Adenosine Triphosphate-Citrate Lyase Criteria |
07/12/2022 |
Allergen Extract Criteria |
08/13/2021 |
Anti-Fungal Medication for Onychomycosis Criteria |
07/12/2022 |
Asthma/Allergy Immunomodulator Criteria |
07/12/2022 |
Atopic Dermatitis Criteria |
07/12/2022 |
Benign Prostatic Hyperplasia Criteria |
08/13/2021 |
Bowel Disorders/GI Motility, Chronic Criteria |
08/13/2021 |
Brand Name Multiple Source Prescription Drug Product Criteria |
07/12/2022 |
Buprenorphine/Naloxone and Buprenorphine (Oral) Criteria |
07/12/2022 |
Calcitonin Gene-Related Peptide (CGRP) Inhibitor Criteria |
01/14/2022 |
Carisoprodol and Combination Medication Criteria |
07/12/2022 |
CNS Stimulant and ADHD/ADD Medications Criteria |
07/12/2022 |
Codeine for Pediatric Use Criteria |
01/14/2022 |
Convenience Kits Criteria |
01/14/2022 |
Direct Renin Inhibitor and Combination Criteria |
08/13/2021 |
Duchenne Muscular Dystrophy Criteria |
08/13/2021 |
Duloxetine Criteria |
07/12/2022 |
Dupixent Criteria |
01/14/2022 |
Evrysdi Criteria |
08/13/2021 |
Fibromyalgia Criteria |
07/12/2022 |
Hematopoietic Agent Criteria |
08/13/2021 |
Hepatitis C Criteria |
01/14/2022 |
Hetlioz Criteria |
07/12/2022 |
Horizant Criteria |
07/12/2022 |
Human Growth Hormones Criteria |
07/12/2022 |
Hyaluronic Acid Derivatives Injection Criteria |
01/14/2022 |
Inhaled Insulin Criteria |
07/12/2022 |
Juxtapid Criteria |
01/14/2022 |
Long-Acting Opioid Analgesic Criteria |
07/12/2022 |
Methadone (Pain Management Only) Criteria |
07/12/2022 |
Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer's Disease Criteria |
07/12/2022 |
Morphine Milligram Equivalent Criteria |
07/12/2022 |
Movement Disorders Criteria |
07/12/2022 |
New Drug Product Criteria |
07/12/2022 |
Oral Isotretinoin Criteria |
07/12/2022 |
Pregabalin Criteria |
07/12/2022 |
Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Criteria |
07/12/2022 |
Psychoactive Medication for Children (5 Years of Age or Younger) Criteria |
07/12/2022 |
Psychotropic Medication Duplicate Therapy (Patients 6 Years and Older) Criteria |
07/12/2022 |
Pulmonary Arterial Hypertension Criteria Phosphodiesterase Type 5 (PDE-5) Inhibitors Only |
01/14/2022 |
Rho Kinase Inhibitor Criteria |
01/14/2022 |
Second-Line Antifungal Criteria |
07/12/2022 |
Short-Acting Fentanyl Analgesic Criteria |
08/13/2021 |
Spinraza (nusinersen) Criteria |
01/14/2022 |
Spravato Criteria |
08/13/2021 |
Stromectol Criteria |
01/14/2022 |
Symlin Criteria |
07/12/2022 |
Synagis Criteria |
07/12/2022 |
Systemic Immunomodulator Criteria |
07/12/2022 |
Verquvo Criteria |
07/12/2022 |
Vuity Criteria |
07/12/2022 |
Weight Management Criteria |
01/14/2022 |
Zolgensma Criteria |
07/12/2022 |