2025 Interoperability Report

Medicare prior authorization requests and responses from 1/1/2025 through 12/31/2025

Primary Biliary Cholangitis - Medicaid

Prior Authorization, Quantity Limit

Primary Biliary Cholangitis - Commercial

Prior Authorization, Quantity Limit

Supply Code List

DME Code List

Dry Eye Disease - Commercial

Prior Authorization, Quantity Limit

Biologic Immunomodulators - BasicRx (For Pharmacy Benefits Only) - Commercial

Prior Authorization, Quantity Limit

Biologic Immunomodulators - FlexRx GenRx KeyRx (For Pharmacy Benefits Only) - Commercial

Prior Authorization, Quantity Limit

Afrezza (regular human insulin, inhaled) - Commercial

Prior Authorization, Quantity Limit

Hereditary Angioedema - Commercial

Prior Authorization, Quantity Limit