Provider
P34-17 Addition of Drug to the Amitiza (lubiprostone), Linzess (linaclotide), and Trulance (plecanatide) Prior Authorization Program
Program effective Date: Jun 13, 2017
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Displaying 3201 - 3210 of 3690 results
Provider
P27-17 New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Antifungal Agents
Program effective Date: May 25, 2017
Provider
P58-17 New Drug-Related Prior Authorization with Quantity Limit Criteria: Topical Doxepin
Program effective Date: Oct 24, 2017
Provider
P59-16 Organization Determination Additions for Platinum Blue - Effective January 23, 2017
Program effective Date: Dec 08, 2016
Provider
P51-16 Addition of a Drug (Belviq XR) to the Weight Loss Agents Prior Authorization with Quantity Limit Program
Program effective Date: Oct 28, 2016
Provider
P19R2-18 Update: New Remittance Code OA-45/N801 for Purchased/Referred Care (PRC) - Eligible Subscribers
Program effective Date: May 01, 2018
Provider
P26-17 New Drug-Related Prior Authorization (PA) Criteria: Urea Cycle Disorders
Program effective Date: May 25, 2017
Provider
P29-17 New Drug-Related Prior Authorization (PA) Criteria: Erythropoietins
Program effective Date: Jun 05, 2017
Provider
P12-17 A New Drug, Pharmaceutical Grade L-Glutamine Will Require Prior Authorization
Program effective Date: Apr 03, 2017
Provider
P28-17 New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Hereditary Angioedema
Program effective Date: May 25, 2017