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Summit Community Care Formulary

Summit Community Care follows the Arkansas Medicaid Preferred Drug List (PDL).  The medications included in the Summit Community Care formulary are reviewed and approved by the Arkansas Medicaid Drug Review Committee (DRC) which consists of both Physicians and Pharmacists. 

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, step therapy or Center for Medicare and Medicaid Services (CMS) coverage requirements.

Medications not listed on the formulary are considered to be non-formulary and are subject to prior authorization.

Additionally, if a medication is available as a generic formulation, the generic will be the preferred agent, unless otherwise noted. If you have any questions about coverage of a certain product, please contact us at 1-844-462-0022.

Machine Readable Data for Prescription Drug Formulary: Summit Community Care Machine Readable File


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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 And Related Products**Antacids**Anthelmintics**Antianginal Agents**Antianxiety Agents**Antiarrhythmics**Antiasthmatic And Bronchodilator Agents**Anticoagulants**Anticonvulsants**Antidepressants**Antidiabetics**Antidiarrheal/Probiotic Agents**Antidotes And Specific Antagonists**Antiemetics**Antifungals**Antihistamines**Antihyperlipidemics**Antihypertensives**Anti-Infective Agents - Misc.**Antimalarials**Antimyasthenic/Cholinergic Agents**Antimycobacterial Agents**Antineoplastics And Adjunctive Therapies**Antiparkinson And Related Therapy Agents**Antipsychotics/Antimanic Agents**Antiseptics & Disinfectants**Antivirals**Beta Blockers**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/Sedatives/Sleep Disorder Agents**Laxatives**Local Anesthetics-Parenteral**Macrolides**Medical Devices And Supplies**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 And Treatment Agents**Penicillins**Pharmaceutical Adjuvants**Progestins**Psychotherapeutic And Neurological Agents - Misc.**Respiratory Agents - Misc.**Sulfonamides**Tetracyclines**Thyroid Agents**Toxoids**Ulcer Drugs/Antispasmodics/Anticholinergics**Urinary Antispasmodics**Vaccines**Vaginal And Related Products**Vasopressors**Vitamins*
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Formulary Effective Date: 05/24/2022
Updated:
06/2022

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