Pharmacy Documents

NameTypeDate AddedDownload
  
Midwest Health_Contour Next Meter.pdf.pdf4/24/2017 Download
Formulary Exception Form.pdf.pdf2/13/2017 Download
HAP Midwest Health Plan Smoking Cessation Grid.pdf.pdf2/13/2017 Download
Henry Ford Pharmacy Advantage Specialty Pharmacy.pdf.pdf12/21/2016 Download
Pharmacy Processing Information (Magellan Rx Pharmacy Management – BIN or PCN or Contact Information).pdf.pdf12/21/2016 Download
MedicaidHealthPlanCarveout_20160809a.pdf.pdf11/9/2016 Download
Prior Authorization Form.pdf.pdf12/22/2014 Download
Criteria for Off Label Use.pdf.pdf7/3/2014 Download