Links to Summaries by State for LTC Drugs on LIS/SNP Plans:
Drug Name | Packaging | NDC | On This Nbr of 2016 Formularies | |
PDPs | MAPDs | |||
YASMIN 28 3-0.03MG TABLET (Drospirenone-Ethinyl Estradiol) | 21 YELLOW + 7 WHITE X 3 BOX | 50419040203 | 5 PDPs | 36 MAPDs |
YAZ 3-0.02MG TABLET (Drospirenone-Ethinyl Estradiol) | 24 X 3 BOX | 50419040503 | 5 PDPs | 40 MAPDs |
YERVOY 5mg/mL 1 VIAL, SINGLE-USE per CARTON / 50 mL in 1 VIAL, SINGLE-USE (IPILIMUMAB) | 1 VIAL, SINGLE-USE in 1 C | 00003232711 | 62 PDPs | 336 MAPDs |
YF-VAX 1 DOSE VIAL/DILUENT 0.5UNTS/DOSE (Yellow Fever Vaccine Subcutaneous) | 1 DOSE WITH DILUENT X 5 VIAL | 49281091501 | 62 PDPs | 338 MAPDs |