| Fecha de vigencia | Policy Name | Reviewed Date |
| 5/25/2022 |
Vabysmo™ (faricimab-svoa)
| 4/19/2023 |
| 1/1/2023 |
Vabysmo™ (faricimab-svoa)
| 4/19/2023 |
| 1/1/2020 |
Valchlor® (mechlorethamine)
| 6/15/2022 |
| 1/1/2021 |
Valstar (valrubicin)
| 7/20/2022 |
| 1/1/2022 |
Vancomycin
| 7/20/2022 |
| 1/1/2022 |
Vancomycin capsules
| 7/20/2022 |
| 3/14/2013 |
Varizig® (varicella zoster immune globulin)
| 5/17/2023 |
| 1/1/2023 |
Varubi (rolapitant)
| 7/20/2022 |
| 1/1/2020 |
Vectibix (panitumumab)
| 4/19/2023 |
| 1/1/2021 |
Vemlidy® (tenofovir alafenamide)
| 9/21/2022 |
| 1/1/2022 |
Venclexta™ (venetoclax)
| 3/15/2023 |
| 1/1/2023 |
Ventavis® (iloprost)
| 10/6/2022 |
| 1/1/2021 |
Veregen® (sinecatechins)
| 8/17/2022 |
| 8/24/2022 |
Verkazia® eye drops in a dropperette
| 8/17/2022 |
| 4/21/2021 |
Verquvo® (vericiguat)
| 3/15/2023 |
| 1/1/2020 |
Versacloz® (clozapine oral solution)
| 3/15/2023 |
| 1/1/2023 |
Verzenio (abemaciclib)
| 4/19/2023 |
| 1/1/2019 |
Vesicare® and Vesicare LS™ (solifenacin)
| 3/15/2023 |
| 1/1/2009 |
VFEND® (voriconazole)
| 8/17/2022 |
| 1/1/2022 |
V-GO Insulin Delivery Device
| 7/20/2022 |
| 1/1/2022 |
Viberzi® (eluxadoline)
| 5/17/2023 |
| 1/1/2023 |
Viberzi® (eluxadoline)
| 5/17/2023 |
| 1/1/2021 |
Viekira® (ombitasvir, paritaprevir, ritonavir, dasabuvir)
| 8/18/2022 |
| 1/1/2021 |
Viekira® (ombitasvir, paritaprevir, ritonavir, dasabuvir)
| 8/18/2022 |
| 1/1/2020 |
Vigabatrin products
| 12/14/2022 |
| 1/1/2022 |
Viibryd® (vilazodone)
| 10/19/2022 |
| 1/1/2023 |
Viibryd® (vilazodone)
| 8/17/2022 |
| 7/27/2022 |
Vijoice® (alpelisib) tablets
| 7/20/2022 |
| 1/1/2022 |
Viltepso™ (viltolarsen) intravenous solution
| 3/15/2023 |
| 3/6/2014 |
Vimizim® (elosulfase alfa)
| 9/1/2022 |
| 1/1/2020 |
Vimovo® (naproxen-esomeprazole magnesium)
| 2/15/2023 |
| 1/1/2019 |
Viscosupplements
| 12/14/2022 |
| 1/1/2022 |
Viscosupplements
| 12/14/2022 |
| 1/1/2022 |
Viscosupplements - Multi Injection
| 12/14/2022 |
| 1/1/2022 |
Viscosupplements - Single Injection
| 12/14/2022 |
| 1/1/2020 |
Visudyne® (verteporfin)
| 12/14/2022 |
| 2/22/2019 |
Vitrakvi (larotrectinib)
| 2/15/2023 |
| 11/30/2022 |
Vivjoa™ (oteseconazole)
| 11/16/2022 |
| 12/10/2015 |
Vivlodex® (meloxicam)
| 9/21/2022 |
| 12/12/2018 |
Vizimpro® (dacomitinib)
| 10/19/2022 |
| 1/20/2017 |
Von Willebrand Factor Replacement Products
| 3/15/2023 |
| 5/18/2022 |
Vonjo (pacritinib)
| 5/18/2022 |
| 1/1/2021 |
Vosevi® (sofosbuvir, velpatasvir, and voxilaprevir)
| 9/21/2022 |
| 1/1/2021 |
Vosevi® (sofosbuvir, velpatasvir, and voxilaprevir)
| 9/21/2022 |
| 1/1/2022 |
Votrient (pazopanib)
| 5/17/2023 |
| 2/23/2022 |
Voxzogo™ (vosoritide)
| 2/15/2023 |
| 3/18/2010 |
VPRIV® (velaglucerase alfa)
| 7/20/2022 |
| 1/1/2020 |
VPRIV® (velaglucerase alfa)
| 7/20/2022 |
| 1/1/2020 |
Vraylar® (cariprazine)
| 4/27/2023 |
| 9/28/2022 |
Vtama® (tapinarof) cream
| 9/21/2022 |
| 1/1/2023 |
Vumerity® (diroximel fumarate) capsule, delayed release
| 4/19/2023 |
| 5/20/2020 |
Vyepti™ (eptinezumab)
| 5/18/2023 |
| 9/1/2022 |
Vyepti™ (eptinezumab)
| 5/18/2023 |
| 1/1/2021 |
Vyndaqel®/Vyndamax™ (tafamidis)
| 2/15/2023 |
| 1/1/2022 |
Vyondys 53™ (golodirsen) intravenous solution
| 3/15/2023 |
| 1/1/2021 |
Vyvanse® (lisdexamfetamine dimesylate)
| 8/17/2022 |
| 3/23/2022 |
Vyvgart™ (efgartigimod alfa-fcab) intravenous injection
| 1/18/2023 |
| 10/4/2017 |
Vyxeos™ (daunorubicin and cytarabine) liposome
| 5/17/2023 |