Diabetes, Insulins
PDL Reference Documents
Newsletters
PDL Status Values
Y = preferred
N = non-preferred. Non-preferred drugs listed as N but without clinical drug use criteria are subject to the
Non-Preferred Drugs in Select PDL Classes prior authorization criteria.
New drugs will be listed as N until reviewed by the P&T Committee and are subject to the
New Drug Policy.
V = voluntary non-preferred. Non-preferred mental health drugs are listed as V and prior authorization is not required.
Null (i.e. blank) = indicates the class or specific drug has not been reviewed for PDL placement.
To request a Prior Authorization, please use this form.
| NDC | Brand Name | Generic Name | Form | Strength | PDL Status |
Rebate | Carveout ‐ Bill FFS |
Current Drug Use Criteria |
|---|---|---|---|---|---|---|---|---|
| 73070010210 | INSULIN ASPART PENFILL | insulin aspart | CARTRIDGE | 100 unit/mL | N | Y | N | Pharmacy PA |
| 73070010215 | INSULIN ASPART PENFILL | insulin aspart | CARTRIDGE | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00169330312 | NOVOLOG PENFILL | insulin aspart | CARTRIDGE | 100 unit/mL | N | Y | N | Pharmacy PA |
| 73070010310 | INSULIN ASPART FLEXPEN | insulin aspart | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 73070010315 | INSULIN ASPART FLEXPEN | insulin aspart | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169210112 | NOVOLOG FLEXPEN | insulin aspart | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169210125 | NOVOLOG FLEXPEN | insulin aspart | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169633910 | NOVOLOG FLEXPEN | insulin aspart | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 73070010011 | INSULIN ASPART | insulin aspart | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00169210011 | NOVOLOG | insulin aspart | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00169750111 | NOVOLOG | insulin aspart | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00169320511 | FIASP PENFILL | insulin aspart (niacinamide) | CARTRIDGE | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169320515 | FIASP PENFILL | insulin aspart (niacinamide) | CARTRIDGE | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169320415 | FIASP FLEXTOUCH | insulin aspart (niacinamide) | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169320111 | FIASP | insulin aspart (niacinamide) | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 73070020310 | INSULIN ASPART PROT MIX 70-30 | insulin aspart prot/insuln asp | INSULN PEN | 100 unit/mL (70-30) | N | Y | N | Pharmacy PA |
| 73070020315 | INSULIN ASPART PROT MIX 70-30 | insulin aspart prot/insuln asp | INSULN PEN | 100 unit/mL (70-30) | N | Y | N | Pharmacy PA |
| 00169220125 | NOVOLOG MIX 70-30 FLEXPEN | insulin aspart prot/insuln asp | INSULN PEN | 100 unit/mL (70-30) | N | Y | N | Pharmacy PA |
| 00169369619 | NOVOLOG MIX 70-30 FLEXPEN | insulin aspart prot/insuln asp | INSULN PEN | 100 unit/mL (70-30) | N | Y | N | Pharmacy PA |
| 73070020011 | INSULIN ASPART PROT MIX 70-30 | insulin aspart prot/insuln asp | VIAL | 100 unit/mL (70-30) | N | Y | N | Pharmacy PA |
| 00169220011 | NOVOLOG MIX 70-30 | insulin aspart prot/insuln asp | VIAL | 100 unit/mL (70-30) | N | Y | N | Pharmacy PA |
| 00169368512 | NOVOLOG MIX 70-30 | insulin aspart prot/insuln asp | VIAL | 100 unit/mL (70-30) | N | Y | N | Pharmacy PA |
| 00024592800 | MERILOG SOLOSTAR | insulin aspart-szjj | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00024592805 | MERILOG SOLOSTAR | insulin aspart-szjj | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00024592700 | MERILOG | insulin aspart-szjj | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 83257000831 | KIRSTY PEN | insulin aspart-xjhz | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 83257000832 | KIRSTY PEN | insulin aspart-xjhz | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 83257000711 | KIRSTY | insulin aspart-xjhz | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00169320611 | FIASP PUMPCART | insulin aspart/B3/pump cart | CARTRIDGE | 100 unit/mL (1.6 mL) | N | Y | N | Pharmacy PA |
| 00169320615 | FIASP PUMPCART | insulin aspart/B3/pump cart | CARTRIDGE | 100 unit/mL (1.6 mL) | N | Y | N | Pharmacy PA |
| 73070040310 | INSULIN DEGLUDEC PEN (U-100) | insulin degludec | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 73070040315 | INSULIN DEGLUDEC PEN (U-100) | insulin degludec | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169266015 | TRESIBA FLEXTOUCH U-100 | insulin degludec | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169266097 | TRESIBA FLEXTOUCH U-100 | insulin degludec | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 73070050310 | INSULIN DEGLUDEC PEN (U-200) | insulin degludec | INSULN PEN | 200 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 73070050315 | INSULIN DEGLUDEC PEN (U-200) | insulin degludec | INSULN PEN | 200 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169255013 | TRESIBA FLEXTOUCH U-200 | insulin degludec | INSULN PEN | 200 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169255097 | TRESIBA FLEXTOUCH U-200 | insulin degludec | INSULN PEN | 200 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 73070040011 | INSULIN DEGLUDEC | insulin degludec | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00169266211 | TRESIBA | insulin degludec | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00169291115 | XULTOPHY 100-3.6 | insulin degludec/liraglutide | INSULN PEN | 100 unit-3.6 mg/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169643210 | LEVEMIR FLEXPEN | insulin detemir | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169643255 | LEVEMIR FLEXPEN | insulin detemir | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169643890 | LEVEMIR FLEXTOUCH | insulin detemir | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169643897 | LEVEMIR FLEXTOUCH | insulin detemir | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169368712 | LEVEMIR | insulin detemir | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00002898001 | REZVOGLAR KWIKPEN | insulin glargine-aglr | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00002898005 | REZVOGLAR KWIKPEN | insulin glargine-aglr | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 49502039471 | INSULIN GLARGINE-YFGN | insulin glargine-yfgn | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 49502039475 | INSULIN GLARGINE-YFGN | insulin glargine-yfgn | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 83257001531 | INSULIN GLARGINE-YFGN | insulin glargine-yfgn | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 83257001532 | INSULIN GLARGINE-YFGN | insulin glargine-yfgn | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 49502025171 | SEMGLEE (YFGN) PEN | insulin glargine-yfgn | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 49502025175 | SEMGLEE (YFGN) PEN | insulin glargine-yfgn | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 83257001231 | SEMGLEE (YFGN) PEN | insulin glargine-yfgn | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 83257001233 | SEMGLEE (YFGN) PEN | insulin glargine-yfgn | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 49502039380 | INSULIN GLARGINE-YFGN | insulin glargine-yfgn | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 83257001411 | INSULIN GLARGINE-YFGN | insulin glargine-yfgn | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 49502025080 | SEMGLEE (YFGN) | insulin glargine-yfgn | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 83257001111 | SEMGLEE (YFGN) | insulin glargine-yfgn | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00002771501 | BASAGLAR KWIKPEN U-100 | insulin glargine,hum.rec.anlog | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00002771559 | BASAGLAR KWIKPEN U-100 | insulin glargine,hum.rec.anlog | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00002821401 | BASAGLAR TEMPO PEN U-100 | insulin glargine,hum.rec.anlog | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00002821405 | BASAGLAR TEMPO PEN U-100 | insulin glargine,hum.rec.anlog | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00955172801 | INSULIN GLARGINE SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00955172805 | INSULIN GLARGINE SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00088221900 | LANTUS SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 100 unit/mL (3 mL) | Y | Y | N | |
| 00088221901 | LANTUS SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 100 unit/mL (3 mL) | Y | Y | N | |
| 00088221905 | LANTUS SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 100 unit/mL (3 mL) | Y | Y | N | |
| 00955390001 | INSULIN GLARGINE SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 300 unit/mL (1.5 mL) | N | Y | N | Pharmacy PA |
| 00955390003 | INSULIN GLARGINE SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 300 unit/mL (1.5 mL) | N | Y | N | Pharmacy PA |
| 00024586900 | TOUJEO SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 300 unit/mL (1.5 mL) | N | Y | N | Pharmacy PA |
| 00024586901 | TOUJEO SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 300 unit/mL (1.5 mL) | N | Y | N | Pharmacy PA |
| 00024586903 | TOUJEO SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 300 unit/mL (1.5 mL) | N | Y | N | Pharmacy PA |
| 00955290001 | INSULIN GLARGINE MAX SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 300 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00955290002 | INSULIN GLARGINE MAX SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 300 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00024587100 | TOUJEO MAX SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 300 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00024587101 | TOUJEO MAX SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 300 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00024587102 | TOUJEO MAX SOLOSTAR | insulin glargine,hum.rec.anlog | INSULN PEN | 300 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00955172901 | INSULIN GLARGINE | insulin glargine,hum.rec.anlog | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00088222033 | LANTUS | insulin glargine,hum.rec.anlog | VIAL | 100 unit/mL | Y | Y | N | |
| 00088222034 | LANTUS | insulin glargine,hum.rec.anlog | VIAL | 100 unit/mL | Y | Y | N | |
| 00024576105 | SOLIQUA 100-33 | insulin glargine/lixisenatide | INSULN PEN | 100 unit-33 mcg/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00088250200 | APIDRA SOLOSTAR | insulin glulisine | INSULN PEN | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00088250205 | APIDRA SOLOSTAR | insulin glulisine | INSULN PEN | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00088250033 | APIDRA | insulin glulisine | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00002751601 | HUMALOG | insulin lispro | CARTRIDGE | 100 unit/mL | Y | Y | N | |
| 00002751659 | HUMALOG | insulin lispro | CARTRIDGE | 100 unit/mL | Y | Y | N | |
| 00002771401 | HUMALOG JUNIOR KWIKPEN | insulin lispro | INS PEN HF | 100 unit/mL | Y | Y | N | |
| 00002771459 | HUMALOG JUNIOR KWIKPEN | insulin lispro | INS PEN HF | 100 unit/mL | Y | Y | N | |
| 00002775201 | INSULIN LISPRO JUNIOR KWIKPEN | insulin lispro | INS PEN HF | 100 unit/mL | Y | Y | N | |
| 00002775205 | INSULIN LISPRO JUNIOR KWIKPEN | insulin lispro | INS PEN HF | 100 unit/mL | Y | Y | N | |
| 00024592500 | ADMELOG SOLOSTAR | insulin lispro | INSULN PEN | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00024592501 | ADMELOG SOLOSTAR | insulin lispro | INSULN PEN | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00024592505 | ADMELOG SOLOSTAR | insulin lispro | INSULN PEN | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00002879901 | HUMALOG KWIKPEN U-100 | insulin lispro | INSULN PEN | 100 unit/mL | Y | Y | N | |
| 00002879959 | HUMALOG KWIKPEN U-100 | insulin lispro | INSULN PEN | 100 unit/mL | Y | Y | N | |
| 00002821301 | HUMALOG TEMPO PEN U-100 | insulin lispro | INSULN PEN | 100 unit/mL | Y | Y | N | |
| 00002821305 | HUMALOG TEMPO PEN U-100 | insulin lispro | INSULN PEN | 100 unit/mL | Y | Y | N | |
| 00002822201 | INSULIN LISPRO KWIKPEN U-100 | insulin lispro | INSULN PEN | 100 unit/mL | Y | Y | N | |
| 00002822259 | INSULIN LISPRO KWIKPEN U-100 | insulin lispro | INSULN PEN | 100 unit/mL | Y | Y | N | |
| 00002771201 | HUMALOG KWIKPEN U-200 | insulin lispro | INSULN PEN | 200 unit/mL (3 mL) | Y | Y | N | |
| 00002771227 | HUMALOG KWIKPEN U-200 | insulin lispro | INSULN PEN | 200 unit/mL (3 mL) | Y | Y | N | |
| 00024592410 | ADMELOG | insulin lispro | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00024592605 | ADMELOG | insulin lispro | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00002751001 | HUMALOG | insulin lispro | VIAL | 100 unit/mL | Y | Y | N | |
| 00002753301 | HUMALOG | insulin lispro | VIAL | 100 unit/mL | Y | Y | N | |
| 00002773701 | INSULIN LISPRO | insulin lispro | VIAL | 100 unit/mL | Y | Y | N | |
| 00002879801 | HUMALOG MIX 50-50 KWIKPEN | insulin lispro protamin/lispro | INSULN PEN | 100 unit/mL (50-50) | Y | Y | N | |
| 00002879859 | HUMALOG MIX 50-50 KWIKPEN | insulin lispro protamin/lispro | INSULN PEN | 100 unit/mL (50-50) | Y | Y | N | |
| 00002879701 | HUMALOG MIX 75-25 KWIKPEN | insulin lispro protamin/lispro | INSULN PEN | 100 unit/mL (75-25) | Y | Y | N | |
| 00002879759 | HUMALOG MIX 75-25 KWIKPEN | insulin lispro protamin/lispro | INSULN PEN | 100 unit/mL (75-25) | Y | Y | N | |
| 00002823301 | INSULIN LISPRO PROTAMINE MIX | insulin lispro protamin/lispro | INSULN PEN | 100 unit/mL (75-25) | Y | Y | N | |
| 00002823305 | INSULIN LISPRO PROTAMINE MIX | insulin lispro protamin/lispro | INSULN PEN | 100 unit/mL (75-25) | Y | Y | N | |
| 00002751101 | HUMALOG MIX 75-25 | insulin lispro protamin/lispro | VIAL | 100 unit/mL (75-25) | Y | Y | N | |
| 00002820701 | LYUMJEV KWIKPEN U-100 | insulin lispro-aabc | INSULN PEN | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00002820705 | LYUMJEV KWIKPEN U-100 | insulin lispro-aabc | INSULN PEN | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00002823501 | LYUMJEV TEMPO PEN U-100 | insulin lispro-aabc | INSULN PEN | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00002823505 | LYUMJEV TEMPO PEN U-100 | insulin lispro-aabc | INSULN PEN | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00002822801 | LYUMJEV KWIKPEN U-200 | insulin lispro-aabc | INSULN PEN | 200 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00002822827 | LYUMJEV KWIKPEN U-200 | insulin lispro-aabc | INSULN PEN | 200 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00002772801 | LYUMJEV | insulin lispro-aabc | VIAL | 100 unit/mL | N | Y | N | Pharmacy PA |
| 00002880301 | HUMULIN 70/30 KWIKPEN | insulin NPH hum/reg insulin hm | INSULN PEN | 100 unit/mL (70-30) | Y | Y | N | Pharmacy PA |
| 00002880359 | HUMULIN 70/30 KWIKPEN | insulin NPH hum/reg insulin hm | INSULN PEN | 100 unit/mL (70-30) | Y | Y | N | Pharmacy PA |
| 00169300701 | NOVOLIN 70-30 FLEXPEN | insulin NPH hum/reg insulin hm | INSULN PEN | 100 unit/mL (70-30) | Y | Y | N | Pharmacy PA |
| 00169300712 | NOVOLIN 70-30 FLEXPEN | insulin NPH hum/reg insulin hm | INSULN PEN | 100 unit/mL (70-30) | Y | Y | N | Pharmacy PA |
| 00169300715 | NOVOLIN 70-30 FLEXPEN | insulin NPH hum/reg insulin hm | INSULN PEN | 100 unit/mL (70-30) | Y | Y | N | Pharmacy PA |
| 00169300725 | NOVOLIN 70-30 FLEXPEN | insulin NPH hum/reg insulin hm | INSULN PEN | 100 unit/mL (70-30) | Y | Y | N | Pharmacy PA |
| 59060231704 | NOVOLIN 70-30 INNOLET | insulin NPH hum/reg insulin hm | INSULN PEN | 100 unit/mL (70-30) | Y | N | N | Pharmacy PA |
| 00002871501 | HUMULIN 70-30 | insulin NPH hum/reg insulin hm | VIAL | 100 unit/mL (70-30) | Y | Y | N | Pharmacy PA |
| 54569346701 | HUMULIN 70/30 | insulin NPH hum/reg insulin hm | VIAL | 100 unit/mL (70-30) | Y | N | N | Pharmacy PA |
| 32849070801 | NOVOLIN 70-30 | insulin NPH hum/reg insulin hm | VIAL | 100 unit/mL (70-30) | Y | N | N | Pharmacy PA |
| 50090040300 | NOVOLIN 70-30 | insulin NPH hum/reg insulin hm | VIAL | 100 unit/mL (70-30) | Y | N | N | Pharmacy PA |
| 00169183702 | NOVOLIN 70-30 | insulin NPH hum/reg insulin hm | VIAL | 100 unit/mL (70-30) | Y | Y | N | Pharmacy PA |
| 00169183711 | NOVOLIN 70-30 | insulin NPH hum/reg insulin hm | VIAL | 100 unit/mL (70-30) | Y | Y | N | Pharmacy PA |
| 00002880501 | HUMULIN N KWIKPEN | insulin NPH human isophane | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00002880559 | HUMULIN N KWIKPEN | insulin NPH human isophane | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169300415 | NOVOLIN N FLEXPEN | insulin NPH human isophane | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169300425 | NOVOLIN N FLEXPEN | insulin NPH human isophane | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00002831501 | HUMULIN N | insulin NPH human isophane | VIAL | 100 unit/mL | Y | Y | N | |
| 32849070601 | NOVOLIN N | insulin NPH human isophane | VIAL | 100 unit/mL | Y | N | N | |
| 54569383501 | NOVOLIN N | insulin NPH human isophane | VIAL | 100 unit/mL | Y | N | N | |
| 00169183402 | NOVOLIN N | insulin NPH human isophane | VIAL | 100 unit/mL | Y | Y | N | |
| 00169183411 | NOVOLIN N | insulin NPH human isophane | VIAL | 100 unit/mL | Y | Y | N | |
| 00338012612 | MYXREDLIN | insulin regular in 0.9 % NaCl | PLAST. BAG | 100 unit/100 mL (1 unit/mL) | Y | N | ||
| 47918089190 | AFREZZA | insulin regular, human | CART INHAL | 12 unit | N | Y | N | Pharmacy PA |
| 47918087490 | AFREZZA | insulin regular, human | CART INHAL | 4 unit | N | Y | N | Pharmacy PA |
| 47918090218 | AFREZZA | insulin regular, human | CART INHAL | 4 unit (60)/8 unit (60)/12 unit (60) | N | Y | N | Pharmacy PA |
| 47918088018 | AFREZZA | insulin regular, human | CART INHAL | 4 unit (90)/8 unit (90) | N | Y | N | Pharmacy PA |
| 47918087890 | AFREZZA | insulin regular, human | CART INHAL | 8 unit | N | Y | N | Pharmacy PA |
| 47918089818 | AFREZZA | insulin regular, human | CART INHAL | 8 unit (90)/12 unit (90) | N | Y | N | Pharmacy PA |
| 00169300301 | NOVOLIN R FLEXPEN | insulin regular, human | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169300312 | NOVOLIN R FLEXPEN | insulin regular, human | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169300315 | NOVOLIN R FLEXPEN | insulin regular, human | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00169300325 | NOVOLIN R FLEXPEN | insulin regular, human | INSULN PEN | 100 unit/mL (3 mL) | N | Y | N | Pharmacy PA |
| 00002882401 | HUMULIN R U-500 KWIKPEN | insulin regular, human | INSULN PEN | 500 unit/mL (3 mL) (concentrated) | Y | Y | N | |
| 00002882427 | HUMULIN R U-500 KWIKPEN | insulin regular, human | INSULN PEN | 500 unit/mL (3 mL) (concentrated) | Y | Y | N | |
| 50090035300 | HUMULIN R | insulin regular, human | VIAL | 100 unit/mL | Y | N | N | |
| 00002021301 | HUMULIN R | insulin regular, human | VIAL | 100 unit/mL | Y | Y | N | |
| 00002821501 | HUMULIN R | insulin regular, human | VIAL | 100 unit/mL | Y | Y | N | |
| 00002821517 | HUMULIN R | insulin regular, human | VIAL | 100 unit/mL | Y | Y | N | |
| 32849070701 | NOVOLIN R | insulin regular, human | VIAL | 100 unit/mL | Y | N | N | |
| 50090049700 | NOVOLIN R | insulin regular, human | VIAL | 100 unit/mL | Y | N | N | |
| 54569383301 | NOVOLIN R | insulin regular, human | VIAL | 100 unit/mL | Y | N | N | |
| 00169183302 | NOVOLIN R | insulin regular, human | VIAL | 100 unit/mL | Y | Y | N | |
| 00169183311 | NOVOLIN R | insulin regular, human | VIAL | 100 unit/mL | Y | Y | N | |
| 00002850101 | HUMULIN R U-500 | insulin regular, human | VIAL | 500 unit/mL (Concentrated) | Y | Y | N | |
| 54569383400 | NOVOLIN L | insulin zinc human recombinant | VIAL | 100 unit/mL | Y | N | N |