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OTC Lists & Information

The Wyoming Department of Health, Pharmacy Services will determine if OTC drugs are covered by Wyoming Medicaid. OTC drugs may be covered only if the drug is listed as rebatable on the quarterly (CMS) rebate file and the manufacturer has submitted all product data to Medispan. The product must have been assigned an NDC number and be ordered by a licensed prescribing practitioner. Please review specific plans in the Wyoming Medicaid Pharmacy Provider Manual for OTC coverage limitations and exclusions.

File Description Date
OTC Covered List 04/15/2023 609.13 KB 2023/04/28
OTC Covered List 02/15/2023 608.69 KB 2023/02/16
OTC Covered List 12/15/2022 615.12 KB 2022/12/23
OTC Covered List 11/15/2022 608.04 KB 2022/11/30
OTC Covered List 10/15/2022 608.02 KB 2022/10/26
OTC Covered List 9/15/2022 608.96 KB 2022/09/23
OTC Covered List 8/15/2022 608.87 KB 2022/08/17
OTC Covered List 7/15/2022 609.2 KB 2022/07/15
OTC Covered List 6/15/2022 609.03 KB 2022/06/17
OTC Covered List 5/15/2022 609.12 KB 2022/05/25
OTC Covered List 4/15/2022 609.5 KB 2022/04/19
OTC Covered List 3/15/2022 609.08 KB 2022/03/18
OTC Covered List 2/15/2022 609.27 KB 2022/02/22
OTC Covered List 12/15/2021 609.02 KB 2022/01/06
OTC Covered List 09/15/2021 609.37 KB 2021/10/04
OTC Covered List 08/15/2021 608.93 KB 2021/08/26
OTC Covered List 07/15/2021 609.1 KB 2021/07/15
OTC Covered List 06/15/2021 609.53 KB 2021/06/17
OTC Covered List 05/15/2021 609.09 KB 2021/05/18
OTC Covered List 04/15/2021 609.16 KB 2021/04/16
OTC Covered List 03/15/2021 609.18 KB 2021/03/17
OTC Covered List 02/15/2021 609.12 KB 2021/02/16
OTC Covered List 01/15/2021 609.17 KB 2021/01/20
OTC Covered List 12/15/2020 608.91 KB 2020/12/15
OTC Covered List 11/15/2020 608.18 KB 2020/11/18
OTC Covered List 10/15/2020 609.2 KB 2020/10/16
OTC Covered List 09/15/2020 609.28 KB 2020/09/15
OTC Covered List 08/15/2020 609.4 KB 2020/08/19
OTC Covered List 07/15/2020 609.51 KB 2020/07/16
OTC Covered List 06/15/2020 609.49 KB 2020/06/16
OTC Covered List 05/15/2020 609.31 KB 2020/05/21
OTC Covered List 04/15/2020 609.37 KB 2020/04/15
OTC Covered List 03/15/2020 609.4 KB 2020/03/16
OTC Covered List 02/15/2020 608.29 KB 2020/02/18
OTC Covered List 01/15/2020 615.94 KB 2020/01/16
OTC Covered List 12/15/2019 609.15 KB 2019/12/24
OTC Covered List 11/15/2019 609.08 KB 2019/11/20
OTC Covered List 10/15/2019 608.69 KB 2019/10/18
OTC Covered List 09/15/2019 609.28 KB 2019/09/17
OTC Covered List 08/15/2019 609.34 KB 2019/08/28
OTC Covered List 07/15/2019 608.29 KB 2019/07/15
OTC Covered List 06/15/2019 609.04 KB 2019/06/18
OTC Covered List 05/15/2019 609.04 KB 2019/05/16
OTC Covered List 04/15/2019 609.04 KB 2019/04/15
OTC Covered List 03/15/2019 608.79 KB 2019/03/15
OTC Covered List 02/15/2019 609.12 KB 2019/03/05
OTC Covered List 01/15/2019 608.85 KB 2019/01/15
OTC Covered List 12/15/2018 608.78 KB 2018/12/18
OTC Covered List 10/15/2018 608.46 KB 2018/10/15
OTC Covered List 9/15/2018 609 KB 2018/09/17
OTC Covered List 8/15/2018 608.09 KB 2018/08/27
OTC Covered List 7/15/2018 608.71 KB 2018/07/16
OTC Covered List 06/15/2018 608.95 KB 2018/06/15
OTC Covered List 05/15/2018 608.15 KB 2018/05/21
OTC Covered List 04/15/2018 608.21 KB 2018/04/18
OTC Covered List 03/15/2018 606.9 KB 2018/03/15
OTC Covered List 02/22/2018 613.94 KB 2018/02/26
OTC Covered List 12/15/2017 607.62 KB 2017/12/15
OTC Covered List 09/18/2017 608.07 KB 2017/09/18
OTC Covered List 07/15/17 256.27 KB 2017/07/18
OTC Covered List 05/20/17 255.25 KB 2017/05/22
OTC Covered List 04/15/17 255.14 KB 2017/04/18
OTC Covered List 02/20/17 257.69 KB 2017/02/21
OTC Covered List 01/15/17 255.43 KB 2017/01/17
OTC Covered List 11/03/16 209.66 KB 2016/11/23
OTC Covered List 10/15/16 252.65 KB 2016/10/17
OTC Covered List 8/20/16 236.85 KB 2016/08/25
OTC Covered List 7/15/16 234.82 KB 2016/07/18
OTC Covered List 5/20/16 234.71 KB 2016/05/23
OTC Covered List 4/15/16 234.93 KB 2016/04/18
OTC Covered List 2/20/16 236.06 KB 2016/02/22
OTC Covered List 1/15/16 173.12 KB 2016/01/18

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