Medications listed in the tables and non-FDA approved indications included in these retrospective criteria are not indicative of Texas Vendor Drug Program formulary coverage.

• Revision history:
  • April 26, 2024
  • April 2022
  • March 2020
  • March 2018
  • March 2017
  • April 2015
  • March 2015
  • Feb. 2013
  • Dec. 2012 (initially developed)