WebDec 1, 2024 · 2024 Over-the-Counter (OTC) Catalog Simply Healthcare Plans makes it easier for you to obtain your Over-the-Counter medications by working directly with OTC Health Solutions. There are several different … WebApr 3, 2024 · Florida Medicaid Preferred Drug Program Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Benefit Preferred Drug List Brand Name Drug Preferred List [ 89.4 kB ] Updated April 3, 2024 Prior Authorization Requirements and Forms Electronic Prior Authorizations [ 20.7 kB ] Drug Criteria
Over-the-Counter (OTC) benefits Simply Healthcare
WebYour OTC items must be ordered through PerformRx SM Your orders from PerformRx will then be mailed directly to you by United Medco Pharmaceuticals. Your allowance Your allowance for OTC health and wellness items is $25 per month, per household. One order per month is permitted. Any unused monthly allowance does not carry over. WebEligible items include but are not limited to: fiber supplements, first aid supplies, medicines, ointments, sprays with active medical ingredients that alleviate symptoms, topical sunscreen, supportive items for comfort such as knee braces and adult incontinence products, and mouth care such as dental floss and toothbrushes. klc architects ltd
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WebKentucky Medicaid Single MCO PBM OTC List Effective July 1, 2024 6 reserved. Digestive and Laxative Drugs, Continued Sennosides 25 mg tablet Sennosides-docusate sodium 8.6-50 mg tablet Simethicone 125 mg capsule Simethicone 180 mg capsule Sodium bicarbonate 325 mg tablet Sodium bicarbonate 650 mg tablet Chewable Tablets Webcovered otc list 01/01/23 00574-0070-30 glutose 15 gel 40% dextrose 40 % 37.5 x x 00574-0069-30 glutose 15 gel dextrose 40 % 37.5 x x 49348-0734-01 sm glucose chw sour app dextrose 4 gm 10 x x 38396-0516-91 tgt glucose chw grape glucose-vitamin c chew tab 4-6 gm-mg 10 x x 56151-1625-01 truepls gluc gel 15/32ml glucose gel 15 gm/32ml 32 x x ... klc cavity batten