{"component": "definition", "props": {"groups": [{"size": 265, "snippet_links": [{"key": "a-list", "type": "definition", "offset": [6, 12]}, {"key": "covered-prescription-drugs", "type": "clause", "offset": [16, 42]}, {"key": "this-plan", "type": "definition", "offset": [58, 67]}, {"key": "brand-name", "type": "definition", "offset": [111, 121]}, {"key": "specialty-prescription", "type": "clause", "offset": [153, 175]}], "samples": [{"hash": "fccIllYVYYf", "uri": "/contracts/fccIllYVYYf#formulary", "label": "Subscriber Agreement", "score": 35.8283280117, "published": true}, {"hash": "grYWINzHu5z", "uri": "/contracts/grYWINzHu5z#formulary", "label": "Subscriber Agreement", "score": 35.817855835, "published": true}, {"hash": "bvAzSGtCvQO", "uri": "/contracts/bvAzSGtCvQO#formulary", "label": "Subscriber Agreement", "score": 35.7877502441, "published": true}], "snippet": "means a list of covered prescription drugs provided under this plan. 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Some prescription drugs are not in the formulary. If a prescription drug is not in our formulary, then it is not covered under this agreement. A committee of local physicians and Pharmacists, set up by us, develop the prescription drug formulary listing which is subject to periodic review and is subject to change. The committee decides the tier placement of drugs in the formulary, which determines the amount you will pay. To obtain coverage information for a specific prescription drug or to get a copy of the most current formulary listing, visit our Web site at \u2587\u2587\u2587\u2587\u2587\u2587.\u2587\u2587\u2587. or you may call our Customer Service Department at (\u2587\u2587\u2587) \u2587\u2587\u2587-\u2587\u2587\u2587\u2587 or \u2587-\u2587\u2587\u2587-\u2587\u2587\u2587-\u2587\u2587\u2587\u2587 for information.", "hash": "16a984672ed48f592bbab16e211f6f4e", "id": 3}, {"size": 14, "snippet_links": [{"key": "pharmacy-benefit", "type": "clause", "offset": [89, 105]}, {"key": "not-covered", "type": "clause", "offset": [144, 155]}, {"key": "formulary-exception", "type": "definition", "offset": [198, 217]}, {"key": "for-a-non", "type": "clause", "offset": [218, 227]}], "samples": [{"hash": "iCosgbgMi4o", "uri": "https://www.azblue.com/~/media/azblue/files/individuals/benefit-books/iu-2017/2017-ste-e-ind-portfolio-neighborhood-zcs-final--20217-0117.pdf?la=en", "label": "www.azblue.com", "score": 8.3634500504, "published": false}, {"hash": "ch2GtEmkohz", "uri": "https://www.azblue.com/~/media/azblue/files/individuals/benefit-books/iu-2017/2017-ste-e-ind-portfolio-neighborhood-on-final--20198-0117.pdf?la=en", "label": "www.azblue.com", "score": 8.3634500504, "published": false}, {"hash": "8MJIYC23yv9", "uri": "https://www.azblue.com/~/media/azblue/files/individuals/benefit-books/iu-2017/2017-ste-e-ind-everydayhealth-neighborhood-zcs-final--20216-0117.pdf?la=en", "label": "www.azblue.com", "score": 8.3634500504, "published": false}], "snippet": "means the list of medications BCBSAZ and/or the PBM has designated as covered under this Pharmacy Benefit. Medications not on the Formulary are not covered unless BCBSAZ and/or the PBM authorizes a Formulary Exception for a Non-Formulary Medication. BCBSAZ and/or the PBM decide which medications are on the Formulary.", "hash": "44d99e0da1545f9dabf38a1a21383a4a", "id": 4}, {"size": 14, "snippet_links": [{"key": "a-list", "type": "definition", "offset": [6, 12]}, {"key": "clinically-appropriate", "type": "definition", "offset": [98, 120]}], "samples": [{"hash": "3JE5ZHrPI4B", "uri": "/contracts/3JE5ZHrPI4B#formulary", "label": "Individual Epo Medical Policy", "score": 35.0930747986, "published": true}, {"hash": "lzKBnNvqVkt", "uri": "/contracts/lzKBnNvqVkt#formulary", "label": "Individual Epo Medical Policy", "score": 34.8100204468, "published": true}, {"hash": "hXarPin3MSP", "uri": "/contracts/hXarPin3MSP#formulary", "label": "Individual Epo Medical Policy", "score": 34.6184043884, "published": true}], "snippet": "means a list of drugs that has been developed, organized and is administered to promote rational, clinically appropriate, safe and cost-effective drug therapy.", "hash": "9d3cfa22feae151ab3f3574f8f065bb1", "id": 5}, {"size": 14, "snippet_links": [{"key": "listing-of-drugs", "type": "clause", "offset": [8, 24]}, {"key": "health-plan", "type": "clause", "offset": [39, 50]}], "samples": [{"hash": "hj9nNG1Dqjc", "uri": "https://app.leg.wa.gov/WAC/default.aspx/default.aspx?cite=284-43&full=true&pdf=true", "label": "app.leg.wa.gov", "score": 19.7409553528, "published": false}, {"hash": "fCbB4r6I1ME", "uri": "https://lawfilesext.leg.wa.gov/law/WACArchive/2024/pdf/WAC%20284%20-%2043%20%20CHAPTER/WAC%20284%20-%2043%20-0160.pdf", "label": "lawfilesext.leg.wa.gov", "score": 18.9670772552, "published": false}, {"hash": "kwoclqDA3AA", "uri": "https://app.leg.wa.gov/documents/LAWS/WSRPDF/2023/24/23-24-034.pdf", "label": "app.leg.wa.gov", "score": 18.8609771729, "published": false}], "snippet": "means a listing of drugs used within a health plan. A formulary must include drugs covered under an enrollee's medi- cal benefit.", "hash": "c98c0d4ed45f229029cad6520bbe8ae1", "id": 6}, {"size": 14, "snippet_links": [{"key": "prescription-drugs", "type": "definition", "offset": [10, 28]}, {"key": "this-agreement", "type": "clause", "offset": [60, 74]}, {"key": "a-prescription-drug", "type": "clause", "offset": [129, 148]}, {"key": "not-covered", "type": "clause", "offset": [185, 196]}, {"key": "a-committee", "type": "clause", "offset": [219, 230]}, {"key": "drug-formulary", "type": "definition", "offset": [286, 300]}, {"key": "subject-to", "type": "clause", "offset": [318, 328]}, {"key": "periodic-review", "type": "definition", "offset": [329, 344]}, {"key": "the-committee", "type": "clause", "offset": [357, 370]}, {"key": "the-tier", "type": "clause", "offset": [379, 387]}, {"key": "placement-of", "type": "definition", "offset": [388, 400]}, {"key": "the-events", "type": "clause", "offset": [568, 578]}, {"key": "determine-whether", "type": "clause", "offset": [598, 615]}, {"key": "coverage-under", "type": "clause", "offset": [654, 668]}, {"key": "final-fda-approval", "type": "definition", "offset": [687, 705]}, {"key": "first-date", "type": "definition", "offset": [713, 723]}, {"key": "generally-available", "type": "definition", "offset": [724, 743]}, {"key": "coverage-information", "type": "clause", "offset": [799, 819]}, {"key": "the-most-current", "type": "definition", "offset": [873, 889]}, {"key": "web-site", "type": "definition", "offset": [919, 927]}, {"key": "customer-service-department", "type": "clause", "offset": [963, 990]}, {"key": "for-information", "type": "clause", "offset": [1027, 1042]}], "samples": [{"hash": "5yUWiBneCcl", "uri": "/contracts/5yUWiBneCcl#formulary", "label": "Subscriber Agreement", "score": 26.8442802429, "published": true}, {"hash": "4ukqczQ6fXQ", "uri": "/contracts/4ukqczQ6fXQ#formulary", "label": "Subscriber Agreement", "score": 26.8442802429, "published": true}, {"hash": "4SGlHVvQic1", "uri": "/contracts/4SGlHVvQic1#formulary", "label": "Subscriber Agreement", "score": 26.8442802429, "published": true}], "snippet": "means the prescription drugs and dosage forms covered under this agreement. Some prescription drugs are not in the formulary. If a prescription drug is not in our formulary, then it is not covered under this agreement. A committee of physicians and pharmacists develop the prescription drug formulary listing which is subject to periodic review and change. The committee decides the tier placement of drugs in the formulary, which determines the amount you will pay. When possible, new prescription drugs are reviewed within six (6) months of the occurrence of one of the events described below to determine whether the prescription drug is eligible for coverage under this agreement: \u2022 final FDA approval; \u2022 the first date generally available in pharmacies (for prescription drugs only). To obtain coverage information for a specific prescription drug or to get a copy of the most current formulary listing, visit our Web site at \u2587\u2587\u2587\u2587\u2587\u2587.\u2587\u2587\u2587. or you may call our Customer Service Department at (\u2587\u2587\u2587) \u2587\u2587\u2587-\u2587\u2587\u2587\u2587 or \u2587-\u2587\u2587\u2587-\u2587\u2587\u2587-\u2587\u2587\u2587\u2587 for information.", "hash": "3c777bbd13dd78184a02d4b210ec0f96", "id": 7}, {"size": 13, "snippet_links": [{"key": "a-list", "type": "definition", "offset": [6, 12]}, {"key": "medicinal-drugs", "type": "definition", "offset": [16, 31]}], "samples": [{"hash": "i2Ol0K82Wl2", "uri": "https://pharmacy.az.gov/sites/default/files/law%20book.pdf", "label": "pharmacy.az.gov", "score": 10.1704311371, "published": false}, {"hash": "lAGFNvryhJd", "uri": "https://pharmacy.az.gov/sites/default/files/editors_choice/attachments/LAW%20BOOK%202014.pdf", "label": "pharmacy.az.gov", "score": 10.1704311371, "published": false}, {"hash": "4SKaXaj1Jc0", "uri": "https://pharmacy.az.gov/sites/default/files/documents/files/ars%207-2014.pdf", "label": "pharmacy.az.gov", "score": 8.1704311371, "published": false}], "snippet": "means a list of medicinal drugs.", "hash": "afcb81773fe9c13a931748b9e7ea706b", "id": 8}, {"size": 13, "snippet_links": [{"key": "dangerous-drugs", "type": "definition", "offset": [10, 25]}, {"key": "schedule-ii", "type": "definition", "offset": [37, 48]}, {"key": "controlled-substances", "type": "clause", "offset": [51, 72]}, {"key": "care-of-patients", "type": "clause", "offset": [100, 116]}, {"key": "patient-relationship", "type": "clause", "offset": [157, 177]}], "samples": [{"hash": "jdD2a2NHlyL", "uri": "https://www.rld.nm.gov/uploads/files/MASTER%20COPY%20OF%20RULES%20AND%20STATUES.pdf", "label": "www.rld.nm.gov", "score": 9.1177272797, "published": false}, {"hash": "6thb2drPOr0", "uri": "http://www.rld.state.nm.us/uploads/files/Osteo%20Rules%20for%20Website%202017.pdf", "label": "www.rld.state.nm.us", "score": 6.5249829292, "published": false}, {"hash": "58F6DMKAa0S", "uri": "http://www.rld.state.nm.us/uploads/files/16%2017%204%20NMAC.docx", "label": "www.rld.state.nm.us", "score": 6.0876111984, "published": false}], "snippet": "means any dangerous drugs; including Schedule II-V controlled substances, physicians may use in the care of patients where there is an established physician-patient relationship.", "hash": "e155ce915253f387dc2616396ac18e11", "id": 9}, {"size": 11, "snippet_links": [{"key": "complete-list", "type": "clause", "offset": [8, 21]}, {"key": "prescription-drugs", "type": "definition", "offset": [25, 43]}, {"key": "coverage-under", "type": "clause", "offset": [57, 71]}, {"key": "health-benefit-plan", "type": "definition", "offset": [74, 93]}], "samples": [{"hash": "amYJvZdWOjj", "uri": "https://www.legis.iowa.gov/docs/publications/iactc/90.2/CH1144.pdf", "label": "www.legis.iowa.gov", "score": 18.7927422143, "published": false}, {"hash": "90HvgSDB3Qq", "uri": "https://www.legis.iowa.gov/docs/code/2025/514F.9.pdf", "label": "www.legis.iowa.gov", "score": 17.6229743958, "published": false}, {"hash": "coWplRgMTOQ", "uri": "https://www.legis.iowa.gov/docs/code/510c.pdf", "label": "www.legis.iowa.gov", "score": 16.5397357941, "published": false}], "snippet": "means a complete list of prescription drugs eligible for coverage under a health benefit plan.", "hash": "ecafee8b3f84a65b264a8d48dba53fbf", "id": 10}], "next_curs": "ClYSUGoVc35sYXdpbnNpZGVyY29udHJhY3RzcjILEhpEZWZpbml0aW9uU25pcHBldEdyb3VwX3Y1NiISZm9ybXVsYXJ5IzAwMDAwMDBhDKIBAmVuGAAgAA==", "definition": {"size": 878, "title": "Formulary", "snippet": "means a list of covered prescription drugs provided under this plan. The formulary includes generic, preferred brand name, non-preferred brand name, and specialty prescription drugs.", "id": "formulary", "examples": ["For appeals of a decision that a prescription drug is not covered because it is not on our <strong>formulary</strong>, please see the <strong>Formulary</strong> Exception Process in the Prescription Drug and Diabetic Equipment and Supplies section.", "The drug <strong>formulary</strong> shall be as defined by Liberty Health <strong>Formulary</strong> Three.", "<strong>Formulary</strong> drug lists shall be made available on the Contractor\u2019s website in a machine-readable file and format as specified by the Secretary.", "Any additions to the Contractor OTC Drug <strong>Formulary</strong> are required to only be from participating rebating labelers.", "A medication may not be added to the <strong>Formulary</strong> if current drugs on the <strong>Formulary</strong> are equally safe and effective and are less costly.", "The primary purpose of the <strong>Formulary</strong> is to encourage the use of safe, effective and most affordable medications.", "Medications chosen for the <strong>Formulary</strong> are selected based on their safety, effectiveness and overall value.", "The medications and related products listed on a <strong>Formulary</strong> are determined by a Pharmacy and Therapeutics (P &amp; T) Committee or an equivalent entity.", "These drugs are found in the Individual and Family Metal Plans/Employer Group Metal Plans <strong>Formulary</strong> as Non-Extended Day Supplies.", "Step Therapy promotes the appropriate use of equally effective but lower-cost <strong>Formulary</strong> drugs first."], "related": [["pharmacy", "Pharmacy", "Pharmacy"], ["prescription", "Prescription", "Prescription"], ["medical-prescription-drugs", "MEDICAL PRESCRIPTION DRUGS", "MEDICAL PRESCRIPTION DRUGS"], ["prescription-drug", "Prescription drug", "Prescription drug"], ["prescription-drugs", "Prescription drugs", "Prescription drugs"]], "related_snippets": [], "updated": "2025-07-24T04:27:51+00:00"}, "json": true, "cursor": ""}}