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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
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
Chela-Preg Tabs Extended Prenatal Multivitamins & Minerals W/Iron & Fa Cap 0.5 Mg 891794006 Prenatal Vitamins
Chela-Preg Trimes 1 Combo Extended Prenatal W/Fe-Fa-Ca Tab & Omega 3 Cap Pack 723117001 Prenatal Vitamins
Chela-Preg Trimes 2 Combo Extended Prenatal W/Fe-Fa-Ca Tab & Omega 3 Cap Pack 723119001 Prenatal Vitamins
Chela-Preg Trimes 3 Combo Extended Prenatal W/Fe-Fa-Ca Tab & Omega 3 Cap Pack 723120001 Prenatal Vitamins
Chelaplus Iron Pregnancy Basic *Prenatal Multivitamins & Minerals W/ Iron & Fa Cap 1 Mg*** 716246001 Prenatal Vitamins
Chelaplus Iron Pregnancy Standard *Prenatal Multivitamins 7 Minerals w/iron & FA Cap 1 MG*** 716246001 Prenatal Vitamins
Chelaplus Iron Pregnancy Extended Prenatal Multivitamins & Minerals W/ Iron & Fa Cap 1 Mg 716246001 Prenatal Vitamins
Click Pregnancy Suppl Ca Extended Prenatal Multivitamins & Minerals W/ Iron & Fa Cap 0.5 Mg 711165001 Prenatal Vitamins
Clicks Pay Less Folic Aci Extended Folic Acid Tab 0.5 Mg 721202001 Prenatal Vitamins
Clicks Pay Less Folic Aci Basic Folic Acid Tab 0.5 Mg 721202001 Prenatal Vitamins
Clicks Pay Less Folic ACI Standard Folic Acid Tab 0.5 MG 721202001 Prenatal Vitamins
Clicks Pay Less Folic ACI Core Folic Acid Tab 0.5 MG 721202001 Prenatal Vitamins
Clicks Pay Less Prenatal Basic Prenatal Multivitamins & Minerals W/Iron & Fa Tab 0.8 Mg 721203001 Prenatal Vitamins
Clicks Pay Less Prenatal Core *Prenatal Multivitamins & Minerals w/iron & FA 0.8 MG*** 721203001 Prenatal Vitamins
Clicks Pay Less Prenatal Standard *Prenatal Multivitamins & Minerals w/iron & FA Tab 0.5 MG*** 721203001 Prenatal Vitamins
Clicks Pay Less Prenatal Extended Prenatal Multivitamins & Minerals W/Iron & Fa Tab 0.8 Mg 721203001 Prenatal Vitamins
Clicks Pregnancy Suppl Ca Basic *Prenatal Multivitamins & Minerals W/Iron & Fa Cap 0.5 Mg*** 711165001 Prenatal Vitamins
Clicks Pregnancy Suppl CA Standard *Prenatal Multivitamins & Minerals w/iron & FA Cap 0.5 MG*** 711165001 Prenatal Vitamins
Egoli Calcium Gluconate 3 Basic Calcium Gluconate Chew Tab 300 MG 710551001 Calcium
Egoli Calcium Gluconate 3 Basic Calcium Gluconate Chew Tab 300 MG 710551002 Calcium
Egoli Calcium Gluconate 3 Core Calcium Gluconate Chew Tab 300 MG 710551001 Calcium
Egoli Calcium Gluconate 3 Core Calcium Gluconate Chew Tab 300 MG 710551002 Calcium
Egoli Calcium Gluconate 3 Extended Calcium Gluconate Chew Tab 300 Mg 710551001 Calcium
Egoli Calcium Gluconate 3 Extended Calcium Gluconate Chew Tab 300 Mg 710551002 Calcium
Egoli Folic Acid 0.5Mg Ta Extended Folic Acid Tab 0.5 Mg 710557001 Prenatal Vitamins
Egoli Folic Acid 0.5Mg Ta Extended Folic Acid Tab 0.5 Mg 710557002 Prenatal Vitamins
Egoli Folic Acid 0.5Mg Ta Extended Folic Acid Tab 0.5 Mg 710557003 Prenatal Vitamins
Egoli Folic Acid 0.5Mg Ta Basic Folic Acid Tab 0.5 Mg 710557001 Prenatal Vitamins
Egoli Folic Acid 0.5Mg Ta Basic Folic Acid Tab 0.5 Mg 710557002 Prenatal Vitamins
Egoli Folic Acid 0.5Mg Ta Basic Folic Acid Tab 0.5 Mg 710557003 Prenatal Vitamins
Egoli Folic Acid 0.5MG TA Standard Folic Acid Tab 0.5 MG 710557001 Prenatal Vitamins
Egoli Folic Acid 0.5MG TA Standard Folic Acid Tab 0.5 MG 710557002 Prenatal Vitamins
Egoli Folic Acid 0.5MG TA Standard Folic Acid Tab 0.5 MG 710557003 Prenatal Vitamins
Egoli Folic Acid 0.5MG TA Core Folic Acid Tab 0.5 MG 710557001 Prenatal Vitamins
Egoli Folic Acid 0.5MG TA Core Folic Acid Tab 0.5 MG 710557002 Prenatal Vitamins
Egoli Folic Acid 0.5MG TA Core Folic Acid Tab 0.5 MG 710557003 Prenatal Vitamins
Fizzical 500MG EFF Tabs Standard Calcium Effer Tab 500MG 704941001 Calcium
Fizzical 500Mg Eff Tabs Extended Calcium Effer Tab 500 Mg 704941001 Calcium
Folapro 800MCG Tabs Core Folic Acid Tab 800 MCG 713056001 Prenatal Vitamins
Folapro 800MCG Tabs Core Folic Acid Tab 800 MCG 713056002 Prenatal Vitamins
Folapro 800Mcg Tabs Extended Folic Acid Tab 800 Mg 713056001 Prenatal Vitamins
Folapro 800Mcg Tabs Extended Folic Acid Tab 800 Mg 713056002 Prenatal Vitamins
Folapro 800Mcg Tabs Basic Folic Acid Tab 800 Mcg 713056001 Prenatal Vitamins
Folapro 800Mcg Tabs Basic Folic Acid Tab 800 Mcg 713056002 Prenatal Vitamins
Folapro 800MCG Tabs Standard Folic Acid Tab 800 MCG 713056002 Prenatal Vitamins

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