Provider
Long Acting Insulin - Medicaid
Quantity Limit
Program effective Date: May 01, 2025
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Provider
Rapid to Intermediate Acting Insulin - Commercial
Quantity Limit
Program effective Date: May 01, 2025
Provider
Rapid to Intermediate Acting Insulin - Medicaid
Quantity Limit
Program effective Date: May 01, 2025
Provider
Zoryve™ (roflumilast) - Commercial - Effective Date 02/01/2025
Prior Authorization
Program effective Date: Feb 01, 2025
Provider
2023 April Bulletins
Program effective Date: Apr 03, 2023
Provider
P25R2-20 Children’s Therapeutic Services and Supports (CTSS) Prior Authorization Requirement
Program effective Date: Apr 03, 2023
Provider
Long Acting Insulin - Commercial
Quantity Limit
Program effective Date: May 01, 2025
Provider
Afrezza® - Medicaid
Quantity Limit
Program effective Date: May 01, 2025