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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Memo Paxlovid Health Care Providers92022-Jan-21Word PDF
Reimbursement COVID vaccinations - Increased Special Services Fee - January 20, 202282022-Jan-21Word PDF
Benefit List Updates_New Addition_Zejula 100mg72022-Jan-19Word PDF
Short Stock-Darifenacin 7.5mg 62022-Jan-17Word PDF
Benefit List update: Dupixent52022-Jan-17Word PDF
Diabetic PINS - Accu-Chek Compact and Accu-Chek Aviva Test Strips42022-Jan-13Word PDF
Short Stock - Ciprofloxacin/Dexamethasone 0.3 Percent w/v/0.1 Percent w/v32022-Jan-11Word PDF
Ascensia Contour Test Strips - Pkg Sizes 50 & 10022022-Jan-10Word PDF
Short-Stock: Pirfenidone 267mg & Pirfenidone 801mg Tablet12022-Jan-07Word PDF
Online version of NIDPF Vol. 85 effective January 1, 20222012021-Dec-30Word PDF
Benefit List update: NYVEPRIA 6 MG/0.6 ML2002021-Dec-29Word PDF
New additions to an existing category: XELJANZ 5 mg, 10mg TABLETS for ulcerative colitis1992021-Dec-29Word PDF
Benefit List update: Monoferric 100mg/ml1982021-Dec-29Word PDF
NLPDP Benefit Status Effective January 1, 20221972021-Dec-23Word PDF
NIDPF Vol. 85 Supplement Effective January 1, 2022 - Refer to Bulletin #197 for Benefit Status1962021-Dec-23Word PDF
Delisting from NIDPF and NLPDP Benefit List Effective January 1, 20221952021-Dec-23Word PDF
NIDPF Delisting Apo-Rizatriptan 5mg1942021-Dec-15Word PDF
COVID-19 Vaccine Booster Doses1932021-Dec-15Word PDF
Short-Stock - Carbamazepine 100mg/5ml1922021-Dec-13Word PDF
Benefit List Update_Status Change_Aripiprazole tablets1912021-Dec-10Word PDF
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Document Name: Date Range: To


Document NameDateView
Coverage Status Table - January 20222022-Jan-25 PDF
Coverage Status Table - December 20212021-Dec-10 PDF
Coverage Status Table - November 20212021-Nov-05 PDF
Coverage Status Table - September 20212021-Sep-02 PDF
Coverage Status Table - July 20212021-Jul-22 PDF
Coverage Status Table - June 20212021-Jun-24 PDF
Coverage Status Table - May 20212021-May-19 PDF
Coverage Status Table - April 20212021-Apr-23 PDF
Coverage Status Table - March 20212021-Mar-22 PDF
Coverage Status Table - February 20212021-Feb-11 PDF
Coverage Status Table - January 20212021-Jan-21 PDF
Coverage Status Table - December 20202020-Dec-10 PDF
Coverage Status Table - November 20202020-Nov-19 PDF
Coverage Status Table - October 20202020-Oct-16 PDF
Coverage Status Table - September 20202020-Sep-22 PDF
Coverage Status Table - August 20202020-Aug-24 PDF
Coverage Status Table - July 20202020-Jul-22 PDF
Coverage Status Table - June 20202020-Jun-25 PDF
Coverage Status Table - May 20202020-May-22 PDF
Coverage Status Table - April 20202020-Apr-24 PDF
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Document NameDateView
Diabetic Listing - January 13, 2022 (Refer to Bulletin #4 posted on January 13, 2022)2022-Jan-13Word PDF
Diabetic Listing - January 10, 2022 (Refer to Bulletin #2 posted on January 10, 2022)2022-Jan-10Word PDF
Diabetic Listing - January 12, 2021 (Refer to Bulletin #9 posted on January 12, 2021)2021-Jan-12Word PDF
Diabetic Listing - May, 2020(Refer to Bulletin #77 posted on May 1, 2020)2020-May-04Word PDF
 
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Benefit List Updates_New Addition_Zejula 100mg72022-Jan-19Word PDF
Benefit List update: Dupixent52022-Jan-17Word PDF
Benefit List update: NYVEPRIA 6 MG/0.6 ML2002021-Dec-29Word PDF
New additions to an existing category: XELJANZ 5 mg, 10mg TABLETS for ulcerative colitis1992021-Dec-29Word PDF
Benefit List update: Monoferric 100mg/ml1982021-Dec-29Word PDF
Benefit List Update: New Additions: NEXPLANON 1892021-Dec-07Word PDF
Benefit List Updates_New Addition_Caprelsa 100mg and 300mg1882021-Dec-06Word PDF
Benefit List Updates_New Criteria_Xtandi 40mg1862021-Dec-01Word PDF
Benefit List Updates_New Addition_Xospata 40mg 1852021-Dec-01Word PDF
Benefit List Update_Criteria Update_Febuxostat 80mg tablets1822021-Nov-24Word PDF
Benefit List Update: New Additions to an Existing Category: Kalydeco1782021-Nov-22Word PDF
Benefit List Update: New Addition: Trikafta1742021-Nov-19Word PDF
Benefit List Update: New Addition: REVESTIVE 5MG/VIAL KIT1682021-Oct-27Word PDF
Benefit List Update: New Addition: ONPATTRO 1672021-Oct-27Word PDF
Benefit list update: New Addition: OPEN benefit: Escitalopram 15mg tab1662021-Oct-27Word PDF
Benefit list update: Benefit status change: Ditropan XL 5mg, 10mg1622021-Oct-18Word PDF
Benefit list updates_New Addition_JAMP Prasugrel 10mg Tablets1572021-Oct-06Word PDF
Benefit list updates_New Additions to Existing Category_BRILINTA 90mg Tablets1562021-Oct-06Word PDF
Benefit List Update: New Addition: NOROMBY PREFILLED SYRINGE1522021-Sep-27Word PDF
Benefit List Update: New addition_OPEN benefit: Suboxone Film1462021-Sep-20Word PDF
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Short Stock-Darifenacin 7.5mg 62022-Jan-17Word PDF
Short Stock - Ciprofloxacin/Dexamethasone 0.3 Percent w/v/0.1 Percent w/v32022-Jan-11Word PDF
Short-Stock: Pirfenidone 267mg & Pirfenidone 801mg Tablet12022-Jan-07Word PDF
Short-Stock - Carbamazepine 100mg/5ml1922021-Dec-13Word PDF
Short-Stock: Dabigatran 110mg1772021-Nov-22Word PDF
Short-Stock: Dabigatran 150mg1762021-Nov-22Word PDF
Update: Short-Stock - Morphine Sulfate SR 15 mg1732021-Nov-19Word PDF
Update: Short-Stock - Brimonidine Tartrate 0.15 Percent1702021-Oct-29Word PDF
Short-Stock: Morphine Sulfate SR 15 mg1692021-Oct-29Word PDF
Update: Short-Stock: Clindamycin/Benzoyl Peroxide 1 Percent / 5 Percent w/w1652021-Oct-26Word PDF
Short Stock - Losartan Potassium 25mg1612021-Oct-15Word PDF
Update: Short-Stock: Timolol Maleate 0.5 percent Ophth Solution1592021-Oct-12Word PDF
Short-Stock: Losartan Potassium 50mg1582021-Oct-08Word PDF
Short Stock: Clindamycin/Benzoyl Peroxide 1 Percent / 5 Percent w/w1532021-Sep-28Word PDF
Update: Short-Stock: Methylphenidate HCL 27 mg1512021-Sep-23Word PDF
Update: Short-Stock: Methylphenidate HCL 18 mg1502021-Sep-23Word PDF
Short Stock - Losartan Potassium 100mg1452021-Sep-16Word PDF
Short-Stock: Methylphenidate HCL 27 mg1352021-Aug-16Word PDF
Update: Short-Stock: Budesonide 0.5mg/ml1322021-Jul-30Word PDF
Short-Stock: Budesonide 0.5mg/ml1262021-Jul-15Word PDF
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Online version of NIDPF Vol. 85 effective January 1, 20222012021-Dec-30Word PDF
NLPDP Benefit Status Effective January 1, 20221972021-Dec-23Word PDF
NIDPF Vol. 85 Supplement Effective January 1, 2022 - Refer to Bulletin #197 for Benefit Status1962021-Dec-23Word PDF
Delisting from NIDPF and NLPDP Benefit List Effective January 1, 20221952021-Dec-23Word PDF
NIDPF Delisting Apo-Rizatriptan 5mg1942021-Dec-15Word PDF
Online version of NIDPF Vol. 85 effective December 1, 20211832021-Dec-01Word PDF
NLPDP Benefit Status Effective December 1, 20211812021-Nov-23Word PDF
NIDPF Vol. 85 Supplement Effective December 1, 2021 - Refer to Bulletin #181 for Benefit Status1802021-Nov-23Word PDF
Online version of NIDPF Vol. 85 effective November 1, 20211712021-Nov-01Word PDF
NLPDP Benefit Status Effective November 1, 20211642021-Oct-25Word PDF
NIDPF Vol. 85 Supplement Effective November 1, 2021 - Refer to Bulletin #164 for Benefit Status1632021-Oct-25Word PDF
Coverage Status of Rizatriptan 5mg Tablets1552021-Oct-05Word PDF
Online version of NIDPF Vol. 85 effective Octoberr 1, 20211542021-Oct-01Word PDF
Updated - NLPDP Benefit Status Effective October 1, 20211492021-Sep-23Word PDF
NLPDP Benefit Status Effective October 1, 20211482021-Sep-22Word PDF
NIDPF Vol. 85 Supplement Effective October 1, 2021 - Refer to Bulletin #149 for Benefit Status1472021-Sep-22Word PDF
Delisting from NIDPF and NLPDP Benefit List Effective October 1, 20211422021-Sep-09Word PDF
Online version of NIDPF Vol. 84 effective September 1, 20211402021-Sep-01Word PDF
NLPDP Benefit Status Effective September 1, 20211392021-Aug-26Word PDF
NIDPF Vol. 84 Supplement Effective September 1, 2021 - Refer to Bulletin #139 for Benefit Status1382021-Aug-26Word PDF
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Document NameDateView
2022 - Payment Schedule2021-Dec-06Word PDF
2021 - Payment Schedule2020-Dec-17Word PDF
 
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