No
No
Yes (no mileage restriction)
Adlyxin™ Admelog™ Amaryl™ Ambien™ Apidra™ Arava™ Avalide™ Avapro™ Doxercalciferol™ Dupixent Enoxaparin Sodium™ Flomax™ Insulin Glargine™ Ibesartan™ Kevzara™ Lantus™ Leflunomide™ Lovenox™ Multaq™ Plavix™ Priftin™ Primaquine™ Renagel™ Renvela™ Sevelamer™ Soliqua™ Toujeo™ Zolpidem™
New policy applies to CAHs, DSH, RRCs and SCHs only. Consolidated Health centers can get access to unlimited number of contract pharmacies if they share data with ESP. Federal grantees are exempted from this policy