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Prescribers

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Commercial Plans

Ambetter from Coordinated Care - Washington Clinical and Payment Policies

Medicaid

Absolute Total Care
- Absolute Total Care - Preferred Drug List (PDF)
- Absolute Total Care - Preferred Drug List (JSON)
Arizona Complete Health
- Arizona Complete Health - Integrated Preferred Drug List - English (PDF)
- Arizona Complete Health - Integrated Preferred Drug List - Spanish (PDF)
- Arizona Complete Health - Integrated Preferred Drug List (JSON)
- Arizona Complete Health - Behavioral Health Preferred Drug List - English (PDF)
- Arizona Complete Health - Behavioral Health Preferred Drug List - Spanish (PDF)
- Arizona Complete Health - Behavioral Health Preferred Drug List (JSON)
Buckeye Health Plan
- Buckeye Health Plan - MyCare Ohio (MMP) - Preferred Drug List (PDF)
- Buckeye Health Plan - MyCare Ohio (MMP) - Preferred Drug List (JSON)
- Ohio Department of Medicaid - State Unified Preferred Drug List
CARE1st Health Plan Arizona
- CARE1st Arizona - Integrated Preferred Drug List - English (PDF)
- CARE1st Arizona - Integrated Preferred Drug List - Spanish (PDF)
- CARE1st Arizona - Integrated Preferred Drug List (JSON)
- CARE1st Arizona - Behavioral Health Preferred Drug List - English (PDF)
- CARE1st Arizona - Behavioral Health Preferred Drug List - Spanish (PDF)
- CARE1st Arizona - Behavioral Health Preferred Drug List (JSON)
Coordinated Care (Apple Health)
- Coordinated Care (Apple Health) - Preferred Drug List (PDF)
- Coordinated Care (Apple Health) - Preferred Drug List (JSON)
- CCW Pharmacy Clinical and Payment Policies
- Prior Authorization Forms
Delaware First Health
- Delaware First Health - Medicaid Preferred Drug List (PDF)
- Delaware First Health - Medicaid Preferred Drug List (JSON)
Louisiana Healthcare Connections
- Louisiana Healthcare Connections - Preferred Drug List
Magnolia Health Plan
- Magnolia Health Plan - Preferred Drug List
Meridian - Illinois HealthChoice Medicaid
- Meridian - Illinois HealthChoice Medicaid - Preferred Drug List (PDF)
- Meridian - Illinois HealthChoice Medicaid - Preferred Drug List (JSON)
Meridian - Michigan
- Meridian - Preferred Drug List (PDF)
- Meridian - Preferred Drug List (JSON)
- Meridian - Children's Special Healthcare Services (CSHCS) Preferred Drug List (PDF)
- Meridian - Children's Special Healthcare Services (CSHCS) Preferred Drug List (JSON)
Nebraska Total Care
- Nebraska Total Care - Preferred Drug List - English (PDF)
- Nebraska Total Care - Preferred Drug List - Spanish (PDF)
- Nebraska Total Care - Preferred Drug List (JSON)
- Nebraska Total Care - State Preferred Drug List
- Nebraska Total Care - Preferred Drug List - Claim Limitations (PDF)
New Hampshire Healthy Families
- New Hampshire Healthy Families - Preferred Drug List (PDF)
- New Hampshire Healthy Families - Preferred Drug List (JSON)
'Ohana Health Plan
- 'Ohana Health Plan: Community Care Services (PDF)
- 'Ohana Health Plan: Community Care Services (JSON)
- 'Ohana Health Plan: QUEST Integration (PDF)
- 'Ohana Health Plan: QUEST Integration (JSON)
- 'Ohana Health Plan: QUEST Integration Notice of Change (PDF)
Oklahoma Complete Health
- Oklahoma Complete Health - Preferred Drug List (PDF)
Peach State Health Plan
- Peach State Health Plan - Medicaid Preferred Drug List (PDF)
- Peach State Health Plan - Medicaid Preferred Drug List (JSON)
- Peach State Health Plan - Inter-Pregnancy Care - Preferred Drug List (PDF)
- Peach State Health Plan - Family Planning - Preferred Drug List (PDF)
- Peach State Health Plan - Family Planning - Preferred Drug List (JSON)
- Peach State Health Plan - NADAC Summary Report 010122-043022 (PDF)
- Peach State Health Plan - NADAC Summary Report 083122 (PDF)
- Peach State Health Plan - NADAC Summary Report 123122 (PDF)
Pennsylvania Health & Wellness
- Pennsylvania Health & Wellness - Supplemental Drug List (PDF)
- Pennsylvania Health & Wellness - Supplemental Drug List (JSON)
- Pennsylvania Health & Wellness - State Supplemental Drug List
SilverSummit Healthplan
- SilverSummit Healthplan - Preferred Drug List (PDF)
- SilverSummit Healthplan - Preferred Drug List (JSON)
Sunflower State Health Plan
- Sunflower State Health Plan - Preferred Drug List
Sunshine Health Plan
- Sunshine Health Plan - Preferred Drug List
- Sunshine Health Plan Preferred Diabetic Products
Superior HealthPlan
- Superior Health Plan - Preferred Drug List
Trillium Community Health Plan
- Trillium Community Health Plan - Preferred Drug List - English (PDF)
- Trillium Community Health Plan - Preferred Drug List - Spanish (PDF)
- Trillium Community Health Plan - Preferred Drug List (JSON)
Western Sky Community Care
- Western Sky Community Care - Preferred Drug List (PDF)
- Western Sky Community Care - Preferred Drug List (JSON)
YouthCare HealthChoice Illinois
- YouthCare HealthChoice Illinois - Preferred Drug List (PDF)
- YouthCare HealthChoice Illinois - Preferred Drug List (JSON)