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Pharmacy
User: Visitor March 10, 2010
Pharmacy Images
Provider Help Desk: (p) 888-420-9711 (f) 800-408-1088 | Member Help Desk: (p) 866-796-2463 (f) 207-287-8601
Prior Authorization (PA) Helpdesk (for Provider PA inquiries): (p) 888-445-0497 (f) 888-879-6938

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General Pharmacy Info

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Name Description Date
MaineCare MAC List Effective 02.26.2010 MaineCare MAC List Effective 02.26.2010 92 kB   2010/02/26
MaineCare MAC List Effective 01.29.2010 MaineCare MAC List Effective 01.29.2010 91 kB   2010/01/22
MaineCare MAC List Effective 12.25.2009 MaineCare MAC List Effective 12.25.2009 94 kB   2010/01/06
MaineCare MAC List Effective 11.28.2009 MaineCare MAC List Effective 11.28.2009 91 kB   2010/01/06
Provider Newsletter - Synagis Provider Newsletter - Synagis 82 kB   2009/10/26
MaineCare MAC List Effective 10.23.2009 MaineCare MAC List Effective 10.23.2009 218 kB   2010/01/06
Pharmacy Listing by Name (09/04/09) Pharmacy Listing by Name (09/04/09) 784 kB   2009/09/21
Pharmacy Listing by NPI Number (09/04/09) Pharmacy Listing by NPI Number (09/04/09) 779 kB   2009/09/21
MaineCare MAC List Effective 09.25.2009 MaineCare MAC List Effective 09.25.2009 85 kB   2010/01/06
MaineCare MAC List Effective 08.28.2009 MaineCare MAC List Effective 08.28.2009 169 kB   2010/01/06
MaineCare MAC List Effective 07.24.2009 MaineCare MAC List Effective 07.24.2009 169 kB   2010/01/06
MaineCare MAC List Effective 6.26.2009 MaineCare MAC List Effective 6.26.2009 399 kB   2010/01/06
MaineCare MAC List Effective 05.30.2009 MaineCare MAC List Effective 05.30.2009 692 kB   2010/01/06
MaineCare MAC List Effective 04.24.2009 MaineCare MAC List Effective 04.24.2009 383 kB   2010/01/06
MaineCare MAC List Effective 03.28.2009 MaineCare MAC List Effective 03.28.2009 378 kB   2010/01/06
MaineCare MAC List Effective 02.27.2009 MaineCare MAC List Effective 02.27.2009 373 kB   2010/01/06
MaineCare MAC list Effective 01.30.2009 MaineCare MAC list Effective 01.30.2009 374 kB   2010/01/06
MaineCare MAC List Effective 01.23.2009 MaineCare MAC List Effective 01.23.2009 378 kB   2010/01/06
Pharmacy Listing by NPI Number Pharmacy Listing by NPI Number 98 kB   2008/12/29
Pharmacy Listing by NABP Number Pharmacy Listing by NABP Number 984 kB   2008/12/29
Pharmacy Listiing by Name Pharmacy Listiing by Name 93 kB   2008/12/29
MaineCare MAC List Effective 12.27.2008 MaineCare MAC List Effective 12.27.2008 365 kB   2010/01/06
MaineCare MAC List Effective 11.29.2008 MaineCare MAC List Effective 11.29.2008 361 kB   2010/01/06
MaineCare MAC List Effective 10.24.2008 MaineCare MAC List Effective 10.24.2008 359 kB   2010/01/06
MaineCare MAC List Effective 09.26.2008 MaineCare MAC List Effective 09.26.2008 356 kB   2010/01/06
MaineCare MAC List Effective 08.29.2008 MaineCare MAC List Effective 08.29.2008 288 kB   2010/01/06
MaineCare MAC List Effective 07.24.2008 MaineCare MAC List Effective 07.24.2008 348 kB   2010/01/06
MaineCare MAC List Effective 06.26.2008 MaineCare MAC List Effective 06.26.2008 347 kB   2010/01/06
MaineCare MAC List Effective 05.22.2008 MaineCare MAC List Effective 05.22.2008 344 kB   2010/01/06
MaineCare MAC List Effective 04.24.2008 MaineCare MAC List Effective 04.24.2008 341 kB   2010/01/06
MaineCare MAC List Effective 03.27.2008 MaineCare MAC List Effective 03.27.2008 341 kB   2010/01/06
MaineCare MAC List Effective 3.20.2008 MaineCare MAC List Effective 3.20.2008 327 kB   2010/01/06
MaineCare MAC List Effective 03.13.2008 MaineCare MAC List Effective 03.13.2008 305 kB   2010/01/06
MaineCare MAC List Effective 02.28.2008 MaineCare MAC List Effective 02.28.2008 274 kB   2010/01/06
MaineCare MAC List Effective 01.24.2008 MaineCare MAC List Effective 01.24.2008 533 kB   2010/01/06
MaineCare MAC List Effective 12.28.2007 MaineCare MAC List Effective 12.28.2007 560 kB   2010/01/06
untitled untitled 296 B   2009/11/05
MaineCare MAC List Effective 10.25.2007 MaineCare MAC List Effective 10.25.2007 255 kB   2010/01/06
MaineCare MAC List Effective 09.27.2007 MaineCare MAC List Effective 09.27.2007 256 kB   2010/01/06
MaineCare Mac List Effective 8.24.2007 MaineCare Mac List Effective 8.24.2007 238 kB   2010/01/06
MaineCare MAC List Effective 08.02.2007 MaineCare MAC List Effective 08.02.2007 237 kB   2010/01/06
MaineCare MAC List Effective 06.28.2007 MaineCare MAC List Effective 06.28.2007 234 kB   2010/01/06
MaineCare MAC List Effective 05.24.2007 MaineCare MAC List Effective 05.24.2007 224 kB   2010/01/06
MaineCare MAC List Effective 04.26.2007 MaineCare MAC List Effective 04.26.2007 231 kB   2010/01/06
NPI Memo April 17, 2007 NPI Memo April 17, 2007 27 kB   2007/04/17
MaineCare MAC List Effective 03.22.2007 MaineCare MAC List Effective 03.22.2007 227 kB   2010/01/06
MaineCare MAC List Effective 02.23.2007 MaineCare MAC List Effective 02.23.2007 217 kB   2010/01/06
Instructions for Submitting Claims for Unassigned Duals & MEPARTD Wrap Processing Instructions for Submitting Claims for Unassigned Duals & MEPARTD Wrap Processing 55 kB   2006/10/25
Enhancement to the MaineCare Safety Net for Unassigned Duals Enhancement to the MaineCare Safety Net for Unassigned Duals 22 kB   2006/08/16
MEDEL MEPARTD Update MEDEL MEPARTD Update 400 kB   2006/08/16
Part D RAC Category chart PROVIDER VERSION Part D RAC Category chart PROVIDER VERSION 76 kB   2006/08/16
Medicare Part D Manual Claim Form Medicare Part D Manual Claim Form 314 kB   2008/10/20
Emergency Procedure for Part D issues Emergency Procedure for Part D issues 402 kB   2006/01/03
Medicare Part D PDP Contact Information (USA) Medicare Part D PDP Contact Information (USA) 159 kB   2005/12/30
Medicare Part D Q & A Medicare Part D Q & A 32 kB   2005/12/30
MaineCare: Medicare Part D Excluded Drugs MaineCare: Medicare Part D Excluded Drugs 26 kB   2005/12/15
Zoloft Splitting Table Zoloft Splitting Table 36 kB   2005/06/24
MaineCare Diabetic Supply List MaineCare Diabetic Supply List 41 kB   2007/03/28
Celexa/Citalopram Splitting Table - 05/2009 Celexa/Citalopram Splitting Table - 05/2009 69 kB   2009/05/18
DAW 8 List - 01/23/2004 DAW 8 List - 01/23/2004 31 kB   2005/04/19
Diabetic Supplies Information - 09/30/2003 Diabetic Supplies Information - 09/30/2003 53 kB   2005/04/19
Diag. SC Eligible Drug List - Current Diag. SC Eligible Drug List - Current 56 kB   2005/04/19
Lexapro Splitting Table - 08/27/2004 Lexapro Splitting Table - 08/27/2004 15 kB   2007/02/19
MaineCare Compound Claim Form MaineCare Compound Claim Form 284 kB   2008/10/20
MaineCare Covered Asthma Supplies List - 02/14/2004 MaineCare Covered Asthma Supplies List - 02/14/2004 61 kB   2005/04/19
MaineCare Diagnosis Codes - 01/09/2004 MaineCare Diagnosis Codes - 01/09/2004 38 kB   2005/04/19
MaineCare OTC MAC List - Effective 04/28/2005 MaineCare OTC MAC List - Effective 04/28/2005 399 B   2005/03/29
MaineCare PA Conversion Chart MaineCare PA Conversion Chart 54 kB   2005/04/19
MaineCare Physician's J-Code/NDC Crosswalk Report - 05/12/2004 MaineCare Physician's J-Code/NDC Crosswalk Report - 05/12/2004 19 kB   2005/04/19
MaineCare Restricted Direct Supply Drug List - 12/2004 MaineCare Restricted Direct Supply Drug List - 12/2004 19 kB   2005/04/19
MaineCare Reversal Form MaineCare Reversal Form 69 kB   2008/10/20
MaineCare Specialty Direct Supply Drug List - 9.27.2005 MaineCare Specialty Direct Supply Drug List - 9.27.2005 57 kB   2005/09/27
MaineCare Supplemental Request Form MaineCare Supplemental Request Form 287 kB   2008/10/21
Pharmaceutical Companies Contact List - 08/13/2004 Pharmaceutical Companies Contact List - 08/13/2004 465 kB   2005/04/19
MaineCare MAC List Effective 08.23.2007 MaineCare MAC List Effective 08.23.2007 237 kB   2009/06/26
For more documents, see archives page.

Memos and Mailings

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Name Description Date
PDL Changes Effective February 19, 2010 PDL Changes Effective February 19, 2010 82 kB   2010/02/19
Savella PDL Change Effective Immediately Savella PDL Change Effective Immediately 75 kB   2010/02/11
PDL Updates Effective 01/01/2010 (Fortical) PDL Updates Effective 01/01/2010 (Fortical) 52 kB   2010/01/04
Emergency Fee Changes Emergency Fee Changes 83 kB   2009/12/16
Pharmacy Benefit Update - Winter 2009 Pharmacy Benefit Update - Winter 2009 67 kB   2009/12/08
PDL Updates Effective 01/01/2010 PDL Updates Effective 01/01/2010 80 kB   2009/12/04
PDL updates Effective 10/23/09 PDL updates Effective 10/23/09 110 kB   2009/10/20
PDL Updates Effective 10/01/09 PDL Updates Effective 10/01/09 75 kB   2009/09/30
Pharmacy Benefit Update - Fall 2009 Pharmacy Benefit Update - Fall 2009 61 kB   2009/09/30
Initial Prescription Limits (Phase III) Initial Prescription Limits (Phase III) 76 kB   2009/09/25
Pharmacy Reimbursements with AWP Pricing Change Pharmacy Reimbursements with AWP Pricing Change 86 kB   2009/09/11
Initial Prescription Limits (Phase II) Initial Prescription Limits (Phase II) 76 kB   2009/09/04
Initial Prescription Limits Initial Prescription Limits 59 kB   2009/08/10
New GERD/Ulcer Drug Utilization Management Program New GERD/Ulcer Drug Utilization Management Program 61 kB   2009/07/17
PDL Changes Effective 07/10/09 PDL Changes Effective 07/10/09 77 kB   2009/07/09
Pharmacy Benefit Update - Spring 2009 Pharmacy Benefit Update - Spring 2009 69 kB   2009/06/03
PDL Changes Effective 06/05/09 PDL Changes Effective 06/05/09 74 kB   2009/07/14
PDL Changes Effective 05/08/09 PDL Changes Effective 05/08/09 78 kB   2009/05/07
PDL Changes Effective 04/03/09 PDL Changes Effective 04/03/09 58 kB   2009/04/30
PDL updates: Effective 02/19/2009 PDL updates: Effective 02/19/2009 59 kB   2009/02/16
Pharmacy Benefit Update - Fall 2008 Pharmacy Benefit Update - Fall 2008 1 MB   2008/12/29
PDL Changes Effective 01/01/09 PDL Changes Effective 01/01/09 127 kB   2008/12/22
PDL Changes Effective 12/09/08 PDL Changes Effective 12/09/08 57 kB   2008/12/16
PDL updates: Effective 10/31/2008 PDL updates: Effective 10/31/2008 58 kB   2008/10/24
PDL Updates Effective 09/11/08 PDL Updates Effective 09/11/08 28 kB   2008/09/25
PDL updates effective 07/03/08 PDL updates effective 07/03/08 58 kB   2008/09/23
Pharmacy Benefit Update - Spring 2008 Pharmacy Benefit Update - Spring 2008 1 MB   2008/04/29
PDL Changes Effective 05/01/08 PDL Changes Effective 05/01/08 30 kB   2008/09/26
PDL Updates Effective 04/17/2008 PDL Updates Effective 04/17/2008 58 kB   2008/04/14
PDL Changes Effective 01/03/2008 PDL Changes Effective 01/03/2008 30 kB   2007/12/27
Pharmacy Benefit Update Newsletter Fall 2007 Pharmacy Benefit Update Newsletter Fall 2007 2 MB   2007/12/27
Pharmacy Benefit Update -Summer 2007 Pharmacy Benefit Update -Summer 2007 2 MB   2007/11/01
Pharmacy MSP Conversion Letter Pharmacy MSP Conversion Letter 43 kB   2007/07/09
Pharmacy Co-Pay 6-07 Pharmacy Co-Pay 6-07 39 kB   2007/07/09
MSP Letter MSP Letter 28 kB   2007/07/09
I Care 5 + Chronic Meds (060507) I Care 5 + Chronic Meds (060507) 28 kB   2007/07/09
HCFA (J-Code) Rejection Process HCFA (J-Code) Rejection Process 57 kB   2007/07/09
Provider Letter - 4 Brand Limit Information Provider Letter - 4 Brand Limit Information 30 kB   2007/07/03
Pharmacy Benefit Update - Spring 2007 Pharmacy Benefit Update - Spring 2007 100 kB   2007/06/22
PDL Changes Effective 06/14/07 PDL Changes Effective 06/14/07 25 kB   2007/06/14
Miscellaneous PDL Changes Effective May 24, 2007 Miscellaneous PDL Changes Effective May 24, 2007 25 kB   2007/05/23
Oxycontin Changes and PDL updates effective 05/17/2007 Oxycontin Changes and PDL updates effective 05/17/2007 26 kB   2007/05/11
PDL-Changes-Effective-04.05.07.htm PDL-Changes-Effective-04.05.07.htm 3 kB   2007/05/09
Duragesic and fentanyl provider newsletter Duragesic and fentanyl provider newsletter 23 kB   2007/05/03
PDL Changes effective 04/19/2007 PDL Changes effective 04/19/2007 29 kB   2007/05/09
Pharmacy Benefit Update - Winter 2007 Pharmacy Benefit Update - Winter 2007 185 kB   2007/03/14
Pharmacy Benefit Update - Fall 2006 Pharmacy Benefit Update - Fall 2006 102 kB   2006/12/04
Pharmacy Benefit Update - Summer 2006 Pharmacy Benefit Update - Summer 2006 66 kB   2006/09/19
For more documents, see archives page.

Maine Rx Plus

(click column headers to sort)
Name Description Date
MaineRx Plus Pharmacy List by NABP MaineRx Plus Pharmacy List by NABP 136 kB   2010/03/05
MaineRx Plus Pharmacy List by NPI MaineRx Plus Pharmacy List by NPI 136 kB   2010/03/05
MaineRx Plus Pharmacy List by NAME MaineRx Plus Pharmacy List by NAME 136 kB   2010/03/05
For more documents, see archives page.

DEL Information

(click column headers to sort)
Name Description Date
MEDEL: Medicare Part D Excluded Drugs MEDEL: Medicare Part D Excluded Drugs 28 kB   2005/12/15
MEDEL OTC Drug List MEDEL OTC Drug List 46 kB   2005/08/30
MEDEL Supplemental Drug List MEDEL Supplemental Drug List 37 kB   2005/08/30
MEDEL Basic Drug List MEDEL Basic Drug List 83 kB   2005/08/30
Medicare Cost Avoidance Drug Listing Alphabetical - 05/12/2004 Medicare Cost Avoidance Drug Listing Alphabetical - 05/12/2004 138 kB   2005/04/19
Medicare Cost Avoidance Drug Listing by NDC - 05/12/2004 Medicare Cost Avoidance Drug Listing by NDC - 05/12/2004 136 kB   2005/04/19
Medicare Drug Benefit Comparison - 04/27/2004 Medicare Drug Benefit Comparison - 04/27/2004 35 kB   2005/04/19
Medicare Drug Discount Card Press Release - 04/27/2004 Medicare Drug Discount Card Press Release - 04/27/2004 24 kB   2005/04/19
Medicare/DEL Letter to Members - 04/27/2004 Medicare/DEL Letter to Members - 04/27/2004 357 kB   2005/04/19
MEDEL Catastrophic Cap Qualifying NDC Numbers - 03/28/2005 MEDEL Catastrophic Cap Qualifying NDC Numbers - 03/28/2005 1 MB   2005/03/29
MEDEL - Catastrophic Benefit Newsletter - 03/28/2005 MEDEL - Catastrophic Benefit Newsletter - 03/28/2005 22 kB   2005/03/29
For more documents, see archives page.