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HMSA's Metallic Drug Formulary and Coverage Codes

 

HMSA Formulary †, * 

 

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

 

HMSA's Metallic Prescription Formulary - October 1, 2018

 

Metallic Formulary Coverage Codes

622

623

624

625

626

627

628

629

630

631

632

661

661

662

663

722

784

800

817

818

819

820

821

822

823

824

825

826

875

876

877

878

879

880

 

 

 

 

 

 

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 Metallic Prescription Formulary - July 2018 (Archived)

 

HMSA's Metallic Prescription Formulary - April 2018 (Archived)

 

HMSA's Metallic Prescription Formulary - January 2018 (Archived)

 

HMSA's Metallic Prescription Formulary - October 2017 (Archived)

 

HMSA's Metallic Prescription Formulary - August 2017 (Archived)

 

HMSA's Metallic Prescription Formulary - July 2017 (Archived)

 

HMSA's Metallic Prescription Formulary - April 2017 (Archived)

 

HMSA's Metallic Prescription Formulary - January 2017 (Archived)

 

HMSA's Metallic Prescription Formulary - December 2016 (Archived)

 

HMSA's Metallic Prescription Formulary - October 2016 (Archived)

 

 

 

First Published:10/05/2016
Latest Revision:09/27/2018
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