Pharmacy information
Amerigroup District of Columbia, Inc. works with CarelonRx to administer pharmacy benefits for enrollees.
Medicaid
Please refer to the Preferred Drug List (PDL) when prescribing for our enrollees. This guide does not contain a complete list of drugs; rather, it lists the preferred drugs within the most commonly prescribed therapeutic categories.
Most medications on the PDL are covered without prior authorization, but there may be some that require you to contact our Pharmacy department for authorization.
Medicaid formulary
The Amerigroup District of Columbia, Inc. drug formulary contains a comprehensive list of drugs in commonly prescribed therapeutic categories, including preferred and non-preferred drugs, and drugs requiring prior authorization.
Tools and medical coverage resources
Find Care tool
Need to get a prescription filled or find an in-network provider? Use our Find Care tool.
Find a Pharmacy
Need to get a prescription filled or find an in-network provider? Find a plan pharmacy nearby.
Pharmacy prior authorizations
By phone
Call the Pharmacy department for Amerigroup District of Columbia, Inc. at 800-454-3730 between 8:00 am – 6:00 pm.
By fax
Fax your request to our Pharmacy department.
Pharmacy outpatient drugs: Fax the Pharmacy Prior Authorization Form to 844-487-9292.
Medical injectable drugs: Fax the Medical Injectable Prior Authorization Form to 844-487-9294.
Mail order pharmacy
Amerigroup District of Columbia, Inc. offers mail-order pharmacy services for certain drugs through CarelonRx’s home delivery pharmacy. To obtain mail-order pharmacy services:
By phone
Call our mail-order provider number at: 833-203-1742.
By fax
Fax your mail-order request to: 800-378-0323.
Specialty pharmacy
Amerigroup District of Columbia, Inc. offers specialty pharmacy services for certain drugs through our preferred specialty vendor, CarelonRx Specialty Pharmacy. To obtain specialty pharmacy services:
CarelonRx Specialty contact information
By phone
Call our mail-order provider number at 833-255-0646.
By fax
Fax your mail-order request to 833-263-2871.
Related information
Prior authorization lookup tool
- Pharmacy Prior Authorization Form
- Medical Injectable Prior Authorization Form
- Synagis Enrollment Form
- Medication code requirements for drugs billed under the medical benefit
- Analgesic Opioid Prior Authorization Form
- Analgesic Opioid Quantity Limits
- Analgesic Opioid Clinical Criteria
- Pharmacy Medical Step Therapy Requirements
Hot Tips
Pharmacy Hot Tips are brief messages to help to provide preferred formulary products used to treat common diseases and conditions such as asthma and diabetes.
If you would like additional pharmacy information to assist our enrollees, contact Provider Services , and we’ll prepare a Pharmacy Hot Tip for you!
Provider tools & resources
- Log in to Availity Essentials
- Launch provider learning hub
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Eligibility & Pharmacy Overview
- Provider Manuals and Guides
- Provider Search Tool
- Forms
- Training Academy
- Pharmacy Information
- Electronic Data Interchange (EDI)