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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
Calcipreg Tabs Basic Prenatal W/O Vit A W/ Fe Fum-Dss-Fa-Dha Cap 26-1.2-300 Mg 704600001 Prenatal Vitamins
Calcipreg Tabs Core *PRENATAL W/O VIT A W/ FE FUM-DSS-FA-DHA CAP 26-1.2-300 MG** 704600001 Prenatal Vitamins
Calcipreg Tabs Standard *Prenatal w/o Vit A w/fe FUM-DSS-FA-DHA Cap 26-1.2-300 MG** 704600001 Prenatal Vitamins
Calcium Gluconate 300Mg C Basic Calcium Gluconate Chew Tab 300 MG 877662002 Calcium
Calcium Gluconate 300MG C Core Calcium Gluconate Chew Tab 300 MG 877662002 Calcium
Calcium Gluconate 300MG C Core Calcium Gluconate Chew Tab 300 MG 877662010 Calcium
Calcium Gluconate 300MG C Core Calcium Gluconate Chew Tab 300 MG 877662011 Calcium
Calcium Gluconate 300MG C Standard Calcium Gluconate Chew Tab 300 MG 877662002 Calcium
Calcium Gluconate 300MG C Standard Calcium Gluconate Chew Tab 300 MG 877662010 Calcium
Calcium Gluconate 300MG C Standard Calcium Gluconate Chew Tab 300 MG 877662011 Calcium
Calcium Gluconate 300MG C Standard Egoli Calcium Gluconate 3 710551001 Calcium
Calcium Gluconate 300MG C Standard Calcium Gluconate Chew Tab 300 MG 710551002 Calcium
Calcium Gluconate 300Mg C Extended Calcium Gluconate Chew Tab 300 Mg 877662002 Calcium
Calcium Gluconate 300Mg C Extended Calcium Gluconate Chew Tab 300 Mg 877662010 Calcium
Calcium Gluconate 300Mg C Extended Calcium Gluconate Chew Tab 300 Mg 877662011 Calcium
Calcium Gluconate 300Mg T Basic Calcium Gluconate Chew Tab300 Mg 721699001 Calcium
Calcium Gluconate 300MG T Core Calcium Gluconate Tab 300 MG (Elemenatl CA) 721699001 Calcium
Calcium Gluconate 300MG T Standard Calcium Gluconate Tab 300 MG (Elemental CA) 721699001 Calcium
Calcium Gluconate 300Mg T Extended Calcium Gluconate Tab 300 Mg (Elemental Ca) 721699001 Calcium
Calcuim Gluconate 300Mg C Basic Calcium Gluconate Chew Tab 300 Mg 877662010 Calcium
Calpin D Tabs Basic *Calcium 750 Mg W/ Vitamin D Tab*** 846155001 Mineral Combinations
Calpin D Tabs Standard *Calcium 750 MG W/Vitamin D Tab*** 846155001 Mineral Combinations
Caltrate 600+D Tabs Basic Calcium W/ Vitamin D Tab 600 Mg-800 Unit 720597002 Mineral Combinations
Caltrate 600+D Tabs Standard Calcium w/vitamin D Tab 600 MG-800 Unit 720597001 Mineral Combinations
Caltrate 600+D Tabs Standard Calcium w/vitamin D Tab 600 MG-800 Unit 720597002 Mineral Combinations
Caltrate 600+D Tabs Extended Calcium W/ Vitamin D Tab 600 Mg-800 Unit 720597001 Mineral Combinations
Caltrate 600+D Tabs Extended Calcium W/ Vitamin D Tab 600 Mg-800 Unit 720597002 Mineral Combinations
Caplin D Tabs Extended Calcium 750 Mg W/ Vitamin D Tab 846155001 Mineral Combinations
Chel-Mag B6 Mother Nam O Extended Prenatal Vitamin Cap 723960001 Prenatal Vitamins
Chela-Mag B6 Mother Nam O Basic Prenatal Vitamin Cap 723960001 Prenatal Vitamins
Chela-Mag B6 mother Nam O Core *Prenatal Vitamins Cap** 723960001 Prenatal Vitamins
Chela-Mag B6 mother Nam O Standard *Prenatal Vitamin Cap** 723960001 Prenatal Vitamins
Chela-Preg Tabs Standard *Prenatal Multivitamins & Minerals w/iron & FA Tab 0.5 MG*** 891794005 Prenatal Vitamins
Chela-Preg Tabs Standard *Prenatal Multivitamins & Minerals w/iron & FA Tab 0.5 MG*** 891794006 Prenatal Vitamins
Chela-Preg Tabs Extended Prenatal Multivitamins & Minerals W/Iron & Fa Cap 0.5 Mg 891794005 Prenatal Vitamins