Provider
Antidepressant Agents - Commercial
Step Therapy, Quantity Limit
Program effective Date: Jun 01, 2025
Step Therapy, Quantity Limit
Program effective Date: Jun 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Jun 01, 2025
Prior Authorization, Quantity Limit
Program effective Date: Jun 01, 2025
Program effective Date: Dec 22, 2021
Program effective Date: Dec 22, 2021
Program effective Date: Dec 22, 2021
Program effective Date: Dec 22, 2021
Program effective Date: Dec 22, 2021
Program effective Date: Dec 22, 2021