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  Wednesday, March 29, 2023
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Other Pharmacy Documents

This section contains additional pharmacy related documents that you may need.

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Other Pharmacy Updates (more than 150 available) List
 
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Other Pharmacy Updates (more than 150 available)

 
 TitleFile TypeSize (KB)Release Date 
PDL by Drug Class - Effective 3 15 23PDF760.403/15/2023 
PDL by Drug Name - Effective 3 15 23PDF670.503/15/2023 
PDL by Drug Class - Effective 3 1 23PDF760.103/01/2023 
PDL by Drug Name - Effective 3 1 23PDF67103/01/2023 
OptumRx Payer Sheet - Version D.0 - B1, B2, and B3 Reversals - Revised 02.01.2023PDF499.202/01/2023 
PDL by Drug Class - Effective 2 1 23PDF764.402/01/2023 
PDL by Drug Name - Effective 2 1 23PDF673.302/01/2023 
PDL by Drug Class - Effective 1 1 23PDF764.401/01/2023 
PDL by Drug Name - Effective 1 1 23PDF673.701/01/2023 
QLL List - 1Q2023PDF470.701/01/2023 
PDL by Drug Class - Effective 12 1 22PDF766.812/01/2022 
PDL by Drug Name - Effective 12 1 22PDF674.712/01/2022 
PDL by Drug Class - Effective 11.1.22PDF767.311/01/2022 
PDL by Drug Name - Effective 11.1.22PDF675.711/01/2022 
PDL by Drug Class - Effective 10.1.22PDF764.310/01/2022 
PDL by Drug Name - Effective 10.1.22PDF672.410/01/2022 
QLL List - 4Q2022PDF460.210/01/2022 
Vaccine Coverage List - Outpatient Pharmacy (Revised 10.01.2022)PDF21110/01/2022 
PDL by Drug Class - Effective 9.1.22PDF766.109/01/2022 
PDL by Drug Name - Effective 9.1.22PDF673.709/01/2022 
PDL by Drug Class - Effective 8.1.22PDF764.608/01/2022 
PDL by Drug Name - Effective 8.1.22PDF67208/01/2022 
PDL by Drug Class - Effective 7.1.22PDF706.407/08/2022 
PDL by Drug Name - Effective 7.1.22PDF575.607/08/2022 
Covered Diabetic Supplies (Effective 07.01.2022)PDF29307/01/2022 
QLL List - 3Q2022PDF461.707/01/2022 
PDL by Drug Class - Effective 6.1.22PDF761.606/01/2022 
PDL by Drug Name - Effective 6.1.22PDF668.206/01/2022 
PDL by Drug Class - Effective 5.1.22PDF762.905/02/2022 
PDL by Drug Name - Effective 5.1.22PDF670.105/02/2022 
PDL by Drug Class - Effective 4.1.22PDF764.204/01/2022 
PDL by Drug Name - Effective 4.1.22PDF672.304/01/2022 
QLL List - 2Q2022PDF74304/01/2022 
PDL by Drug Class - Effective 3.1.22PDF762.103/01/2022 
PDL by Drug Name - Effective 3.1.22PDF669.503/01/2022 
PDL by Drug Class - Effective 2.1.22PDF761.602/01/2022 
PDL by Drug Name - Effective 2.1.22PDF669.202/01/2022 
PDL by Drug Class - Effective 1.1.22PDF760.301/01/2022 
PDL by Drug Name - Effective 1.1.22PDF667.701/01/2022 
QLL List - 1Q2022PDF726.701/01/2022 
PDL by Drug Class - Effective 12 1 21PDF756.212/01/2021 
PDL by Drug Name - Effective 12 1 21PDF663.812/01/2021 
PDL by Drug Class - Effective 11 1 21PDF756.711/01/2021 
PDL by Drug Name - Effective 11 1 21PDF664.411/01/2021 
PDL by Drug Class - Effective 10 1 21PDF759.910/01/2021 
PDL by Drug Name - Effective 10 1 21PDF66810/01/2021 
QLL List - 4Q2021PDF718.910/01/2021 
PDL by Drug Class - Effective 9 1 21PDF756.609/01/2021 
PDL by Drug Name - Effective 9 1 21PDF664.509/01/2021 
PDL by Drug Class - Effective 8 1 21PDF756.108/01/2021 
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