Provider
QP33-18 Pharmacy Benefit Update - New Drug-Related Prior Authorization (PA) Criteria: Strensiq (asfotase alfa)
Program effective Date: May 15, 2018
Documents & Forms Results
Displaying 2631 - 2640 of 3623 results
Provider
QP7-18 Disclosure of Ownership Form
Program effective Date: Jan 18, 2018
Provider
QP9-18 New Drug-Related Pharmacy Step Therapy (ST) Program Ophthalmic Antihistamine
Program effective Date: Feb 05, 2018
Provider
QP27-17 Viewing Chiropractic Benefits
Program effective Date: Sep 10, 2017
Provider
QP41-17 Participation Status in the High Value and Access Networks
Program effective Date: Nov 30, 2017
Provider
QP29-17 Pharmacy Benefit Exclusion for Kymriah
Program effective Date: Sep 21, 2017
Provider
QP18-18 Medical Drug Exclusion Lists Expanded to Include Ixifi, Durolane, Visco 3 and TriVisc
Program effective Date: Mar 08, 2018
Provider
QP41-18 Addition of Drugs to the Self-Administered Oncology Prior Authorization with Quantity Limit Program
Program effective Date: Jun 06, 2018
Provider
QP33-17 ICD-10 Grouper Updates
Program effective Date: Oct 17, 2017
Provider
QP10-18 Routes of Administration Pharmacy Benefit Exclusion
Program effective Date: Feb 05, 2018