MagellanRX Commercial Prior Authorization List
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Displaying 1081 - 1090 of 3698 results
Provider
QP59-24 Commercial Pharmacy Benefit Exclusion for Select Medications
Program effective Date: Jul 24, 2024
Provider
Glucose Test Strips and Meters - Commercial
Quantity Limit
Program effective Date: Jun 01, 2025
Provider
Fabhalta (iptacopan) - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Jun 01, 2025
Provider
Fabhalta® (iptacopan) - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Jan 01, 2025
Provider
QP57-24 Commercial and MHCP Pharmacy Benefit Exclusion for Beqvez® and Hepzato™
Program effective Date: Jul 10, 2024
Provider
QP55-24 MHCP Pharmacy Benefit Update: Revised Drug-Related Prior Authorization (PA) Requirement Notification, Effective August 1, 2024
Program effective Date: Jul 10, 2024
Provider
QP56-24 Commercial Pharmacy Benefit Update: New and Revised Drug-Related Prior Authorization (PA) Requirement Notification, Effective September 1, 2024
Program effective Date: Jul 10, 2024
Provider
P46-24 Medical Policy Updates: Coupe Health and Self-Funded Benefit Plans Managed by Blue Cross and Blue Shield of Alabama
Program effective Date: Jul 01, 2024
Provider
P47-24 MagellanRx Management, a Prime Therapeutics Company (UM) Program: Medical Drug Updates
Program effective Date: Jul 01, 2024