Provider
Transmucosal Immediate Release Fentanyl (TIRF) - Medicaid - Opens in a new window
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Quantity Limit
Program effective Date: Apr 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025