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Pharmacy Provider Help Desk
Pharmacists and prescribers only (800) 558-1655
Pharmacy Services Manual

Preferred Drug List (PDL)
Providers may search the online PDL below,view and print a quick reference PDF version or download a PDA version

The PDL is subject to change at any time by the MDwise Clinical Policy Committee. Preferred branded drugs are listed on the PDL but only representative generic medications are listed. The most current version is always posted on this website.

Generics Policy
All generic medications are included as part of the pharmacy benefit, unless excluded by law (e.g. anorectics 405 IAC 5-29-1). Generics are mandatory when an FDA AB rated generic is available.

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Pharmacy Forms
PA Antibiotic
PA ARB
PA COX 2 Inhibitor
PA EMEND
PA Enbrel Humira Kinert Self Injectable
PA Enteral Nutrition
PA Forteo Boniva
PA Growth Hormone
PA Hepatitis C Treatment
PA Immunomodulator
PA Leukotriene
PA Non Sedating Antihistamine
PA Office Administered Injectable
PA Proton Pump Inhibitor
PA Serevent Diskus
PA Suboxone
PA Synagis
PA Universal Pharmacy
PA Xoliar
Glucometer Progam
Indiana Medicaid MHQA Medical Necessity
Request for Addition to MDwise PDL
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Page Last Updated 03.08