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Molina Healthcare of Washington Medicaid …

January 2018 Molina Healthcare of Washington Medicaid preferred Drug List (Formulary) Molina Healthcare of Washington Medicaid preferred Drug List (Formulary) (01/01/2018) INTRODUCTION .. 4 PREFACE .. 4 PHARMACY AND THERAPEUTICS (P&T) COMMITTEE .. 4 DRUG LIST PRODUCT DESCRIPTIONS .. 4 PRESCRIPTION QUANTITIES .. 4 GENERIC SUBSTITUTION .. 4 PLAN DESIGN .. 5 PRIOR AUTHORIZATION REQUEST PROCEDURE .. 5 PRIOR AUTHORIZATION HELPFUL HINTS .. 5 NON-COVERED MEDICATIONS .. 5 CARVED-OUT MEDICATIONS (MEDICATIONS COVERED UNDER THE APPLE HEALTH FEE-FOR-SERVICE PROGRAM): .. 5 LEGEND.

4 INTRODUCTION We are pleased to provide the 2018 Molina Healthcare of Washington Medicaid Preferred Drug List (Formulary) as a useful reference and informational tool. This document can assist medical providers in selecting clinically-appropriate and cost-effecti

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