Provider Enrollment and Management System Information

Pharmacy Enrollment

Managed Care

Formulary Resources

Prior Authorization

Manufacturer Resources

Drug Utilization Review Board

    Education and Training Materials

    Name Revised
    Dispensing 72-hour Emergency Prescriptions (PDF) 07/2019
    Pharmacy Resources for Managed Care (PDF) 07/2019
    Real-time Eligibility Verification (PDF) 07/2019
    Mosquito Repellent Benefit (PDF) 07/2019

    Claim Forms

    Delimited Data Files

    File Layout File
    Drug Index (TXT)  Layout (PDF)
    Product Index (TXT) Layout (PDF)
    Clinical Prior Authorization Index (TXT) Layout (PDF)
    Clinician-administered Drug Index (TXT) Layout (PDF)
    HTW and HTW Plus Program (XLS) (Updated April 2021) Layout (PDF)
    Pharmacy Index (TXT) Layout (PDF)
    Prescriber Index (ZIP) Layout (PDF)
    • † Denotes a weekly file last updated May 10.
    • ‡ Denotes a quarterly file last updated April 12.
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