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Medicaid-Approved Preferred Drug List. Information provided by the drug lookup tool does not guarantee coverage or payment from Kentucky Medicaid. DO: Dose Optimization Program . This is not an all-inclusive list, the formulary covers many more drugs. AL: Age Limit Restrictions . Effective August 1, 2020. Welcome to the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services Fee-For-Service Pharmacy Program portal, administered and maintained in conjunction with Magellan Medicaid Administration. Welcome to the Magellan Medicaid Administration The web portal provides online access to prescription and Kentucky specific plan information as well as supporting documentation. Generic drug: Lowercase in plain type . Use this link for a printer-friendly Preferred Drug Listing — In each class, drugs are listed alphabetically by either brand name or generic name. PDL_December_1_2019.pdf. Michigan Department of Health and Human Services Preferred Drug List Effective 07/14/2020 Preferred Agents do not require prior authorization, except as noted in the chart at the bottom of the page 1 Prior Authorization Not Required for Beneficiaries Under the Age of 12.

Welcome to the Magellan Medicaid Administration ... Use this link for a printer-friendly Preferred Drug Listing — full list ... Information provided by the drug lookup tool does not guarantee coverage or payment from Kentucky Medicaid. Welcome to the Kentucky Cabinet for Health and Family Services, Department for Medicaid Services Fee-For-Service Pharmacy Program portal, administered and maintained in conjunction with Magellan Medicaid Administration.The web portal provides online access to prescription and Kentucky specific plan information as well as supporting documentation.Online access to drug coverage, a pharmacy locator, and benefit plan information.Processing and management of provider transactions, notices, and general support.Access to current PDL, P&T and DMRAB notices, and other general information.
Brand name drug: Uppercase in bold type .

NC Medicaid and Health Choice Preferred Drug List (PDL) effective Dec. 1, 2019 Magellan Medicaid Administration, part of the Magellan Rx Management division of Magellan Health, Inc. Kentucky Pharmacy Preferred Drug List Effective: August 24, 2020 GENERAL DEFINITION OF TERMS Clinical Criteria (CC) – Due to the nature of some medications, prior authorization may be required for the medication to be covered at any copay tier. You can learn more about a member’s eligibility by exploring the member eligibility function of this Web Portal. the Department for Medicaid Services (DMS) based on the Drug Review and Options for Consideration document prepared for the Pharmacy and Therapeutics (P&T) Advisory Committee’s review on March 21, 2019, and the resulting official Committee recommendations. This is a summary of the final Preferred Drug List (PDL) selections made by the Commissioner of the Department for Medicaid Services (DMS) based on the Drug Review and Options for Consideration document prepared for the Pharmacy and Therapeutics (P&T) Advisory Committee’s review on September 19, 2019, and the resulting official Committee Updated 10/2019, Effective 1/2020 Key 2020 Standard Quick Reference Formulary Most Commonly Prescribed Medications The Standard Quick Reference Formulary is intended to provide a list of commonly prescribed drugs that are covered.

Legend . However, real-time claim submission provides the most accurate member enrollment, drug coverage, recipient portion responsibility, and provider reimbursement information.

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