UnitedHealthcare Community Plan
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Pharmacy Program


Centennial Care - UnitedHealthcare Community Plan

Pharmacy Program

Preferred Drug List (PDL) Search  
Preferred Drug List  (PDF 932.88 KB)

4/1/2017 PDL Update (PDF 63.45 KB)
1/1/2017 PDL Update (PDF 173.18 KB)
10/1/2016 PDL Update (PDF 68.47 KB)
8/1/2016 PDL Update (PDF 65.17 KB)


Pharmacy Bulletins

New Mexico Synagis Form (PDF 101.73 KB)
Synagis Enrollment Form (PDF 511.58 KB)  
Synagis Program  (PDF 58.92 KB) 
Synagis Program 5 Doses (PDF 51.26 KB)


Quantity Limit Initiatives and Policy

Quantity Limit Policy (PDF 20.11 KB)


Step Therapy Information

Step Therapy Policy (PDF 21.02 KB)


Prior Authorization 

Pharmacy Prior Authorization Forms

Click on the arrow above to view the pharmacy prior authorization forms. 


UnitedHealthcare Dual Complete® (HMO-POS SNP)

UnitedHealthcare Dual Complete® (Local PPO SNP)

UnitedHealthcare Dual Complete® (Local PPO SNP)