Provider
QP103-20 Commercial Pharmacy Benefit Exclusion for Emtricitabine-Tenofovir Disoproxil Fumarate Tablet 200-300 mg
Program effective Date: Oct 28, 2020
Documents & Forms Results
Displaying 2231 - 2240 of 3111 results
Provider
QP104-20 Update: Cotiviti to Perform Focused and Limited Hospital Bill Validation (HBV) Services
Program effective Date: Oct 28, 2020
Provider
QP99-20 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Insulin Pump PA with QL
Program effective Date: Oct 14, 2020
Provider
QP96-20 Medical Drug Update for New to Market Inclisiran
Program effective Date: Oct 14, 2020
Provider
QP97-20 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Hemophilia Factor VIII PA with QL
Program effective Date: Oct 14, 2020
Provider
QP98-20 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Fintepla® (fenfluramine) PA with QL
Program effective Date: Oct 14, 2020
Provider
QP101-20 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) Criteria: Dojolvi™ PA
Program effective Date: Oct 14, 2020
Provider
QP100-20 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Hemophilia Factor IX PA with QL
Program effective Date: Oct 14, 2020
Provider
QP95-20 Commercial Pharmacy Benefit Exclusion for Jelmyto®
Program effective Date: Oct 14, 2020
Provider
QP94-20 Commercial Pharmacy Benefit Exclusion for Condylox®, Lyumjev™, Veregen® and Zilxi™
Program effective Date: Oct 14, 2020