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  1. Home
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  3. Manuals
  4. Pharmacy Provider Procedure Manual
  5. P-18. Forms
  6. Formulary Management Forms

Pharmacy Provider Procedure Manual

  • Search this manual
  • P-1. Introduction
  • P-2. Contact Information
  • P-3. Enrollment
  • P-4. Managed Care
  • P-5. System Requirements
  • P-6. Eligibility
  • P-7. Coordination of Benefits
  • P-8. Drug Policy
  • P-9. Formulary Coverage
  • P-10. Drug Utilization Review
  • P-11. Prior Authorization
  • P-12. Pricing and Reimbursement
  • P-13. 340B Resources
  • P-14. Payment
  • P-15. Audits
  • P-16. Drug Rebates
  • P-17. Documents
  • P-18. Forms
    • Claim Processing Forms
    • Eligibility Forms
    • Enrollment Forms
    • Formulary Management Forms
    • Payment Forms
    • Prior Authorization Reconsideration (Medicaid fee-for-service)
    • Prior Authorization Requests (CSHCN Services Program)
    • Prior Authorization Requests (Medicaid fee-for-service)

Formulary Management Forms

Drug Shortage Notification

  • HHS Form 1315
  • hhs.texas.gov/laws-regulations/forms/1000-1999/form-1315-drug-shortage-notification

Long-acting Reversible Contraception (LARC) Product Forms

  • Bayer Abandoned Unit Frequently Asked Questions (FAQ) and Return Form
    • txvendordrug.com/sites/default/files/docs/bayer-abandoned-unit-faq.pdf
  • Cooper Surgical Abandoned Unit Process
    • txvendordrug.com/sites/default/files/docs/teva-abandoned-unit-process.pdf
  • Organon Abandoned Unit Program FAQ
    • txvendordrug.com/sites/default/files/docs/organon-abandoned-unit-faq.pdf
  • Organon Abandoned Unit Return Form
    • txvendordrug.com/sites/default/files/docs/organon-abandoned-unit-form.pdf
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