Opzelura (ruxolitinib) - Commercial

Prior Authorization, Quantity Limit

Vesicular Monoamine Transporter 2 (VMAT2) - Commercial

Prior Authorization, Quantity Limit

Triptans - Commercial

Step Therapy, Quantity Limit

Xhance - Commercial

Prior Authorization, Quantity Limit

Vesicular Monoamine Transporter 2 (VMAT2) - Medicaid

Prior Authorization, Quantity Limit

Topical Corticosteroids - Commercial

Step Therapy, Quantity Limit

Symlin - Medicaid

Step Therapy, Quantity Limit

Zeposia (ozanimod) - Medicaid

Prior Authorization, Quantity Limit

Zeposia (ozanimod) - Commercial

Prior Authorization, Quantity Limit

P22-22 eviCore Healthcare Specialty Utilization Management (UM) Program – Medical Oncology Drug Prior Authorization Updates