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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.
Maintenance Drugs
(49 KB PDF): Medications considered to be necessary for long periods of time.
Prior Authorization List
(37 KB PDF): Medications that require prior approval. For authorization, call
501-378-3392
.
Formulary One
(1867 KB PDF): List of common generic, preferred and third-tier drugs and those that require prior authorization.
Formulary One Preferred Drug List
(34 KB PDF): Generic and lower-cost brand-name medications.
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