Provider
QP44-18 Pharmacy Benefit Update - New Drug-Related PA with QL Criteria: Lyrica CR (pregabalin Extended Release)
Program effective Date: Jun 06, 2018
Documents & Forms Results
Displaying 3091 - 3100 of 3633 results
Provider
QP40-18 Pharmacy Benefit Update - New Drug-Related PA with QL Criteria: Selective Serotonin Inverse Agonist (SSIA)
Program effective Date: May 31, 2018
Provider
QP30-18 Subscriber Identification (ID) Cards
Program effective Date: Apr 27, 2018
Provider
QP11-18 Qualified Medicare Beneficiary Program Changes
Program effective Date: Feb 15, 2018
Provider
QP31-18 Pharmacy Benefit Update - New Drug-Related Step Therapy with Quantity Limit Criteria: Metformin ER
Program effective Date: May 04, 2018
Provider
QP53-18 Medical Drug Policy Criteria Expanded for Stelara and Simponi Aria
Program effective Date: Jun 27, 2018
Provider
QP23-18 Pharmacy Benefit Exclusion for Crysvita
Program effective Date: Apr 13, 2018
Provider
QP36-18 Pre-Admission Notification Update Effective May 21, 2018
Program effective Date: May 18, 2018
Provider
QP14-18 Pharmacy Benefit Exclusion for Fasenra
Program effective Date: Feb 19, 2018
Provider
QP26-18 Predetermination Request Form for Commercial Lines of Business
Program effective Date: Apr 19, 2018