Hospital Pharmacy (COS 0288)
- Owned and operated by an Article 28 facility or other entities;
- Services patients in the hospital and may also provide outpatient services;
- Physically adjacent to or embedded within the hospital it serves;
Clinic Pharmacy (COS 0161)
- Owned and operated by an Article 28 facility or other entities;
- Services only the patients of the clinic;
- Physically adjacent to or embedded within the clinic it serves;
Click here for the Enrollment Form and Instructions.
Pharmacy (COS 0441)
- Outpatient dispensing, community-based pharmacies that include:
- Independently owned;
- Chain; and
- Those owned by a non-profit entity
- Pharmacies that are contracted with and provide drugs to Medicaid members residing in Medicaid enrolled facilities; and/or
- Pharmacies that provide drugs to Medicaid members at the site where they are being administered or infused by a practitioner.
Click here for the Enrollment Form and Instructions.
