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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Reminder: Paxlovid Claiming Procedures 382025-Mar-27Word PDF
Benefit List Update: New Addition Special Authorization: OMVOH372025-Mar-24Word PDF
Changes to COPD Inhaler Criteria362025-Mar-21Word PDF
Short-Stock: Budesonide 0.125mg/ml352025-Mar-21Word PDF
Benefit Status Effective April 1, 2025342025-Mar-21Word PDF
NIDPF Vol. 92 Supplement Effective April 1, 2025 - Refer to Bulletin #34 for Benefit Status332025-Mar-21Word PDF
Update - Short-Stock: Octreotide 20mg/Vial322025-Mar-21Word PDF
Update - Short-Stock: Estradiol Transdermal 50 ug Patch312025-Mar-21Word PDF
Update - Short-Stock: Estradiol Transdermal 75ug302025-Mar-21Word PDF
Short-Stock: Olmesartan/Hydrochlorothiazide 40mg/25mg292025-Mar-19Word PDF
NLPDP Security Certificate Renewals282025-Mar-19Word PDF
Short-Stock: Ipratropium Bromide 20mcg/Metered Dose Inhaler272025-Mar-10Word PDF
Short-Stock: Octreotide 20mg/Vial262025-Mar-05Word PDF
Update - Short-Stock: Betahistine Dihydrochloride 24mg252025-Mar-04Word PDF
Online version of NIDPF Vol. 91 effective March 1, 2025242025-Feb-28Word PDF
Short-Stock - Testosterone 100mg/ml232025-Feb-27Word PDF
Benefit List Update: QULIPTA 10mg, 30mg, 60mg tablet222025-Feb-24Word PDF
Short Stock - Estradiol Transdermal 50 ug Patch212025-Feb-20Word PDF
Benefit Status Effective March 1, 2025202025-Feb-20Word PDF
NIDPF Vol. 91 Supplement Effective March 1, 2025 - Refer to Bulletin #20 for Benefit Status192025-Feb-20Word PDF
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Document Name: Date Range: To


Document NameDateView
Coverage Status Table - March 20252025-Mar-21 PDF
Coverage Status Table - February 20252025-Feb-18 PDF
Coverage Status Table - January 20252025-Jan-15 PDF
Coverage Status Table - December 20242024-Dec-06 PDF
Coverage Status Table - November 20242024-Nov-14 PDF
Coverage Status Table - October 20242024-Oct-16 PDF
Coverage Status Table - September 20242024-Sep-23 PDF
Coverage Status Table - August 20242024-Aug-16 PDF
Coverage Status Table - July 20242024-Jul-04 PDF
Coverage Status Table - June 20242024-Jun-18 PDF
Coverage Status Table - May 20242024-May-15 PDF
Coverage Status Table - April 20242024-Apr-23 PDF
Coverage Status Table - March 20242024-Mar-12 PDF
Coverage Status Table - February 20242024-Feb-21 PDF
Coverage Status Table - January 20242024-Jan-24 PDF
Coverage Status Table - December 20232023-Dec-12 PDF
Coverage Status Table - November 20232023-Nov-20 PDF
Coverage Status Table - October 20232023-Oct-25 PDF
Coverage Status Table - September 20232023-Sep-08 PDF
Coverage Status Table - August 20232023-Aug-22 PDF
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Document NameDateView
Diabetic Listing - December 13, 20222025-Mar-12Word 
 
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Benefit List Update: New Addition Special Authorization: OMVOH372025-Mar-24Word PDF
Benefit List Update: QULIPTA 10mg, 30mg, 60mg tablet222025-Feb-24Word PDF
Benefit List Update: New Addition: Vraylar 152025-Feb-12Word PDF
Benefit List Update: New Addition: Eylea HD142025-Feb-11Word PDF
Benefit List Update: STEQEYMA 62025-Jan-21Word PDF
Benefit list updates_New addition_WELIREG42025-Jan-15Word PDF
Benefit List Update: Livtencity22025-Jan-13Word PDF
Benefit List Update: Open Benefit2002024-Dec-13Word PDF
Benefit List Update_New Criteria_Trikafta1982024-Dec-12Word PDF
Benefit List Update_New Criteria_INLYTA Tablets1972024-Dec-11Word PDF
Benefit List Update: New addition: CoSentyx 75mg1952024-Dec-05Word PDF
Benefit List Update: New addition: RYMTI 50 MG/ML1932024-Dec-03Word PDF
Benefit List Update: Rinvoq for ankylosing Spondylitis1832024-Nov-12Word PDF
Benefit List Update_New Indication_ABIRATERONE Tablets1822024-Nov-06Word PDF
Benefit List Update_New Indication_LYNPARZA Tablets1812024-Nov-06Word PDF
Benefit List Update: New Addition: MAR-TRIENTINE 250mg1742024-Oct-18Word PDF
Benefit List Update: New Addition: VYEPTI 300mg/3ml 1722024-Oct-16Word PDF
Benefit List Update: New Addition: MAVACAMTEN (CAMZYOS 2.5mg, 5mg, 10mg, 15mg CAPSULES)1712024-Oct-16Word PDF
Benefit List Update1702024-Oct-11Word PDF
Benefit list updates_New Additions to Existing Category_Non-Insulin Anti-Diabetic Agents1662024-Oct-07Word PDF
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Short-Stock: Budesonide 0.125mg/ml352025-Mar-21Word PDF
Update - Short-Stock: Octreotide 20mg/Vial322025-Mar-21Word PDF
Update - Short-Stock: Estradiol Transdermal 50 ug Patch312025-Mar-21Word PDF
Update - Short-Stock: Estradiol Transdermal 75ug302025-Mar-21Word PDF
Short-Stock: Olmesartan/Hydrochlorothiazide 40mg/25mg292025-Mar-19Word PDF
Short-Stock: Ipratropium Bromide 20mcg/Metered Dose Inhaler272025-Mar-10Word PDF
Short-Stock: Octreotide 20mg/Vial262025-Mar-05Word PDF
Update - Short-Stock: Betahistine Dihydrochloride 24mg252025-Mar-04Word PDF
Short-Stock - Testosterone 100mg/ml232025-Feb-27Word PDF
Short Stock - Estradiol Transdermal 50 ug Patch212025-Feb-20Word PDF
Short-Stock: Tobramycin 60mg/ml182025-Feb-18Word PDF
Short-Stock: Citalopram 30mg172025-Feb-17Word PDF
Update - Short-Stock: Betahistine Dihydrochloride 16mg162025-Feb-14Word PDF
Short Stock: Estradiol Transdermal 75ug132025-Feb-11Word PDF
Update - Short-Stock: Bupropion 150mg92025-Jan-31Word PDF
Update: Short-Stock: Gliclazide MR 60mg52025-Jan-17Word PDF
Update: Short Stock-Varenicline 0.5mg and 1mg Kit2092024-Dec-30Word PDF
Update: Short Stock - Bupropion 300mg2082024-Dec-27Word PDF
Update: Short Stock - Carbamazepine 400 mg CR2072024-Dec-27Word PDF
Update: Short Stock - Olmesartan/Hydrochlorothiazide 40mg/25mg2062024-Dec-27Word PDF
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Benefit Status Effective April 1, 2025342025-Mar-21Word PDF
NIDPF Vol. 92 Supplement Effective April 1, 2025 - Refer to Bulletin #34 for Benefit Status332025-Mar-21Word PDF
Online version of NIDPF Vol. 91 effective March 1, 2025242025-Feb-28Word PDF
Benefit Status Effective March 1, 2025202025-Feb-20Word PDF
NIDPF Vol. 91 Supplement Effective March 1, 2025 - Refer to Bulletin #20 for Benefit Status192025-Feb-20Word PDF
Online version of NIDPF Vol. 91 effective February 1, 2025102025-Jan-31Word PDF
Benefit Status Effective February 1, 202582025-Jan-27Word PDF
NIDPF Vol. 91 Supplement Effective February 1, 2025 - Refer to Bulletin #8 for Benefit Status72025-Jan-27Word PDF
NIDPF Update: Delisting of Lanthanum 500mg, 750mg, and 1000mg Tablets12025-Jan-13Word PDF
Online version of NIDPF Vol. 91 effective January 1, 20252102024-Dec-31Word PDF
Benefit Status Effective January 1, 20252052024-Dec-19Word PDF
NIDPF Vol. 91 Supplement Effective January 1, 2025 - Refer to Bulletin #205 for Benefit Status2042024-Dec-19Word PDF
NIDPF Update - Delisting of Alitretinoin 10mg and Alitretinoin 30mg1962024-Dec-06Word PDF
Online version of NIDPF Vol. 91 effective December 1, 20241902024-Nov-29Word PDF
Benefit Status Effective December 1, 20241892024-Nov-21Word PDF
NIDPF Vol. 91 Supplement Effective December 1, 2024 - Refer to Bulletin #189 for Benefit Status1882024-Nov-21Word PDF
Online version of NIDPF Vol. 91 effective November 1, 20241802024-Nov-01Word PDF
Benefit Status Effective November 1, 20241772024-Oct-25Word PDF
NIDPF Vol. 91 Supplement Effective November 1, 2024 - Refer to Bulletin #177 for Benefit Status1762024-Oct-25Word PDF
Online version of NIDPF Vol. 91 effective October 1, 20241622024-Oct-01Word PDF
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Document NameDateView
2025 - Payment Schedule2024-Dec-03Word PDF
2024 - Payment Schedule2023-Dec-05Word PDF
 
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