Last Updated

This layout document contains all drugs on the Medicaid formulary with clinical prior authorization criteria requirements for traditional Medicaid. HHSC updates the database weekly. Data from the file does not appear in any search.

Field Name Description Length Format Note
Drug_NDC Identifies the 11-digit National Drug Code (NDC) number      11    
Drug_cpa_name Identifies the clinical prior authorization criteria name 30    
Drug_cpa_description Identifies the clinical prior authorization criteria description 50    
Drug_cpa_EffDate Identifies the clinical prior authorization criteria effective date 10 MM/DD/CCYY  
Drug_cpa_EndDate Identifies the clinical prior authorization criteria termination date 10 MM/DD/CCYY