*Required Information provided by the drug search tool does not guarantee coverage or payment from Minnesota Health Care Programs. Real-time claim submission provides the most accurate member enrollment, drug coverage, recipient portion responsibility, and provider reimbursement information. Information in this drug search is applicable to outpatient point-of-sale pharmacy claims and does not reflect the coverage status of drugs, vaccines, and supplies covered on professional or institutional claims using Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS) or Revenue Codes (Rev Codes). If major program is HH, Medicare Part D products may be submitted as secondary for reimbursement consideration. 1Drugs with a PDL Status of ‘Non-Preferred’ require prior authorization and must meet the non-preferred drug prior authorization criteria. Drugs with a Clinical PA Req status of ‘Yes’ require clinical documentation. Criteria are available online at [2] https://mn.gov/dhs/partners-and-providers/policies-procedures/minnesota-health-care-programs/provider/types/rx/pa-criteria
