| Fecha de vigencia | Policy Name | Reviewed Date |
| 11/6/2019 |
Baclofen Products (Fleqsuvy™, baclofen oral solution, baclofen oral suspension, Ozobax™, Lyvispah™)
| 7/19/2023 |
| 1/1/2023 |
Bafiertam® (monomethyl fumarate) capsule, delayed release
| 5/17/2023 |
| 1/1/2022 |
Balversa™ (erdafitinib)
| 8/16/2023 |
| 1/1/2022 |
Banzel® (rufinamide)
| 3/15/2023 |
| 1/1/2019 |
Bavencio® (avelumab)
| 8/16/2023 |
| 7/24/2014 |
Beleodaq® (belinostat)
| 2/15/2023 |
| 5/1/2021 |
Bempedoic Acid Products
| 5/11/2023 |
| 1/1/2023 |
Bendamustine products (Treanda, Bendeka, Belrapzo, Vivimusta)
| 8/3/2023 |
| 1/1/2022 |
Benlysta® (belimumab)
| 8/16/2023 |
| 1/1/2019 |
Benzodiazepine Limited Days' Supply
| 6/15/2023 |
| 7/27/2022 |
Beovu® (brolucizumab)
| 4/19/2023 |
| 1/1/2023 |
Beovu® (brolucizumab)
| 4/19/2023 |
| 1/1/2024 |
Beovu® (brolucizumab)
| 9/20/2023 |
| 1/1/2024 |
Berinert (C1 esterase inhibitor, human)
| 7/19/2023 |
| 1/1/2024 |
Berinert (C1 esterase inhibitor, human)
| 7/19/2023 |
| 1/1/2022 |
Berinert® (C1 esterase inhibitor, human)
| 7/19/2023 |
| 1/1/2022 |
Berinert® (C1 esterase inhibitor, human)
| 7/19/2023 |
| 1/1/2019 |
Besponsa™ (inotuzumab ozogamicin)
| 2/16/2022 |
| 2/16/2022 |
Besremi (ropeginterferon alfa-2b-njft)
| 2/15/2023 |
| 1/1/2022 |
Betaseron® (interferon beta-1b)
| 6/21/2023 |
| 1/1/2023 |
Bevacizumab products
| 2/23/2023 |
| 3/1/2023 |
Productos Bevacizumab
| 2/23/2023 |
| 1/1/2024 |
Bevacizumab products
| 7/19/2023 |
| 1/1/2022 |
BiDil® (isosorbide dinitrate/hydralazine)
| 8/16/2023 |
| 1/1/2019 |
Biguanide Agents
| 7/19/2023 |
| 1/1/2017 |
Bisphosphonates
| 1/18/2023 |
| 10/14/2020 |
Blenrep (belantamab mafodotin-blmf)
| 8/24/2023 |
| 1/1/2020 |
Blincyto® (blinatumomab)
| 5/17/2023 |
| 1/1/2022 |
Bortezomib products (Velcade and Bortezomib for injection)
| 8/16/2023 |
| 1/1/2022 |
Bosentan Products
| 3/15/2023 |
| 1/1/2022 |
Bosulif® (bosutinib)
| 5/17/2023 |
| 1/1/2022 |
Bosulif® (bosutinib)
| 5/17/2023 |
| 9/29/2006 |
Botox® (Botulinum Toxin)
| 8/16/2023 |
| 1/1/2024 |
Botox® (onabotulinumtoxinA)
| 8/31/2023 |
| 1/1/2022 |
Bowel Prep Agents
| 7/20/2023 |
| 1/1/2023 |
Bowel Prep Agents
| 7/20/2023 |
| 1/1/2024 |
Bowel Prep Agents
| 7/20/2023 |
| 1/1/2016 |
BPH Agents
| 6/21/2023 |
| 1/1/2020 |
Braftovi™ (encorafenib) and Mektovi® (binimetinib)
| 11/15/2023 |
| 3/17/2021 |
Breyanzi® (lisocabtagene maraleucel)
| 4/19/2023 |
| 1/1/2023 |
Breyanzi® (lisocabtagene maraleucel)
| 4/19/2023 |
| 4/21/2021 |
Breyanzi® (lisocabtagene maraleucel)
| 4/19/2023 |
| 9/16/2020 |
Breztri Aerosphere™ (budesonide/glycopyrrolate/formoterol fumarate)
| 3/15/2023 |
| 1/1/2024 |
Breztri Aerosphere™ (budesonide/glycopyrrolate/formoterol fumarate)
| 8/16/2023 |
| 2/23/2022 |
Brimonidine-timolol eye drops (generic Combigan)
| 10/18/2023 |
| 7/19/2017 |
Brineura™ (cerliponase alfa)
| 2/15/2023 |
| 6/7/2023 |
Briumvi™ (ublituximab) intravenous solution
| 5/17/2023 |
| 6/7/2023 |
Briumvi™ (ublituximab) intravenous solution
| 5/17/2023 |
| 6/7/2023 |
Briumvi™ (ublituximab) intravenous solution
| 5/17/2023 |
| 6/22/2016 |
Briviact® (brivaracetam)
| 8/16/2023 |
| 1/1/2024 |
Briviact® (brivaracetam)
| 6/21/2023 |
| 11/22/2023 |
Brixadi™ (buprenorphine)
| 11/15/2023 |
| 5/19/2021 |
Bronchitol® (mannitol)
| 3/15/2023 |
| 1/1/2023 |
Brukinsa™ (zanubrutinib)
| 2/16/2023 |
| 1/1/2020 |
Buprenorphine Containing Products
| 8/16/2023 |
| 1/1/2023 |
Buprenorphine Containing Products
| 8/16/2023 |
| 1/1/2022 |
Buprenorphine transdermal patch
| 6/21/2023 |
| 1/1/2022 |
Bupropion Containing Products (Aplenzin®, Forfivo® XL)
| 10/18/2023 |
| 1/1/2021 |
Bupropion Containing Products (Aplenzin®, Forfivo® XL, Wellbutrin XL®)
| 5/17/2023 |
| 11/17/2021 |
Bylvay (odevixibat)
| 7/19/2023 |
| 8/19/2020 |
Bynfezia Pen™ (octreotide acetate) injection
| 4/19/2023 |
| 6/22/2022 |
Byooviz™ (ranibizumab-nuna)
| 4/19/2023 |
| 1/1/2024 |
Byooviz™ (ranibizumab-nuna)
| 11/15/2023 |
| 1/1/2024 |
Byooviz™ (ranibizumab-nuna)
| 8/16/2023 |