Entry Point Page Alexey
Attachments List
$name
2022 Optima Health Standard Formulary for Small Groups (50 or less employees)
PDF, 1 MB
PDF, 1 MB
2022 OptimaFit Formulary (Individual & Family Plan)
PDF, 1 MB
PDF, 1 MB
2023 Optima Community Complete (HMO D-SNP) Prescription Drug Formulary
PDF, 2 MB
PDF, 2 MB
2023 Optima Community Complete (HMO D-SNP) Prescription Drug Formulary TEST
PDF, 2 MB
PDF, 2 MB
2023 Optima Health Step Therapy Criteria
PDF, 157 KB
PDF, 157 KB
2023 Optima Medicare Engage - Diabetes and Heart (HMO C-SNP) Prescription Drug Formulary
PDF, 2 MB
PDF, 2 MB
2023 Optima Medicare HMO Formulario Completo
PDF, 2 MB
PDF, 2 MB
2023 Optima Medicare HMO Prescription Drug Formulary
PDF, 2 MB
PDF, 2 MB
2023 Optima Medicare HMO Prior Authorization Criteria
PDF, 1 MB
PDF, 1 MB
2023 Optima Medicare HMO Step Therapy Criteria
PDF, 163 KB
PDF, 163 KB
2023 Optima Medicare Over-the-Counter Product Catalog
PDF, 892 KB
PDF, 892 KB
2023 Optima Medicare Rx (PDP) Prescription Drug Formulary
PDF, 2 MB
PDF, 2 MB
2023 Sentara Community Plan (FAMIS) Comprehensive Formulary
PDF, 2 MB
PDF, 2 MB
2023 Sentara Community Plan Formulary Changes - Effective July 1, 2023
PDF, 141 KB
PDF, 141 KB
2023 Sentara Community Plan Prescription Drug Formulary
PDF, 2 MB
PDF, 2 MB
2024 Sentara Community Complete (HMO D-SNP) Abridged Prescription Drug Formulary
PDF, 1 MB
PDF, 1 MB
2024 Sentara Community Complete (HMO D-SNP) Prescription Drug Formulary
PDF, 2 MB
PDF, 2 MB
2024 Sentara Community Plan (FAMIS) Comprehensive Formulary
PDF, 2 MB
PDF, 2 MB
2024 Sentara Community Plan (FAMIS) Comprehensive Formulary (Effective 7/1/2024)
PDF, 2 MB
PDF, 2 MB
2024 Sentara Community Plan Prescription Drug Formulary
PDF, 1 MB
PDF, 1 MB
2024 Sentara Community Plan Prescription Drug Formulary - JSON Format
JSON, 1 MB
JSON, 1 MB
2024 Sentara Community Plan Prescription Drug Formulary (Effective 7/1/2024)
PDF, 2 MB
PDF, 2 MB
2024 Sentara Health Individual & Family Plan Formulary
PDF, 1 MB
PDF, 1 MB
2024 Sentara Health Standard Formulary for Small Groups (50 or less employees)
PDF, 1 MB
PDF, 1 MB
2024 Sentara Medicare Engage - Diabetes and Heart (HMO C-SNP) Prescription Drug Formulary
PDF, 1 MB
PDF, 1 MB
2024 Sentara Medicare Formulario Completo (En Español)
PDF, 2 MB
PDF, 2 MB
2024 Sentara Medicare HMO Abridged Prescription Drug Formulary
PDF, 1 MB
PDF, 1 MB
2024 Sentara Medicare HMO Part B Step Therapy Criteria
PDF, 730 KB
PDF, 730 KB
2024 Sentara Medicare HMO Prior Authorization Criteria
PDF, 1 MB
PDF, 1 MB
2024 Sentara Medicare HMO Step Therapy Criteria
PDF, 80 KB
PDF, 80 KB
2024 Sentara Medicare Over-the-Counter Product Catalog
PDF, 3 MB
PDF, 3 MB
2024 Sentara Medicare Prescription Drug Formulary
PDF, 2 MB
PDF, 2 MB
2024 Sentara Medicare Prior Authorization Criteria
PDF, 1 MB
PDF, 1 MB
2024 Sentara Medicare Rx (PDP) Prescription Drug Formulary
PDF, 1 MB
PDF, 1 MB
2024 Sentara Medicare Step Therapy Criteria
PDF, 80 KB
PDF, 80 KB
2025 Sentara Health Individual & Family Plan Formulary
PDF, 1 MB
PDF, 1 MB
2025 Sentara Health Standard Formulary for Small Groups (50 or less employees)
PDF, 1 MB
PDF, 1 MB
Alena Drug List
ALENA TEST Document Drug List.pdf
PDF, 20 KB
PDF, 20 KB
AQA_SHP NS Drug List.docx
DOCX, 14 KB
DOCX, 14 KB
Equity Preventive Drug List - Alphabetical Listing
PDF, 124 KB
PDF, 124 KB
Equity Preventive Drug List - Preventive Class
PDF, 124 KB
PDF, 124 KB
High Risk Medications in the Elderly
PDF, 188 KB
PDF, 188 KB
Injectable & Infusion Medication List
PDF, 143 KB
PDF, 143 KB
Medical Benefit Oncology Drugs - Commercial Coverage - Not Managed by Carelon - Referred Back to Sentara Health Plans
PDF, 134 KB
PDF, 134 KB
Medical Benefit Oncology Drugs - Medicare Coverage - Not Managed by Carelon - Referred Back to Sentara Health Plans
PDF, 127 KB
PDF, 127 KB
Medical Benefit Oncology Drugs - Medicaid Coverage (Sentara Community Plan) - Not Managed by Carelon - Referred Back to Sentara Health Plans
PDF, 127 KB
PDF, 127 KB
Medical Benefit Oncology Drugs Requiring Prior Authorization - Managed by Carelon Medical Benefits Management
PDF, 129 KB
PDF, 129 KB
MQA_Drug List 8227
Open Drug Formulary (2024)
PDF, 2 MB
PDF, 2 MB
Optima Health Prior Authorizations
PDF, 1 MB
PDF, 1 MB
Pharmacy Alternative Drug List
PDF, 299 KB
PDF, 299 KB
Potentially Harmful Drug-Disease Interactions in the Elderly
PDF, 188 KB
PDF, 188 KB
Quarterly Pharmacy Changes
PDF, 546 KB
PDF, 546 KB
Sentara Community Plan Non-Part-D Covered Drug List
PDF, 394 KB
PDF, 394 KB
Sentara Health Plans Medicare Drug Prior Authorization Changes - Effective July 1, 2023
PDF, 141 KB
PDF, 141 KB
Sentara Individual & Family Health Plans Formulary (2024)
PDF, 1 MB
PDF, 1 MB
Specialty Pharmacy Drug List
PDF, 266 KB
PDF, 266 KB
Standard Formulary - Large Group (51 or more employees)
PDF, 1 MB
PDF, 1 MB
Standard Formulary (Small Group-50 or less employees) (2023)
PDF, 1 MB
PDF, 1 MB
Standard Formulary (Small Group-50 or less employees) (2024)
PDF, 1 MB
PDF, 1 MB
TEST Document Drug List.pdf
PDF, 20 KB
PDF, 20 KB
TEST Document Drug List.pdf
PDF, 20 KB
PDF, 20 KB
Virginia Commonwealth University Health System Authority Formulary
PDF, 2 MB
PDF, 2 MB
links list test
0417-Authorization-Disclose-Protected-Health-Information.pdf
external cta link