Illinois Healthcare and Family Services Illinois Healthcare and Family Services  
www.hfs.illinois.gov/
Bruce Rauner, Govenor
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Pharmacy Information
Prior Approval Process Information
Four Prescription Policy Override Request and Status Inquiry
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Four Prescription Limit Form
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Refill Too Soon Form
Fax:217-524-7264
Preferred Drug List
Approval Criteria
Illinois Healthy Women Formulary
Vaccines for Children
Drug Utilization Review
ACE Inhibitor Combinations
ACE Inhibitors
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Topical Corticosteroids
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Label Name Generic Name BrandGeneric 
ACULAR 0.5% EYE DROPS KETOROLAC TROMETHAMINE PA RequiredNo PA Required
KETOROLAC 0.5% OPHTH SOLUTION KETOROLAC TROMETHAMINE PA RequiredNo PA Required
ACULAR LS 0.4% OPHTH SOL KETOROLAC TROMETHAMINE PA RequiredNo PA Required
KETOROLAC 0.4% OPHTH SOLUTION KETOROLAC TROMETHAMINE PA RequiredNo PA Required
ACUVAIL 0.45% OPHTH SOLUTION KETOROLAC TROMETHAMINE/PF PA RequiredNot Available
KETOROLAC 10 MG TABLET KETOROLAC TROMETHAMINE PA RequiredNo PA Required
KETOROLAC 30 MG/ML CARPUJECT KETOROLAC TROMETHAMINE PA RequiredNo PA Required
KETOROLAC 15 MG/ML CARPUJECT KETOROLAC TROMETHAMINE Not AvailableNo PA Required
KETOROLAC 60 MG/2 ML VIAL KETOROLAC TROMETHAMINE PA RequiredNo PA Required
KETOROLAC 15 MG/ML SYRINGE KETOROLAC TROMETHAMINE Not AvailablePA Required
KETOROLAC 15 MG/ML VIAL KETOROLAC TROMETHAMINE PA RequiredNo PA Required
KETOROLAC 30 MG/ML VIAL KETOROLAC TROMETHAMINE PA RequiredNo PA Required
KETOROLAC 30 MG/ML ISECURE SYR KETOROLAC TROMETHAMINE PA RequiredPA Required
KETOROLAC 30 MG/ML SYRINGE KETOROLAC TROMETHAMINE PA RequiredPA Required
KETOROLAC 60 MG/2 ML SYRINGE KETOROLAC TROMETHAMINE Not AvailablePA Required
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*This site is designed to provide information regarding Medicaid covered drugs. The search function contains prescription drugs covered by Medicaid, including those that require prior authorization. This information is current as of Thursday, January 12, 2017. For additional information please call 1-800-252-8942.

It is important to note that individual client eligibility may limit coverage for some drug categories.

Please Note: This site should be used for reference only; it is not to be used to verify payment of a particular product by Illinois Department of Healthcare and Family Services. It is intended as an education and information resource.
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