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Formulary

Medicaid

  • Arizona Complete Health
    • Arizona Complete Health - Integrated Preferred Drug List - English (PDF)
    • Arizona Complete Health - Integrated Preferred Drug List - Spanish (PDF)
    • Arizona Complete Health - Integrated Preferred Drug List (JSON)
    • Arizona Complete Health - Behavioral Health Preferred Drug List - English (PDF)
    • Arizona Complete Health - Behavioral Health Preferred Drug List - Spanish (PDF) 
    • Arizona Complete Health - Behavioral Health Preferred Drug List (JSON)   
  • Coordinated Care (Apple Health)
    • Coordinated Care (Apple Health) - Preferred Drug List (PDF)
    • Coordinated Care (Apple Health) - Preferred Drug List (JSON)
    • Coordinated Care (Apple Health Expansion) - Preferred Drug List (PDF)
    • Coordinated Care (Apple Health Expansion) - Preferred Drug List (JSON) 
    • CCW Pharmacy Clinical and Payment Policies
    • Prior Authorization Forms
  • 'Ohana Health Plan
    • 'Ohana Health Plan: Community Care Services (PDF)
    • 'Ohana Health Plan: Community Care Services (JSON)
    • 'Ohana Health Plan: QUEST Integration (PDF)
    • 'Ohana Health Plan: QUEST Integration (JSON)
    • 'Ohana Health Plan: QUEST Integration Notice of Change (PDF)
  • SilverSummit Healthplan
    • SilverSummit Healthplan - Preferred Drug List (PDF)
    • SilverSummit Healthplan - Preferred Drug List (JSON)
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