{"data":{"sdpdlcontent":{"items":[{"data":{"sdpdlcontent":{"pdlTabsDetails":[{"drugClassList":[{"preferredDrugs":["non-stimulant oral agents (e.g., atomoxetine, clonidine, etc)","QELBREE"],"therapeuticCategory":"ADHD NON-STIMULANT"},{"preferredDrugs":["stimulant oral agents (e.g., dextroamphetamine, methylphenidate, etc)","VYVANSE"],"therapeuticCategory":"ADHD AGENTS"},{"preferredDrugs":["warfarin tab","ELIQUIS TAB"],"therapeuticCategory":"ANTICOAGULANTS - ORAL"},{"preferredDrugs":["ANTISEIZURE AGENTS (e.g., carbamazepine, lamotrigine, phenytoin, topiramate, etc)","DIAZEPAM RECTAL GEL","EPIDIOLEX SOLUTION","NAYZILAM NASAL SPRAY","VALTOCO NASAL SPRAY"],"therapeuticCategory":"ANTICONVULSANTS"},{"preferredDrugs":["MOUNJARO ","OZEMPIC","RYBELSUS","TRULICITY","VICTOZA","WEGOVY (MACE or MASH only)","ZEPBOUND (OSA only)"],"therapeuticCategory":"ANTIDIABETICS GLP-1 RECEPTOR AGONISTS   **No coverage for weight loss"},{"preferredDrugs":["antiretroviral agents (e.g., abacavir, atazanavir, efavirenz, emtricitabine, lamivudine, nevirapine, ritonavir, tenofovir, zidovudine, & combinations, etc)","BIKTARVY","DESCOVY"],"therapeuticCategory":"ANTIRETROVIRALS"},{"preferredDrugs":["APRETUDE (covered under Medical only)","CABENUVA (covered under Medical only)"],"therapeuticCategory":"ANTIRETROVIRALS (Medical only)"},{"preferredDrugs":["PAXLOVID"],"therapeuticCategory":"ANTIVIRALS - COMBINATIONS"},{"preferredDrugs":["DEXCOM G6 ","DEXCOM G7 ","DEXCOM G7 15 DAY","FREESTYLE LIBRE 14 DAY","FREESTYLE LIBRE 2","FREESTYLE LIBRE 3"],"therapeuticCategory":"CGM - CONTINUOUS GLUCOSE MONITORING"},{"preferredDrugs":[" LINZESS"],"therapeuticCategory":"CHRONIC CONSTIPATION AGENTS "},{"preferredDrugs":["ORAL AGENTS (e.g., aripiprazole, clozapine, olanzapine, paliperidone, risperidone, etc)","ABILIFY ASIMTUFI","ABILIFY MAINTENA","ARISTADA","ARISTADA INITIO","CAPLYTA","INVEGA SUSTENNA","INVEGA TRINZA","INVEGA HAFYERA","PERSERIS","UZEDY","VRAYLAR"],"therapeuticCategory":"CNS ANTIPSYCHOTICS"},{"preferredDrugs":["EBGLYSS","ENBREL","ENBREL MINI","ENBREL SURECLICK","HUMIRA","HUMIRA Pen","HUMIRA Pen-PS/UV Starter","OMVOH","PYZCHIVA","RINVOQ","RINVOQ LQ","SELARDSI","STEQEYMA","SKYRIZI","SKYRIZI Pen","TALTZ","TREMFYA","TYENNE","YUFLYMA"],"therapeuticCategory":"CYTOKINE MODULATORS"},{"preferredDrugs":["PYZCHIVA","SELARDSI","STEQEYMA"],"therapeuticCategory":"STELARA BIOSIMILARS"},{"preferredDrugs":["atopic dermatitis topical agents (e.g., pimecrolimus cream,  tacrolimus ointment, topical corticosterioid, Eucrisa, etc)","DUPIXENT","NUCALA","XOLAIR",""],"therapeuticCategory":"DERM-ATOPIC DERMATITIS MONOCLONAL ANTIBODY - ANTI-IL, ANTI IGE"},{"preferredDrugs":["epinephrine injections","EPI-PEN","EPI-PEN JR"],"therapeuticCategory":"EPINEPHRINE INJECTORS"},{"preferredDrugs":["ZENPEP"],"therapeuticCategory":"GI PANCREATIC ENZYMES"},{"preferredDrugs":["ACCU-CHEK GUIDE","ACCU-CHEK GUIDE ME","ACCU-CHEK GUIDE TEST STRIP","ACCU-CHEK SOFTCLIX LANCET","ACCU-CHEK SOFTCLIX LANCING DEVICE ","CONTOUR ","CONTOUR NEXT","CONTOUR NEXT EZ","CONTOUR NEXT GEN","CONTOUR NEXT ONE","CONTOUR PLUS ","CONTOUR PLUS BLUE"],"therapeuticCategory":"GLUCOSE TESTING"},{"preferredDrugs":["GENOTROPIN","GENOTROPIN MINIQUICK","NORDITROPIN FLEXPRO",""],"therapeuticCategory":"GROWTH HORMONES"},{"preferredDrugs":["ARANESP"],"therapeuticCategory":"HEMATOPOIETICS – ESA"},{"preferredDrugs":["KOVALTRY","XYNTHA","XYNTHA SOLOFUSE",""],"therapeuticCategory":"HEMOPHILIA TREATMENTS – FACTOR VIII"},{"preferredDrugs":["SOFOSBUVIR/VELPATASVIR TAB","MAVYRET"],"therapeuticCategory":"HEPATITIS  C"},{"preferredDrugs":["BAQSIMI","GVOKE"],"therapeuticCategory":"HYPOGLYCEMIA"},{"preferredDrugs":["AIMOVIG","AJOVY","EMGALITY"],"therapeuticCategory":"MIGRAINE - CGRP INHIBITORS"},{"preferredDrugs":["TRIPTANS (e.g., almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan, etc)","NURTEC","UBRELVY"],"therapeuticCategory":"MIGRAINE TREATMENT"},{"preferredDrugs":["tetrabenazine","AUSTEDO","AUSTEDO XR","INGREZZA"],"therapeuticCategory":"MOVEMENT DISORDER"},{"preferredDrugs":["DYSPORT (covered under Medical only)"],"therapeuticCategory":"NEUROTOXINS (Medical only)"},{"preferredDrugs":["buprenorphine","buprenorphine-naloxone","SUBLOCADE (covered under Medical only)"],"therapeuticCategory":"OPIOID PARTIAL AGONISTS"},{"preferredDrugs":["REPATHA","REPATHA SURECLICK"],"therapeuticCategory":"PCSK9 INHIBITOR – CHOLESTEROL LOWERING"},{"preferredDrugs":["sodium polystyrene sulfonate (oral) powder, SPS","LOKELMA"],"therapeuticCategory":"POTASSIUM REMOVING AGENTS"},{"preferredDrugs":["COMBIVENT RESPIMAT","STIOLTO RESPIMAT","TRELEGY ELLIPTA"],"therapeuticCategory":"RESPIRATORY - ADRENERGIC COMBINATIONS"},{"preferredDrugs":["SPIRIVA RESPIMAT"],"therapeuticCategory":"RESPIRATORY - ANTICHOLINERGICS"},{"preferredDrugs":["ORILISSA"],"therapeuticCategory":"UTERINE FIBROIDS AGENT"}],"icon":"https://contenthub-aem.optumrx.com/content/dam/contenthub/retail-pharmacy-override/assets/customsite-southdokata/icons/MedicineBottle.png","tableHeaders":["Therapeutic Category","Preferred Drugs"],"heading":"PDL 2026"},{"drugClassList":[{"preferredDrugs":["non-stimulant oral agents (e.g., atomoxetine, clonidine, etc)","QELBREE"],"therapeuticCategory":"ADHD NON-STIMULANT "},{"therapeuticCategory":"ANTICONVULSANTS","preferredDrugs":["ANTISEIZURE AGENTS (e.g., carbamazepine, lamotrigine, phenytoin, topiramate, etc)","DIAZEPAM RECTAL GEL","EPIDIOLEX SOLUTION","NAYZILAM NASAL SPRAY","VALTOCO NASAL SPRAY"]},{"therapeuticCategory":"ANTIDIABETICS GLP-1 RECEPTOR AGONISTS","preferredDrugs":["OZEMPIC","TRULICITY","BYDUREON","BYETTA","RYBELSUS","SOLIQUA","TANZEUM","VICTOZA","XULTOPHY"]},{"therapeuticCategory":"ANTIRETROVIRALS","preferredDrugs":["antiretroviral agents (e.g., abacavir, atazanavir, efavirenz, emtricitabine, lamivudine, nevirapine, ritonavir, tenofovir, zidovudine, & combinations, etc)","BIKTARVY","DESCOVY","GENVOYA","ODEFSEY"]},{"preferredDrugs":["APRETUDE (covered under Medical only)","CABENUVA (covered under Medical only)"],"therapeuticCategory":"ANTIRETROVIRALS (Medical only)"},{"preferredDrugs":["DEXCOM G6","DEXCOM G7","DEXCOM G7 15 DAY","FREESTYLE LIBRE 14 DAY","FREESTYLE LIBRE 2","FREESTYLE LIBRE 3","GUARDIAN 4","GUARDIAN CONNECT","GUARDIAN LINK 3","GUARDIAN SENSOR 3"],"therapeuticCategory":"CGM - CONTINUOUS GLUCOSE MONITORING"},{"therapeuticCategory":"CNS ANTIPSYCHOTICS","preferredDrugs":["ORAL AGENTS (e.g., aripiprazole, clozapine, olanzapine, paliperidone, risperidone, etc)","ABILIFY ASIMTUFI","ABILIFY MAINTENA","ARISTADA","ARISTADA INITIO","CAPLYTA","INVEGA SUSTENNA","INVEGA TRINZA","INVEGA HAFYERA","VRAYLAR"]},{"preferredDrugs":["ENBREL","ENBREL MINI","ENBREL SURECLICK","HUMIRA","HUMIRA Pen","HUMIRA Pediatric Crohns-UC-HS","HUMIRA Pen Crohns-UC-HS","OTEZLA","RINVOQ","SKYRIZI","SKYRIZI Pen","TALTZ","TREMFYA"],"therapeuticCategory":"CYTOKINE MODULATORS"},{"therapeuticCategory":"DERM-ATOPIC DERMATITIS MONOCLONAL ANTIBODY - ANTI-IL, ANTI IGE","preferredDrugs":["atopic dermatitis topical agents (e.g., pimecrolimus cream,  tacrolimus ointment, topical corticosterioid, Eucrisa, etc)","DUPIXENT","NUCALA","XOLAIR",""]},{"therapeuticCategory":"EPINEPHRINE INJECTORS","preferredDrugs":["EPIPEN"]},{"therapeuticCategory":"GI PANCREATIC ENZYMES","preferredDrugs":["ZENPEP"]},{"therapeuticCategory":"GLUCOSE TESTING","preferredDrugs":["ACCU-CHEK GUIDE","ACCU-CHEK GUIDE ME","ACCU-CHEK GUIDE TEST STRIP","ACCU-CHEK SOFTCLIX LANCET","CONTOUR NEXT EZ","CONTOUR NEXT GEN","CONTOUR NEXT ONE","CONTOUR PLUS BLUE","CONTOUR BLOOD GLUCOSE TEST STRIP","CONTOUR NEXT BLOOD GLUCOSE TEST STRIP","CONTOUR PLUS BLOOD GLUCOSE TEST STRIP",""]},{"therapeuticCategory":"GROWTH HORMONES","preferredDrugs":["GENOTROPIN","GENOTROPIN MINIQUICK","NORDITROPIN FLEXPRO",""]},{"therapeuticCategory":"HEMATOPOIETICS – ESA","preferredDrugs":["ARANESP"]},{"therapeuticCategory":"HEMOPHILIA TREATMENTS – FACTOR VIII","preferredDrugs":["KOVALTRY","XYNTHA","XYNTHA SOLOFUSE",""]},{"therapeuticCategory":"HEPATITIS  C","preferredDrugs":["SOFOSBUVIR/VELPATASVIR TAB","MAVYRET"]},{"therapeuticCategory":"MIGRAINE - CGRP INHIBITORS","preferredDrugs":["AIMOVIG","AJOVY","EMGALITY"]},{"therapeuticCategory":"MIGRAINE TREATMENT","preferredDrugs":["TRIPTANS (e.g., almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan, etc)","UBRELVY"]},{"therapeuticCategory":"MOVEMENT DISORDER","preferredDrugs":["tetrabenazine","AUSTEDO","AUSTEDO XR","INGREZZA"]},{"therapeuticCategory":"OPIOID PARTIAL AGONISTS","preferredDrugs":["buprenorphine","buprenorphine-naloxone","SUBLOCADE (covered under Medical only)"]},{"therapeuticCategory":"PCSK9 INHIBITOR – CHOLESTEROL LOWERING","preferredDrugs":["REPATHA"]},{"therapeuticCategory":"POTASSIUM REMOVING AGENTS","preferredDrugs":["sodium polystyrene sulfonate (oral) powder, SPS","LOKELMA"]},{"therapeuticCategory":"RESPIRATORY - ADRENERGIC COMBINATIONS","preferredDrugs":["COMBIVENT RESPIMAT","STIOLTO RESPIMAT"]},{"therapeuticCategory":"UTERINE FIBROIDS AGENT","preferredDrugs":["ORILISSA"]}],"icon":"https://contenthub-aem.optumrx.com/content/dam/contenthub/retail-pharmacy-override/assets/customsite-southdokata/icons/MedicineBottle.png","tableHeaders":["Therapeutic Category","Preferred Drugs"],"heading":"PDL 2025"},{"drugClassList":[{"preferredDrugs":["non-stimulant oral agents (e.g., atomoxetine, clonidine, etc)","QELBREE"],"therapeuticCategory":"ADHD NON-STIMULANT"},{"therapeuticCategory":"ANTICONVULSANTS","preferredDrugs":["ANTISEIZURE AGENTS (e.g., carbamazepine, lamotrigine, phenytoin, topiramate, etc)","DIAZEPAM RECTAL GEL","EPIDIOLEX SOLUTION","NAYZILAM NASAL SPRAY","VALTOCO NASAL SPRAY"]},{"therapeuticCategory":"ANTIDIABETICS GLP-1 RECEPTOR AGONISTS","preferredDrugs":["OZEMPIC","RYBELSUS","TRULICITY"]},{"therapeuticCategory":"ANTIRETROVIRALS","preferredDrugs":["BIKTARVY","DESCOVY","GENVOYA"]},{"preferredDrugs":["DEXCOM G6","DEXCOM G7","DEXCOM G7 15 DAY","FREESTYLE LIBRE 14 DAY","FREESTYLE LIBRE 2","FREESTYLE LIBRE 3","GUARDIAN 4","GUARDIAN CONNECT","GUARDIAN LINK 3","GUARDIAN SENSOR 3"],"therapeuticCategory":"CGM - CONTINUOUS GLUCOSE MONITORING"},{"therapeuticCategory":"CNS ANTIPSYCHOTICS","preferredDrugs":["ORAL AGENTS (e.g., aripiprazole, clozapine, olanzapine, paliperidone, risperidone, etc)","ABILIFY ASIMTUFI","ABILIFY MAINTENA","ARISTADA","ARISTADA INITIO","INVEGA SUSTENNA","INVEGA TRINZA","INVEGA HAFYERA","VRAYLAR"]},{"therapeuticCategory":"CARDIOVASCULAR - ARB-NEPRILYSIN INHIBITOR","preferredDrugs":["ENTRESTO"]},{"preferredDrugs":["ENBREL","ENBREL MINI","ENBREL SURECLICK","HUMIRA","HUMIRA Pen","HUMIRA Pediatric Crohns","HUMIRA Pen-PS/UV Starter","SKYRIZI","SKYRIZI Pen","TALTZ"],"therapeuticCategory":"CYTOKINE MODULATORS"},{"therapeuticCategory":"DERM-ATOPIC DERMATITIS MONOCLONAL ANTIBODY - ANTI-IL, ANTI IGE","preferredDrugs":["TOPICAL AGENTS (e.g., pimecrolimus cream, tacrolimus ointment, topical corticosterioid, Eucrisa, etc)","DUPIXENT"]},{"therapeuticCategory":"GI PANCREATIC ENZYMES","preferredDrugs":["ZENPEP"]},{"therapeuticCategory":"GROWTH HORMONES","preferredDrugs":["GENOTROPIN","GENOTROPIN MINIQUICK","NORDITROPIN FLEXPRO"]},{"therapeuticCategory":"HEPATITIS C","preferredDrugs":["SOFOSBUVIR/VELPATASVIR TAB","MAVYRET"]},{"preferredDrugs":["BAQSIMI","GVOKE"],"therapeuticCategory":"HYPOGLYCEMIA"},{"therapeuticCategory":"MIGRAINE - CGRP INHIBITORS","preferredDrugs":["AIMOVIG","EMGALITY"]},{"preferredDrugs":["TRIPTANS (e.g., almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan, etc)","NURTEC","UBRELVY"],"therapeuticCategory":"MIGRAINE TREATMENT"},{"therapeuticCategory":"MOVEMENT DISORDER","preferredDrugs":["AUSTEDO","AUSTEDO XR","INGREZZA"]},{"preferredDrugs":["DYSPORT (covered under Medical only)"],"therapeuticCategory":"NEUROTOXINS (Medical only)"},{"therapeuticCategory":"RESPIRATORY - ADRENERGIC COMBINATIONS","preferredDrugs":["COMBIVENT RESPIMAT","STIOLTO RESPIMAT"]},{"preferredDrugs":["SPIRIVA RESPIMAT"],"therapeuticCategory":"RESPIRATORY - ANTICHOLINERGICS"}],"icon":"https://contenthub-aem.optumrx.com/content/dam/contenthub/retail-pharmacy-override/assets/customsite-southdokata/icons/MedicineBottle.png","tableHeaders":["Therapeutic Category","Preferred Drugs"],"heading":"PDL 2024"},{"drugClassList":[{"therapeuticCategory":"ANTICOAGULANTS - ORAL","preferredDrugs":["WARFARIN TAB","ELIQUIS TAB","ELIQUIS STARTER PACK","XARELTO TAB","XARELTO STARTER PACK"]},{"therapeuticCategory":"ANTICONVULSANTS","preferredDrugs":["ANTISEIZURE AGENTS (e.g., CARBAMAZEPINE, LAMOTRIGINE, PHENYTOIN, TOPIRAMATE, etc)","DIAZEPAM RECTAL GEL","EPIDIOLEX SOLUTION","NAYZILAM NASAL SPRAY","VALTOCO NASAL SPRAY"]},{"therapeuticCategory":"ARB-NEPRILYSIN INHIBITOR - CARDIOVASCULAR","preferredDrugs":["ENTRESTO TAB"]},{"therapeuticCategory":"HEPATITIS C - effective April 1, 2023","preferredDrugs":["SOFOSBUVIR/VELPATASVIR TAB","MAVYRET"]},{"therapeuticCategory":"PCSK9 INHIBITOR - CHOLESTEROL LOWERING","preferredDrugs":["PRALUENT INJ","REPATHA INJ","REPATHA SURE INJ","REPATHA PUSH INJ"]},{"therapeuticCategory":"MOVEMENT DISORDER DRUG THERAPY","preferredDrugs":["INGREZZA CAP"]},{"therapeuticCategory":"RESPIRATORY - ADRENERGIC COMBINATIONS","preferredDrugs":["COMBIVENT RESPIMAT","STIOLTO RESPIMAT"]},{"therapeuticCategory":"RESPIRATORY - ANTICHOLINERGICS","preferredDrugs":["SPIRIVA RESPIMAT"]}],"icon":"https://contenthub-aem.optumrx.com/content/dam/contenthub/retail-pharmacy-override/assets/customsite-southdokata/icons/MedicineBottle.png","tableHeaders":["Therapeutic Category","Preferred Drugs"],"heading":"PDL 2023"}],"pdlTabs":["PDL 2026","PDL 2025","PDL 2024","PDL 2023"],"pdlLabel":"Preferred Drug List (PDL)","title":"If a medication is not listed within a PDL class, it is considered Non-Preferred for that class and may require additional steps for approval.","title2":"If a drug class is not included on the PDL at all, it is not subject to PDL requirements; however, medications in that class may still be subject to PA."}}}]}}}