Provider
Daybue (trofinetide) - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
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Displaying 2331 - 2340 of 3878 results
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
Provider
Ophthalmic Prostaglandins - Medicaid
Quantity Limit
Program effective Date: Sep 01, 2025
Provider
Urinary Incontinence - Medicaid
Quantity Limit
Program effective Date: Nov 01, 2024
Provider
Skyclarys (omaveloxolone) - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Aug 01, 2025
Provider
Ophthalmic Pilocarpine - Medicaid
Quantity Limit
Program effective Date: Sep 01, 2025
Provider
Daybue (trofinetide) - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Apr 01, 2025
Provider
QP71-23 Register for Webinar | Trauma-Informed Care 102 | Tuesday, September 28, 5-6:30 pm
Program effective Date: Sep 13, 2023
Provider
QP72-23 Commercial Pharmacy Benefit Update: New and Revised Drug-Related Prior Authorization (PA) Requirement Notification, Effective November 1, 2023
Program effective Date: Sep 13, 2023