Provider
Dry Eye Disease - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Oct 01, 2024
Documents & Forms Results
Displaying 1331 - 1340 of 3165 results
Provider
Benign Prostatic Hypertrophy (BPH) - Medicaid
Quantity Limit
Program effective Date: Oct 01, 2024
Provider
Angiotensin II Receptor Antagonists (ARBs), Renin Inhibitors and Combinations - Medicaid
Quantity Limit
Program effective Date: Oct 01, 2024
Provider
Neurotrophic Keratitis - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Oct 01, 2024
Provider
Neurotrophic Keratitis - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Oct 01, 2024
Provider
Hyperpolarization-Activated Cyclic Nucleotide-Gated (HCN) Channel Blocker (Corlanor) - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Oct 01, 2024
Provider
Proton Pump Inhibitors (PPI's) - Medicaid
Quantity Limit
Program effective Date: Oct 01, 2024
Provider
Angiotensin II Receptor Antagonists (ARBs), Renin Inhibitors and Combinations - Commercial
Step Therapy, Quantity Limit
Program effective Date: Oct 01, 2024
Provider
QP73-24 Prime Therapeutics/Magellan Rx Management (medical pharmacy solutions program) to become “Prime Therapeutics Management”
Program effective Date: Sep 25, 2024
Provider
QP71-24 MHCP Pharmacy Benefit Update: Revised Drug-Related Prior Authorization (PA) Requirement Notification, Effective October 1, 2024
Program effective Date: Sep 11, 2024