Provider
Daybue™ (trofinetide) - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
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Displaying 1431 - 1440 of 3661 results
Provider
Ophthalmic Pilocarpine - Commercial
Quantity Limit
Program effective Date: Sep 01, 2024
Provider
Ophthalmic Prostaglandins - Commercial
Quantity Limit
Program effective Date: Sep 01, 2024
Provider
Daybue™ (trofinetide) - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
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: Apr 01, 2025
Provider
Ophthalmic Prostaglandins - Medicaid
Quantity Limit
Program effective Date: Sep 01, 2024
Provider
Urinary Incontinence - Medicaid
Quantity Limit
Program effective Date: Nov 01, 2024
Provider
Antiretroviral - Commercial
Quantity Limit
Program effective Date: Sep 01, 2024
Provider
Benign Prostatic Hypertrophy (BPH) - Commercial
Quantity Limit
Program effective Date: Jan 01, 2025