Pharmacy Pill bottles

Indiana Pharmacy Benefit Manager

OptumRx is the Pharmacy Benefit Manager (PBM) and fee-for-service (FFS) pharmacy claims processor for the Indiana Health Coverage Programs (IHCP). For information related to the IHCP pharmacy program, see the following resources:

  • The Pharmacy Services quick link at this website: Use this quick link to access information on topics including:
    • Therapeutics Committee
    • Drug Utilization Review (DUR) Board
    • Mental Health Quality Advisory Committee (MHQAC)
    • Preferred Drug List (PDL) and Over-the-Counter (OTC) Drug Formulary
    • Preferred Diabetic Supply List (PDSL)
    • State Maximum Allowable Cost (SMAC) program
    • Medicare prescription drug coverage
  • The Procedure Codes That Require NDCs appear on the Code Sets page.
  • Chapter 9 - Pharmacy Services: This chapter of the IHCP Provider Manual, found on the Manuals page on this website, outlines pharmacy policies and procedures.