Pharmacy Enrollment

Managed Care

Drugs and Products

Prior Authorization

Drug Rebates

Drug Utilization Review Board

    Education and Training Materials

    Claim Forms

    Delimited Data Files

    Data File Layout File
    Formulary Drug Index (zip) (Updated Jan. 27) Layout (PDF)
    Formulary Product Index (zip) (Updated Jan. 27) Layout (PDF)
    Formulary Clinical Prior Authorization Index (txt) (Updated Jan. 27) Layout (PDF)
    Formulary HTW Program (XLS) (Updated Oct. 2019) Layout (PDF)
    Formulary NDC-to-HCPCS Crosswalk (Updated quarterly) Layout (PDF)
    Pharmacy Pharmacy Index (txt) (Updated Jan. 27) Layout (PDF)
    Prescriber Prescriber Index (ZIP) (Updated Jan. 27) Layout (PDF)