Provider
Topical Corticosteroids - Medicaid
Quantity Limit
Program effective Date: Jan 01, 2025
Documents & Forms Results
Displaying 751 - 760 of 3159 results
Provider
Winlevi® (clascoterone) - Commercial
Prior Authorization
Program effective Date: Jan 01, 2025
Provider
Benign Prostatic Hypertrophy (BPH) - Commercial
Quantity Limit
Program effective Date: Jan 01, 2025
Provider
Otezla® (apremilast) - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Jan 01, 2025
Provider
Cholestasis Pruiritis - Commercial
Prior Authorization
Program effective Date: Jan 01, 2025
Provider
Rayos® (prednisone delayed-release tablet) - Commercial
Prior Authorization
Program effective Date: Jan 01, 2025
Provider
Topical Lidocaine - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Jan 01, 2025
Provider
Topical Doxepin - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Jan 01, 2025
Provider
Topical Lidocaine - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Jan 01, 2025
Provider
Topical Doxepin - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Jan 01, 2025