Bixiye
Proton Pump Inhibitors (PPIs) - Commercial
Step Therapy, Quantity Limit
Taariikhda uu dhaqangalayo Barnaamijka: : Abr 01, 2025
Dukumentiyadda & Foomamka Natiijooyinka
Soo bandhiga 371 - 380 ee natiijooyinka 3167
Bixiye
Sunosi™ (solriamfetol) - Commercial
Prior Authorization, Quantity Limit
Taariikhda uu dhaqangalayo Barnaamijka: : Abr 01, 2025
Bixiye
Sunosi™ (solriamfetol) - Medicaid
Prior Authorization, Quantity Limit
Taariikhda uu dhaqangalayo Barnaamijka: : Abr 01, 2025
Bixiye
Oxybate - Commercial
Prior Authorization, Quantity Limit
Taariikhda uu dhaqangalayo Barnaamijka: : Abr 01, 2025
Bixiye
Insulin Pumps - Medicaid
Prior Authorization, Quantity Limit
Taariikhda uu dhaqangalayo Barnaamijka: : Abr 01, 2025
Bixiye
Transmucosal Immediate Release Fentanyl (TIRF) - Medicaid
Prior Authorization, Quantity Limit
Taariikhda uu dhaqangalayo Barnaamijka: : Abr 01, 2025
Bixiye
Transmucosal Immediate Release Fentanyl (TIRF) - Commercial
Prior Authorization, Quantity Limit
Taariikhda uu dhaqangalayo Barnaamijka: : Abr 01, 2025
Bixiye
Xolair® (omalizumab) - Medicaid
Prior Authorization
Taariikhda uu dhaqangalayo Barnaamijka: : Abr 01, 2025
Bixiye
Xolair® (omalizumab) - Commercial
Prior Authorization
Taariikhda uu dhaqangalayo Barnaamijka: : Abr 01, 2025
Bixiye
Erectile Dysfunction - Phosphodiesterase Type 5 Inhibitors, Topical Prostaglandin - Commercial
Quantity Limit
Taariikhda uu dhaqangalayo Barnaamijka: : Abr 01, 2025