| Code | Display | Definition |
| generic | Generic | Commonly prescribed generic drugs that cost more than drugs in the 'preferred generic' tier. |
| preferred | Preferred | Commonly prescribed drugs that are preferred by the plan. |
| non-preferred | Non-preferred | Commonly prescribed drugs that cost more than drugs in the 'preferred' tier. |
| preferred-generic | Preferred Generic | Commonly prescribed generic drugs. |
| non-preferred-generic | Non-preferred Generic | Generic drugs that cost more than drugs in ‘generic’ tier. |
| specialty | Specialty | Drugs used to treat complex conditions like cancer and multiple sclerosis. They can be generic or brand name, and are typically the most expensive drugs on the formulary. |
| brand | Brand | Brand name drugs that cost more than ‘preferred brand’ drugs. |
| preferred-brand | Preferred Brand | Brand name drugs |
| non-preferred-brand | Non-preferred Brand | Brand name drugs that cost more than ‘brand’ drugs. |
| zero-cost-share-preventative | Zero cost-share preventative | Preventive medications and products available at no cost. |
| medical-service | Medical Service | Drugs that must be administered by a clinician or in a facility and may be covered under a medical benefit. |