Tus kws kho mob
Gabapentin ER (extended-release) [Horizant, Gralise] - Commercial
Step Therapy, Quantity Limit
Hnub Tim pib siv tau ntawm lub khoos kas: Rau Hlis Ntuj Tim 01, 2026
Tshawb Nrhiav
Nthuav pom cov txiaj ntsig tshwm sim 4191 - 4200 ntawm 4303
Tus kws kho mob
Fintepla (fenfluramine) - Commercial
Prior Authorization, Quantity Limit
Hnub Tim pib siv tau ntawm lub khoos kas: Rau Hlis Ntuj Tim 01, 2026
Tus kws kho mob
Vijoice (alpelisib) - Commercial
Prior Authorization, Quantity Limit
Hnub Tim pib siv tau ntawm lub khoos kas: Rau Hlis Ntuj Tim 01, 2026
Tus kws kho mob
Triptans - Commercial
Step Therapy, Quantity Limit
Hnub Tim pib siv tau ntawm lub khoos kas: Rau Hlis Ntuj Tim 01, 2026
Tus kws kho mob
Pancreatic Enzymes - Commercial
Step Therapy
Hnub Tim pib siv tau ntawm lub khoos kas: Rau Hlis Ntuj Tim 01, 2026
Tus kws kho mob
Benzodiazepines - Medicaid
Quantity Limit
Hnub Tim pib siv tau ntawm lub khoos kas: Rau Hlis Ntuj Tim 01, 2026
Tus kws kho mob
Cannabidiol - Medicaid
Prior Authorization, Quantity Limit
Hnub Tim pib siv tau ntawm lub khoos kas: Rau Hlis Ntuj Tim 01, 2026
Tus kws kho mob
Cannabidiol - Commercial
Prior Authorization, Quantity Limit
Hnub Tim pib siv tau ntawm lub khoos kas: Rau Hlis Ntuj Tim 01, 2026
Tus kws kho mob
Continuous Glucose Monitor (CGM) - Commercial
Quantity Limit
Hnub Tim pib siv tau ntawm lub khoos kas: Rau Hlis Ntuj Tim 01, 2026
Tus kws kho mob
2026 June Bulletins
Hnub Tim pib siv tau ntawm lub khoos kas: Rau Hlis Ntuj Tim 01, 2026