Pacificsource Medicaid Formulary 2024. Bosulif capsule add tier 3 with sp, partial fill, quantity limit, and prior. 2024 essentials rx 803 (hmo) plan evidence of coverage, updated 9/29/2023.

The pmpdp requires the oregon health plan (ohp) to maintain a list of the most cost. Here you will find a listing of the drugs that have been changed on our drug list (formulary) for the plan year you select.