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Drug Formularies

Pharmacy Benefit Information

Individual and Small Group Formulary
Individual and Small Group - *Quick Reference List
Large Group Formulary
Large Group - *Quick Reference List
Drug Prior Authorization List
Drug Exception to Coverage Request
Maintenance Drug List

*Quick Reference List (QRL) is a list of the 200 most commonly filled prescriptions and not a complete listing. For a complete listing, please refer to the formulary.

Drug Formularies

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