Provider
QP82-20 Commercial Pharmacy Benefit Exclusion for Amzeeq™ (minocycline) foam, brimonidine ophthalmic solution 0.15% and ProAir® (albuterol sulfate) HFA
Program effective Date: Aug 26, 2020
Documents & Forms Results
Displaying 2271 - 2280 of 3108 results
Provider
QP78-20 Commercial Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Isturisa®
Program effective Date: Aug 26, 2020
Provider
QP77-20 Commercial Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Bempedoic Acid
Program effective Date: Aug 26, 2020
Provider
2020 September Provider Press
Program effective Date: Aug 19, 2020
Provider
QP73-20 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Bempedoic Acid PA with QL
Program effective Date: Aug 12, 2020
Provider
QP72-20 MHCP Pharmacy Benefit Update – Pharmacy Benefit Exclusion for Anjeso™, Fetroja®, Herzuma®, Ontruzant®, Potassium Phosphates, Scenesse® and Trazimera™
Program effective Date: Aug 12, 2020
Provider
QP71-20 MHCP Pharmacy Benefit Update: Pharmacy Benefit Exclusion for Phesgo™, Uplizna™, and Zepzelca™
Program effective Date: Aug 12, 2020
Provider
QP76-20 Outlier Outpatient Therapy Management Program
Program effective Date: Aug 12, 2020
Provider
QP74-20 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Isturisa PA with QL
Program effective Date: Aug 12, 2020
Provider
QP75-20 Commercial Pharmacy Benefit Exclusion for Aralast®NP, Eylea®, Glassia®, Lucentis®, Prolastin®-C, and UpliznaTM
Program effective Date: Aug 12, 2020