Provider
QP56-19 Pharmacy Benefit Update – New Drug-Related Step Therapy Criteria: Topical Corticosteroids
Program effective Date: Jun 12, 2019
Documents & Forms Results
Displaying 3041 - 3050 of 3629 results
Provider
QP48-19 Pharmacy Benefit Update – New Drug-Related Prior Authorization with Quantity Limit Criteria: Somatostatin Analogs
Program effective Date: Jun 12, 2019
Provider
QP47-19 Pharmacy Benefit Update – New Drug-Related Prior Authorization with Quantity Limit Criteria: Hereditary transthyretin-mediated (hATTR) Amyloidosis Neuropathy
Program effective Date: Jun 12, 2019
Provider
QP57-19 Pharmacy Benefit Update – New Drug-Related Prior Authorization Criteria: tafamidis
Program effective Date: Jun 12, 2019
Provider
QP49-19 Pharmacy Benefit Exclusion for Proventil (albuterol sulfate) HFA and Proventil (albuterol sulfate) HFA Authorized Generic (AG)
Program effective Date: Jun 12, 2019
Provider
QP54-19 Pharmacy Benefit Update – New Drug-Related Utilization Management Program: Opioid Immediate Release (IR) New to Therapy (NTT) Program
Program effective Date: Jun 12, 2019
Provider
QP52-19 Pharmacy Benefit Exclusion for Cimzia, Elzonris, Gamifant, Kalbitor, Khapzory, leucovorin calcium, Nuzyra and Panzyga
Program effective Date: Jun 12, 2019
Provider
QP53-19 Pharmacy Benefit Update – New Drug-Related Prior Authorization with Quantity Limit Criteria: Neurotrophic Keratitis
Program effective Date: Jun 12, 2019
Provider
QP59-19 eviCore Group Number List to be Removed
Program effective Date: Jun 12, 2019
Provider
QP51-19 Pharmacy Benefit Update – New Drug-Related Prior Authorization with Quantity Limit Criteria: Firdapse
Program effective Date: Jun 12, 2019