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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
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
B-Cal-Dm Tabs Extended Calcium-Magnesium W/ Vitamin D Tab 500 Mg-125 Mg-250 Unit 862010020 Mineral Combinations
Bao Filivit Capsules Basic *Prenatal Multivitamins & Minerals W/ Iron Cap*** 713206001 Prenatal Vitamins
Bao Filivit Capsules Standard *Prenatal Multivitamins & Minerals w/iron Cap*** 713206001 Prenatal Vitamins
Bao Filivit Capsules Extended Prenatal Multivitamins & Minerals W/ Iron Cap 713206001 Prenatal Vitamins
Be-Tabs Folic Acid 5MG TA Core Folic Acid Tab 5 MG 810967006 Prenatal Vitamins
Be-Tabs Folic Acid 5MG TA Core Folic Acid Tab 5 MG 810967014 Prenatal Vitamins
Be-Tabs Folic Acid 5MG TA Core Folic Acid Tab 5 MG 810967015 Prenatal Vitamins
Be-Tabs Folic Acid 5Mg Ta Extended Folic Acid Tabs 5 Mg 810967006 Prenatal Vitamins
Be-Tabs Folic Acid 5Mg Ta Extended Folic Acid Tab 5 Mg 810967014 Prenatal Vitamins
Be-Tabs Folic Acid 5Mg Ta Extended Folic Acid Tab 5 Mg 810967015 Prenatal Vitamins
Be-Tabs Folic Acid 5Mg Ta Basic Folic Acid Tab 5 Mg 810967006 Prenatal Vitamins
Be-Tabs Folic Acid 5Mg Ta Basic Folic Acid Tab 5 Mg 810967014 Prenatal Vitamins
Be-Tabs Folic Acid 5Mg Ta Basic Folic Acid Tab 5 Mg 810967015 Prenatal Vitamins
Be-Tabs Folic Acid 5MG TA Standard Folic Acid Tab 5 MG 810967006 Prenatal Vitamins
Be-Tabs Folic Acid 5MG TA Standard Folic Acid Tab 5 MG 810967014 Prenatal Vitamins
Be-Tabs Folic Acid 5MG TA Standard Folic Acid Tab 5 MG 810967015 Prenatal Vitamins
Bump 2 Baby Prenatal Supp Basic *Prenatal Multivitamins & Minerals W/Iron & Fa Cap 0.5 Mg*** 3004348001 Prenatal Vitamins
Bump 2 Baby Prenatal Supp Standard *Prenatal Multivitamins & Minerals w/iron & FA Cap 0.5 MG*** 3004348001 Prenatal Vitamins
Bump 2 Baby Prenatal Supp Extended Prenatal Multivitamins & Minerals W/ Iron & Fa Cap 0.5 Mg 3004348001 Prenatal Vitamins
Calcipreg Tabs Extended Prenatal W/O Vit A W/ Fe Fum-Dss-Fa-Dha Cap 26-1.2-300 Mg 704600001 Prenatal Vitamins