67:16:14:02.01 PHS provider identification number.
67:16:14:04 Items and services covered.
67:16:14:05 Items and services not covered.
67:16:14:06 Payment for items dispensed by pharmacy.
67:16:14:06.02 State MAC list.
67:16:14:06.03 Dispensing fee for maintenance drugs.
67:16:14:06.04 Payment of container costs for drugs dispensed under unit dose system.
67:16:14:06.05 Prescriptions for family planning items.
67:16:14:06.06 Payment for drugs dispensed by physician.
67:16:14:06.09 Payment for items dispensed by PHS provider.
67:16:14:06.10 Coverage limits -- Growth hormones.
67:16:14:06.11 Required use of tamper-resistant prescriptions.
67:16:14:08 Utilization review.
67:16:14:13 Billing requirements.
67:16:14:14 Claim requirements.
67:16:14:15 Application of other chapters.
67:16:14:16 Over-the-counter items covered.
67:16:14:17 Drug review by P and T committee.
67:16:14:18 Prior authorization for certain prescription drugs.
67:16:14:19 P and T committee to make recommendations to department.
67:16:14:20 Notice to interested parties before drug placed on list -- Opportunity for interested parties to present data, opinions, and arguments.
67:16:14:21 Notice to providers when drug is to be placed on list.
67:16:14:22 Cost of drug not covered if substitution not made or prior authorization obtained.
67:16:14:23 Emergency supplies.
67:16:14:24 Appeal process.