Prescription Claim Form (PDF) Prior Authorization Form for Prescription Drugs (PDF)
2015 Standard Formulary (PDF) Maintenance Drugs (PDF) Medications considered to be necessary for long periods of time.2015 Value Formulary (PDF) Prior Authorization List (PDF) Medications that require prior approval. For authorization, call 1-877-433-2973.2015 Metallic Drug List (PDF) 2015 Comprehensive Specialty List (PDF)
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Shield Association and is licensed to offer health plans in all 75 counties in Arkansas.
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