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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
NLPDP Benefit Status Effective March 1, 2020282020-Feb-20Word PDF
NIDPF Vol. 81 Supplement Effective March 1, 2020 - Refer to Bulletin #28 for Benefit Status272020-Feb-20Word PDF
New Addition: SPINRAZA 2.4MG/ML INTRATHECAL SOLUTION262020-Feb-14Word PDF
New Addition: Repatha 140 MG/ML PREFILLED AUTOINJECTOR, 120mg/ml AUTOMATED MINI-DOSER WITH PREFILLED252020-Feb-14Word PDF
Short-Stock - Telmisartan 40mg 242020-Feb-11Word PDF
Short-Stock - Fulvestrant 50 mg/ml232020-Feb-11Word PDF
Update: Short-Stock - Acetaminophen Compound with Codeine 30 mg222020-Feb-07Word PDF
Update: Short-Stock - Verapamil SR 120 mg212020-Feb-07Word PDF
Update: Short-Stock - Valsartan 80 mg202020-Feb-07Word PDF
Update: Short-Stock - Valsartan 160 mg192020-Feb-07Word PDF
Benefit Status Change - Effective February 1, 2020182020-Feb-05Word PDF
Delistings from NLPDP Benefit List Effective March 1, 2020172020-Feb-04Word PDF
De-prescribing Expansion to Phase 2162020-Jan-31Word PDF
Online version of NIDPF Vol. 81 effective February 1, 2020152020-Jan-31Word PDF
NLPDP Benefit Status Effective February1, 2020142020-Jan-28Word PDF
NIDPF Vol. 81 Supplement Effective February 1, 2020- Refer to Bulletin #14 for Benefit Status132020-Jan-28Word PDF
Short Stock - Acetaminophen Compound with Codeine 30 mg122020-Jan-28Word PDF
Update: Short Stock - Repaglinide 1 mg 112020-Jan-24Word PDF
Update: Short Stock - Norethindrone 0.35mg102020-Jan-24Word PDF
RE: State of Emergency in effect for Monday, January 20, 202092020-Jan-20Word PDF
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Document Name: Date Range: To


Document NameDateView
Coverage Status Table - February 20202020-Feb-14 PDF
Coverage Status Table - January 20202020-Jan-09 PDF
Coverage Status Table - December 20192019-Dec-20 PDF
Coverage Status Table - November 20192019-Nov-22 PDF
Coverage Status Table - October 20192019-Oct-25 PDF
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
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Document Name: Date Range: To


Document NameDateView
Diabetic Listing - October, 2019 (Refer to Bulletin #206 posted on October 29, 2019)2019-Oct-30Word PDF
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
 
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
New Addition: SPINRAZA 2.4MG/ML INTRATHECAL SOLUTION262020-Feb-14Word PDF
New Addition: Repatha 140 MG/ML PREFILLED AUTOINJECTOR, 120mg/ml AUTOMATED MINI-DOSER WITH PREFILLED252020-Feb-14Word PDF
Benefit List Update: New Addition: Trelegy Ellipta 100 mcg-62.5 mcg-25 mcg22020-Jan-03Word PDF
Benefit List Update: New Addition: MAVIRET 100 MG-40 MG TABLET2342019-Dec-18Word PDF
Benefit List Update: Special Authorization: New Addition: ACCEL-SEVELAMER 800mg2312019-Dec-10Word PDF
Benefit List Update: KEVZARA 150mg and 200mg , 1.14ml prefilled syringe and pen2292019-Dec-04Word PDF
Benefit List Update: Probuphine 80mg Implant2282019-Dec-04Word PDF
New Din Addition: Special Authorization_Ozempic2242019-Nov-27Word PDF
Benefit List Update: New Addition Juluca 50mg/25mg2052019-Oct-29Word PDF
Benefit List Update: New Addition: Biktarvy 50mg/200mg/25mg2002019-Oct-24Word PDF
Benefit list updates_New additions_FULVESTRANT 250MG/5ML SYRINGE1982019-Oct-22Word PDF
Benefit List Update: New Addition: Synjardy and Jardiance 1972019-Oct-22Word PDF
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
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
Short-Stock - Telmisartan 40mg 242020-Feb-11Word PDF
Update: Short-Stock - Acetaminophen Compound with Codeine 30 mg222020-Feb-07Word PDF
Update: Short-Stock - Verapamil SR 120 mg212020-Feb-07Word PDF
Update: Short-Stock - Valsartan 80 mg202020-Feb-07Word PDF
Update: Short-Stock - Valsartan 160 mg192020-Feb-07Word PDF
Short Stock - Acetaminophen Compound with Codeine 30 mg122020-Jan-28Word PDF
Update: Short Stock - Repaglinide 1 mg 112020-Jan-24Word PDF
Update: Short Stock - Norethindrone 0.35mg102020-Jan-24Word PDF
Short Stock - Dorzolamide Timolol 20mg/5mg/ml 72020-Jan-13Word PDF
Short Stock -Timolol Maleate 0.5 percent Ophth Solution62020-Jan-10Word PDF
Short Stock - Losartan Potassium 100mg52020-Jan-09Word PDF
Short Stock - Candesartan 32mg42020-Jan-08Word PDF
Short Stock - Verapamil SR 120 mg12020-Jan-02Word PDF
Short Stock - Candesartan Cilexetil/Hydrochlorothiazide 32mg/25mg2422019-Dec-30Word PDF
Update: Short-Stock - Carbamazepine 200 mg2412019-Dec-27Word PDF
Update: Short-Stock - Olmesartan/Hydrochlorothiazide 40mg/12.5mg 2392019-Dec-27Word PDF
Short Stock - Butalbital/Codeine Phosphate/Acetylasalicylic Acid/Caffeine C1/22382019-Dec-23Word PDF
Short-Stock - Butalbital/Codeine Phosphate/Acetylasalicylic Acid/Caffeine C1/42332019-Dec-18Word PDF
Short Stock - Repaglinide 1 mg 2322019-Dec-13Word PDF
Update: Short-Stock - Buprenorphine/Naloxone 2mg/0.5mg 2302019-Dec-06Word PDF
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Document Name: Bulletin #: Date Range: To


Document NameBulletin NumberDateView
NLPDP Benefit Status Effective March 1, 2020282020-Feb-20Word PDF
NIDPF Vol. 81 Supplement Effective March 1, 2020 - Refer to Bulletin #28 for Benefit Status272020-Feb-20Word PDF
Short-Stock - Fulvestrant 50 mg/ml232020-Feb-11Word PDF
Online version of NIDPF Vol. 81 effective February 1, 2020152020-Jan-31Word PDF
NLPDP Benefit Status Effective February1, 2020142020-Jan-28Word PDF
NIDPF Vol. 81 Supplement Effective February 1, 2020- Refer to Bulletin #14 for Benefit Status132020-Jan-28Word PDF
Online version of NIDPF Vol. 81 effective January 1, 20202432019-Dec-31Word PDF
NLPDP Benefit Status Effective January 1, 20202372019-Dec-20Word PDF
NIDPF Vol. 81 Supplement Effective January 1, 2020- Refer to Bulletin #237 for Benefit Status2362019-Dec-20Word PDF
Online version of NIDPF Vol. 81 effective December 1, 20192252019-Nov-29Word PDF
NLPDP Benefit Status Effective December 1, 20192232019-Nov-27Word PDF
NIDPF Vol. 81 Supplement Effective December 1, 2019 - Refer to Bulletin #223 for Benefit Status2222019-Nov-27Word PDF
Teva-Fulvestrant Pricing Error2202019-Nov-20Word PDF
Change in Billing Format for Imiquimod 5 percent Cream2182019-Nov-13Word PDF
Online version of NIDPF Vol. 81 effective November 1, 20192092019-Nov-01Word PDF
NLPDP Benefit Status Effective November 1, 20192042019-Oct-29Word PDF
NIDPF Vol. 81 Supplement Effective November 1, 2019 - Refer to Bulletin #204 for Benefit Status2032019-Oct-29Word PDF
Online version of NIDPF Vol. 81 effective October 28, 20192022019-Oct-28Word PDF
NIDPF Vol. 81 Supplement Effective October 28, 2019 - Refer to Bulletin #198 for Benefit Status2012019-Oct-28Word PDF
UPDATE TO BULLETIN #193 Regarding Coverage of Teva-Varenicline Starter Kit 0.5 mg/1 mg1992019-Oct-23Word PDF
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Document Name: Date Range: To


Document NameDateView
2020 Payment Schedule2019-Dec-09Word PDF
2019 Payment Schedule2018-Dec-20Word PDF
NLPDP Application for Participation2018-Jun-18Word PDF
 
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