Provider
Pseudobulbar Affect (PBA) - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Mar 01, 2025
Step Therapy, Quantity Limit
Program effective Date: Mar 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: May 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Jun 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Jun 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Sep 01, 2025
Program effective Date: Jun 01, 2023
Program effective Date: Jun 01, 2023