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Comprehensive Formulary

Use the links below to access the INTEGRIS Health Partners+ Comprehensive and Abridged Formularies.


Abridged Formulary


Formulary Changes and Utilization Management Criteria

2022 INTEGRIS Health Partners+ Utilization Management Criteria Documents
  Formulary Changes Prior Authorization Step Therapy Quantity Limits
JanuaryJanuary 2022 Formulary ChangesJanuary 2022 Prior Authorization Criteria - updated 12/2/2021January 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
FebruaryFebruary 2022 Formulary ChangesFebruary 2022 Prior Authorization CriteriaFebruary 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
MarchMarch 2022 Formulary ChangesMarch 2022 Prior Authorization CriteriaMarch 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
AprilApril 2022 Formulary ChangesApril 2022 Prior Authorization CriteriaApril 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
MayMay 2022 Formulary ChangesMay 2022 Prior Authorization CriteriaMay 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
JuneJune 2022 Formulary ChangesJune 2022 Prior Authorization CriteriaJune 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.
JulyJuly 2022 Formulary ChangesJuly 2022 Prior Authorization CriteriaJuly 2022 Step Therapy CriteriaSee comprehensive formulary for quantity limits.

HPMS Formulary ID: 00022069 Version 13
HPMS Formulary Approval Date: 6/21/2022
Updated: 7/2022



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