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HMSA's Essential Drug Formulary and Coverage Codes

HMSA Formulary †, * 

 

To view the current drug formulary, please click the links below:

 

HMSA's Essential Drug Formulary (Comprehensive) - October 1, 2018

 

HMSA's Essential Drug Formulary (Abridged) - October 1, 2018

 

Essential Formulary Coverage Codes

120

317

332

401

402

405

406

407

408

409

413

483

503

504

511

512

515

518

519

558

559

583

584

637

638

639

664

665

782

793

795

797

798

799

801

802

815

816

827

847

848

860

861

862

863

864

865

866

873

874

948

949

950

951

955

956

957

958

959

964

965

966

967

968

972

973

974

975

976

977

978

979

980

981

993

994

00F

 

 

 

 

Brand drugs not listed in the formulary should be considered OTHER BRAND.

 

* The online HMSA Drug Formulary is updated quarterly. Providers may request a CD version of the formulary by contacting HMSA Provider Services.

 

 

 

 

 

To view previous versions of the formulary that are now expired and archived, please click on the links below:

 

HMSA's Essential Drug Formulary (Comprehensive) - July 2018 (Archived)

 

HMSA's Essential Drug Formulary (Abridged) - July 2018 (Archived)

 

HMSA's Essential Drug Formulary (Comprehensive) - April 2018 (Archived)

 

HMSA's Essential Drug Formulary (Abridged) - April 2018 (Archived)

 

HMSA's Essential Drug Formulary (Comprehensive) - January 2018 (Archived)

 

HMSA's Essential Drug Formulary (Abridged) - January 2018 (Archived)

 

HMSA's Essential Drug Formulary (Comprehensive) - October 2017 (Archived)

 

HMSA's Essential Drug Formulary (Abridged) - October 2017 (Archived)

 

HMSA's Essential Drug Formulary (Comprehensive) - July 2017 (Archived)

 

HMSA's Essential Drug Formulary (Abridged) - July 2017 (Archived)

 

HMSA's Essential Drug Formulary (Comprehensive) - April 2017 (Archived)

 

HMSA's Essential Drug Formulary (Abridged) - April 2017 (Archived)

 

HMSA's Essential Drug Formulary (Comprehensive) - January 2017 (Archived)

 

HMSA's Essential Drug Formulary (Abridged) - January 2017 (Archived)

 

HMSA's Essential Drug Formulary (Comprehensive) - December 2016 (Archived)

 

HMSA's Essential Drug Formulary (Abridged) - December 2016 (Archived)

 

HMSA's Essential Drug Formulary (Comprehensive) - October 2016 (Archived)

 

HMSA's Essential Drug Formulary (Abridged) - October 2016 (Archived)

 

HMSA's Essential Drug Formulary - July 2016 (Archived)

 

HMSA's Essential Drug Formulary (Abridged) - July 2016 (Archived)

 

HMSA's Essential Drug Formulary - April 2016 (Archived)

 

 

 

First Published:05/25/2016
Latest Revision:09/27/2018
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