Provider
QP52-21 Commercial and MHCP Pharmacy Benefit Exclusion for AduhelmTM
Program effective Date: Jun 23, 2021
Program effective Date: Jun 23, 2021
Prior Authorization
Program effective Date: Aug 01, 2025
Prior Authorization
Program effective Date: Aug 01, 2025
Quantity Limit
Program effective Date: Jun 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Jun 01, 2025
Program effective Date: May 26, 2021
Program effective Date: Jun 09, 2021
Program effective Date: Jun 09, 2021
Program effective Date: Jun 01, 2021