2022 February Bulletins

Anti-COVID19 - Medicaid

Quantity Limit

Iron Chelation - Commercial

Prior Authorization, Quantity Limit

Xolair (omalizumab) - Medicaid

Prior Authorization

Xolair (omalizumab) - Commercial

Prior Authorization

Urea Cycle Disorders - Medicaid

Prior Authorization

Urea Cycle Disorders - Commercial

Prior Authorization

Transmucosal Immediate Release Fentanyl (TIRF) - Medicaid

Prior Authorization, Quantity Limit

Transmucosal Immediate Release Fentanyl (TIRF) - Commercial

Prior Authorization, Quantity Limit

Procysbi (cysteamine bitartrate) - Commercial

Prior Authorization