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Printable Drug Lists
Note: Your plan's covered drug list may vary from this standard formulary. Call the Customer Service number on your ID card or consult your group administrator to verify this formulary.

  • 2008 Preferred Drug List (41 KB PDF): Generic and lower-cost brand-name medications.

  • Maintenance Drugs (48 KB PDF): Medications considered to be necessary for long periods of time.

  • Prior Authorization List (40 KB PDF): Medications that require prior approval. For authorization, call (501) 378-3392.

  • Three-Tier Formulary (2894 KB PDF): List of common generic, preferred and third-tier drugs and those that require prior authorization.

Printable Drug Lists



 
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