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Medicaid Pharmacy List of Reimbursable Drugs

This page contains drug information from the pharmacy file. The full list of reimbursable drugs may be viewed online or downloaded, using the link provided below. Only those prescription and non-prescription drugs which appear on the list are reimbursable under the fee-for-service Medicaid Pharmacy Program.

Attention Prescribers:
View/Download PDF of Reimbursable Drugs

View/Download Formulary and Benefits File Format
This zip file contains eight pipe delimited text files and creates the following output files: Formulary Status; Copay List; Age Limit Coverage; Gender Limit; Prior Auth Coverage; Quantity Limit Coverage; Text Message Coverage; Cross Reference

Formulary File Information
This file contains the Formulary File Information and field layouts.

Find File Information
 
 

Search Tips:

Select the field you wish to use, then enter your search term in the "Value" field. Enter only one value at a time, using letters and/or numbers. Instead of using an asterisk ("*") character as a wildcard to search for multiple values, simply include only the partial string for which you are searching. Finally, select the field you would like to use when sorting your matches and click "Search" to begin searching. If you have questions or need assistance, please let us know.

Example: To find all drugs whose NDC code contains "1234", sorted by price, you would start by selecting "NDC Code" as the field to use. Enter "1234" as the "Value" (not "1234*"), and select "MRA Cost" as the "Sort By" field. When you click on "Search", your matches are displayed, sorted by price.

PA Code Field Values:

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