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Drug Formulary Lookup - Search Results

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DIN Brand Name Generic Name Description Eligibility
Status		 ATC Code
02491281  METHOTREXATE SUBCUTANEOUS METHOTREXATE 10MG/0.2ML INJ Part 1 Benefit L04AX03
02491303  METHOTREXATE SUBCUTANEOUS METHOTREXATE 12.5MG/.25 INJ Part 1 Benefit L04AX03
02491311  METHOTREXATE SUBCUTANEOUS METHOTREXATE 15MG/0.3ML INJ Part 1 Benefit L04AX03
02491338  METHOTREXATE SUBCUTANEOUS METHOTREXATE 17.5/.35ML INJ Part 1 Benefit L04AX03
02491346  METHOTREXATE SUBCUTANEOUS METHOTREXATE 20MG/0.4ML INJ Part 1 Benefit L04AX03
02491354  METHOTREXATE SUBCUTANEOUS METHOTREXATE 22.5/.45ML INJ Part 1 Benefit L04AX03

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Data Last Updated: 4/27/2026 6:00:06 AM