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HMSA's Essential Drug Formulary and Coverage Codes

 Essential Formulary Coverage Codes

120

483

503

504

511

512

515

518

519

558

559

583

584

637

638

639

664

665

782

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

00F

 

 

 

HMSA Formulary †, * 

 

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

 

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

 

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

 

 

 

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) - January 1, 2018

 

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

 

HMSA's Essential Drug Formulary (Comprehensive) - October 1, 2017

 

HMSA's Essential Drug Formulary (Abridged) - October 1, 2017

 

HMSA's Essential Drug Formulary (Comprehensive) - July 1, 2017

 

HMSA's Essential Drug Formulary (Abridged) - July 1, 2017

 

HMSA's Essential Drug Formulary (Comprehensive) - April 1, 2017

 

HMSA's Essential Drug Formulary (Abridged) - April 1, 2017

 

HMSA's Essential Drug Formulary (Comprehensive) - January 1, 2017

 

HMSA's Essential Drug Formulary (Abridged) - January 1, 2017

 

HMSA's Essential Drug Formulary (Comprehensive) - December 1, 2016

 

HMSA's Essential Drug Formulary (Abridged) - December 1, 2016

 

HMSA's Essential Drug Formulary (Comprehensive) - October 1, 2016

 

HMSA's Essential Drug Formulary (Abridged) - October 1, 2016

 

HMSA's Essential Drug Formulary - July 1, 2016

 

HMSA's Essential Drug Formulary (Abridged) - July 1, 2016

 

HMSA's Essential Drug Formulary - April 2016

 

 

 

First Published:05/25/2016
Latest Revision:04/19/2018
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