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  Tuesday, March 19, 2024
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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 2.1.24 PDF778.602/01/2024 
PDL by Drug Name - Effective 2.1.24PDF688.202/01/2024 
PDL by Drug Class - Effective 1.4.24 revPDF776.701/05/2024 
PDL by Drug Name - Effective 1.4.24 revPDF685.501/05/2024 
PDL by Drug Class - Effective 1.1.24 revPDF778.501/01/2024 
PDL by Drug Name - Effective 1.1.24 revPDF687.501/01/2024 
QLL List - 1Q2024PDF767.601/01/2024 
PDL by Drug Class - Effective 12.1.23PDF772.512/01/2023 
PDL by Drug Name - Effective 12.1.23PDF68512/01/2023 
PDL by Drug Class - Effective 11.1.23PDF771.611/01/2023 
PDL by Drug Name - Effective 11.1.23PDF67911/01/2023 
PDL by Drug Class - Effective 10.1.23PDF772.610/01/2023 
PDL by Drug Name - Effective 10.1.23PDF684.610/01/2023 
PDL by Drug Class - Effective 9.1.23PDF771.709/01/2023 
PDL by Drug Name - Effective 9.1.23PDF68009/01/2023 
QLL List - 3Q2023PDF756.508/15/2023 
PDL by Drug Class - Effective 8.1.23PDF770.308/01/2023 
PDL by Drug Name - Effective 8.1.23PDF67908/01/2023 
PDL by Drug Class - Effective 7.1.23PDF77007/01/2023 
PDL by Drug Name - Effective 7.1.23PDF67607/01/2023 
PDL by Drug Class - Effective 6.1.23PDF769.106/01/2023 
PDL by Drug Name - Effective 6.1.23PDF675.306/01/2023 
PDL by Drug Class - Effective 5 1 23PDF762.705/01/2023 
PDL by Drug Name - Effective 5 1 23PDF671.605/01/2023 
PDL by Drug Class - Effective 4 1 23PDF762.204/01/2023 
PDL by Drug Name - Effective 4 1 23PDF670.204/01/2023 
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 
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