test-1025-5.pdf
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Prescription & Pharmacy
Provider
policyii-174-med-drug-eval-process-list-2023-1001.pdf
Prescription & Pharmacy
Provider
bc-com-med-adv-preferred-drug-list-2023-1002.pdf
Provider
P67-23 Expansion of the Peer Specialist Benefit
Program effective Date: Oct 02, 2023
Provider
P69-23 eviCore Healthcare Specialty Utilization Management (UM) Program: Medical Oncology Drug Prior Authorization Updates
Program effective Date: Oct 02, 2023
Provider
Angiotensin II Receptor Antagonists (ARBs), Renin Inhibitors and Combinations - Medicaid
Quantity Limit
Program effective Date: Oct 01, 2024
Provider
Filspari (sparsentan) - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Jul 01, 2025
Provider
Filspari (sparsentan) - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Jul 01, 2025