Palm Formulary

Palm Formulary

To get an updated version of the palm formulary, enter your validation code and press the "Submit" button.


*Required Fields

*First Name:
Last Name:
Medical Group:
*Email Address:
*Validation Code:



To access your formulary, click here.
To submit questions or comments, click here.


Health Care Professionals:

To get additional information on how to access the Palm Formulary application, click here.
To get Additional information on Medicare Part D, click here.
To request a Prior Authorization, click here.