Providers: Prescription Drugs

As providers, we supply you with the most current of forms to use in the office, or to check to make sure your copy is the newest available.

Commercial (Group & Individual) Formularies

2020

• 5 Tier Commerical Metal:
  PDF | Online Search | Prior Authorization and Step Therapy Criteria
• 5 Tier Commerical:
  PDF | Online Search | Prior Authorization and Step Therapy Criteria
• 3 Tier Commercial:
  PDF | Online Search | Prior Authorization and Step Therapy Criteria

2019

• 5 Tier Commercial Metal:
  PDF | Online Search | Prior Authorization & Step Therapy
• 5 Tier Commercial:
  PDF | Online Search | Prior Authorization & Step Therapy
• 3 Tier Commercial:
  PDF | Online Search | Prior Authorization & Step Therapy

Medicare Formularies

2020

• (MA-PD):
  PDF | Online Search | Prior Authorization and Step Therapy
• (MA-PD Employer Groups):
  PDF | Online Search | Prior Authorization and Step Therapy Criteria

2019

• Rewards/Value/Classic:
  PDF | Online Search | Prior Authorization & Step Therapy
• Employer Groups:
  PDF | Online Search | Prior Authorization & Step Therapy