Políticas de cobertura médica y de farmacia - Inicio

Políticas de cobertura de farmacia

Resultados de la búsqueda

Fecha de vigenciaPolicy NameReviewed Date
1/1/2020 Lamotrigine Products
12/14/2022
1/1/2020 Latuda® (lurasidone)
3/15/2023
1/1/2020 Ledipasvir/sofosbuvir
8/18/2022
1/1/2021 Ledipasvir/sofosbuvir
8/18/2022
1/1/2021 Lemtrada® (alemtuzumab) intravenous solution
4/19/2023
1/1/2022 Lenvima (lenvatinib)
4/19/2023
6/22/2022 Leqvio® (inclisiran)
5/17/2023
1/1/2021 Letairis® (ambrisentan)
3/15/2023
1/1/2020 Leukine® (sargramostim/GM-CSF)
4/19/2023
1/1/2017 Leuprolide acetate
11/16/2022
4/17/2019 Levoleucovorin products (Fusilev, Khapzory)
2/15/2023
1/1/2023 Levoleucovorin products (Fusilev, Khapzory)
9/22/2022
1/1/2020 Levorphanol tartrate tablet
2/15/2023
1/1/2023 Levothyroxine Products
12/14/2022
12/12/2018 Lexette® (halobetasol) Topical Foam
11/16/2022
12/12/2018 Libtayo® (cemiplimab-rwlc)
3/15/2023
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
1/1/2022 Lifetime Dosing Limits
10/21/2021
1/1/2019 Limited Day Supply
3/23/2023
1/1/2023 Linzess® (linaclotide)
8/17/2022
1/1/2023 Liposomal doxorubucin
8/17/2022
1/1/2022 Livalo® (pitavastatin)
5/17/2023
12/15/2021 Livmarli™ (maralixibat)
4/19/2023
1/19/2022 Livtencity (maribavir) tablet
1/18/2023
1/1/2023 Lokelma® (sodium zirconium cyclosilicate)
4/19/2023
1/1/2021 Long Acting Anticholinergics
3/15/2023
1/1/2022 Long Acting Anticholinergics
5/17/2023
1/1/2021 Long Acting Beta Agonists
5/17/2023
11/11/2020 Long Acting Insulins
4/19/2023
10/8/2021 Long Acting Insulins
10/19/2022
1/1/2019 Long Acting Muscarinic Antagonist / Long Acting Beta Agonist Combination Inhalers
5/17/2023
1/1/2021 Long Acting Muscarinic Antagonist / Long Acting Beta Agonist Combo Inhalers
5/17/2023
1/1/2021 Long Acting Opioids
2/15/2023
1/1/2022 Long Acting Opioids
2/15/2023
1/1/2020 Lonsurf® (trifluridine and tipiracil)
5/17/2023
1/1/2022 Lorbrena (lorlatinib)
5/17/2023
9/22/2021 Loreev XR (lorazepam)
9/8/2022
11/3/2011 Lorzone® (chlorzoxazone)
9/21/2022
1/1/2023 Lotronex® (alosetron HCl)
5/17/2023
1/1/2018 Lovaza® (omega-3-acid ethyl esters)
2/15/2023
1/1/2020 Lucemyra® (lofexidine)
2/15/2023
1/1/2022 Lucentis® (ranibizumab)
4/19/2023
8/20/2021 Lumakras (sotorasib)
8/17/2022
1/1/2011 Lumizyme® (alglucosidase alpha)
11/16/2022
12/12/2018 Lumoxiti™ (moxetumomab pasudotox-tdfk)
4/19/2023
3/22/2023 Lunsumio (mosunetuzumab-axgb)
3/15/2023
1/30/2014 Lupaneta Pack® (leuprolide acetate and norethindrone acetate)
4/20/2022
5/19/2021 Lupkynis™ (voclosporin)
4/19/2023
1/1/2020 Lupron® (leuprolide acetate) and Generic Depot Products
12/14/2022
1/1/2020 Lutathera (lutetium Lu 177 dotatate)
6/15/2022
1/1/2020 Luxturna™ (voretigene neparvovec-rzyl)
2/15/2023
12/15/2021 Lybalvi™ (olanzapine and samidorphan)
12/14/2022
1/1/2022 Lynparza (olaparib)
12/14/2022
1/1/2023 Lynparza (olaparib)
12/14/2022
1/1/2020 Lyrica® CR (pregabalin)
12/14/2022
2/15/2023 Lytgobi (futibatinib)
1/19/2023
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