Mississippi Medicaid

Favorable for Coverage: Pharmacy Benefit (OTC)
Gelmix and Purathick are favorable for coverage as over-the-counter (OTC) products with a prescription under the pharmacy benefit.

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Requirements
-Prescription required

Product NDC Codes in MS
-Gelmix Infant Thickener (125g Jar): 55764-0007-02
-Gelmix Infant Thickener (2.4g Sticks): 55764-0007-11
-Purathick Natural Thickener (125g Jar): 55764-0007-10
-Purathick Natural Thickener (2.4g Sticks): 55764-0007-14

Resources / Links
Mississippi Medicaid Covered OTC NDC List