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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Update: Short Stock - Norgestimate/Ethinyl Estradiol (21 Day)1522019-Aug-23Word PDF
Short Stock - Budesonide AQ. N.S. 64mcg1512019-Aug-20Word PDF
Short Stock - Olmesartan 40mg1502019-Aug-16Word PDF
Benefit List Update_New Addition_OCALIVA 5MG, 10MG TABLETS1492019-Aug-16Word PDF
Update: Short Stock - Fenofibrate 160mg1482019-Aug-09Word PDF
Short-Stock - Cilazapril Monohydrate 5mg1472019-Aug-06Word PDF
Short Stock - Olmesartan/Hydrochlorothiazide 40mg/25mg 1462019-Aug-06Word PDF
Update: Short Stock- Olmesartan 20mg1452019-Aug-06Word PDF
Short Stock - Olmesartan 20mg 1442019-Aug-02Word PDF
Online version of NIDPF Vol. 80 effective August 1, 20191432019-Aug-01Word PDF
Benefit List Update_New Addition to Existing Category: Afinitor 2.5mg, 5mg, and 10mg tablets1422019-Jul-29Word PDF
Update: Short Stock - Levonorgestrel / Ethinyl Estradiol 0.15mg/0.03mg1412019-Jul-29Word PDF
NLPDP Benefit Status Effective August 1, 20191402019-Jul-26Word PDF
NIDPF Vol. 80 Supplement Effective August 1, 2019 - Refer to Bulletin #140 for Benefit Status1392019-Jul-26Word PDF
Benefit List Update_New Addition_ Akynzeo 300mg/0.5mg capsule1382019-Jul-19Word PDF
Benefit List Update_Criteria Update_Nucala 100mg vial1372019-Jul-19Word PDF
Benefit List Update_New Addition_Fasenra 30mg/ml syringe1362019-Jul-19Word PDF
Update: Short Stock - Methylphenidate HCL 27 mg1352019-Jul-19Word PDF
Update: Short Stock - Methylphenidate HCL 36 mg1342019-Jul-19Word PDF
Notice to Pharmacists Requesting Special Authorization as a Prescriber1332019-Jul-18Word PDF
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Document Name: Date Range: To


Document NameDateView
Coverage Status Table - July, 20192019-Jul-05 PDF
Coverage Status Table - June 20192019-Jun-18 PDF
Coverage Status Table - May 20192019-May-17 PDF
Coverage Status Table - April, 20192019-Apr-15 PDF
Coverage Status Table - March, 20192019-Mar-25 PDF
Coverage Status Table - February, 20192019-Feb-08 PDF
Coverage Status Table - January 20192019-Jan-24 PDF
Coverage Status Table - December 20182018-Dec-21 PDF
Coverage Status Table - November 20182018-Nov-23 PDF
Coverage Status Table - October 20182018-Nov-16 PDF
Coverage Status Table - September, 20182018-Sep-25 PDF
Coverage Status Table - August, 20182018-Aug-23 PDF
Coverage Status Table - July, 20182018-Jul-26 PDF
Coverage Status Table - June, 20182018-Jun-20 PDF
Coverage Status Table - April, 20182018-Apr-24 PDF
Coverage Status Table - March, 20182018-Mar-21 PDF
Coverage Status Table - February, 20182018-Feb-13 PDF
Coverage Status Table - January, 20182018-Jan-18 PDF
Coverage Status Table - December 1, 20172017-Dec-18 PDF
Coverage Status Table - November 1, 20172017-Nov-22 PDF
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Document NameDateView
Diabetic Listing - July, 2019 (Refer to Bulletin #132 posted on July 12, 2019)2019-Jul-12Word PDF
Diabetic Listing - March, 2019 (Refer to Bulletin #56 posted on March 22, 2019)2019-Mar-22Word PDF
Diabetic Listing - August 3, 2018 (Refer to Bulletin #116 posted on August 3, 2018)2018-Aug-03Word PDF
Diabetic Listing - November 10, 2017 (Refer to Bulletin #192 posted on November 10, 2017)2017-Nov-10Word PDF
Diabetic Listing - October 31, 2017 (Refer to Bulletin #189 posted on October 31, 2017)2017-Oct-31Word PDF
Diabetic Listing - September 22, 2017 (Refer to Bulletin #164 posted on September 22, 2017)2017-Sep-22Word PDF
 
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Benefit List Update_New Addition_OCALIVA 5MG, 10MG TABLETS1492019-Aug-16Word PDF
Benefit List Update_New Addition to Existing Category: Afinitor 2.5mg, 5mg, and 10mg tablets1422019-Jul-29Word PDF
Benefit List Update_New Addition_ Akynzeo 300mg/0.5mg capsule1382019-Jul-19Word PDF
Benefit List Update_Criteria Update_Nucala 100mg vial1372019-Jul-19Word PDF
Benefit List Update_New Addition_Fasenra 30mg/ml syringe1362019-Jul-19Word PDF
Benefit Status Changes882019-May-13Word PDF
Benefit Change Update: New Special Authorization Criteria872019-May-13Word PDF
Benefit List Update: New Addition: SILIQ (BRODALUMAB)832019-May-06Word PDF
Benefit List Update: New Addition: Lixiana (edoxaban)822019-May-06Word PDF
Benefit List Update: New Benefit Addition: REXULTI (BREXPIPRAZOLE)792019-May-01Word PDF
Benefit List Update: New indication: Erelzi_Psoriatic Arthritis762019-Apr-30Word PDF
Benefit List Update: Criteria Update-Hep B752019-Apr-30Word PDF
Benefit List Update: Delist Hepsera 10mg (& generics)742019-Apr-30Word PDF
Benefit List Updates: OPEN benefit Ezetimibe (Ezetrol 10mg732019-Apr-26Word PDF
Benefit Status Update: Delist April 1, 2019512019-Mar-14Word PDF
DELIST_Thyroid 30mg, 60mg & 120mg502019-Mar-14Word PDF
DELIST: Zovirax topical cream & ointment492019-Mar-14Word PDF
New DIN addition: QUINSAIR 240MG/2.4ML INHALATION SOLUTION442019-Mar-07Word PDF
New DIN addition: RAVICTI ORAL LIQUID 1.1G/ML432019-Mar-07Word PDF
Correction to Bulletin #25 issued on February 6, 2019312019-Feb-12Word PDF
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Update: Short Stock - Norgestimate/Ethinyl Estradiol (21 Day)1522019-Aug-23Word PDF
Short Stock - Budesonide AQ. N.S. 64mcg1512019-Aug-20Word PDF
Short Stock - Olmesartan 40mg1502019-Aug-16Word PDF
Update: Short Stock - Fenofibrate 160mg1482019-Aug-09Word PDF
Short-Stock - Cilazapril Monohydrate 5mg1472019-Aug-06Word PDF
Short Stock - Olmesartan/Hydrochlorothiazide 40mg/25mg 1462019-Aug-06Word PDF
Update: Short Stock- Olmesartan 20mg1452019-Aug-06Word PDF
Short Stock - Olmesartan 20mg 1442019-Aug-02Word PDF
Update: Short Stock - Levonorgestrel / Ethinyl Estradiol 0.15mg/0.03mg1412019-Jul-29Word PDF
Update: Short Stock - Methylphenidate HCL 27 mg1352019-Jul-19Word PDF
Update: Short Stock - Methylphenidate HCL 36 mg1342019-Jul-19Word PDF
Short-Stock - Fenofibrate 160mg1312019-Jul-12Word PDF
Short-Stock - Hydrocortisone Acetate 19mg/Zinc Sulfate 10mg1302019-Jul-10Word PDF
Update: Short Stock - Olmesartan 40mg1292019-Jul-05Word PDF
Update: Short Stock - Budesonide AQ. N.S. 64mcg1282019-Jul-05Word PDF
Update: Short Stock - Prednisolone Acetate 1 Percent Ophthalmic1262019-Jun-28Word PDF
Short-Stock - Metoprolol Tartrate 200mg SR1252019-Jun-28Word PDF
Update: Short Stock - Varenicline 1mg1242019-Jun-27Word PDF
Update: Short Stock - Varenicline 0.5mg1232019-Jun-27Word PDF
Update: Short Stock - Varenicline 0.5 mg and 1 mg Kit1222019-Jun-27Word PDF
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Online version of NIDPF Vol. 80 effective August 1, 20191432019-Aug-01Word PDF
NLPDP Benefit Status Effective August 1, 20191402019-Jul-26Word PDF
NIDPF Vol. 80 Supplement Effective August 1, 2019 - Refer to Bulletin #140 for Benefit Status1392019-Jul-26Word PDF
Online version of NIDPF Vol. 80 effective July 1, 20191272019-Jun-28Word PDF
Delisting from NIDPF and NLPDP Benefit List Effective July 1, 20191212019-Jun-25Word PDF
NLPDP Benefit Status Effective July 1, 20191202019-Jun-25Word PDF
NIDPF Vol. 80 Supplement Effective July 1, 2019 - Refer to Bulletin #120 for Benefit Status1192019-Jun-25Word PDF
Delistings from NIDPF and NLPDP Benefit List Effective July 1, 20191182019-Jun-25Word PDF
Delisting from NIDPF and NLPDP Benefit List Effective July 1, 20191172019-Jun-25Word PDF
Coverage Status of Teva-Gemfibrozil 600mg Tablets - DIN 021420741042019-Jun-03Word PDF
Delisting from NIDPF and NLPDP Benefit List Effective June 1, 20191032019-Jun-03Word PDF
Online version of NIDPF Vol. 80 effective June 1, 20191022019-Jun-03Word PDF
NLPDP Benefit Status Effective June 1, 20191002019-May-28Word PDF
NIDPF Vol. 80 Supplement Effective June 1, 2019 - Refer to Bulletin #100 for Benefit Status992019-May-28Word PDF
Delisting from NIDPF and NLPDP Benefit List Effective June 1, 2019982019-May-28Word PDF
Delisting from NIDPF and NLPDP Benefit List Effective June 1, 2019902019-May-15Word PDF
Online version of NIDPF Vol. 80 effective May 1, 2019782019-May-01Word PDF
NLPDP Benefit Status Effective May 1, 2019702019-Apr-24Word PDF
NIDPF Vol. 80 Supplement Effective May 1, 2019 - Refer to Bulletin #70 for Benefit Status692019-Apr-24Word PDF
Delistings from NIDPF and NLPDP Benefit List Effective May 1, 2019682019-Apr-24Word PDF
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Document Name: Date Range: To


Document NameDateView
2019 Payment Schedule2018-Dec-20Word PDF
NLPDP Application for Participation2018-Jun-18Word PDF
2018 Payment Schedule2017-Dec-12Word PDF
 
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