Provider
Otezla® (apremilast) - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Sep 01, 2024
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Displaying 2031 - 2040 of 3661 results
Provider
Formulary Exception with Quantity Limit - Standard Guidelines - FlexRx and GenRx
Formulary Exception, Quantity Limit
Program effective Date: Jan 01, 2025
Provider
Erectile Dysfunction - Phosphodiesterase Type 5 Inhibitors, Topical Prostaglandin - Commercial
Quantity Limit
Program effective Date: Jan 01, 2025
Provider
Oral Tetracycline Derivatives - Commercial
Prior Authorization
Program effective Date: Jan 01, 2025
Provider
Myalept® (metreleptin) - Commercial - Effective Date 02/01/2025
Prior Authorization
Program effective Date: Feb 01, 2025
Provider
Carbaglu® (carglumic acid) - Medicaid
Prior Authorization
Program effective Date: Dec 01, 2024
Provider
Weight Loss Agents - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Dec 01, 2024
Provider
Weight Loss Agents - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Jan 01, 2025
Provider
Topical NSAID (Non-Steroidal Anti-Inflammatory Drug) - Commercial - Effective Date 02/01/2025
Step Therapy, Quantity Limit
Program effective Date: Feb 01, 2025
Provider
Topical Actinic Keratosis, Basal Cell Carcinoma, Genital Wart Agents - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Jan 01, 2025