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)

• Prior Authorization Request (PA) form (PDF) | Word

• Medication Prior Authorization Request (PA) form (PDF)

• Erectile Dysfunction Medication: Questionnaire and Prior Authorization Form (PDF)

• Synagis Prior Authorization Request form (PDF)

• Direct Member Reimbursement Form (PDF)

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