Provider
QP87-24 MHCP Pharmacy Benefit Exclusion for Aurlumyn™, MydCombi™, paclitaxel protein-bound particles, Pavblu™ and Vyloy®
Program effective Date: Dec 11, 2024
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Displaying 3331 - 3340 of 3688 results
Provider
QP88-24 Commercial Pharmacy Benefit Exclusion for Aurlumyn™, MydCombi™, Pavblu™ and Vafseo®
Program effective Date: Dec 11, 2024
Provider
QP89-24 TriWest Healthcare Alliance (TriWest) Partnership
Program effective Date: Dec 11, 2024
Provider
Resmetirom - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Jan 01, 2025
Provider
Peginterferon & Ribavirin PA - Medicaid
Prior Authorization
Program effective Date: Jan 01, 2025
Provider
Xolremdi™ - Commercial
Prior Authorization, Quantity Limit
Program effective Date: Jan 01, 2025
Provider
Hepatitis C Direct Acting Antivirals - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Jan 01, 2025
Provider
IBS-D (Lotronex, Viberzi) - Medicaid
Prior Authorization, Quantity Limit
Program effective Date: Jan 01, 2025