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)   
• Care1st Arizona Health Plan
  • Care1st Arizona - Integrated Preferred Drug List - English (PDF)
  • Care1st Arizona - Integrated Preferred Drug List - Spanish (PDF)    
  • Care1st Arizona - Integrated Preferred Drug List (JSON)
  • Care1st Arizona - Behavioral Preferred Drug List - English (PDF)
  • Care1st Arizona - Behavioral Health Preferred Drug List - Spanish (PDF)    
  • Care1st Arizona - 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)