Políticas de cobertura médica y de farmacia

Fecha de vigencia	Policy Name	Reviewed Date
1/1/2018	Effient® (prasugrel)	10/19/2022
12/16/2010	Egrifta® (tesamorelin acetate)	3/15/2023
1/1/2023	Elahere (mirvetuximab soravtansine-gynx)	12/14/2022
9/29/2008	Elaprase® (idursulfase)	11/16/2022
5/22/2012	Elelyso® (taliglucerase alfa)	9/1/2022
4/21/2021	Elepsia™ XR (levetiracetam) extended-release tablets	1/18/2023
1/1/2022	Elidel® (pimecrolimus)	4/19/2023
1/1/2020	Eligard® (leuprolide acetate)	11/16/2022
1/1/2012	Elitek® (rasburicase)	2/15/2023
1/1/2023	Elzonris™ (tagraxofusp-erzs)	5/17/2023
1/1/2020	Emend IV (fosaprepitant)	5/17/2023
1/1/2008	Emend® Oral (aprepitant)	2/15/2023
1/1/2020	Emflaza® (deflazacort)	11/16/2022
7/21/2021	Empaveli™ (pegcetacoplan)	2/23/2023
1/1/2022	Empliciti (elotuzumab)	8/17/2022
1/1/2022	EMSAM® (selegiline transdermal system)	7/21/2022
1/1/2022	Enbrel® (etanercept)	5/17/2023
11/8/2017	Endari™ (L-glutamine)	2/15/2023
1/1/2023	Enhertu (fam-trastuzumab deruxtecan-nxki)	9/21/2022
7/27/2022	Enjaymo™ (sutimlimab-jome)	7/20/2022
1/20/2021	Enspryng™ (satralizumab-mwge)	11/16/2022
9/28/2022	Entadfi™ (finasteride and tadalafil)	9/21/2022
1/1/2022	Entocort® (budesonide)	5/17/2023
1/1/2019	Entyvio® (vedolizumab)	12/21/2022
1/1/2020	Entyvio® (vedolizumab)	1/18/2023
1/1/2022	Entyvio® (vedolizumab)	11/16/2022
1/1/2019	Envarsus XR® (tacrolimus extended-release)	7/20/2022
1/1/2021	Envarsus XR® (tacrolimus extended-release)	7/20/2022
1/1/2021	Epclusa® (sofosbuvir/velpatasvir)	8/17/2022
1/1/2022	Epidiolex® (cannabidiol) oral solution	2/15/2023
1/1/2019	EpiPen® and EpiPen Jr® (epinephrine)	1/18/2023
1/1/2023	Eplerenone Products	7/20/2022
1/1/2023	Epoetin Alfa (Epogen, Procrit, Retacrit)	11/10/2022
1/1/2021	Epoprostenol Products	5/17/2023
12/15/2021	Eprontia™ (topiramate) oral solution	11/16/2022
1/1/2021	Equetro® (carbamazepine)	8/17/2022
1/1/2021	Erbitux® (cetuximab)	8/17/2022
1/4/2017	Erectile Dysfunction Medications	2/15/2023
2/9/2012	Erivedge® (vismodegib)	12/14/2022
1/1/2022	Erleada™ (apalutamide)	12/14/2022
1/1/2019	Erwinaze® (asparaginase Erwinia chrysanthemi)	2/16/2022
1/1/2023	Esbriet® (pirfenidone)	1/19/2023
1/1/2022	Eucrisa® (crisaborole)	4/19/2023
1/1/2023	Eulexin (Flutamide)	5/17/2023
6/19/2019	Evenity™ (romosozumab-aqqg)	4/19/2023
1/1/2023	Evenity™ (romosozumab-aqqg)	5/17/2023
1/1/2021	Evista (raloxifene)	4/19/2023
3/17/2021	Evkeeza™ (evinacumab-dgnb)	4/19/2023
6/1/2016	Evomela (melphalan)	2/15/2023
11/11/2020	Evrysdi™ (risdiplam) Oral Solution	3/15/2023
11/17/2021	Exkivity (mobocertinib)	10/19/2022
1/1/2022	Exondys 51™ (eteplirsen) intravenous solution	2/15/2023
8/18/2021	Exservan™ (riluzole)	8/17/2022
1/1/2022	Eylea® (aflibercept)	4/19/2023
1/1/2023	Eylea® (aflibercept)	4/19/2023
1/1/2023	Eysuvis™ (loteprednol etabonate)	3/15/2023
1/1/2021	Ezetimibe-Containing Products	5/17/2023

Políticas de cobertura de farmacia

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