Provider
QP81-23 Update: Medical Drug Update for Tofersen (Qalsody), Delandistrogene Moxeparvovec (Elevidys), and Donislecel (Lantidra)
Program effective Date: Oct 11, 2023
Program effective Date: Oct 11, 2023
Prior Authorization, Quantity Limit
Program effective Date: May 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Aug 01, 2025
Program effective Date: Oct 25, 2023