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HIP, HHW, and HCC Online Formulary

The MHS Online Formulary is the list of covered drugs. The MHS Formulary is continually evaluated by the MHS Pharmacy and Therapeutics (P&T) Committee to promote the appropriate and cost-effective use of medications. The Committee is composed of the MHS Medical Director, MHS Pharmacy Director, and several Indiana physicians, pharmacists, and specialists.

Please select a drug from the list below to see all coverage details regarding the medication. Some medications listed may have additional requirements or limitations of coverage. These requirements and limits may include prior authorization, quantity limits, age limits or step therapy.


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*Adhd/Anti-Narcolepsy/Anti-Obesity/Anorexiants**Allergenic Extracts/Biologicals Misc**Alternative Medicines**Amebicides**Aminoglycosides**Analgesics - Anti-Inflammatory**Analgesics - Nonnarcotic**Analgesics - Opioid**Androgens-Anabolic**Anorectal Agents**Antacids**Anthelmintics**Antianginal Agents**Antianxiety Agents**Antiarrhythmics**Antiasthmatic And Bronchodilator Agents**Anticoagulants**Anticonvulsants**Antidepressants**Antidiabetics**Antidiarrheal/Probiotic Agents**Antidiarrheals**Antidotes And Specific Antagonists**Antidotes**Antiemetics**Antifungals**Antihistamines**Antihyperlipidemics**Antihypertensives**Anti-Infective Agents - Misc.**Antimalarials**Antimyasthenic/Cholinergic Agents**Antimycobacterial Agents**Antineoplastics And Adjunctive Therapies**Antiparkinson Agents**Antiparkinson And Related Therapy 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**Dietary Products/Dietary Management Products**Digestive Aids**Diuretics**Endocrine And Metabolic Agents - Misc.**Estrogens**Fluoroquinolones**Gastrointestinal Agents - Misc.**General Anesthetics**Genitourinary Agents - Miscellaneous**Gout Agents**Hematological Agents - Misc.**Hematopoietic Agents**Hemostatics**Hypnotics**Hypnotics/Sedatives/Sleep Disorder Agents**Laxatives**Local Anesthetics-Parenteral**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**Passive Immunizing And Treatment Agents**Penicillins**Pharmaceutical Adjuvants**Progestins**Psychotherapeutic And Neurological Agents - Misc.**Respiratory Agents - Misc.**Sulfonamides**Tetracyclines**Thyroid Agents**Toxoids**Ulcer Drugs**Ulcer Drugs/Antispasmodics/Anticholinergics**Urinary Anti-Infectives**Urinary Antispasmodics**Vaccines**Vaginal And Related Products**Vaginal Products**Vasopressors**Vitamins*
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Formulary Id: 14507
Formulary Effective Date: 08/01/2022
Updated:
08/2022
CMS Approval Date:
07/06/2022
CMS Version:
3

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