3540 ANTIDEPRESSANTS
paromomycindrugId:1482 ANTIPARASITICS
paroxetine 7.5 mg capsuledrugId:2839 - PA UNCLASSIFIED DRUG PRODUCTS
paroxetine controlled-release - PA; See Table 17drugId:1485; See Table 71drugId:3800 ANTIDEPRESSANTS
paroxetine hydrochloride - PA < 6 years; See Table 17drugId:1484; See Table 71drugId:3801 ANTIDEPRESSANTS
paroxetine mesylate - PA; See Table 17drugId:1483; See Table 71drugId:3802 ANTIDEPRESSANTS
Parsabiv (etelcalcetide) ^ CALCIMIMETIC
Paser (aminosalicylic acid)drugId:2500 TB PREPARATIONS
pasireotide injectable suspensiondrugId:4912 - PA ENDOCRINE/METABOLIC AGENTS
pasireotidedrugId:2791 - PA ENDOCRINE/METABOLIC AGENTS
Pataday (olopatadine 0.2% eye drops)drugId:1284 - PA ANTIHISTAMINES
Patanase (olopatadine nasal spray)drugId:1283 - PA NASAL PREPARATIONS
Patanol (olopatadine 0.1% eye drops)drugId:1285 - PA ANTIHISTAMINES
patiromerdrugId:5320 - PA > 30 units/month CHELATING AGENT
Paxil # (paroxetine hydrochloride) - PA < 6 years; See Table 17drugId:1484; See Table 71drugId:3801 ANTIDEPRESSANTS
Paxil CR (paroxetine controlled-release) - PA; See Table 17drugId:1485; See Table 71drugId:3800 ANTIDEPRESSANTS
Pazeo (olopatadine 0.7% eye drops)drugId:4791 - PA ANTIHISTAMINES
pazopanibdrugId:1486 - PA CHEMOTHERAPY
PCE (erythromycin delayed-release tablet-PCE)drugId:5132 ANTIBIOTICS
PediapreddrugId:1578 # (prednisolone 5 mg/5 mL oral solution)drugId:1578 GLUCOCORTICOIDS
Pediarix (diphtheria / tetanus toxoids / acellular pertussis / hepatitis B, recombinant / poliovirus, inactivated vaccine)drugId:700 1 BIOLOGICAL
pediatric multivitaminsdrugId:1487 * ELECTROLYTES AND NUTRIENTS
Pedvaxhib (haemophilus B conjugate vaccine-Pedvaxhib)drugId:694 1 BIOLOGICAL
pegademase bovinedrugId:2682 - PA UNCLASSIFIED DRUG PRODUCTS
Peganone (ethotoin); See Table 20drugId:669; See Table 71drugId:3420 ANTICONVULSANTS
pegaspargasedrugId:2430 ^ CHEMOTHERAPY
Pegasys (peginterferon alfa-2a)drugId:2059 - PA ANTIVIRALS
pegfilgrastimdrugId:1489 HEMATINIC AGENT
pegfilgrastim-bmezdrugId:7337 HEMATINIC AGENT
pegfilgrastim-cbqvdrugId:7012 HEMATINIC AGENT
pegfilgrastim-jmdbdrugId:6903 HEMATINIC AGENT
peginterferon alfa-2adrugId:2059 - PA ANTIVIRALS
peginterferon alfa-2bdrugId:1490 - PA ANTIVIRALS
peginterferon alfa-2b-Sylatron ANTIVIRALS
peginterferon beta-1adrugId:4631 - PA MULTIPLE SCLEROSIS AGENTS
Pegintron (peginterferon alfa-2b)drugId:1490 - PA ANTIVIRALS
pegloticasedrugId:6294 - PA GOUT AGENTS
pegvaliase-pqpzdrugId:6923 - PA ENZYMES
pegvisomantdrugId:1491 - PA HORMONE AGENTS
pembrolizumabdrugId:4780 - PA CHEMOTHERAPY
pemetrexeddrugId:1492 CHEMOTHERAPY
penbutololdrugId:1494 - PA CARDIOVASCULAR
penciclovirdrugId:1495 - PA ANTIVIRALS
penicillamine capsule BP CHELATING AGENT
penicillamine tablet CHELATING AGENT
penicillin G 0.6 million, 1.2 million, 2.4 million unitsdrugId:2625 ANTIBIOTICS
penicillin G 5 million, 20 million unitsdrugId:1499 ANTIBIOTICS
penicillin G benzathine / penicillin G procainedrugId:2624 ANTIBIOTICS
penicillin VdrugId:1500 ANTIBIOTICS
PenlacdrugId:233 # (ciclopirox 8% nail lacquer)drugId:233 FUNGICIDES
Pennsaid (diclofenac topical solution)drugId:1944 - PA NONSTEROIDAL ANTI-INFLAMMATORY
Pentacel (diphtheria / tetanus / acellular pertussis / poliovirus inactivated / haemophilus B conjugate vaccine)drugId:581 1 BIOLOGICAL
Pentasa (mesalamine controlled-release)drugId:1154 - PA GI ANTI-INFLAMMATORY
pentazocinedrugId:1502 OPIOID ANALGESICS
pentazocine / naloxonedrugId:1504 - PA OPIOID ANALGESICS
pentostatindrugId:2692 CHEMOTHERAPY
pentoxifylline CARDIOVASCULAR
Pepcid (famotidine suspension)drugId:5602 - PA H2 ANTAGONISTS
PepciddrugId:461 # (famotidine tablet)drugId:461 * H2 ANTAGONISTS
perampanel - PA; See Table 20drugId:2926; See Table 71drugId:4444 ANTICONVULSANTS
PercocetdrugId:1323 # (oxycodone / acetaminophen-Percocet)drugId:1323 - PA > 80 mg/day OPIOID ANALGESICS
Perforomist (formoterol inhalation solution)drugId:906 - PA BRONCHODILATORS
perindoprildrugId:1509 CARDIOVASCULAR
perindopril / amlodipinedrugId:5287 - PA CARDIOVASCULAR
Perjeta (pertuzumab)drugId:2583 - PA CHEMOTHERAPY
permethrindrugId:1510 * ANTIPARASITICS
permethrin creamdrugId:4700 ANTIPARASITICS
perphenazine - PA < 6 years; See Table 24drugId:6326; See Table 71drugId:1511 ANTIPSYCHOTIC
Perseris (risperidone extended-release subcutaneous injection) - PA; See Table 24drugId:7007; See Table 71drugId:7009 ANTIPSYCHOTIC
pertuzumabdrugId:2583 - PA CHEMOTHERAPY
Pertzye DR (pancrelipase-Pertzye DR)drugId:2730 ENZYMES
Pexeva (paroxetine mesylate) - PA; See Table 17drugId:1483; See Table 71drugId:3802 ANTIDEPRESSANTS
pexidartinibdrugId:7279 - PA CHEMOTHERAPY
PfizerpendrugId:1499 # (penicillin G 5 million, 20 million units)drugId:1499 ANTIBIOTICS
phenazopyridine ANALGESICS
phenelzine - PA < 6 years; See Table 17drugId:1515; See Table 71drugId:3580 ANTIDEPRESSANTS
PhenergandrugId:1593 # (promethazine)drugId:1593 ANTIHISTAMINES
phenobarbitaldrugId:1516 BARBITURATES
phenoxybenzaminedrugId:5123 - PA CARDIOVASCULAR
phenylephrine ADRENERGICS
phenylephrine / ketorolac ^ OPHTHALMIC PREPARATIONS
phenylephrine / promethazine DECONGESTANT
phenytoin chewable tablet; See Table 20drugId:1523; See Table 71drugId:4520 ANTICONVULSANTS
phenytoin extended 200 mg and 300 mg capsule; See Table 20drugId:1526; See Table 71drugId:4524 ANTICONVULSANTS
phenytoin extended 30 mg and 100 mg capsule; See Table 20drugId:1525; See Table 71drugId:4523 ANTICONVULSANTS
phenytoin injectiondrugId:2661 ^ ANTICONVULSANTS
phenytoin suspension; See Table 20drugId:2938; See Table 71drugId:4522 ANTICONVULSANTS
Phos-Flur (sodium fluoride oral rinse) ELECTROLYTES AND NUTRIENTS
Phoslyra (calcium acetate) ELECTROLYTES AND NUTRIENTS
Phospholine Iodide (echothiophate)drugId:587 OPHTHALMIC PREPARATIONS
Picato (ingenol gel)drugId:2521 - PA DERMATOLOGICAL
Pifeltro (doravirine)drugId:6986 ANTIVIRALS
pilocarpine eye dropsdrugId:2635 OPHTHALMIC PREPARATIONS
pimavanserindrugId:5588 - PA ANTIPSYCHOTIC
pimecrolimusdrugId:1531 BP DERMATOLOGICAL
pimozide - PA < 6 years; See Table 24drugId:6327; See Table 71drugId:1532 ANTIPSYCHOTIC
pindololdrugId:1533 CARDIOVASCULAR
Pin-X (pyrantel pamoate)drugId:6215 ANTIPARASITICS
pioglitazonedrugId:1534 DIABETIC AGENTS
pioglitazone / metformin extended-releasedrugId:1937 - PA DIABETIC AGENTS
pioglitazone / metformindrugId:1536 - PA DIABETIC AGENTS
piperacillin / tazobactamdrugId:1537 ANTIBIOTICS
piperonyl butoxide / pyrethrinsdrugId:1538 * ANTIPARASITICS
Piqray (alpelisib)drugId:7225 - PA CHEMOTHERAPY
pirfenidonedrugId:4767 - PA PULMONARY FIBROSIS AGENTS
pitavastatin calciumdrugId:1962 - PA LIPID LOWERING AGENTS
pitavastatin magnesiumdrugId:7109 - PA LIPID LOWERING AGENTS
PlavixdrugId:277 # (clopidogrel)drugId:277 ANTIPLATELET AGENT
plazomicindrugId:7014 - PA ANTIBIOTICS
plecanatidedrugId:6043 - PA CONSTIPATION AGENTS
Plegridy (peginterferon beta-1a)drugId:4631 - PA MULTIPLE SCLEROSIS AGENTS
Plenvu (polyethylene glycol-electrolyte solution-Plenvu)drugId:7137 - PA LAXATIVES
pneumococcal 13-valent conjugate vaccinedrugId:1542 1 BIOLOGICAL
pneumococcal vaccinedrugId:1544 BIOLOGICAL
Pneumovax (pneumococcal vaccine)drugId:1544 BIOLOGICAL
podofilox geldrugId:2261 - PA DERMATOLOGICAL
podofilox solutiondrugId:1545 DERMATOLOGICAL
polatuzumab vedotin-piiqdrugId:7263 - PA CHEMOTHERAPY
polidocanoldrugId:2934 ^ - PA CARDIOVASCULAR
poliovirus vaccine, inactivateddrugId:1546 1 BIOLOGICAL
Polivy (polatuzumab vedotin-piiq)drugId:7263 - PA CHEMOTHERAPY
polyethylene glycol 3350drugId:1547 * LAXATIVES
polyethylene glycol-electrolyte solution-ColytedrugId:2539 LAXATIVES
polyethylene glycol-electrolyte solution-GolytelydrugId:1549 LAXATIVES
polyethylene glycol-electrolyte solution-MoviprepdrugId:1551 LAXATIVES
polyethylene glycol-electrolyte solution-NulytelydrugId:1552 LAXATIVES
polyethylene glycol-electrolyte solution-PlenvudrugId:7137 - PA LAXATIVES
PolytrimdrugId:2060 # (trimethoprim / polymyxin B ophthalmic solution)drugId:2060 OPHTHALMIC PREPARATIONS
pomalidomidedrugId:2787 - PA CHEMOTHERAPY
Pomalyst (pomalidomide)drugId:2787 - PA CHEMOTHERAPY
ponatinibdrugId:2724 - PA CHEMOTHERAPY
Portrazza (necitumumab)drugId:5420 - PA CHEMOTHERAPY
posaconazoledrugId:2928 BP - PA FUNGICIDES
potassium bicarbonate ELECTROLYTES AND NUTRIENTS
potassium chloride injection ELECTROLYTES AND NUTRIENTS
potassium chloride-Kaochlor ELECTROLYTES AND NUTRIENTS
potassium chloride-Klor-Con ELECTROLYTES AND NUTRIENTS
potassium chloride-Micro-K ELECTROLYTES AND NUTRIENTS
potassium citrate / citric acid ELECTROLYTES AND NUTRIENTS
potassium citrate / sodium citrate / citric acid ELECTROLYTES AND NUTRIENTS
potassium phosphate / dibasic sodium phosphate / monobasic sodium phosphate ELECTROLYTES AND NUTRIENTS
potassium phosphate / sodium phosphate ELECTROLYTES AND NUTRIENTS
potassium phosphate / sodium phosphate / phosphorus ELECTROLYTES AND NUTRIENTS
potassium phosphate * ELECTROLYTES AND NUTRIENTS
Poteligeo (mogamulizumab-kpkc)drugId:6924 - PA CHEMOTHERAPY
povidonedrugId:1567 * ANTISEPTICS
Pradaxa (dabigatran etexilate mesylate 110 mg)drugId:5286 - PA > 70 capsules/365 days ANTICOAGULANTS
Pradaxa (dabigatran etexilate mesylate 75 mg, 150 mg)drugId:2081 - PA ANTICOAGULANTS
pralatrexatedrugId:1568 CHEMOTHERAPY
Praluent (alirocumab)drugId:5119 - PA LIPID LOWERING AGENTS
pramipexoledrugId:1569 ANTIPARKINSON
pramipexole extended-releasedrugId:1943 - PA ANTIPARKINSON
pramlintidedrugId:1570 - PA DIABETIC AGENTS
PrandindrugId:1642 # (repaglinide)drugId:1642 DIABETIC AGENTS
prasugreldrugId:1571 ANTIPLATELET AGENT
PravacholdrugId:2736 # (pravastatin 10 mg, 20 mg, 40 mg)drugId:2736 - PA > 45 units/month LIPID LOWERING AGENTS
PravacholdrugId:1572 # (pravastatin 80 mg)drugId:1572 - PA > 30 units/month LIPID LOWERING AGENTS
pravastatin 10 mg, 20 mg, 40 mgdrugId:2736 - PA > 45 units/month LIPID LOWERING AGENTS
pravastatin 80 mgdrugId:1572 - PA > 30 units/month LIPID LOWERING AGENTS
praziquanteldrugId:2358 BP ANTIPARASITICS
prazosin; See Table 18drugId:1573; See Table 19drugId:5164 CARDIOVASCULAR
PrecosedrugId:143 # (acarbose)drugId:143 DIABETIC AGENTS
Pred FortedrugId:1580 # (prednisolone acetate 1% ophthalmic suspension-Pred Forte)drugId:1580 OPHTHALMIC PREPARATIONS
Pred-G (gentamicin / prednisolone ophthalmic ointment, suspension)drugId:929 - PA OPHTHALMIC PREPARATIONS
Pred Mild (prednisolone acetate 0.12% ophthalmic suspension)drugId:5001 OPHTHALMIC PREPARATIONS
prednicarbate cream, ointmentdrugId:1574 GLUCOCORTICOIDS
prednisolone 10 mg/5 mL oral solutiondrugId:1575 - PA GLUCOCORTICOIDS
prednisolone 15 mg/5 mL, 25 mg/5 mL oral solutiondrugId:1576 GLUCOCORTICOIDS
prednisolone 20 mg/5 mL oral solutiondrugId:1579 - PA GLUCOCORTICOIDS
prednisolone 5 mg/5 mL oral solutiondrugId:1578 GLUCOCORTICOIDS
prednisolone acetate 0.12% ophthalmic suspensiondrugId:5001 OPHTHALMIC PREPARATIONS
prednisolone acetate 1% ophthalmic suspension-OmnipreddrugId:2633 OPHTHALMIC PREPARATIONS
prednisolone acetate 1% ophthalmic suspension-Pred FortedrugId:1580 OPHTHALMIC PREPARATIONS
prednisolone orally disintegrating tabletdrugId:1577 - PA GLUCOCORTICOIDS
prednisolone sodium phosphate ophthalmic solutiondrugId:2618 OPHTHALMIC PREPARATIONS
prednisolone tabletdrugId:2199 GLUCOCORTICOIDS
prednisonedrugId:1581 GLUCOCORTICOIDS
prednisone delayed-releasedrugId:2645 - PA GLUCOCORTICOIDS
Prefest (estradiol / norgestimate) HORMONE REPLACEMENT THERAPY
pregabalin extended-release - PA; See Table 71drugId:6609; See Table 72drugId:6608 GABA ANALOGS
pregabalin - PA; See Table 20drugId:1582; See Table 71drugId:4460 ANTICONVULSANTS
Premarin (estrogens, conjugated) HORMONE REPLACEMENT THERAPY
Premphase (medroxyprogesterone / estrogens, conjugated-Premphase) HORMONE REPLACEMENT THERAPY
Prempro (medroxyprogesterone / estrogens, conjugated-Prempro) HORMONE REPLACEMENT THERAPY
prenatal vitaminsdrugId:1583 * ELECTROLYTES AND NUTRIENTS
Prepopik (sodium picosulfate / magnesium oxide / anhydrous citric acid-Prepopik)drugId:2644 LAXATIVES
Prestalia (perindopril / amlodipine)drugId:5287 - PA CARDIOVASCULAR
PrevaciddrugId:1021 # (lansoprazole capsule)drugId:1021 - PA > 30 units/month PROTON PUMP INHIBITORS
Prevacid Solutab (lansoprazole orally disintegrating tablet)drugId:1022 BP - PA ≥ 2 years PROTON PUMP INHIBITORS
PrevalitedrugId:228 # (cholestyramine / aspartame-Prevalite)drugId:228 LIPID LOWERING AGENTS
Prevnar 13 (pneumococcal 13-valent conjugate vaccine)drugId:1542 1 BIOLOGICAL
Prevymis (letermovir)drugId:6615 - PA ANTIVIRALS
Prezcobix (darunavir / cobicistat)drugId:4792 ANTIVIRALS
Prezista (darunavir)drugId:330 ANTIVIRALS
Prialt (ziconotide)drugId:1819 - PA ANALGESICS
Priftin (rifapentine)drugId:2501 TB PREPARATIONS
Prilosec (omeprazole suspension)drugId:2054 - PA PROTON PUMP INHIBITORS
PrimaxindrugId:781 # (imipenem / cilastatin)drugId:781 ANTIBIOTICS
primidone; See Table 20drugId:1586; See Table 71drugId:4461 ANTICONVULSANTS
PrinivildrugId:1087 # (lisinopril)drugId:1087 CARDIOVASCULAR
Pristiq (desvenlafaxine succinate extended-release) - PA; See Table 17drugId:490; See Table 71drugId:3940 ANTIDEPRESSANTS
Privigen (immune globulin IV, human-Privigen)drugId:2197 - PA BIOLOGICAL
Proair HFA (albuterol inhaler-Proair HFA)drugId:1 BP BRONCHODILATORS
Proair Respiclick (albuterol inhalation powder)drugId:5109 BRONCHODILATORS
probeneciddrugId:1587 GOUT AGENTS
probenecid / colchicinedrugId:287 GOUT AGENTS
Probuphine (buprenorphine implant)drugId:5591 - PA ALCOHOL AND DRUG CESSATION AGENT
procarbazinedrugId:1589 CHEMOTHERAPY
ProcardiadrugId:2064 # (nifedipine capsule)drugId:2064 CARDIOVASCULAR
Procardia XLdrugId:1215 # (nifedipine extended-release)drugId:1215 CARDIOVASCULAR
prochlorperazine ANTIEMETICS
Procrit (epoetin alfa-Procrit)drugId:611 - PA HEMATINIC AGENT
Procysbi (cysteamine delayed-release capsule)drugId:2861 - PA ENZYMES
Profilnine SD (factor IX complex human-Profilnine SD) ANTI-HEMOPHILIA AGENTS
progesterone geldrugId:2587 - PA HORMONE REPLACEMENT THERAPY
progesterone injection PROGESTERONE
Proglycem (diazoxide) DIABETIC AGENTS
Prograf (tacrolimus granules)drugId:7264 - PA IMMUNOMODULATOR
Prograf (tacrolimus injection)drugId:2741 ^ IMMUNOMODULATOR
PrografdrugId:1918 # (tacrolimus immediate-release capsule)drugId:1918 IMMUNOMODULATOR
Prolastin (alpha-1-proteinase inhibitor, human-Prolastin) ENZYMES
Prolensa (bromfenac 0.07%)drugId:2788 - PA OPHTHALMIC PREPARATIONS
Proleukin (aldesleukin)drugId:2307 CHEMOTHERAPY
Prolia (denosumab-Prolia)drugId:1967 - PA BIOLOGICAL
Promacta (eltrombopag)drugId:594 - PA HEMATINIC AGENT
promethazinedrugId:1593 ANTIHISTAMINES
Prometrium # (progesterone capsule) HORMONE REPLACEMENT THERAPY
propranolol / hydrochlorothiazidedrugId:1603 CARDIOVASCULAR
propranolol extended-releasedrugId:1601 CARDIOVASCULAR
propranolol immediate-releasedrugId:1600 CARDIOVASCULAR
propranolol long-acting capsuledrugId:6562 - PA CARDIOVASCULAR
propranolol solutiondrugId:2959 - PA CARDIOVASCULAR
Proquad (measles / mumps / rubella / varicella virus vaccine)drugId:1122 1 BIOLOGICAL
Proscar (finasteride)drugId:857 - PA BENIGN PROSTATIC HYPERPLASIA AGENTS
protein C concentratedrugId:1605 - PA HEMATINIC AGENT
prothrombin complex concentrate, human HEMOSTATICS
Protonix (pantoprazole 40 mg suspension)drugId:2702 - PA PROTON PUMP INHIBITORS
ProtonixdrugId:1476 # (pantoprazole tablet)drugId:1476 - PA > 120 units/month PROTON PUMP INHIBITORS
Protonix IVdrugId:1477 # (pantoprazole IV)drugId:1477 PROTON PUMP INHIBITORS
Protopic (tacrolimus topical)drugId:1919 BP DERMATOLOGICAL
protriptyline - PA < 6 years; See Table 17drugId:1606; See Table 71drugId:4140 ANTIDEPRESSANTS
Provenge (sipuleucel-T)drugId:2288 ^ - PA CHEMOTHERAPY
ProventildrugId:2 # (albuterol inhaler-Proventil)drugId:2 BRONCHODILATORS
Provera # (medroxyprogesterone tablet) HORMONE REPLACEMENT THERAPY
Provigil (modafinil)drugId:1373 - PA NARCOLEPSY AGENTS
Prozac # (fluoxetine 10 mg, 20 mg, 40 mg capsule, solution) - PA < 6 years; See Table 17drugId:879; See Table 71drugId:3721 ANTIDEPRESSANTS
Prozac Weekly (fluoxetine 90 mg delayed-release capsule) - PA; See Table 17drugId:880; See Table 71drugId:3720 ANTIDEPRESSANTS
prucalopridedrugId:7136 - PA CONSTIPATION AGENTS
Prudoxin (doxepin cream-Prudoxin)drugId:568 - PA DERMATOLOGICAL
pseudoephedrinedrugId:1607* - PA > 240 mg/day DECONGESTANT
psylliumdrugId:1610 * CONSTIPATION AGENTS
Pulmicort (budesonide inhalation powder)drugId:380 BRONCHODILATORS
PulmicortdrugId:381 # (budesonide inhalation suspension)drugId:381 BRONCHODILATORS
Pulmozyme (dornase alfa) ENZYMES
Purixan (mercaptopurine oral suspension)drugId:4632 - PA CHEMOTHERAPY
Pylera (bismuth subcitrate / metronidazole / tetracycline)drugId:367 - PA H. PYLORI AGENTS
pyrantel pamoatedrugId:6215 ANTIPARASITICS
pyrazinamidedrugId:1611 ANTIBIOTICS
Pyridium (phenazopyridine) ANALGESICS
pyridostigmine bromidedrugId:1612 PARASYMPATHETIC AGENTS
pyridostigmine bromide 30 mg tabletdrugId:7226 - PA PARASYMPATHETIC AGENTS
pyridoxinedrugId:1613 * ELECTROLYTES AND NUTRIENTS
pyridoxine crystalsdrugId:7341 - PA ELECTROLYTES AND NUTRIENTS
pyrimethaminedrugId:1614 - PA ANTIMALARIALS

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 03/30/20