Preferred Drug List

Contra Costa Health Plan has adopted a Preferred Drug List (PDL). Starting July 15, 2002 all new prescriptions for CCHP patients (except permanent County employees) must be taken from our PDL formulary or be accompanied by a Medication Prior Authorization Request (PA) form. Both of these documents are available for download in PDF format:

CCHP Preferred Drug List (PDL) (PDF, 71pp.)

- updated July 15, 2008

Medication Prior Authorization Request (PA) form (170k PDF, 1p.)

- updated June 21, 2006

Erectile Dysfunction Medication: Questionnaire and Prior Authorization Form (457k PDF, 1p.)

- updated July 3, 2006

Synagis Prior Authorization Request form (113k PDF, 1p.)

- 2007-2008 Nov - Mar Season

Direct Member Reimbursement Form (131k PDF, 2pp.)

Need Help with PDF files?

Viewing PDF files requires a free program called Adobe Acrobat Reader [download Acrobat].

If you do not wish to or cannot run Acrobat Reader, you may still view PDF files by using Adobe's [PDF to text conversion].

Having Trouble?

Due to a known bug in the software, users of Microsoft Internet Explorer may not be able to use the search function within PDF documents. This bug does not affect any other browser. Our help file describes several easy solutions to this problem.

The Preferred Drug List is the prescription drug formulary for the Contra Costa Health Plan.

See more information designed specifically for health care providers.