Please select the desired PDL from the options provided below. Depending on the software you have installed on your computer, you will also need to select the appropriate format.
If you cannot view a file, please download the appropriate free plug-in: MS Word Viewer (.doc or .rtf), MS Excel Viewer (.xls), Acrobat Viewer (.pdf)
Additional PDL News & Info
- Diabetic Supply List- effective 7/31/2024
- Over the Counter Rebate List - effective 8/6/2024
- 15-Day Initial Fill List
- 90-Day Maintenance Drug List
- Cash Waiver Form