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State of Tennessee Partners for Health - Clinical Documentation

Choose a tab below to select Clinical Criteria or Exceptions.

Clinical Criteria

Select the starting letter of the medication to find the desired form. Drug coverage is dependent on member’s formulary.

A

Glossary list of letter A

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

Exceptions

Select the starting letter of the medication to find the desired form. Drug coverage is dependent on member’s formulary.

B

Glossary list of letter B

J

Glossary list of letter J

K

Glossary list of letter K

V

Glossary list of letter V

W

Glossary list of letter W

X

Glossary list of letter X

Y

Glossary list of letter Y