Document Name: Date Range: To
| Document Name | Date | View |
| Coverage Status Table - September 2019 | 2019-Sep-24 | PDF |
| Coverage Status Table - August 2019 | 2019-Aug-27 | PDF |
| Coverage Status Table - July, 2019 | 2019-Jul-05 | PDF |
| Coverage Status Table - June 2019 | 2019-Jun-18 | PDF |
| Coverage Status Table - May 2019 | 2019-May-17 | PDF |
| Coverage Status Table - April, 2019 | 2019-Apr-15 | PDF |
| Coverage Status Table - March, 2019 | 2019-Mar-25 | PDF |
| Coverage Status Table - February, 2019 | 2019-Feb-08 | PDF |
| Coverage Status Table - January 2019 | 2019-Jan-24 | PDF |
| Coverage Status Table - December 2018 | 2018-Dec-21 | PDF |
| Coverage Status Table - November 2018 | 2018-Nov-23 | PDF |
| Coverage Status Table - October 2018 | 2018-Nov-16 | PDF |
| Coverage Status Table - September, 2018 | 2018-Sep-25 | PDF |
| Coverage Status Table - August, 2018 | 2018-Aug-23 | PDF |
| Coverage Status Table - July, 2018 | 2018-Jul-26 | PDF |
| Coverage Status Table - June, 2018 | 2018-Jun-20 | PDF |
| Coverage Status Table - April, 2018 | 2018-Apr-24 | PDF |
| Coverage Status Table - March, 2018 | 2018-Mar-21 | PDF |
| Coverage Status Table - February, 2018 | 2018-Feb-13 | PDF |
| Coverage Status Table - January, 2018 | 2018-Jan-18 | PDF |
|
Document Name: Date Range: To
| Document Name | Date | View |
| Diabetic Listing - July, 2019 (Refer to Bulletin #132 posted on July 12, 2019) | 2019-Jul-12 | Word PDF |
| Diabetic Listing - March, 2019 (Refer to Bulletin #56 posted on March 22, 2019) | 2019-Mar-22 | Word PDF |
| Diabetic Listing - August 3, 2018 (Refer to Bulletin #116 posted on August 3, 2018) | 2018-Aug-03 | Word PDF |
| Diabetic Listing - November 10, 2017 (Refer to Bulletin #192 posted on November 10, 2017) | 2017-Nov-10 | Word PDF |
| Diabetic Listing - October 31, 2017 (Refer to Bulletin #189 posted on October 31, 2017) | 2017-Oct-31 | Word PDF |
|
Document Name: Bulletin #: Date Range: To
| Document Name | Bulletin Number | Date | View |
| New Addition: Sandoz Levetiracetam 1000 MG TABLET | 195 | 2019-Oct-18 | Word PDF |
| Benefit List Update: New Addition_Ocrevus 300mg | 191 | 2019-Oct-10 | Word PDF |
| Benefit list updates_New addition_ALECENSARO 150MG CAPSULES | 190 | 2019-Oct-08 | Word PDF |
| Benefit List Update_ New Addition: VENCLEXTA 10MG, 50MG, 100MG TABLETS, AND STARTER PACK | 170 | 2019-Sep-13 | Word PDF |
| Benefit List Update_New Add: LYNPARZA 100, 150 MG & New Add to existing Cat: JAKAVI 5,10,15, 20 MG | 163 | 2019-Sep-03 | Word PDF |
| Benefit List Update_ New Addition: HEMANGIOL 3.75 MG/ML SOLUTION | 158 | 2019-Aug-27 | Word PDF |
| Benefit List Update_Humira for Hidradenitis suppurative (HS) | 157 | 2019-Aug-27 | Word PDF |
| Benefit List Update_COPD Criteria Update | 156 | 2019-Aug-27 | Word PDF |
| Benefit List Update_New Addition_OCALIVA 5MG, 10MG TABLETS | 149 | 2019-Aug-16 | Word PDF |
| Benefit List Update_New Addition to Existing Category: Afinitor 2.5mg, 5mg, and 10mg tablets | 142 | 2019-Jul-29 | Word PDF |
| Benefit List Update_New Addition_ Akynzeo 300mg/0.5mg capsule | 138 | 2019-Jul-19 | Word PDF |
| Benefit List Update_Criteria Update_Nucala 100mg vial | 137 | 2019-Jul-19 | Word PDF |
| Benefit List Update_New Addition_Fasenra 30mg/ml syringe | 136 | 2019-Jul-19 | Word PDF |
| Benefit Status Changes | 88 | 2019-May-13 | Word PDF |
| Benefit Change Update: New Special Authorization Criteria | 87 | 2019-May-13 | Word PDF |
| Benefit List Update: New Addition: SILIQ (BRODALUMAB) | 83 | 2019-May-06 | Word PDF |
| Benefit List Update: New Addition: Lixiana (edoxaban) | 82 | 2019-May-06 | Word PDF |
| Benefit List Update: New Benefit Addition: REXULTI (BREXPIPRAZOLE) | 79 | 2019-May-01 | Word PDF |
| Benefit List Update: New indication: Erelzi_Psoriatic Arthritis | 76 | 2019-Apr-30 | Word PDF |
| Benefit List Update: Criteria Update-Hep B | 75 | 2019-Apr-30 | Word PDF |
|
Document Name: Bulletin #: Date Range: To
| Document Name | Bulletin Number | Date | View |
| Error in Coverage Status for Teva-Varenicline Starter Kit 0.5 mg/1 mg tablets DIN 02426781 | 193 | 2019-Oct-17 | Word PDF |
| Online version of NIDPF Vol. 81 effective October 1, 2019 | 183 | 2019-Oct-01 | Word PDF |
| NLPDP Benefit Status Effective October 1, 2019 | 176 | 2019-Sep-25 | Word PDF |
| NIDPF Vol. 81 Supplement Effective October 1, 2019 - Refer to Bulletin #176 for Benefit Status | 175 | 2019-Sep-25 | Word PDF |
| Delisting from NIDPF and NLPDP Benefit List Effective October 1, 2019 | 169 | 2019-Sep-13 | Word PDF |
| Online version of NIDPF Vol. 80 effective September 1, 2019 | 162 | 2019-Aug-30 | Word PDF |
| NLPDP Benefit Status Effective September 1, 2019 | 155 | 2019-Aug-26 | Word PDF |
| NIDPF Vol. 80 Supplement Effective September 1, 2019 - Refer to Bulletin #155 for Benefit Status | 154 | 2019-Aug-26 | Word PDF |
| Online version of NIDPF Vol. 80 effective August 1, 2019 | 143 | 2019-Aug-01 | Word PDF |
| NLPDP Benefit Status Effective August 1, 2019 | 140 | 2019-Jul-26 | Word PDF |
| NIDPF Vol. 80 Supplement Effective August 1, 2019 - Refer to Bulletin #140 for Benefit Status | 139 | 2019-Jul-26 | Word PDF |
| Online version of NIDPF Vol. 80 effective July 1, 2019 | 127 | 2019-Jun-28 | Word PDF |
| Delisting from NIDPF and NLPDP Benefit List Effective July 1, 2019 | 121 | 2019-Jun-25 | Word PDF |
| NLPDP Benefit Status Effective July 1, 2019 | 120 | 2019-Jun-25 | Word PDF |
| NIDPF Vol. 80 Supplement Effective July 1, 2019 - Refer to Bulletin #120 for Benefit Status | 119 | 2019-Jun-25 | Word PDF |
| Delistings from NIDPF and NLPDP Benefit List Effective July 1, 2019 | 118 | 2019-Jun-25 | Word PDF |
| Delisting from NIDPF and NLPDP Benefit List Effective July 1, 2019 | 117 | 2019-Jun-25 | Word PDF |
| Coverage Status of Teva-Gemfibrozil 600mg Tablets - DIN 02142074 | 104 | 2019-Jun-03 | Word PDF |
| Delisting from NIDPF and NLPDP Benefit List Effective June 1, 2019 | 103 | 2019-Jun-03 | Word PDF |
| Online version of NIDPF Vol. 80 effective June 1, 2019 | 102 | 2019-Jun-03 | Word PDF |
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