PA Form Lookup

ND Medicaid PA Form Search

Information contained on this website is not a guarantee of payment. The Department will continue to pay for medications pursuant to current Department policies.

Please use the PA Criteria menu option on the home page to view prior authorization criteria. Please use the PDL menu option to view the preferred drug list and prior authorization criteria for PDL managed classes. The PDL is not an all-inclusive list of covered medications or medications that require prior authorization.