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Formulary List

Explore our comprehensive list of medications covered under your health plan. This list currently shows pre-natal formularies to support our patient’s well-being. All Core health plans use the Pregnancy Core formulary, All Plus health plans use the Pregnancy Basic, All Extra health plans use the Pregnancy Standard and All Max health plans use the Pregnancy Extended. Review this page regularly to stay informed.
Drug Name9 Months + Calcium & Omega
Active Ingredient
Prenatal W/Fe-Fa Tab & Omega 3 Cap Pack
NAPPI Code
723620001
Therapeutic Group
Prenatal Vitamins
Drug Name Formulary Active Ingredient NAPPI Code Therapeutic Group
9 Months + Calcium & Omega Extended Prenatal W/Fe-Fa Tab & Omega 3 Cap Pack 723620001 Prenatal Vitamins
9 Months + Tabs Basic Prenatal Multivitamins & Minerals w/Iron & Fa Tab 0.8 Mg 723505001 Prenatal Vitamins
9 Months + Tabs Core *Prenatal Multivitamins & Minerals w/iron & FA 0.8 MG*** 723505001 Prenatal Vitamins
9 Months + Tabs Standard *Prenatal Multivitamins & Minerals w/iron & FA Tab 0.8 MG*** 723505001 Prenatal Vitamins
9 Months + Tabs Extended Prenatal Multivitamins & Minerals W/Iron & Fa Tab 0.8 Mg 723505001 Prenatal Vitamins
Active Folate 800Mcg Caps Extended Folic Acid Cap 0.8 Mg 716765001 Prenatal Vitamins
Active Folate 800Mcg Caps Basic Folic Acid Cap 0.8 Mg 716765001 Prenatal Vitamins
Active Folate 800MCG Caps Core Folic Acid Cap 0.8 MG 716765001 Prenatal Vitamins
Active Folate 800MCG Caps Standard Folic Acid Cap 0.8 MG 716765001 Prenatal Vitamins
Aha Folic Acid 0.5Mg Tabs Extended Folic Acid Tab 0.5 Mg 705531001 Prenatal Vitamins
Aha Folic Acid 0.5Mg Tabs Basic Folic Acid Tab 0.5 Mg 705531001 Prenatal Vitamins
AHA Folic Acid 0.5MG Tabs Standard Folic Acid Tab 0.5 MG 705531001 Prenatal Vitamins
AHA Folic Acid 0.5MG Tabs Core Folic Acid Tab 0.5 MG 705531001 Prenatal Vitamins
APO Folic Bots 5MG Tab Core Folic Acid Tab 5 MG 967239001 Prenatal Vitamins
Apo Folic Bots 5Mg Tabs Extended Folic Acid Tab 5 Mg 967239001 Prenatal Vitamins
Apo Folic Bots 5Mg Tabs Basic Folic Acid Tab 5 Mg 967239001 Prenatal Vitamins
APO Folic Bots 5MG Tabs Standard Folic Acid Tab 5 MG 967239001 Prenatal Vitamins
B-Cal Chew Basic Calcium Carbonate Chew Tab 1250 Mg (500 Mg Elemental Ca) 828289018 Calcium
B-Cal Chew Core Calcium Carbonate Chew Tab 1250 MG (500 MG Elemental CA) 828289018 Calcium
B-Cal Chew Standard Calcium Carbonate Chew Tab 1250 MG (500 MG Elemental CA) 828289018 Calcium
B-Cal Chew Extended Calcium Carbonate Chew Tab 1250 Mg (500 Mg Elemental Ca) 828289018 Calcuim
B-Cal-D Chew Basic Calcium Carbonate-Vitamin D Chew Tab 1250 Mg-200 Unit 821586009 Mineral Combinations
B-Cal-D Chew Basic Calcium Carbonate-Vitamin D Chew Tab 1250 Mg-200 Unit 821586017 Mineral Combinations
B-Cal-D Chew Standard Calcium Carbonate-Vitamin D Chew Tab 1250 MG-200 Unit 821586009 Mineral Combinations
B-Cal-D Chew Standard Calcium Carbonate-Vitamin D Chew Tab 1250 MG-200 Unit 821586017 Mineral Combinations
B-Cal-D Chew Extended Calcium Carbonate-Vitamin D Chew Tab 1250 Mg-200 Unit 821586009 Mineral Combinations
B-Cal-D Chew Extended Calcium Carbonate-Vitamin D Chew Tab 1250 Mg-200 Unit 821586017 Mineral Combinations
B-Cal-D Tab Basic Calcium Carbonate-Vitamin D Tab 1250 Mg-400 Unit 889211004 Mineral Combinations
B-Cal-D Tab Basic Calcium Carbonate-Vitamin D Tab 1250 Mg-400 Unit 889211012 Mineral Combination
B-Cal-D Tab Basic Calcium Carbonate-Vitamin D Tab 1250 Mg-400 Unit 889211019 Mineral Combination
B-Cal-D Tab Standard Calcium carbonate-Vitamin D Tab 1250 MG-400 Unit 889211004 Mineral Combinations
B-Cal-D Tab Standard Calcium carbonate-Vitamin D Tab 1250 MG-400 Unit 889211012 Mineral Combinations
B-Cal-D Tab Standard Calcium carbonate-Vitamin D Tab 1250 MG-400 Unit 889211019 Mineral Combinations
B-Cal-D Tab Extended Calcium Carbonate-Vitamin D Tab 1250 Mg-400 Unit 889211004 Mineral Combinations
B-Cal-D Tab Extended Calcium Carbonate-Vitamin D Tab 1250 Mg-400 Unit 889211012 Mineral Combinations
B-Cal-D Tab Extended Calcium Carbonate-Vitamin D Tab 1250 Mg-400 Unit 889211019 Mineral Combinations
B-Cal-Dm Chew Tab Basic Calcium-Magnesium W/ Vitamin D Chew TAB 500Mg-125Mg-250 Unit 894049003 Mineral Combinations
B-Cal-Dm Chew Tab Basic Calcium-Magnesium W/ Vitamin D Chew Tab 500Mg-125Mg-250 Unit 894049011 Mineral Combinations
B-Cal-DM Chew Tab Standard Calcium-Magnesium w/vitamin D Chew Tab 500MG-125MG-250 Unit 894049003 Mineral Combinations
B-Cal-DM Chew Tab Standard Calcium-Magnesium w/vitamin D Chew Tab 500MG-125MG-250 Unit 894049011 Mineral Combinations
B-Cal-Dm Chew Tab Extended Calcium-Magnesium W/ Vitamin D Chew Tab 500Mg-125Mg-250 Unit 894049003 Mineral Combinations
B-Cal-Dm Chew Tab Extended Calcium-Magnesium W/ Vitamin D Chew Tab 500Mg-125Mg-250 Unit 894049011 Mineral Combinations
B-Cal-Dm Tabs Basic Calcium-Magnesium W/ Vitamin D Tab 500 Mg-125 Mg-250 Unit 862010004 Mineral Combinations
B-Cal-Dm Tabs Basic Calcium-Magnesium W/ Vitamin D Tab 500 Mg-125 Mg-250 Unit 862010012 Mineral Combinations
B-Cal-Dm Tabs Basic Calcium-Magnesium W/ Vitamin D Tab 500 Mg-125 Mg-250 Unit 862010020 Mineral Combinations
B-Cal-DM Tabs Standard Calcium-Magnesium w/vitamin D Tab 500MG-125MG-250 Unit 862010004 Mineral Combinations
B-Cal-DM Tabs Standard Calcium-Magnesium w/vitamin D Tab 500MG-125MG-250 Unit 862010012 Mineral Combinations
B-Cal-DM Tabs Standard Calcium-Magnesium w/vitamin D Tab 500MG-125MG-250 Unit 862010020 Mineral Combinations
B-Cal-Dm Tabs Extended Calcium-Magnesium W/ Vitamin D Tab 500 Mg-125 Mg-250 Unit 862010004 Mineral Combinations
B-Cal-Dm Tabs Extended Calcium-Magnesium W/ Vitamin D Tab 500 Mg-125 Mg-250 Unit 862010012 Mineral Combinations

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