There is no substitute for safety when prescribing medication.
Get a current list of pharmacies in the network or find out which drugs are on the formulary:
You can also read or download the:
Important: The formulary and search do not apply to Medicare Advantage Plan members. If you are a Medicare Advantage provider, see the Medicare Advantage Plan formulary.
To request a prior authorization, step therapy, nonformulary, or quantity limit override, please call ESI at 1-888-256-6132, 24 hours a day, 7 days a week, and speak to a prior authorization service specialist. This specialist will review medical information and criteria with the provider or designee regarding the need for the requested drug. We are in the process of developing our comprehensive list of drugs that require a Prior Authorization. Please see the list of drugs that require a prior authorization for:
Medication Therapy Management
Coverage for Medication Therapy Management services is now available to Apple Health providers and members who meet certain eligibility requirements.
If you are a Medicare Advantage member, visit the Community HealthFirst website for information on Medicare HealthFirst Medication Therapy information.
- MTM Provider Credentialing Checklist
- MTM Provider and Member Requirements
- Sample MTM form (for assistance in guiding medication therapy review)
Pharmacy and Therapeutics (P&T) Committee
Our P&T Committee meets quarterly to evaluate our formulary, prior authorization requirements, and safety measures to ensure quality. Read the most recent decisions:
- November 11, 2016 P&T Decisions
- June 17, 2016 P&T Decisions
- March 11, 2016 P&T Decisions
- November 6, 2015 P&T Decisions
- June 26, 2015 P&T Decisions
Be sure to read the latest Drug Recalls Report for updates on medications that are recalled due to safety issues.