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VIRGINIA PREMIER PREFERRED INDIVIDUAL PLANS
Searchable Formulary for 2019

Virginia Premier is a HMO organization. 

This online drug search represents the Comprehensive Formulary.  A comprehensive formulary is a list of all covered drugs selected by Virginia Premier in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Virginia Premier will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a Virginia Premier network pharmacy, and other plan rules are followed.

For questions about your benefits or enrollment please call our customer service number at 1-833-672-8075 or TTY users call 711, Monday – Friday 8am to 6pm; Saturday 8am to 2pm or visit our website at Virginia Premier Individual Family 

To download a PDF of our formulary click here


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*adhd/anti-narcolepsy/anti-obesity/anorexiants**aminoglycosides**analgesics - anti-inflammatory**analgesics - nonnarcotic**analgesics - opioid**androgens-anabolic**anorectal agents**anthelmintics**antianginal agents**antianxiety agents**antiarrhythmics**antiasthmatic and bronchodilator agents**anticoagulants**anticonvulsants**antidepressants**antidiabetics**antidiarrheals**antidotes and specific antagonists**antidotes**antiemetics**antifungals**antihistamines**antihyperlipidemics**antihypertensives**anti-infective agents - misc.**antimalarials**antimyasthenic agents**antimyasthenic/cholinergic agents**antimycobacterial agents**antineoplastics and adjunctive therapies**antiparkinson agents**antipsychotics/antimanic agents**antiseptics & disinfectants**antivirals**assorted classes**beta blockers**biologicals misc**calcium channel blockers**cardiotonics**cardiovascular agents - misc.**cephalosporins**chemicals**contraceptives**corticosteroids**cough/cold/allergy**dermatologicals**diagnostic products**digestive aids**diuretics**endocrine and metabolic agents - misc.**estrogens**fluoroquinolones**gastrointestinal agents - misc.**genitourinary agents - miscellaneous**gout agents**hematological agents - misc.**hematopoietic agents**hemostatics**hypnotics**hypnotics/sedatives/sleep disorder agents**laxatives**macrolides**medical devices and supplies**medical devices**migraine products**minerals & electrolytes**miscellaneous therapeutic classes**mouth/throat/dental agents**multivitamins**musculoskeletal therapy agents**nasal agents - systemic and topical**neuromuscular agents**nutrients**ophthalmic agents**otic agents**oxytocics**passive immunizing agents**penicillins**pharmaceutical adjuvants**progestins**psychotherapeutic and neurological agents - misc.**respiratory agents - misc.**sulfonamides**tetracyclines**thyroid agents**ulcer drugs**urinary anti-infectives**urinary antispasmodics**vaccines**vaginal products**vasopressors**vitamins*
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For information on initiating a Coverage Determination, including prior authorization, step therapy, and formulary exceptions, visit our website at Virginia Premier Individual Family or contact Envision at 1-833-626-1350.
Formulary Id: 13813
Formulary Effective Date: 05/01/2019
Updated:
05/2019

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