Nebraska Medicaid program

Preferred Drug List and Claim Limitations

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Current Preferred Drug List and Claim Limitations

Effective Date	Preferred Drug List	Claim Limitations
Effective Date	Preferred Drug List	Claim Limitations
12/02/2024	Preferred Drug List	Claim Limitations

Archived Preferred Drug Lists and Claim Limitations

Effective Date	Preferred Drug List	Claim Limitations
Effective Date	Preferred Drug List	Claim Limitations
11/01/2024	Preferred Drug List	Claim Limitations
10/02/2024	Preferred Drug List	Claim Limitations
09/03/2024	Preferred Drug List	Claim Limitations
08/01/2024	Preferred Drug List	Claim Limitations
07/19/2024	Preferred Drug List	Claim Limitations
07/01/2024	Preferred Drug List	Claim Limitations
06/01/2024	Preferred Drug List	Claim Limitations
05/01/2024	Preferred Drug List	Claim Limitations
04/01/2024	Preferred Drug List	Claim Limitations
03/01/2024	Preferred Drug List	Claim Limitations
02/01/2024	Preferred Drug List	Claim Limitations
01/19/2024	Preferred Drug List	Claim Limitations
01/11/2024	Preferred Drug List	Claim Limitations
01/02/2024	Preferred Drug List	Claim Limitations
12/01/2023	Preferred Drug List	Claim Limitations
11/03/2023	Preferred Drug List	Claim Limitations
11/01/2023	Preferred Drug List	Claim Limitations
10/01/2023	Preferred Drug List	Claim Limitations
09/01/2023	Preferred Drug List	Claim Limitations
08/01/2023	Preferred Drug List	Claim Limitations
07/21/2023	Preferred Drug List	Claim Limitations
07/01/2023	Preferred Drug List	Claim Limitations
06/01/2023	Preferred Drug List	Claim Limitations
05/01/2023	Preferred Drug List	Claim Limitations
04/01/2023	Preferred Drug List	Claim Limitations
03/01/2023	Preferred Drug List	Claim Limitations
02/01/2023	Preferred Drug List	Claim Limitations
01/01/2023	Preferred Drug List	Claim Limitations
12/20/2022	Preferred Drug List	Claim Limitations
12/01/2022	Preferred Drug List	Claim Limitations
11/01/2022	Preferred Drug List	Claim Limitations
10/06/2022	Preferred Drug List	Claim Limitations
10/01/2022	Preferred Drug List	Claim Limitations
09/01/2022	Preferred Drug List	Claim Limitations
08/01/2022	Preferred Drug List	Claim Limitations
07/22/2022	Preferred Drug List	Claim Limitations
06/01/2022	Preferred Drug List	Claim Limitations
05/02/2022	Preferred Drug List	Claim Limitations
04/01/2022	Preferred Drug List	Claim Limitations
03/01/2022	Preferred Drug List	Claim Limitations
02/01/2022	Preferred Drug List	Claim Limitations
01/21/2022	Preferred Drug List	Claim Limitations
01/03/2022	Preferred Drug List	Claim Limitations
12/21/2021	Preferred Drug List	Claim Limitations
12/01/2021	Preferred Drug List	Claim Limitations
11/01/2021	Preferred Drug List	Claim Limitations
10/01/2021	Preferred Drug List	Claim Limitations
09/02/2021	Preferred Drug List	Claim Limitations
08/02/2021	Preferred Drug List	Claim Limitations
07/15/2021	Preferred Drug List	Claim Limitations
07/01/2021	Preferred Drug List	Claim Limitations
06/01/2021	Preferred Drug List	Claim Limitations
05/01/2021	Preferred Drug List	Claim Limitations
04/01/2021	Preferred Drug List	Claim Limitations
03/01/2021	Preferred Drug List	Claim Limitations
02/01/2021	Preferred Drug List	Claim Limitations
01/21/2021	Preferred Drug List	Claim Limitations
12/01/2020	Preferred Drug List	Claim Limitations
11/03/2020	Preferred Drug List	Claim Limitations
10/01/2020	Preferred Drug List	Claim Limitations
09/01/2020	Preferred Drug List	Claim Limitations
08/07/2020	Preferred Drug List	Claim Limitations
08/01/2020	Preferred Drug List	Claim Limitations
07/16/2020	Preferred Drug List	Claim Limitations
07/01/2020	Preferred Drug List	Claim Limitations
06/01/2020	Preferred Drug List	Claim Limitations
05/01/2020	Preferred Drug List	Claim Limitations
04/01/2020	Preferred Drug List	Claim Limitations
03/01/2020	Preferred Drug List	Claim Limitations
02/01/2020	Preferred Drug List	Claim Limitations
01/16/2020	Preferred Drug List	Claim Limitations