Ryan White Primary and Specialty Care (Medical and Dental) Services
The following documents are intended for Ryan White Primary Care Providers.
Clinic, Lab, and Pharmacy
- Drug Formulary
- Allowable Dental Services
- Dental Practice Guidelines
- Excluded Procedure Codes
- Standards of Care Committee Practice Guidelines
- Medical Practice Guidelines
- Nutritional Supplement Form
Health Risk Assessment English
- Sexual Health Risk Assessment Spanish
- Specialty Care Authorization Form—Medical
- Specialty Care Authorization Form—Dental
- Specialty Care Authorization Form—Home Health and Hospice
- Viral Load Test Form*
Provider Registration Form (Rev.
- HRSA Ryan White HIV/AIDS Program Performance Measures
- Ryan White Primary Care Contract Administrator—(619) 293-4716; please contact us if you have any questions.
For more information,
call (619) 293-4700 or send us an e-mail.
Last updated September 20, 2022.