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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Short Stock - Olmesartan/Hydrochlorothiazide 40mg/25mg 1962019-Oct-18Word PDF
New Addition: Sandoz Levetiracetam 1000 MG TABLET1952019-Oct-18Word PDF
Short Stock - Buprenorphine/Naloxone 8mg/2mg1942019-Oct-18Word PDF
Error in Coverage Status for Teva-Varenicline Starter Kit 0.5 mg/1 mg tablets DIN 024267811932019-Oct-17Word PDF
Short Stock - Hydromorphone Controlled Release 9mg1922019-Oct-11Word PDF
Benefit List Update: New Addition_Ocrevus 300mg1912019-Oct-10Word PDF
Benefit list updates_New addition_ALECENSARO 150MG CAPSULES1902019-Oct-08Word PDF
Update: Short Stock - Buprenorphine/Naloxone 8mg/2mg1892019-Oct-08Word PDF
Short Stock - Valsartan 160 mg1882019-Oct-08Word PDF
Short Stock - Buprenorphine/Naloxone 8mg/2mg1872019-Oct-07Word PDF
Reimbursement of Public Flu Vaccinations under NLPDP for 2019 - 2020 Flu Season1862019-Oct-04Word PDF
Update: Short Stock - Benzoyl Peroxide, Clindamycin 5 percent / 1 percent1852019-Oct-04Word PDF
Short Stock: Olmesartan 20mg1842019-Oct-04Word PDF
Online version of NIDPF Vol. 81 effective October 1, 20191832019-Oct-01Word PDF
Short Stock: Norethindrone 0.35mg1822019-Oct-01Word PDF
Update: Short Stock: Imiquimod 5 percent1812019-Sep-27Word PDF
Update: Short Stock: Latanoprost/Timolol Maleate 50ug/ml / 5mg/ml1802019-Sep-27Word PDF
Update: Short Stock - Clindamycin/Benzoyl Peroxide 1 Percent / 5 Percent w/w 1792019-Sep-27Word PDF
Short Stock Benzoyl Peroxide, Clindamycin 5 Percent/ 1 Percent1782019-Sep-26Word PDF
Short Stock - Olmesartan/Hydrochlorothiazide 40mg/12.5mg1772019-Sep-26Word PDF
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Document Name: Date Range: To


Document NameDateView
Coverage Status Table - September 20192019-Sep-24 PDF
Coverage Status Table - August 20192019-Aug-27 PDF
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
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Document Name: Date Range: To


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
 
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
New Addition: Sandoz Levetiracetam 1000 MG TABLET1952019-Oct-18Word PDF
Benefit List Update: New Addition_Ocrevus 300mg1912019-Oct-10Word PDF
Benefit list updates_New addition_ALECENSARO 150MG CAPSULES1902019-Oct-08Word PDF
Benefit List Update_ New Addition: VENCLEXTA 10MG, 50MG, 100MG TABLETS, AND STARTER PACK1702019-Sep-13Word PDF
Benefit List Update_New Add: LYNPARZA 100, 150 MG & New Add to existing Cat: JAKAVI 5,10,15, 20 MG1632019-Sep-03Word PDF
Benefit List Update_ New Addition: HEMANGIOL 3.75 MG/ML SOLUTION1582019-Aug-27Word PDF
Benefit List Update_Humira for Hidradenitis suppurative (HS)1572019-Aug-27Word PDF
Benefit List Update_COPD Criteria Update1562019-Aug-27Word PDF
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
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Short Stock - Olmesartan/Hydrochlorothiazide 40mg/25mg 1962019-Oct-18Word PDF
Short Stock - Buprenorphine/Naloxone 8mg/2mg1942019-Oct-18Word PDF
Short Stock - Hydromorphone Controlled Release 9mg1922019-Oct-11Word PDF
Update: Short Stock - Buprenorphine/Naloxone 8mg/2mg1892019-Oct-08Word PDF
Short Stock - Valsartan 160 mg1882019-Oct-08Word PDF
Short Stock - Buprenorphine/Naloxone 8mg/2mg1872019-Oct-07Word PDF
Update: Short Stock - Benzoyl Peroxide, Clindamycin 5 percent / 1 percent1852019-Oct-04Word PDF
Short Stock: Olmesartan 20mg1842019-Oct-04Word PDF
Short Stock: Norethindrone 0.35mg1822019-Oct-01Word PDF
Update: Short Stock: Imiquimod 5 percent1812019-Sep-27Word PDF
Update: Short Stock: Latanoprost/Timolol Maleate 50ug/ml / 5mg/ml1802019-Sep-27Word PDF
Update: Short Stock - Clindamycin/Benzoyl Peroxide 1 Percent / 5 Percent w/w 1792019-Sep-27Word PDF
Short Stock-Benzoyl Peroxide, Clindamycin 5 Percent/ 1 Percent1782019-Sep-26Word PDF
Short Stock - Olmesartan/Hydrochlorothiazide 40mg/12.5mg1772019-Sep-26Word PDF
Short Stock - Quinapril/Hydrochlorothiazide 20mg/12.5mg1742019-Sep-23Word PDF
Short Stock - Losartan Potassium 25mg, 50mg & 100mg1732019-Sep-23Word PDF
Short Stock - Losartan Potassium Hydrochlorothiazide 100mg/12.5mg1722019-Sep-20Word PDF
Short Stock - Dabigatran 110mg1712019-Sep-17Word PDF
Update: Short Stock - Pinaverium 100mg1682019-Sep-13Word PDF
Update: Short Stock - Pinaverium 50mg1672019-Sep-06Word PDF
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Error in Coverage Status for Teva-Varenicline Starter Kit 0.5 mg/1 mg tablets DIN 024267811932019-Oct-17Word PDF
Online version of NIDPF Vol. 81 effective October 1, 20191832019-Oct-01Word PDF
NLPDP Benefit Status Effective October 1, 20191762019-Sep-25Word PDF
NIDPF Vol. 81 Supplement Effective October 1, 2019 - Refer to Bulletin #176 for Benefit Status1752019-Sep-25Word PDF
Delisting from NIDPF and NLPDP Benefit List Effective October 1, 20191692019-Sep-13Word PDF
Online version of NIDPF Vol. 80 effective September 1, 20191622019-Aug-30Word PDF
NLPDP Benefit Status Effective September 1, 20191552019-Aug-26Word PDF
NIDPF Vol. 80 Supplement Effective September 1, 2019 - Refer to Bulletin #155 for Benefit Status1542019-Aug-26Word PDF
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
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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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