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Preferred Drug List (PDL) & Clinical Criteria

last modified 05/13/2019 - 11:07 AM

 

2019
PDL AND CLINICAL CRITERIA

 

2018
PDL AND CLINICAL CRITERIA

 

2017
PDL AND CLINICAL CRITERIA

 

2016
PDL AND CLINICAL CRITERIA 

 

2015
PDL AND CLINICAL CRITERIA


 

Scroll below for 2011 - 2014
Preferred Drug List
and
Clinical Criteria


 

 

 

 

 

Prior Authorization Request and Order Forms

 


 

2017
PDL AND CLINICAL CRITERIA

 

 

2016
PDL AND CLINICAL CRITERIA


 

2015
PDL AND CLINICAL CRITERIA

 

 


Scroll below for 2011 - 2014
Preferred Drug List

and
Clinical Criteria List

     


-ARCHIEVED - PREFERRED DRUG LIST

 

 

ARCHIVED - CLINICAL CRITERIA

 

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