Políticas de cobertura de farmacia

Resultados de la búsqueda

Fecha de vigenciaPolicy NameReviewed Date
1/1/2023 Esbriet® (pirfenidone)
1/19/2023
1/1/2022 APOKYN® (apomorphine hydrochloride) subcutaneous injection
1/18/2023
1/1/2017 Aggrenox® (aspirin/dipyridamole)
1/18/2023
1/1/2019 Angiotensin-Calcium Channel Blocking Agents
1/18/2023
6/17/2020 Avsola® (infliximab-axxq)
1/18/2023
1/1/2022 Azilect® (rasagiline) tablets
1/18/2023
1/1/2017 Bisphosphonates
1/18/2023
9/29/2006 Botox® (Botulinum Toxin)
1/18/2023
5/15/2019 Cablivi® (caplacizumab-yhdp)
1/18/2023
1/20/2017 Corifact® (Factor XIII Concentrate [Human])
1/18/2023
1/1/2022 Cosentyx® (secukinumab)
1/18/2023
1/1/2013 Cyklokapron® (tranexamic acid)
1/18/2023
2/23/2022 Dartisla ODT (glycopyrrolate)
1/18/2023
1/1/2023 Dysport® (botulinum toxin)
1/18/2023
4/21/2021 Elepsia™ XR (levetiracetam) extended-release tablets
1/18/2023
1/1/2020 Entyvio® (vedolizumab)
1/18/2023
1/1/2019 EpiPen® and EpiPen Jr® (epinephrine)
1/18/2023
1/20/2017 Factor IX Replacement Products (Hemophilia B)
1/18/2023
1/20/2017 Factor VIII Replacement Products (Hemophilia A)
1/18/2023
1/1/2020 Ilumya™ (tildrakizumab)
1/18/2023
7/6/2017 Imfinzi (durvalumab)
1/18/2023
1/1/2023 Inflectra ® (infliximab-dyyb)
1/18/2023
1/1/2019 Inflectra® (infliximab-dyyb)
1/18/2023
1/1/2022 Infliximab intravenous solution
1/18/2023
1/19/2022 Livtencity (maribavir) tablet
1/18/2023
1/1/2020 Mupirocin Topical Cream
1/18/2023
5/8/2014 Myalept® (metreleptin)
1/18/2023
1/1/2017 Myalept® (metreleptin)
1/18/2023
1/1/2023 Myobloc® (botulinum toxin)
1/18/2023
5/10/2012 Neupro® (rotigotine) transdermal patch
1/18/2023
2/2/2022 Opsumit® (macitentan)
1/18/2023
1/1/2020 Oral Acne Antibiotics
1/18/2023
1/1/2021 Oral Penicillamine Products
1/18/2023
1/1/2020 Orencia® IV (abatacept)
1/18/2023
1/1/2022 Orencia® IV (abatacept)
1/18/2023
2/1/2021 Oriahnn™ (elagolix, estradiol, and norethindrone acetate)
1/18/2023
6/20/2018 Osmolex ER™ (amantadine) extended-release tablets
1/18/2023
5/8/2020 Oxbryta™ (voxelotor)
1/18/2023
1/1/2021 Pliaglis® (lidocaine-tetracaine) cream
1/18/2023
1/1/2014 Qualaquin® (quinine sulfate)
1/18/2023
7/19/2017 Radicava® and Radicava ORS® (edaravone)
1/18/2023
1/1/2018 Rayos® (prednisone delayed-release)
1/18/2023
1/25/2023 Rebyota™ (fecal microbiota, live-jslm)
1/18/2023
1/1/2019 Remicade® (infliximab)
1/18/2023
1/1/2020 Remicade® (infliximab)
1/18/2023
1/1/2020 Renflexis (infliximab-abda)
1/18/2023
1/1/2023 Renflexis® (infliximab-abda)
1/18/2023
1/1/2022 Renflexis® (infliximab-abda)
1/18/2023
1/1/2022 Skyrizi® (risankizumab-rzaa)
1/18/2023
1/1/2020 Syprine® (trientine hydrochloride) capsules
1/18/2023
1/25/2023 Tascenso ODT™ (fingolimod)
1/18/2023
9/28/2022 Tascenso ODT™ (fingolimod)
1/18/2023
1/1/2020 Topical Antifungals
1/18/2023
1/1/2021 Tysabri® (natalizumab) intravenous solution
1/18/2023
3/23/2022 Vyvgart™ (efgartigimod alfa-fcab) intravenous injection
1/18/2023
9/29/2006 Xeomin® (botulinum toxin)
1/18/2023
1/1/2020 Xepi (ozenoxacin) topical cream
1/18/2023
1/1/2014 Zortress® (everolimus)
1/18/2023
1/1/2020 Gleostine® (lomustine)
1/12/2023
7/27/2022 RoxyBond™ tablet, oral ONLY (not feeding tubes)
1/5/2023
11/23/2022 Zoryve® (roflumilast) cream
1/5/2023
1/1/2019 Actemra® (tocilizumab) Intravenous
12/21/2022
1/1/2019 Entyvio® (vedolizumab)
12/21/2022
1/16/2019 Ilumya® (tildrakizumab)
12/21/2022
1/1/2023 Non-preferred Pegfilgrastim Products - Fylnetra (pegfilgrastim-pbbk), Neulasta (pegfilgrastim), Stimufend (pegfilgrastim-fpgk), and Udenyca (pegfilgrastim-cbqv)
12/21/2022
1/1/2023 Non-preferred Pegfilgrastim Products - Fylnetra (pegfilgrastim-pbbk), Neulasta (pegfilgrastim), Nyvepria (pegfilgrastim-apfg), Stimufend (pegfilgrastim-fpgk) and Ziextenzo (pegfilgrastim-bmez)
12/21/2022
1/1/2023 Non-preferred Pegfilgrastim Products - Fylnetra (pegfilgrastim-pbbk), Nyvepria (pegfilgrastim-apfg), Stimufend (pegfilgrastim-fpgk) and Ziextenzo (pegfilgrastim- bmez)
12/21/2022
1/1/2019 Orencia® (abatacept) Intravenous
12/21/2022
3/16/2022 Susvimo™ (ranibizumab)
12/21/2022
1/1/2023 Tysabri (natalizumab) intravenous solution
12/21/2022
1/1/2020 Allergy Ophthalmics
12/14/2022
1/1/2019 Allergy Ophthalmics
12/14/2022
7/20/2017 Alunbrig™ (brigatinib)
12/14/2022
1/1/2020 Aptiom® (eslicarbazepine acetate) tablets
12/14/2022
1/1/2023 Beovu® (brolucizumab)
12/14/2022
7/27/2022 Beovu® (brolucizumab)
12/14/2022
2/23/2022 Brimonidine-timolol eye drops (generic Combigan)
12/14/2022
1/1/2020 Buprenorphine Containing Products
12/14/2022
1/1/2023 Buprenorphine Containing Products
12/14/2022
1/1/2022 Buprenorphine transdermal patch
12/14/2022
1/1/2020 Carbinoxamine 6mg tablet
12/14/2022
1/1/2022 Cimzia® (certolizumab pegol)
12/14/2022
2/17/2021 Danyelza® (naxitamab-gqgk)
12/14/2022
1/1/2020 Duexis® (ibuprofen-famotidine)
12/14/2022
1/1/2021 Duexis® (ibuprofen-famotidine) tablet
12/14/2022
1/1/2023 Elahere (mirvetuximab soravtansine-gynx)
12/14/2022
2/9/2012 Erivedge® (vismodegib)
12/14/2022
1/1/2022 Erleada™ (apalutamide)
12/14/2022
9/5/2018 Florida Statute 456.44(5)(a) Opioid Days' Supply Limitation
12/14/2022
12/28/2022 Furoscix® (furosemide)
12/14/2022
2/23/2022 Fyarro (sirolimus protein-bound particles for injectable suspension)
12/14/2022
11/11/2020 Gavreto™ (pralsetinib)
12/14/2022
3/18/2020 Givlaari® (givosiran) subcutaneous injection
12/14/2022
1/1/2020 Gralise® (gabapentin)
12/14/2022
1/1/2018 Horizant® (gabapentin enacarbil)
12/14/2022
1/1/2020 Lamotrigine Products
12/14/2022
1/1/2023 Levothyroxine Products
12/14/2022
1/1/2020 Lidocaine 5% topical ointment
12/14/2022
1/1/2020 Lidocaine 5% topical patch
12/14/2022
1/1/2020 Lidoderm (lidocaine patch 5%)
12/14/2022
1/1/2019 Limited Day Supply
12/14/2022
1/1/2020 Lupron® (leuprolide acetate) and Generic Depot Products
12/14/2022
12/15/2021 Lybalvi™ (olanzapine and samidorphan)
12/14/2022
1/1/2022 Lynparza (olaparib)
12/14/2022
1/1/2020 Lyrica® CR (pregabalin)
12/14/2022
1/1/2023 Mavenclad® (cladribine) tablet
12/14/2022
1/1/2020 NSAID Combination Products
12/14/2022
1/1/2023 Non-Preferred Multiple Sclerosis Interferons
12/14/2022
1/1/2023 Non-Preferred Oral Multiple Sclerosis Products
12/14/2022
11/1/2006 Noxafil® (posaconazole)
12/14/2022
1/1/2022 Nubeqa® (darolutamide)
12/14/2022
1/1/2023 Ocrevus® (ocrelizumab) intravenous solution
12/14/2022
10/29/2015 Odomzo® (sonidegib)
12/14/2022
1/1/2020 Ophthalmic Antibiotics
12/14/2022
1/1/2020 Ophthalmic Antibiotics
12/14/2022
1/1/2020 Ophthalmic Non-Steroidal Anti-Inflammatory Drugs
12/14/2022
1/1/2020 Ophthalmic Non-Steroidal Anti-Inflammatory Drugs
12/14/2022
1/1/2020 Ophthalmic Steroids
12/14/2022
1/1/2020 Ophthalmic Steroids
12/14/2022
6/19/2019 Orphenadrine Products
12/14/2022
1/1/2020 Oxaydo® (oxycodone HCL)
12/14/2022
1/1/2020 Oxtellar XR® (oxcarbazepine) extended-release tablet
12/14/2022
4/15/2020 Palforzia™ (peanut allergen powder)
12/14/2022
1/1/2023 Pediatric Cardiovascular Products
12/14/2022
1/1/2020 Pennsaid® (diclofenac topical solution)
12/14/2022
12/28/2022 Pheburane® (sodium phenylbutyrate) oral pellets
12/14/2022
1/1/2022 Preferred Multiple Sclerosis Products
12/14/2022
9/21/2016 Probuphine® (buprenorphine) Implant
12/14/2022
1/1/2020 Qudexy XR®, Trokendi XR® (topiramate) extended-release capsules
12/14/2022
1/1/2018 Rapid-Acting Fentanyl products
12/14/2022
1/1/2019 Relistor® (methylnaltrexone)
12/14/2022
1/1/2022 Rexulti (brexpiprazole)
12/14/2022
5/16/2018 Rhopressa® (netarsudil)
12/14/2022
10/14/2020 Rhopressa® (netarsudil), Rocklatan® (netarsudil and latanoprost)
12/14/2022
1/1/2023 Rolvedon™ (eflapegrastim-xnst)
12/14/2022
1/1/2023 Rolvedon™ (eflapegrastim-xnst)
12/14/2022
1/1/2023 Rolvedon™ (eflapegrastim-xnst)
12/14/2022
1/1/2022 Rubraca (rucaparib)
12/14/2022
1/1/2023 Rubraca (rucaparib)
12/14/2022
1/1/2020 Sabril® (vigabatrin)
12/14/2022
1/1/2019 Savella® (milnacipran)
12/14/2022
3/23/2022 Seglentis® (celecoxib-tramadol)
12/14/2022
3/21/2018 Sinuva™ (mometasone furoate) sinus implant
12/14/2022
1/1/2020 Sprix® (ketorolac tromethamine) nasal spray
12/14/2022
1/1/2020 Sublocade™ (buprenorphine extended-release) injection
12/14/2022
1/1/2020 Synera® (lidocaine and tetracaine) topical patch
12/14/2022
1/1/2022 Taltz® (ixekizumab)
12/14/2022
1/1/2023 Tecvayli (teclistamab-cqyv)
12/14/2022
1/1/2022 Tepezza™ (teprotumumab)
12/14/2022
1/1/2020 Vigabatrin products
12/14/2022
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
1/1/2016 Xenical® (orlistat)
12/14/2022
2/23/2022 Xipere™ (triamcinolone acetonide)
12/14/2022
1/1/2020 ZTlido® (lidocaine topical system)
12/14/2022
1/1/2021 ZTlido™ (lidocaine topical system)
12/14/2022
1/1/2022 Zejula (niraparib)
12/14/2022
1/1/2023 Zejula (niraparib)
12/14/2022
5/1/2021 Zypitamag® (pitavastatin)
12/14/2022
1/1/2021 Zypitamag™ (pitavastatin)
12/14/2022
1/1/2021 Opioid Utilization Program - Morphine Milligram Equivalents (MME) edits
12/8/2022
4/28/2011 Caprelsa® (vandetanib)
12/1/2022
1/1/2019 Non-Formulary Exceptions
12/1/2022
1/1/2022 Cimzia® (certolizumab pegol)
11/17/2022
1/1/2023 Site of Care and Specialty Medication Sourcing for Injectable Drugs
11/17/2022
1/1/2022 Taltz® (ixekizumab)
11/17/2022
1/1/2022 ADHD Long Acting Stimulants
11/16/2022
1/1/2020 Ampyra® (dalfampridine) extended-release tablets
11/16/2022
1/1/2020 Antidepressant Agents
11/16/2022
12/11/2019 Asparlas™ (calaspargase pegol-mknl)
11/16/2022
11/30/2022 Auvelity™ (dextromethorphan and bupropion)
11/16/2022
1/1/2023 Avsola® (infliximab-axxq)
11/16/2022
1/1/2022 Avsola™ (infliximab-axxq)
11/16/2022
1/1/2019 Azopt® (brinzolamide ophthalmic suspension) 1%
11/16/2022
1/1/2019 Boniva® and generic ibandronate sodium Injection
11/16/2022
11/17/2021 Bylvay (odevixibat) capsules
11/16/2022
1/1/2015 Chenodal™ (chenodiol) tablets
11/16/2022
1/1/2020 Clindagel® (clindamycin phosphate gel)
11/16/2022
1/1/2021 Cotellic® (cobimetinib)
11/16/2022
1/1/2021 Cotellic® (cobimetinib)
11/16/2022
5/9/2013 Cysteamine Ophthalmic Products (Cystaran™, Cystadrops®)
11/16/2022
1/16/2019 Daurismo™ (glasdegib)
11/16/2022
1/1/2023 Deferasirox Products
11/16/2022
1/1/2023 Diacomit® (stiripentol)
11/16/2022
4/21/2021 Dupixent® (dupilumab) injection
11/16/2022
1/1/2022 Dupixent® (dupilumab) injection
11/16/2022
9/29/2008 Elaprase® (idursulfase)
11/16/2022
1/1/2020 Eligard® (leuprolide acetate)
11/16/2022
1/1/2020 Emflaza® (deflazacort)
11/16/2022
1/20/2021 Enspryng™ (satralizumab-mwge)
11/16/2022
1/1/2022 Entyvio® (vedolizumab)
11/16/2022
12/15/2021 Eprontia™ (topiramate) oral solution
11/16/2022
1/1/2022 Eylea® (aflibercept)
11/16/2022
7/20/2017 FEIBA NF (Anti-Inhibitor Coagulant Complex)
11/16/2022
1/1/2020 Firdapse® (amifampridine) tablets
11/16/2022
1/1/2020 Firmagon® (degarelix)
11/16/2022
1/1/2019 Gattex® (teduglutide)
11/16/2022
1/20/2021 Gimoti™ (metoclopramide)
11/16/2022
12/9/2020 Hemady™ (dexamethasone tablet)
11/16/2022
1/1/2022 Ilumya® (tildrakizumab)
11/16/2022
1/1/2016 Intuniv® (guanfacine extended-release tablets)
11/16/2022
1/20/2016 Kanuma® (sebelipase alfa)
11/16/2022
1/1/2016 Kapvay® (clonidine extended-release)
11/16/2022
10/15/2015 Keveyis® (dichlorphenamide) tablets
11/16/2022
1/1/2023 Kisqali (ribociclib)
11/16/2022
1/1/2017 Leuprolide acetate
11/16/2022
12/12/2018 Lexette® (halobetasol) Topical Foam
11/16/2022
12/15/2021 Livmarli™ (maralixibat)
11/16/2022
1/1/2022 Lucentis® (ranibizumab)
11/16/2022
1/1/2011 Lumizyme® (alglucosidase alpha)
11/16/2022
11/23/2022 Methocarbamol tablet
11/16/2022
1/1/2020 Molindone hydrochloride
11/16/2022
1/20/2017 NovoSeven® RT (Coagulation Factor VIIa [Recombinant])
11/16/2022
1/1/2021 Nplate® (romiplastim)
11/16/2022
1/20/2017 Obizur [antihemophilic (recombinant), porcine sequence]
11/16/2022
4/21/2021 Oxlumo® (lumasiran)
11/16/2022
11/30/2022 Pedmark ® (sodium thiosulfate injection)
11/16/2022
6/3/2020 Pemazyre™ (pemigatinib)
11/16/2022
1/1/2022 Pomalyst® (pomalidomide)
11/16/2022
2/17/2021 Preferred Multiple Sclerosis Products
11/16/2022
6/6/2013 Procysbi® (cysteamine)
11/16/2022
7/8/2020 Retevmo™ (selpercatinib)
11/16/2022
1/1/2023 Rinvoq® (upadacitinib)
11/16/2022
1/1/2020 Rozerem (ramelteon)
11/16/2022
12/15/2021 Saphnelo™ (anifrolumab-fnia)
11/16/2022
5/2/2013 Sirturo® (bedaquiline)
11/16/2022
2/21/2018 Solosec™ (secnidazole)
11/16/2022
11/23/2022 Spevigo® (spesolimab-sbzo)
11/16/2022
1/1/2018 Thrombate III® [Antithrombin III (Human)]
11/16/2022
12/24/2021 Tivdak (tisotumab vedotin-tftv)
11/16/2022
1/1/2018 Topical Doxepin Products (doxepin, Prudoxin®, Zonalon®)
11/16/2022
1/1/2020 Trelstar® (triptorelin pamoate)
11/16/2022
5/16/2018 Trogarzo™ (ibalizumab-uiyk)
11/16/2022
11/30/2022 Vivjoa™ (oteseconazole)
11/16/2022
7/19/2017 Xadago® (safinamide) tablets
11/16/2022
5/20/2020 Xcopri® (cenobamate) tablets
11/16/2022
11/30/2022 Xenpozyme™ (olipudase alfa) intravenous solution
11/16/2022
1/1/2018 Xiidra® (lifitegrast ophthalmic solution)
11/16/2022
4/20/2016 Xuriden® (uridine triacetate)
11/16/2022
1/1/2017 Zegerid® (omeprazole, sodium bicarbonate)
11/16/2022
10/16/2019 Zelnorm™ (tegaserod)
11/16/2022
1/1/2016 Zyclara® (imiquimod)
11/16/2022
1/1/2023 Epoetin Alfa (Epogen, Procrit, Retacrit)
11/10/2022
1/24/2019 Drug Management Program-Opioid Program
11/3/2022
1/1/2022 Mircera® (methoxy polyethylene glycol-epoetin beta)
11/3/2022
11/1/2022 Cimerli™ (ranibizumab-eqrn)
10/27/2022
1/1/2023 Opioid Days' Supply Limitation
10/27/2022
1/1/2022 Opioid Days' Supply Limitation
10/27/2022
1/1/2019 Opioid Days' Supply Limitation
10/27/2022
1/1/2021 Opioid Utilization Program - Morphine Milligram Equivalent (MME) edits
10/27/2022
6/19/2019 Medical Necessity Determinations
10/20/2022
12/1/2022 Medical Necessity Determinations
10/20/2022
1/1/2023 Medical Necessity Determinations
10/20/2022
12/9/2020 Alkindi® (hydrocortisone) sprinkle capsule
10/19/2022
1/1/2016 Alpha-1 Proteinase Inhibitors (Aralast NP®, Glassia®)
10/19/2022
1/1/2016 Alpha-1 Proteinase Inhibitors (Prolastin-C®, Zemaira®)
10/19/2022
6/16/2021 Amondys 45 (casimersen)
10/19/2022
1/1/2022 Austedo® (deutetrabenazine)
10/19/2022
1/1/2023 Bortezomib products (Velcade and Bortezomib for injection)
10/19/2022
1/1/2022 Bupropion Containing Products (Aplenzin®, Forfivo® XL)
10/19/2022
1/1/2021 Cabometyx™ (cabozantinib)
10/19/2022
10/26/2022 Camzyos™ (mavacamten)
10/19/2022
1/1/2006 Medicamentos para tos y resfríos
10/19/2022
1/1/2022 Defitelio® (defibrotide sodium)
10/19/2022
1/1/2022 Dihydroergotamine Products
10/19/2022
10/16/2019 Duloxetine Containing Products
10/19/2022
1/1/2018 Effient® (prasugrel)
10/19/2022
11/17/2021 Exkivity (mobocertinib)
10/19/2022
1/1/2022 Fetzima® (levomilnacipran)
10/19/2022
1/1/2022 Imbruvica® (ibrutinib)
10/19/2022
1/1/2023 Intranasal Rhinitis Agents
10/19/2022
1/1/2023 Intranasal Rhinitis Agents
10/19/2022
10/18/2017 Kymriah™ (tisagenlecleucel)
10/19/2022
1/1/2023 Kymriah™ (tisagenlecleucel)
10/19/2022
10/8/2021 Long Acting Insulins
10/19/2022
1/1/2016 Megace® ES (megestrol acetate)
10/19/2022
1/1/2020 Nalocet® (oxycodone/acetaminophen) tablet
10/19/2022
10/26/2022 Nexiclon™ XR (clonidine ER) tablet
10/19/2022
1/1/2021 Nonsteroidal Anti-Inflammatory Drug Products
10/19/2022
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
1/26/2022 Opzelura™ (ruxolitinib)
10/19/2022
3/6/2019 Oxandrin® (oxandrolone)
10/19/2022
1/1/2016 Oxandrolone
10/19/2022
1/1/2016 Pancreatic Enzymes
10/19/2022
1/1/2020 Pancreatic Enzymes
10/19/2022
1/20/2021 Qdolo™ (tramadol) oral solution
10/19/2022
3/7/2013 Ravicti® (glycerol phenylbutyrate) oral liquid
10/19/2022
3/18/2020 Reyvow™ (lasmiditan)
10/19/2022
11/1/2019 Rozlytrek™ (entrectinib)
10/19/2022
1/22/2015 Savaysa® (edoxaban)
10/19/2022
2/20/2019 Short Acting Beta Agonists
10/19/2022
5/22/2014 Sitavig® (acyclovir)
10/19/2022
1/1/2020 Spritam® (levetiracetam)
10/19/2022
1/1/2022 Synagis® (palivizumab)
10/19/2022
11/21/2012 Synribo® (omacetaxine mepesuccinate)
10/19/2022
12/12/2018 Talzenna™(talazoparib)
10/19/2022
12/12/2018 Tegsedi® (inotersen)
10/19/2022
1/16/2019 Tolsura (itraconazole)
10/19/2022
1/1/2022 Trintellix (vortioxetine)
10/19/2022
10/21/2021 Trudhesa™ (dihydroergotamine mesylate)
10/19/2022
2/19/2020 Ubrelvy™ (ubrogepant)
10/19/2022
1/20/2021 Upneeq™ (oxymetazoline)
10/19/2022
1/1/2022 Viibryd® (vilazodone)
10/19/2022
12/12/2018 Vizimpro® (dacomitinib)
10/19/2022
11/1/2021 Welireg (belzutifan)
10/19/2022
11/8/2017 XHANCE™ (fluticasone propionate)
10/19/2022
1/1/2023 Xifaxan® (rifaximin)
10/19/2022
2/20/2019 Yutiq™ (fluocinolone acetonide intravitreal implant)
10/19/2022
1/1/2023 Zeposia® (ozanimod) capsules
10/19/2022
10/26/2022 Zonisade™ (zonisamide) oral suspension
10/19/2022
8/5/2010 Zuplenz® (ondansetron oral soluble film)
10/19/2022
1/1/2023 Xatmep™ (methotrexate) oral solution
10/7/2022
1/1/2023 Alpha-1 Proteinase Inhibitors (Aralast NP®, Glassia®, Zemaira®)
10/6/2022
1/1/2023 Cholbam® (cholic acid) capsules
10/6/2022
1/1/2023 Kisqali (ribociclib)
10/6/2022
1/1/2023 Kynmobi® (apomorphine hydrochloride) sublingual film
10/6/2022
1/1/2023 Otezla® (apremilast)
10/6/2022
1/1/2023 Prolastin-C® (alpha-1 proteinase inhibitor)
10/6/2022
1/1/2023 Pyrukynd® (mitapivat)
10/6/2022
1/1/2023 Stivarga (regorafenib)
10/6/2022
1/1/2023 Ventavis® (iloprost)
10/6/2022
11/11/2020 Long Acting Insulins
9/29/2022
1/1/2023 Abecma® (idecabtagene vicleucel)
9/22/2022
1/1/2023 Abraxane (nab) paclitaxel
9/22/2022
1/1/2023 Breyanzi® (lisocabtagene maraleucel)
9/22/2022
1/1/2023 Carvykti™ (ciltacabtagene autoleucel)
9/22/2022
1/1/2023 Eylea® (aflibercept)
9/22/2022
1/1/2023 Jemperli (dostarlimab-gxly)
9/22/2022
1/1/2023 Levoleucovorin products (Fusilev, Khapzory)
9/22/2022
1/1/2023 Opdualag (nivolumab and relatlimab-rmbw)
9/22/2022
1/1/2021 Regranex® (becaplermin)
9/22/2022
1/1/2023 Signifor® LAR (pasireotide)
9/22/2022
1/1/2023 Tecartus™ (brexucabtagene autoleucel)
9/22/2022
1/1/2023 Vabysmo™ (faricimab-svoa)
9/22/2022
1/1/2023 Yescarta™ (axicabtagene ciloleucel)
9/22/2022
1/1/2013 Aldurazyme® (laronidase)
9/21/2022
9/28/2022 Amvuttra™ (vutrisiran)
9/21/2022
1/1/2019 Asthma Interleukin Inhibitors (Cinqair® , Nucala™, Fasenra®)
9/21/2022
1/1/2023 Brukinsa™ (zanubrutinib)
9/21/2022
11/11/2020 Conjupri® (levamlodipine)
9/21/2022
1/1/2020 Crysvita® (burosumab)
9/21/2022
1/1/2017 Diabetic Test Strips and Meters
9/21/2022
1/1/2023 Dopamine Agonists
9/21/2022
1/1/2021 Dopamine Agonists
9/21/2022
1/1/2023 Enhertu (fam-trastuzumab deruxtecan-nxki)
9/21/2022
9/28/2022 Entadfi™ (finasteride and tadalafil)
9/21/2022
1/1/2023 Finacea® (azelaic acid) topical foam
9/21/2022
1/1/2021 Flector®, Licart™ (diclofenac epolamine patch 1.3%)
9/21/2022
1/1/2021 Glatiramer Products
9/21/2022
9/28/2022 Hyftor™ (sirolimus topical gel)
9/21/2022
4/2/2015 Iluvien® (fluocinolone acetonide intravitreal implant)
9/21/2022
9/28/2022 Inhaled Corticosteroid and Long Acting Beta Agonists
9/21/2022
1/1/2020 Jakafi® (ruxolitinib)
9/21/2022
8/1/2021 Jemperli (dostarlimab-gxly)
9/21/2022
11/17/2021 Kerendia® (finerenone)
9/21/2022
11/17/2021 Kerendia® (finerenone)
9/21/2022
11/3/2011 Lorzone® (chlorzoxazone)
9/21/2022
9/28/2022 Meloxicam oral suspension
9/21/2022
1/1/2023 Nebivolol (generic Bystolic)
9/21/2022
5/1/2021 Nexletol® (bempedoic acid)
9/21/2022
10/20/2021 Nexviazyme™ (avalglucosidase alfa-ngpt) Injection
9/21/2022
1/1/2023 Non-Preferred GLP Analogs
9/21/2022
1/1/2023 Ocaliva® (obeticholic acid)
9/21/2022
12/9/2020 Ongentys® (opicapone) capsules
9/21/2022
1/20/2016 Onivyde ® (liposomal irinotecan)
9/21/2022
11/11/2020 Onureg™ (azacitidine)
9/21/2022
8/15/2018 Palynziq™ (pegvaliase-pqpz) Injection
9/21/2022
1/23/2012 Prialt® (ziconotide intrathecal infusion)
9/21/2022
12/19/2018 Qbrexza® (glycopyrronium)
9/21/2022
1/1/2018 Retisert® (fluocinolone acetonide intravitreal implant)
9/21/2022
1/1/2023 Revlimid (lenalidomida)
9/21/2022
10/8/2021 Rezurock (belumosudil)
9/21/2022
1/1/2022 Stelara® (ustekinumab)
9/21/2022
1/1/2019 Topical Rosacea Products
9/21/2022
1/1/2019 Topical Rosacea Products
9/21/2022
1/1/2019 Torisel® (temsirolimus)
9/21/2022
1/1/2021 Vemlidy® (tenofovir alafenamide)
9/21/2022
12/10/2015 Vivlodex® (meloxicam)
9/21/2022
1/1/2021 Vosevi® (sofosbuvir, velpatasvir, and voxilaprevir)
9/21/2022
1/1/2021 Vosevi® (sofosbuvir, velpatasvir, and voxilaprevir)
9/21/2022
9/28/2022 Vtama® (tapinarof) cream
9/21/2022
1/1/2023 Xarelto® (rivaroxaban) oral suspension
9/21/2022
1/1/2022 Xgeva (denosumab)
9/21/2022
1/20/2016 Yondelis® (trabectedin)
9/21/2022
9/28/2022 fluticasone propionate HFA inhaler
9/21/2022
9/22/2021 Loreev XR (lorazepam)
9/8/2022
3/17/2021 Reltone™ (ursodiol capsule)
9/8/2022
1/1/2022 Bowel Prep Agents
9/1/2022
6/22/2016 Briviact® (brivaracetam)
9/1/2022
1/1/2020 Corticotropin Products
9/1/2022
5/22/2012 Elelyso® (taliglucerase alfa)
9/1/2022
12/13/2017 Mepsevii™ (vestronidase alfa-vjbk)
9/1/2022
5/7/2015 Natpara® (parathyroid hormone)
9/1/2022
10/18/2017 Triptodur™ (triptorelin)
9/1/2022
3/6/2014 Vimizim® (elosulfase alfa)
9/1/2022
9/7/2016 Zurampic® (lesinurad), Duzallo® (lesinurad and allopurinol)
9/1/2022
9/1/2022 Inhibidores del péptido relacionado con el gen de la calcitonina (CGRP)
8/18/2022
1/1/2013 Cytogam® (cytomegalovirus immune globulin, human)
8/18/2022
8/19/2020 GnRH Receptor Antagonists (Myfembree®, Oriahnn™)
8/18/2022
1/1/2020 Ledipasvir/sofosbuvir
8/18/2022
1/1/2021 Ledipasvir/sofosbuvir
8/18/2022
8/18/2021 Myfembree® (relugolix, estradiol, and norethindrone acetate)
8/18/2022
9/1/2022 Qulipta™ (atogepant)
8/18/2022
9/1/2022 Reyvow™ (lasmiditan)
8/18/2022
1/1/2021 Santyl (collagenase)
8/18/2022
1/1/2022 Sovaldi® (sofosbuvir)
8/18/2022
1/1/2021 Sovaldi® (sofosbuvir)
8/18/2022
1/1/2021 Topical Nystatin Powder
8/18/2022
9/1/2022 Ubrelvy™ (ubrogepant)
8/18/2022
1/1/2021 Viekira® (ombitasvir, paritaprevir, ritonavir, dasabuvir)
8/18/2022
1/1/2021 Viekira® (ombitasvir, paritaprevir, ritonavir, dasabuvir)
8/18/2022
9/1/2022 Vyepti™ (eptinezumab)
8/18/2022
1/1/2021 Zepatier® (elbasvir/grazoprevir)
8/18/2022
1/1/2021 Zepatier® (elbasvir/grazoprevir)
8/18/2022
1/1/2021 Abilify® (aripiprazole)
8/17/2022
1/1/2006 Actimmune® (interferon gamma-1b)
8/17/2022
1/1/2022 Actinic Keratosis Agents
8/17/2022
12/20/2017 Aliqopa™ (copanlisib)
8/17/2022
1/1/2019 Aloxi (palonosetron)
8/17/2022
1/1/2022 Anticholinergics and Central Nervous System Polypharmacy Agents
8/17/2022
3/4/2020 Ayvakit™ (avapritinib)
8/17/2022
1/1/2022 Balversa™ (erdafitinib)
8/17/2022
1/1/2019 Bavencio® (avelumab)
8/17/2022
1/1/2022 Benlysta® (belimumab)
8/17/2022
1/1/2022 Berinert® (C1 esterase inhibitor, human)
8/17/2022
1/1/2022 Berinert® (C1 esterase inhibitor, human)
8/17/2022
1/1/2022 BiDil® (isosorbide dinitrate/hydralazine)
8/17/2022
10/14/2020 Blenrep (belantamab mafodotin-blmf)
8/17/2022
1/1/2022 Bortezomib products (Velcade and Bortezomib for injection)
8/17/2022
3/17/2021 Breyanzi® (lisocabtagene maraleucel)
8/17/2022
4/21/2021 Breyanzi® (lisocabtagene maraleucel)
8/17/2022
9/18/2014 Cerdelga® (eliglustat)
8/17/2022
1/1/2010 Cerezyme® (imiglucerase)
8/17/2022
1/1/2022 Cinryze® (C1 esterase inhibitor, human)
8/17/2022
1/1/2022 Cinryze® (C1 esterase inhibitor, human)
8/17/2022
1/1/2021 Compounded Medications
8/17/2022
5/28/2015 Cresemba® (isavuconazonium sulfate)
8/17/2022
1/1/2022 Darzalex Faspro™ (daratumumab and hyaluronidase- fihj)
8/17/2022
1/1/2022 Darzalex® (daratumumab)
8/17/2022
1/1/2023