Políticas de cobertura médica y de farmacia - Inicio

Políticas de cobertura de farmacia

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Fecha de vigenciaPolicy NameReviewed Date
1/1/2021 Obesity Medications
7/20/2022
1/20/2017 Obizur [antihemophilic (recombinant), porcine sequence]
11/16/2022
1/1/2023 Ocaliva® (obeticholic acid)
9/21/2022
1/1/2022 Ocrevus® (ocrelizumab)
11/17/2021
1/1/2023 Ocrevus® (ocrelizumab) Intravenous Solution
4/19/2023
1/1/2023 Ocrevus® (ocrelizumab) intravenous solution
12/14/2022
8/19/2020 Octreotide Products
4/19/2023
10/29/2015 Odomzo® (sonidegib)
12/14/2022
1/1/2021 Ofev® (nintedanib)
8/17/2022
1/1/2023 Olinvyk® (olicerdine)
3/15/2023
7/1/2022 Olumiant® (baricitinib)
6/23/2022
7/1/2022 Olumiant® (baricitinib)
6/23/2022
1/1/2018 Oncaspar® (pegaspargase)
3/16/2023
1/1/2020 Onfi® (clobazam)
2/15/2023
12/9/2020 Ongentys® (opicapone) capsules
9/21/2022
1/20/2016 Onivyde ® (liposomal irinotecan)
9/21/2022
1/1/2023 Onpattro® (patisiran)
7/20/2022
11/11/2020 Onureg™ (azacitidine)
9/21/2022
1/1/2023 Opdivo (nivolumab)
7/20/2022
4/13/2022 Opdualag (nivolumab and relatlimab-rmbw)
4/7/2022
1/1/2023 Opdualag (nivolumab and relatlimab-rmbw)
9/22/2022
1/1/2020 Ophthalmic Antibiotics
12/14/2022
1/1/2020 Ophthalmic Antibiotics
12/14/2022
1/1/2017 Ophthalmic Beta Blockers
7/20/2022
1/1/2019 Ophthalmic Beta Blockers
7/20/2022
1/1/2020 Ophthalmic Non-Steroidal Anti-Inflammatory Drugs
12/14/2022
1/1/2020 Ophthalmic Non-Steroidal Anti-Inflammatory Drugs
12/14/2022
1/1/2019 Ophthalmic Prostaglandins
3/15/2023
1/1/2021 Ophthalmic Prostaglandins
5/18/2022
1/1/2023 Ophthalmic Prostaglandins
3/15/2023
1/1/2020 Ophthalmic Steroids
12/14/2022
1/1/2020 Ophthalmic Steroids
12/14/2022
1/1/2023 Ophthalmic Cyclosporine (Cequa™, generic Restasis)
4/19/2023
1/1/2023 Ophthalmic Cyclosporine (Cequa™, generic Restasis)
3/15/2023
1/1/2019 Opioid Days' Supply Limitation
10/27/2022
1/1/2022 Opioid Days' Supply Limitation
10/27/2022
1/1/2023 Opioid Days' Supply Limitation
10/27/2022
11/3/2021 Opioid Days' Supply Limitation - Florida Statute 456.44(5)(a) Prescription Supply Limits
10/19/2022
2/1/2021 Opioid Utilization Program - Concurrent Use of Opioids and Benzodiazepines (COB) edits
10/19/2022
1/1/2021 Opioid Utilization Program - Morphine Milligram Equivalent (MME) edits
2/9/2023
1/1/2021 Opioid Utilization Program - Morphine Milligram Equivalents (MME) edits
12/8/2022
7/1/2021 Opioid Utilization Program - Morphine Milligram Equivalents (MME) edits
5/18/2022
2/2/2022 Opsumit® (macitentan)
1/18/2023
1/26/2022 Opzelura™ (ruxolitinib)
10/19/2022
1/1/2019 Oracea® (doxycycline)
7/20/2022
1/1/2020 Oral Acne Antibiotics
1/18/2023
1/1/2022 Oral Acne Antibiotics
5/17/2023
1/1/2021 Oral Isotretinoin Products
5/17/2023
1/1/2021 Oral Penicillamine Products
1/18/2023
1/1/2014 Oral tretinoin (tretinoin capsule)
3/16/2022
1/1/2019 Orencia® (abatacept) Intravenous
12/21/2022
1/1/2022 Orencia® (abatacept) Subcutaneous
2/15/2023
1/1/2022 Orencia® (abatacept) Subcutaneous
5/17/2023
1/1/2020 Orencia® IV (abatacept)
1/18/2023
1/1/2022 Orencia® IV (abatacept)
1/18/2023
7/1/2020 Orenitram® (treprostinil)
4/19/2023
1/1/2022 Orenitram® (treprostinil)
4/19/2023
1/1/2023 Orgovyx (relugolix) tablets
5/18/2022
2/1/2021 Oriahnn™ (elagolix, estradiol, and norethindrone acetate)
1/18/2023
10/17/2018 Orilissa™ (elagolix)
7/20/2022
1/1/2021 Orilissa™ (elagolix)
7/20/2022
12/23/2020 Orladeyo™ (berotralstat)
8/17/2022
6/19/2019 Orphenadrine Products
12/14/2022
4/19/2023 Orserdu (elacestrant)
3/30/2023
10/14/2020 Ortikos™ (budesonide)
5/17/2023
6/20/2018 Osmolex ER™ (amantadine) extended-release tablets
1/18/2023
1/1/2020 Osphena® (ospemifene)
3/15/2023
1/1/2023 Otezla® (apremilast)
10/6/2022
1/1/2022 Otic Antibiotics
5/17/2023
1/1/2019 Overactive Bladder Agents
3/15/2023
1/1/2022 Overactive Bladder Agents
8/17/2022
3/6/2019 Oxandrin® (oxandrolone)
10/19/2022
1/1/2016 Oxandrolone
10/19/2022
1/1/2020 Oxaydo® (oxycodone HCL)
12/14/2022
5/8/2020 Oxbryta™ (voxelotor)
1/18/2023
1/16/2019 Oxervate™ (cenegermin) ophthalmic solution
5/17/2023
1/1/2021 Oxistat® (oxiconazole)
7/20/2022
4/21/2021 Oxlumo® (lumasiran)
11/16/2022
1/1/2020 Oxtellar XR® (oxcarbazepine) extended-release tablet
12/14/2022
1/1/2022 Oxycodone-Acetaminophen Products
7/20/2022
1/1/2020 OxyContin® (oxycodone hydrochloride controlled-release)
2/15/2023
1/1/2020 OxyContin® (oxycodone hydrochloride controlled-release)
2/15/2023
10/14/2009 Ozurdex® (dexamethasone intravitreal implant)
4/19/2023
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