Pharmacy Help Desk: 1-877-209-1264, Provider PA Help Desk: 1-877-207-1126

PDL Archive Files

File Description Date
PDL Effective 10-12-11 126.47 KB 2011/09/23
PDL Effective 6-15-11 109.95 KB 2011/06/15
PDL Effective 5-25-11 111.23 KB 2011/05/23
PDL Effective 05-01-11 111.41 KB 2011/05/03
PDL Effective 04-01-11 111.51 KB 2011/04/13
PDL Effective 01-01-11 110.9 KB 2011/01/11
Anticipated PDL Effective 01-01-11 109.37 KB 2010/12/21
Additional Therapeutic Criteria 62.84 KB 2010/10/07
Additional Therapeutic Criteria 65.86 KB 2010/10/07
PDL Effective 10-01-10 102.27 KB 2010/10/01
Dosage Limit Chart (July 2010) 62.39 KB 2010/08/06
PDL Effective 06-01-10 90.5 KB 2010/06/11
PDL Effective 01-06-10 91.37 KB 2010/05/21
PDL Effective 04-01-10 90.17 KB 2010/05/21
PDL Effective 03-03-10 90.14 KB 2010/05/21
PDL Effective 12-02-09 60.81 KB 2009/11/24
PDL Effective (9-30-09) 60.96 KB 2009/10/16
PDL (effective 7-1-2009) 111.65 KB 2009/07/01
PDL (Effective 5-28-2009) 53.92 KB 2009/05/11