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Contact Us
Molina Healthcare of New Mexico 8801 Horizon Blvd. NE Albuquerque, NM 87113 (855) 322-4078   24 Hour Grievance Line ...
/providers/nm/marketplace/contacts/contactus.aspx
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Pharmacy Prior Authorization Form
New Mexico Prior Authorization Form New Mexico Synagis Prior Authorization Form
/providers/nm/marketplace/drug/pharmacy-prior-authorization-form.aspx
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Drug List
Drug List Drug List 20131117T000000Z {A87A00B1-E6DB-45AB-8B54-636FEC3B5523}|{4647D5CB-E3D0-4511-B1BC-3D8773C1AF08}|{A2AA33AD-A5FB-4105-960A-75630EE7F0CF}|{9B1F6D94-AC7D-4A51-876A-D703E8506EA8}|{1CF4...
/providers/nm/marketplace/drug/drug.aspx
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Drug Formulary
Drug Formulary Please click on a form below to view a PDF printable version. The files below are in PDF format ()   2020 Marketplace Drug Formulary      
/providers/nm/marketplace/drug/Physician-Administered-Preferred-Drug-List.aspx
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Frequently Used Forms
Please click on a form below to view a PDF printable version. The files below are in PDF format ()   New Mexico Uniform Prior Authorization Form Provider Information Form Member Authorization to R...
/providers/nm/marketplace/forms/fuf.aspx
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Drug Formulary
Drug Formulary Please click on a form below to view a PDF printable version. The files below are in PDF format ()    2020 Marketplace Drug Formulary
/providers/nm/marketplace/drug/formulary.aspx
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Forms
Forms 20131117T000000Z 1 20221116T170943Z {A87A00B1-E6DB-45AB-8B54-636FEC3B5523}|{4647D5CB-E3D0-4511-B1BC-3D8773C1AF08}|{A2AA33AD-A5FB-4105-960A-75630EE7F0CF}|{9B1F6D94-AC7D-4A51-876A-D703E8506EA8}|...
/providers/nm/marketplace/forms/forms.aspx
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Manual
Manual 20131117T000000Z 1 {A87A00B1-E6DB-45AB-8B54-636FEC3B5523}|{4647D5CB-E3D0-4511-B1BC-3D8773C1AF08}|{A2AA33AD-A5FB-4105-960A-75630EE7F0CF}|{9B1F6D94-AC7D-4A51-876A-D703E8506EA8}|{1CF4DEE5-9FE7-4...
/providers/nm/marketplace/manual/manual.aspx
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Provider Manual
2020 Provider Manual 2019 Provider Manual   Adobe Acrobat Reader is required to view the file(s) above. Download a free version.
/providers/nm/marketplace/manual/provd.aspx
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Fraud Prevention Tips
Molina Healthcare of New Mexico ("Molina") seeks to uphold the highest ethical standards for the provision of health care benefits and services to its members and supports the efforts of federal and s...
/providers/nm/marketplace/policies/fraud.aspx
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