Tus kws kho mob
Radicava (edaravone) - Medicaid
Prior Authorization, Quantity Limit
Hnub Tim pib siv tau lub khoos kas: Lub Xya Hli Ntuj Tim 01, 2025
Tshawb Nrhiav
Nthuav pom cov txiaj ntsig tshwm sim 3621 - 3630 ntawm 3669
Tus kws kho mob
Self-Administered Oncology Agents - Commercial
Prior Authorization, Quantity Limit
Hnub Tim pib siv tau lub khoos kas: Lub Xya Hli Ntuj Tim 01, 2025
Tus kws kho mob
Oral NSAID (Nonsteroidal Anti-Inflammatory Drugs) - Commercial
Step Therapy
Hnub Tim pib siv tau lub khoos kas: Lub Xya Hli Ntuj Tim 01, 2025
Tus kws kho mob
Oral Anticoagulant - Commercial
Quantity Limit
Hnub Tim pib siv tau lub khoos kas: Lub Xya Hli Ntuj Tim 01, 2025
Tus kws kho mob
Self-Administered Oncology Agents - Medicaid
Prior Authorization, Quantity Limit
Hnub Tim pib siv tau lub khoos kas: Lub Xya Hli Ntuj Tim 01, 2025
Tus kws kho mob
Oral Tetracycline Derivatives - Commercial
Kev Tso Cai Ua Ntej
Hnub Tim pib siv tau lub khoos kas: Lub Xya Hli Ntuj Tim 01, 2025
Tus kws kho mob
Selective Serotonin Inverse Agonist (SSIA) - Commercial
Prior Authorization, Quantity Limit
Hnub Tim pib siv tau lub khoos kas: Lub Xya Hli Ntuj Tim 01, 2025
Tus kws kho mob
Opioid Concurrent Opioid Dependence Therapy - Medicaid
Kev Tso Cai Ua Ntej
Hnub Tim pib siv tau lub khoos kas: Lub Xya Hli Ntuj Tim 01, 2025
Tus kws kho mob
Low Molecular Weight Heparins (LMWH) and Arixtra - Commercial
Quantity Limit
Hnub Tim pib siv tau lub khoos kas: Lub Xya Hli Ntuj Tim 01, 2025
Tus kws kho mob
Insomnia Agents - Medicaid
Quantity Limit
Hnub Tim pib siv tau lub khoos kas: Lub Xya Hli Ntuj Tim 01, 2025