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Virginia Medicaid’s Preferred Drug List (PDL)/ Common Core ...

Virginia Medicaid’s Preferred Drug List (PDL)/ Common Core Formulary 1/1/2019 2 | P a g e Preferred Agents Non-Preferred Agents SA Criteria Analgesics * Opioids – Long Acting (LAO) Preferred (Sch III-VI) Non-Preferred *All Long Acting Opioids (preferred and non-preferred) require submission of a ®Butrans (buprenorphine) Transdermal Patch

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