Skip to main content

State of Minnesota Health Plan

Clinical Criteria

Select the starting letter of the medication to find the desired form.

A

Glossary list of letter A

C

Glossary list of letter C

E

Glossary list of letter E

L

Glossary list of letter L

O

Glossary list of letter O

R

Glossary list of letter R

S

Glossary list of letter S

T

Glossary list of letter T

V

Glossary list of letter V

A

Glossary list of letter A

C

Glossary list of letter C

E

Glossary list of letter E

L

Glossary list of letter L

O

Glossary list of letter O

R

Glossary list of letter R

S

Glossary list of letter S

T

Glossary list of letter T

V

Glossary list of letter V

Regulatory Reports

2025

PEIP Clinical prior authorization documentation for CVS Caremark 2025 (This is a large file and may take some time to download.)

SEGIP Clinical prior authorization documentation for CVS Caremark 2025 (This is a large file and may take some time to download.)

2021-2024

PEIP Clinical prior authorization documentation for CVS Caremark 2021-2024 (This is a large file and may take some time to download.)

SEGIP Clinical prior authorization documentation for CVS Caremark 2021-2024 (This is a large file and may take some time to download.)