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POLICIES BY PLAN TYPE

Uhealthplan.utah.edu MEDPOLICY PDF

Mountain Health CO-OP PHARM-MHC-FE MHC Pharmacy Formulary Exception Form N/A N/A N/A
Mountain Health CO-OP PHARM-MHC-PA MHC General Pharmacy Prior Authorization Form N/A N/A N/A
UUHP Individual & Commercial PHARM-FE Pharmacy Formulary Exception Request Form - Commercial and Individual N/A N/A N/A
UUHP Individual & Commercial PHARM-PA General Pharmacy Prior Authorization Form N/A N/A N/A
Healthy U PHARM-HU-PA Pharmacy Prior Authorization Request Form N/A N/A N/A
Healthy U PHARM-HU-FE Pharmacy Formulary Exception Request Form N/A N/A N/A
Healthy U CHIP PHARM-CHIP-PA Pharmacy Prior Authorization Request Form CHIP N/A N/A N/A
Healthy U CHIP PHARM-CHIP-FE Pharmacy Formulary Exception Request Form CHIP N/A N/A N/A

POLICIES BY PLAN TYPE

UUHP Individual Commercial & Mountain Health CO-OP pharm-001 June 01, 2024 May 22, 2024 May 22, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-002 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-003 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-004 April 01, 2024 March 27, 2024 March 27, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-006 August 22, 2022 July 22, 2022 July 22, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-007 September 01, 2021 August 18, 2021 August 18, 2022
UUHP Individual Commercial & Mountain Health CO-OP pharm-008 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-009 October 01, 2022 September 19, 2022 September 19, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-011 June 01, 2023 May 19, 2023 May 19, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-012 January 01, 2023 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-013 April 01, 2024 March 27, 2024 March 27, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-014 April 01, 2023 March 15, 2023 March 15, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-015 April 01, 2023 March 15, 2023 March 15, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-016 June 01, 2024 May 22, 2024 May 22, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-017 April 01, 2024 March 27, 2024 March 27, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-019 June 01, 2024 May 22, 2024 May 22, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-022 April 01, 2024 March 27, 2024 March 27, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-024 April 01, 2024 March 27, 2024 March 27, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-026 August 01, 2023 July 31, 2023 July 31, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-027 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-028 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-030 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-031 February 01, 2021 January 27, 2021 January 27, 2022
UUHP Individual Commercial & Mountain Health CO-OP pharm-032 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-033 March 01, 2023 February 17, 2023 February 17, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-034 June 01, 2024 May 22, 2024 May 22, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-035 November 01, 2022 October 26, 2022 October 26, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-036 June 01, 2022 May 18, 2022 May 18, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-039 April 01, 2023 March 15, 2023 March 15, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-041 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-043 April 01, 2023 March 15, 2023 March 15, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-044 November 01, 2022 August 24 , 2022 August 24, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-045 August 01, 2023 July 31, 2023 July 31, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-047 June 01, 2022 May 18, 2022 May 18, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-049 April 01, 2024 March 27, 2024 March 27, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-050 August 01, 2023 July 31, 2023 July 31, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-051 April 01, 2023 March 15, 2023 March 15, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-052 September 01, 2022 August 24, 2022 August 24, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-054 April 01, 2023 March 15, 2023 March 15, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-056 March 08, 2024 March 05, 2024 March 05, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-057 August 01, 2023 July 31, 2023 July 31, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-058 November 01, 2022 October 26, 2022 October 26, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-059 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-060 June 01, 2023 May 17, 2023 May 17, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-061 June 01, 2024 May 22, 2024 May 22, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-062 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-063 September 01, 2021 August 18, 2021 August 18, 2022
UUHP Individual Commercial & Mountain Health CO-OP pharm-065 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-066 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-067 April 01, 2023 March 15, 2023 March 15, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-068 August 01, 2023 July 31, 2023 July 31, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-069 June 01, 2022 May 18, 2022 May 18, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-070 August 01, 2023 July 31, 2023 July 31, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-071 June 01, 2022 May 18, 2022 May 18, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-074 July 01, 2023 June 28, 2023 June 28, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-075 June 01, 2024 May 22, 2024 May 22, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-077 June 01, 2022 May 18, 2022 May 18, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-078 March 01, 2023 February 17, 2023 February 17, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-079 June 01, 2024 May 22, 2024 May 22, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-080 December 01, 2022 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-081 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-082 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-082 October 01, 2022 September 19, 2022 September 19, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-083 April 01, 2024 March 27, 2024 March 27, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-084 November 01, 2021 October 13, 2021 October 13, 2022
UUHP Individual Commercial & Mountain Health CO-OP pharm-086 June 01, 2024 May 22, 2024 May 22, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-087 April 01, 2024 March 27, 2024 March 27, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-088 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-089 April 01, 2023 March 15, 2023 March 15, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-090 June 01, 2022 May 18, 2022 May 18, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-091 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-091 January 1, 2022 December 13, 2021 December 13, 2022
UUHP Individual Commercial & Mountain Health CO-OP pharm-094 June 01, 2022 May 18, 2022 May 18, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-098 August 10, 2020 August 19, 2020 August 19, 2021
UUHP Individual Commercial & Mountain Health CO-OP pharm-099 July 01, 2023 June 28, 2023 June 28, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-100 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-101 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-103 May 22, 2023 May 18, 2023 May 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-104 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-105 January 1, 2022 December 13, 2021 December 13, 2022
UUHP Individual Commercial & Mountain Health CO-OP pharm-107 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-108 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-109 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-110 June 01, 2024 May 22, 2024 May 22, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-111 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-112 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-113 March 01, 2023 February 17, 2023 February 17, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-114 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-115 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-117 February 01, 2024 January 17, 2024 January 17, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-125 February 1, 2022 January 19, 2022 January 19, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-126 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-127 February 1, 2022 January 19, 2022 January 19, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-128 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-130 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-131 March 01, 2023 February 17, 2023 February 17, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-135 January 01, 2023 October 26, 2022 October 26, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-141 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-142 February 01, 2023 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-144 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-146 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-147 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-148 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-149 April 01, 2023 March 15, 2023 March 15, 2024
UUHP Individual & Commercial pharm-150 August 01, 2023 July 31, 2023 July 31, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-153 June 01, 2023 May 19, 2023 May 19, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-154 October 07, 2023 October 03, 2023 October 03, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-158 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-001 June 01, 2024 May 22, 2024 May 22, 2025
Healthy U pharm-hu-002 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-HU-003 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-HU-004 April 01, 2024 March 27, 2024 March 27, 2025
Healthy U pharm-hu-008 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-011 January 01, 2024 September 13, 2023 September 13, 2024
Healthy U pharm-hu-014 April 01, 2023 March 15, 2023 March 15, 2024
Healthy U pharm-HU-015 April 01, 2023 March 15, 2023 March 15, 2024
Healthy U pharm-hu-016 April 01, 2024 March 27, 2024 March 27, 2025
Healthy U pharm-HU-017 April 01, 2024 March 27, 2024 March 27, 2025
Healthy U pharm-HU-019 June 01, 2024 May 22, 2024 May 22, 2025
Healthy U pharm-HU-022 April 01, 2024 March 27, 2024 March 27, 2025
Healthy U pharm-hu-026 August 01, 2023 July 31, 2023 July 31, 2024
Healthy U pharm-HU-027 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-028 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-HU-030 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-031 December 1, 2024 November 08, 2023 November 08, 2024
Healthy U pharm-HU-032 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-033 March 1, 2023 February 17, 2023 February 17, 2024
Healthy U pharm-hu-034 June 01, 2024 May 22, 2024 May 22, 2025
Healthy U pharm-hu-035 November 01, 2022 October 26, 2022 October 26, 2023
Healthy U pharm-hu-036 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-039 April 01, 2023 March 15, 2023 March 15, 2024
Healthy U pharm-HU-041 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-HU-044 November 01, 2022 August 24 , 2022 August 24, 2023
Healthy U pharm-hu-045 August 01, 2023 July 31, 2023 July 31, 2024
Healthy U pharm-hu-047 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-051 April 01, 2023 March 15, 2023 March 15, 2024
Healthy U pharm-hu-052 September 01, 2022 August 24, 2022 August 24, 2023
Healthy U pharm-HU-054 April 01, 2023 March 15, 2023 March 15, 2024
Healthy U pharm-hu-056 November 01, 2022 October 26, 2022 October 26, 2023
Healthy U pharm-hu-058 November 01, 2022 October 26, 2022 October 26, 2023
Healthy U pharm-hu-059 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-060 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-HU-061 June 01, 2024 May 22, 2024 May 22, 2025
Healthy U pharm-hu-062 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-hu-063 December 01, 2023 November 08, 2023 November 08, 2024
Healthy U pharm-HU-065 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-hu-066 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-hu-067 April 01, 2023 March 15, 2023 March 15, 2024
Healthy U pharm-hu-068 August 01, 2023 July 31, 2023 July 31, 2024
Healthy U pharm-hu-069 June 01, 2022 May 18, 2022 May 18, 2023
Healthy U pharm-hu-070 August 01, 2023 July 31, 2023 July 31, 2024
Healthy U pharm-hu-071 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-HU-073 October 07, 2023 October 03, 2023 October 03, 2024
Healthy U pharm-HU-075 June 01, 2024 May 22, 2024 May 22, 2025
Healthy U pharm-hu-077 June 01, 2022 May 18, 2022 May 18, 2023
Healthy U pharm-hu-078 March 1, 2023 February 17, 2023 February 17, 2024
Healthy U pharm-hu-079 June 01, 2024 May 22, 2024 May 22, 2025
Healthy U pharm-hu-080 December 01, 2022 November 21, 2022 November 21, 2023
Healthy U pharm-HU-081 February 01, 2023 January 18, 2023 January 18, 2024
Healthy U pharm-HU-082 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-083 April 01, 2024 March 27, 2024 March 27, 2025
Healthy U pharm-HU-086 June 01, 2024 May 22, 2024 May 22, 2025
Healthy U pharm-hu-087 April 01, 2024 March 27, 2024 March 27, 2025
Healthy U pharm-hu-088 April 01, 2024 March 27, 2024 March 27, 2025
Healthy U pharm-hu-089 April 01, 2023 March 15, 2023 March 15, 2024
Healthy U pharm-hu-090 December 01, 2023 November 08, 2023 November 08, 2024
Healthy U pharm-hu-091 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-094 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-099 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-hu-100 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-hu-101 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-hu-104 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-105 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-107 February 01, 2023 January 18, 2023 January 18, 2024
Healthy U pharm-hu-108 February 01, 2023 January 18, 2023 January 18, 2024
Healthy U pharm-hu-109 February 01, 2023 January 18, 2023 January 18, 2024
Healthy U pharm-HU-111 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-112 February 01, 2023 January 18, 2023 January 18, 2024
Healthy U pharm-hu-113 March 1, 2023 February 17, 2023 February 17, 2024
Healthy U pharm-hu-115 November 01, 2022 October 26, 2022 October 26, 2023
Healthy U pharm-hu-117 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-118 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-119 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-127 February 1, 2022 January 19, 2022 January 19, 2023
Healthy U pharm-hu-128 February 01, 2023 January 18, 2023 January 18, 2024
Healthy U pharm-HU-130 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-HU-131 March 1, 2023 February 17, 2023 February 17, 2024
Healthy U pharm-HU-132 April 01, 2023 March 15, 2023 March 15, 2024
Healthy U pharm-hu-134 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-135 February 01, 2023 January 18, 2023 January 18, 2024
Healthy U pharm-hu-142 September 01, 2022 August 24, 2022 August 24, 2023
Healthy U pharm-hu-144 February 01, 2023 January 18, 2023 January 18, 2024
Healthy U pharm-hu-145 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-146 February 01, 2023 January 18, 2023 January 18, 2024
Healthy U pharm-hu-147 May 01, 2023 April 19, 2023 April 19, 2024
Healthy U pharm-hu-148 February 01, 2023 January 18, 2023 January 18, 2024
Healthy U pharm-hu-149 April 01, 2023 March 15, 2023 March 15, 2024
Healthy U pharm-hu-150 August 01, 2023 July 31, 2023 July 31, 2024
Healthy U pharm-hu-152 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-153 June 01, 2023 May 19, 2023 May 19, 2024
Healthy U pharm-hu-156 December 01, 2023 November 08, 2023 November 08, 2024
Healthy U pharm-hu-157 December 01, 2023 November 08, 2023 November 08, 2024
Healthy U pharm-hu-159 February 01, 2024 January 17, 2024 January 17, 2025
Healthy U pharm-hu-m002 April 01, 2024 March 27, 2024 March 27, 2025
Healthy U pharm-hu-m003 November 01, 2022 October 26, 2022 October 26, 2023
Healthy U pharm-HU-M004 July 01, 2023 June 28, 2023 June 28, 2024
Healthy U pharm-hu-m005 April 01, 2023 March 15, 2023 March 15, 2024
Healthy U pharm-HU-M006 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-hu-m007 June 01, 2024 May 22, 2024 May 22, 2025
Healthy U pharm-HU-M008 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-hu-M009 July 01, 2023 June 28, 2023 June 28, 2024
Healthy U pharm-HU-M010 July 01, 2023 June 28, 2023 June 28, 2024
Healthy U pharm-hu-m011 March 01, 2023 February 17, 2023 February 17, 2024
Healthy U pharm-hu-m012 November 01, 2022 October 26, 2022 October 26, 2023
Healthy U pharm-hu-m013 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-hu-m014 February 01, 2023 January 18, 2023 January 18, 2024
Healthy U pharm-hu-M016 October 01, 2023 September 13, 2023 September 13, 2024
Healthy U pharm-hu-M027 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-M028 August 01, 2023 July 31, 2023 July 31, 2024
Healthy U pharm-hu-m029 July 01, 2023 June 28, 2023 June 28, 2024
Healthy U pharm-HU-M030 August 01, 2022 May 18, 2022 May 18, 2023
Healthy U pharm-hu-m031 May 19, 2023 April 19, 2024 April 19, 2024
Healthy U pharm-hu-M032 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-M033 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-M034 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-M035 April 01, 2024 March 27, 2024 March 27, 2025
Healthy U pharm-hu-m036 December 01, 2023 November 08, 2023 November 08, 2024
Healthy U pharm-hu-m037 March 01, 2023 February 17, 2023 February 17, 2024
Healthy U pharm-HU-M039 May 01, 2023 April 19, 2023 April 19, 2024
Healthy U pharm-hu-m042 February 01, 2023 January 18, 2023 January 18, 2024
Healthy U pharm-hu-m043 April 01, 2023 March 15, 2023 March 15, 2024
Healthy U pharm-hu-m044 June 01, 2023 May 17, 2023 May 17, 2024
Healthy U pharm-hu-m045 June 01, 2023 May 19, 2023 May 19, 2024
Healthy U pharm-hu-m046 April 01, 2024 March 27, 2024 March 27, 2025
Healthy U pharm-hu-m047 December 01, 2023 November 08, 2023 November 08, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m001 June 01, 2024 May 22, 2024 May 22, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-m002 April 01, 2024 March 27, 2024 March 27, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-m003 November 01, 2022 October 26, 2022 October 26, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m004 July 01, 2023 June 28, 2023 June 28, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m005 April 01, 2023 March 15, 2023 March 15, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m005 April 01, 2023 March 15, 2023 March 15, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m006 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m007 June 01, 2024 May 22, 2024 May 22, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-m008 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m009 July 01, 2023 June 28, 2023 June 28, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m010 July 01, 2022 June 21, 2022 June 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m011 March 01, 2023 February 17, 2023 February 17, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m012 November 01, 2022 October 26, 2022 October 26, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m013 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m014 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m016 October 01, 2023 September 13, 2023 September 13, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m017 September 01, 2021 August 18, 2021 August 18, 2022
UUHP Individual Commercial & Mountain Health CO-OP pharm-m018 January 01, 2023 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m019 January 01, 2023 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m020 January 01, 2023 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m021 January 01, 2023 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m022 January 01, 2023 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m023 January 01, 2023 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m024 January 01, 2023 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m025 January 01, 2023 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-M026 September 01, 2021 August 18, 2021 August 18, 2022
UUHP Individual Commercial & Mountain Health CO-OP pharm-m027 June 1, 2022 May 18, 2022 May 18, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m028 August 01, 2023 July 31, 2023 July 31, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m029 July 01, 2023 June 28, 2023 June 28, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-M030 January 01, 2023 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m031 November 01, 2020 October 28, 2020 October 28, 2021
UUHP Individual Commercial & Mountain Health CO-OP pharm-m032 June 1, 2022 May 18, 2022 May 18, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m033 June 1, 2022 May 18, 2022 May 18, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m034 June 1, 2022 May 18, 2022 May 18, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m035 April 01, 2024 March 27, 2024 March 27, 2025
UUHP Individual Commercial & Mountain Health CO-OP pharm-m036 October 01, 2022 September 19, 2022 September 19, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m037 March 01, 2023 February 17, 2023 February 17, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-M039 April 01, 2022 March 16, 2022 March 16, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-m041 January 01, 2023 November 21, 2022 November 21, 2023
UUHP Individual Commercial & Mountain Health CO-OP pharm-M042 February 01, 2023 January 18, 2023 January 18, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m043 April 01, 2023 March 15, 2023 March 15, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m045 June 01, 2023 May 19, 2023 May 19, 2024
UUHP Individual Commercial & Mountain Health CO-OP pharm-m046 April 01, 2024 March 27, 2024 March 27, 2025
Healthy U CHIP PHARM-CHIP-001 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-002 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-003 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-004 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-006 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-007 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-008 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-011 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-012 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-013 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-014 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-015 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-016 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-017 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-019 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-022 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-024 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-026 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-027 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-028 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-030 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-031 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-032 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-033 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-034 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-035 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-036 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-038 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-039 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-041 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-043 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-044 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-045 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-047 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-049 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-050 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-051 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-052 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-54 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-056 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-058 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-059 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-060 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-061 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-062 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-063 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-065 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-066 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-067 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-068 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-069 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-070 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-071 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-073 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-074 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-075 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-078 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-079 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-080 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-081 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-082 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-083 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-086 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-087 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-088 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-089 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-090 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-091 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-094 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-099 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-100 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-101 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-103 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-104 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-105 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-107 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-108 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-109 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-110 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-111 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-112 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-113 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-115 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-117 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-118 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-119 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-127 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-128 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-130 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-131 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-132 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-134 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-135 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-142 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-144 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-145 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-146 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-147 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-148 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-149 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-150 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-151 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-152 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-153 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-154 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-156 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-157 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-158 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-159 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M002 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M003 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M004 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M005 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M006 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M007 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M008 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M011 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M012 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M013 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M014 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M016 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M017 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M026 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M027 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M028 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M029 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M030 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M032 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M035 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M036 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M037 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M042 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M043 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M044 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M045 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M046 July 01, 2024 July 01, 2024 July 01, 2025
Healthy U CHIP PHARM-CHIP-M047 July 01, 2024 July 01, 2024 July 01, 2025