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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
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
Short Stock - Levonorgestrel / Ethinyl Estradiol 0.15mg/0.03mg1162019-Jun-21Word PDF
Short Stock - Clindamycin/Benzoyl Peroxide 1 Percent / 5 Percent w/w 1152019-Jun-20Word PDF
Short-Stock - Brimonidine Tartrate 0.15 Percent1142019-Jun-18Word PDF
Benefit Status Change - Effective May 1, 20191132019-Jun-17Word PDF
Application for Rural Subsidy1122019-Jun-17Word PDF
Update: Short Stock - Methylphenidate HCL 54 mg1112019-Jun-14Word PDF
Update: Short Stock - Methylphenidate HCL 18 mg1102019-Jun-14Word PDF
Short Stock - Hydrocortisone Acetate 0.5 percent / Zinc Sulfate 0.5 percent1092019-Jun-11Word PDF
Update: Short Stock - Bupropion 300mg1082019-Jun-07Word PDF
Short Stock -Varenicline 1 mg Tablet1072019-Jun-06Word PDF
Short Stock - Prednisolone Acetate 1 percent Ophthalmic1062019-Jun-04Word PDF
Changes to the Natural Product Number (NPN) of Nicoderm Step 1, 2 & 3 Patches 1052019-Jun-03Word 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
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Document Name: Date Range: To


Document NameDateView
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
Coverage Status Table - October 1, 20172017-Oct-13 PDF
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Document Name: Date Range: To


Document NameDateView
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 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
New Additions to existing category_Taltz for Psoriatic Arthritis272019-Feb-06Word PDF
New Benefit Addition: TRESIBA FLEX (INSULIN DEGLUDEC) 262019-Feb-06Word PDF
New Benefit Addition: ENSTILAR 50 MCG-0.5 MG/G FOAM (CALCIPOTRIOL/BETAMETHASONE)252019-Feb-06Word PDF
Benefit Status Update: New Drug Addition: ACTIKERALL 0.5 percent-10 percent SOLUTION_OPEN benefit1942018-Dec-21Word PDF
Benefit List Update: New Addition to an existing category: BASAGLAR KWIKPEN 100UNIT/ML (80 UNITS PER1902018-Dec-19Word PDF
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Short Stock - Levonorgestrel / Ethinyl Estradiol 0.15mg/0.03mg1162019-Jun-21Word PDF
Short Stock - Clindamycin/Benzoyl Peroxide 1 Percent / 5 Percent w/w 1152019-Jun-20Word PDF
Short-Stock - Brimonidine Tartrate 0.15 Percent1142019-Jun-18Word PDF
Update: Short Stock - Methylphenidate HCL 54 mg1112019-Jun-14Word PDF
Update: Short Stock - Methylphenidate HCL 18 mg1102019-Jun-14Word PDF
Short Stock - Hydrocortisone Acetate 0.5 percent / Zinc Sulfate 0.5 percent1092019-Jun-11Word PDF
Update: Short Stock - Bupropion 300mg1082019-Jun-07Word PDF
Short Stock -Varenicline 1 mg Tablet1072019-Jun-06Word PDF
Short Stock - Prednisolone Acetate 1 percent Ophthalmic1062019-Jun-04Word PDF
Short Stock -Varenicline 0.5 mg1012019-May-29Word PDF
Update: Short Stock - Norgestimate/Ethinyl Estradiol (28 Day)972019-May-24Word PDF
Update: Short Stock- Carbamazepine 200 mg962019-May-24Word PDF
Update: Short Stock - Quinapril 20mg952019-May-24Word PDF
Update: Short Stock - Quinapril 5mg942019-May-24Word PDF
Update: Short Stock-Quinapril 10mg932019-May-24Word PDF
Update: Short-Stock - Quinapril 40mg 922019-May-24Word PDF
Short Stock -Varenicline 0.5 mg and 1 mg Kit912019-May-23Word PDF
Short Stock - Norgestimate/Ethinyl Estradiol (21 & 28 Day)892019-May-15Word PDF
Update: Short Stock - Bupropion 150mg862019-May-10Word PDF
Update: Short Stock - Desogestrel/Ethinyl Estradiol 0.15mg/0.03mg852019-May-10Word PDF
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
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
Delistings from NIDPF and NLPDP Benefit List Effective June 1, 2019622019-Apr-04Word PDF
Re: Coverage Status of NovAmoxin 250 mg and 500 mg Capsules612019-Apr-03Word PDF
Online version of NIDPF Vol. 80 effective April 1, 2019592019-Apr-01Word PDF
NLPDP Benefit Status Effective April 1, 2019552019-Mar-20Word 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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