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Drug Formulary

Passport Health Plan

Online Drug Formulary

Learn How to Find Your Medicine

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Passport Advantage

Passport Advantage Online Drug Formulary

Learn How to Find Your Medicine: PAD

Call Us with Questions: PAD

Additional Formulary Resources

Antipsychotic ICD-9 Codes (PDF)

Request for Drug List Review (PDF)

Over the Counter Drug List (PDF)

Alphabetical Preferred Prenatal Vitamin NDCs List (PDF)

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*As reported by "NCQA's Medical Health Insurance Plan Rankings 2012 - 2013". NCQA is the National Committee for Quality Assurance.