Central California  Alliance For Health


Pharmacy Formulary

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The Alliance formulary was developed under the direction of the Pharmacy & Therapeutics (P&T) Committee and is continually reviewed by the P&T Committee and Alliance staff. Please note that since benefits vary by line of business, some drugs or classes of drugs are not covered for some members. Please refer to the appropriate Evidence of Coverage for specific benefit restrictions.

Medications on the Maintenance Drug List can be filled for a 90-day supply.

View our formulary by:

• Therapeutic Class (PDF)

• Brand Name

• Generic Name

• Full print version (PDF)

• Online or downloaded to your mobile devices through


Epocrates is a free online drug and formulary reference that contains the latest drug and prescribing information.

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View formulary changes by year:

• 2014

• 2013

• 2012

• 2011

Prescription Prior Authorization Form

Knox Keene lines of business (Healthy Kids, IHSS, and Medi-Cal Access Program - AIM) are required to use a standardized Prescription Drug Prior Authorization form to request prior authorizations.

If you have any questions, please contact the Alliance Pharmacy Department at (831) 430-5507.


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