Provider Resources
Payer Sheets
- 194 ACPA Payer Sheet (PDF)
- 194 Keystone First Payer Sheet (PDF)
- 218 Select Health of SC Payer Sheet (PDF)
- 397 Contra Costa Payer Sheet (PDF)
- 603 ACLA Payer Sheet (PDF)
- 618 South Country Health Alliance Payer Sheet (PDF)
- 621 Blue Cross Complete Payer Sheet (PDF)
- 628 AmeriHealth Caritas DC Payer Sheet (PDF)
- 630 San Francisco Health Plan Payer Sheet (PDF)
- 632 Alameda Payer Sheet (PDF)
- 636 Alameda Group Care Payer Sheet (PDF)
- 740 NextGen Healthcare (HSI) Payer Sheet (PDF)
- 763 ACFC CHC Payer Sheet (PDF)
- 763 KF CHC Payer Sheet (PDF)
- 771 AmeriHealth Caritas Delaware Payer Sheet (PDF)
- 774 Ascella Health Payer Sheet (PDF)
- 786 PHP Care Preferred Payer Sheet (PDF)
- 808 AmeriHealth Caritas NC Exchange Payer Sheet (PDF)
- 811 Trillium Health Resources Payer Sheet (PDF)
- 812 AmeriHealth Caritas Delaware Exchange Payer Sheet (PDF)
- 813 AmeriHealth Caritas Florida Exchange Payer Sheet (PDF)
- 814 AmeriHealth Caritas South Carolina Exchange Payer Sheet (PDF)
- AmeriHealth Caritas NH Payer Sheet (PDF)
- AmeriHealth Casualty Payer Sheet (PDF)
Formulary Files
For a full list of preferred drugs, please refer to your health plan's website.