Virginia Medicaid PDL Program
- PDL Quick list (effective 07-1-08)
- PDL Criteria (effective 07-01-08)
- PDL Quick list (effective 01-1-08)
- Ketek PA Request Form (06/2007)
- Proton Pump Inhibitors (PPI) PA Request Form(03/2007)
- How to download the PDA Quicklist
- PDL Appeals Process1/08/2004)
- PDL 72 Hour Policy (1/08/2004)
PDL PA Request Fax Form (03/2007)
First Health Services Corporation