Medicaid-Approved Preferred Drug List (partial formulary entries)
Lists formulary entries and coverage notes (OTC, PA, QL, DO, AL, SP) for Anthem Medicaid in North Carolina; affects prescribers, pharmacies, and prior authorization staff responsible for dispensing and reimbursement.
No material clinical or coverage changes in this revision.
Coverage summary & scope
This formulary excerpt is a legend-style listing of dermatologic and topical products with administrative coverage annotations. Items are presented with shorthand Notes such as QL (quantity limit), OTC (over-the-counter), and PA/SP for biologic injectables; no explicit clinical exclusion language or medical necessity criteria are provided in this segment. Examples include topical antifungals and corticosteroids (e.g., clotrimazole, clobetasol propionate) and specialty biologic entries (e.g., DUPIXENT — Notes = PA; SP), where the Notes indicate administrative controls rather than in-text coverage rules.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.