Pharmacy Information
BCBSOK Drug Formulary (Non-Medicare)1 
Updated 04/01/09 - The formulary includes information regarding prescription drugs with dispensing limits and the speciality pharmacy program.
Medicare Blue Rx Formulary
Medicare Blue PPO Formulary
Maintenance Drug Listing [File: 117 KB] (Updated: February 2009) - A drug is considered a maintenance medication when it is being taken to treat chronic condition for an extended amount of time. Some drug programs allow maintenance medications to be dispensed in quantities that exceed a 30-day supply.
1 Note: Blue Cross and Blue Shield of Oklahoma health plans offered by self-insured employer groups may have different coverage options, plans or benefits. Please refer to your health plan contract, which governs eligibility, coverage exclusions and available benefits.
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Triessent Fax Form [File: 168 KB]
Drug Card Prescription Claim Form
Comprehensive Prescription Drug Claim Form [File: 48 KB] (Updated: 04/21/09)
Lincs Rx NCPDP Version 5.1 Payor Sheet [File: 87 KB]
Medicare Blue Rx (Part D) Payor Sheet [File: 277 KB]
Medicare Blue PPO Payor Sheet [File: 204 KB]
Clinical Quantity Limit Override Request [File: 35 KB]
Provider Newsletters
