New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 51 - PHARMACEUTICAL SERVICES MANUAL
Appendix B

UPPER PAYMENT LIMITS FOR MAXIMUM ALLOWABLE COST (MAC) DRUGS

Appendix B lists the multiple source drugs which meet the criteria set forth in 42 CFR Part 447, Subpart I, which is updated periodically by the Centers for Medicare and Medicaid Services subsequent to published listing changes in the Federal Register.

AGENCY NOTE: Appendix B is filed as a part of this chapter/manual but is not reproduced in the New Jersey Administrative Code. When revisions are made to Appendix B, replacement pages will be distributed to providers, placed on the website at www.njmmis.com and copies will be filed with the Office of Administrative Law.

For a copy of Appendix B, write to:

Molina Medicaid Solutions

PO Box 4801

Trenton, New Jersey 08650-4801

or contact:

Office of Administrative Law

Quakerbridge Plaza, Building 9

PO Box 049

Trenton, New Jersey 08625-0049