Search

The formulary drug database file contains all drugs available in Medicaid, CHIP, and other state programs. HHSC updates the database weekly. Users can search the database by submitting a combination of the following fields:

  • Drug name
  • 11-digit NDC
  • Manufacturer name
  • Preferred drug class
  • Clinical prior authorizations name

Users can also filter findings by selecting the following:

  • By program
    • Medicaid
    • CHIP
    • CSHCN
    • HTW
    • HTW-Plus
    • KHC
  • By identifiers
    • All drugs requiring non-preferred prior authorization
    • All drugs requiring clinical prior authorization in fee-for-service Medicaid
    • All family planning drugs
    • All drugs requiring 90% use before a refill
    • All over-the-counter drugs
    • All injectable drugs
    • All Medicare Part B cost-share drugs
    • All Medicare Part D wrap-around drugs
    • All long-acting reversible contraception drugs

Search Results

The search results return the information described below. Users can click the hyperlink in the Brand Name/Generic Name/Package Size column for further details.

  • Brand Name/Generic Name/Package Size
    • Identifies the brand and generic name of the drug and its package size
  • NDC/Manufacturer/Class
    • Identifies the 11-digit NDC number, manufacturer name, and PDL class name
  • Medicaid PA Required
    • Identifies if the NDC has traditional Medicaid clinical prior authorization or Medicaid PDL prior authorization requirements
  • Programs/Coverage Dates
    • Identifies the program name, program start date, and program end date in which the drug is payable

Search Result Details

The details include general drug information, fee-for-service pricing, and program coverage. Drugs requiring fee-for-service clinical prior authorization include a link to the prior authorization criteria document.

A drug with a termination date will appear on the search for 90 days following the termination date.