Políticas de cobertura de farmacia

Resultados de la búsqueda

Fecha de vigenciaPolicy NameReviewed Date
9/19/2018 Macrilen™ (macimorelin)
6/15/2022
1/1/2022 Macugen® (pegaptanib octasodium)
9/16/2021
5/19/2021 Margenza™ (margetuximab-cmkb)
4/20/2022
1/1/2020 Marqibo® (vincristine sulfate liposome injection)
8/17/2022
1/1/2022 Mavenclad® (cladribine)
6/15/2022
1/1/2023 Mavenclad® (cladribine)
6/15/2022
1/1/2023 Mavenclad® (cladribine)
10/19/2022
1/1/2021 Mavenclad® (cladribine) tablets
5/18/2022
1/1/2021 Mavyret™ (glecaprevir/pibrentasvir)
8/17/2022
1/1/2021 Mavyret™ (glecaprevir/pibrentasvir)
8/17/2022
9/22/2021 Mavyret™ (glecaprevir/pibrentasvir)
8/17/2022
1/1/2023 Mayzent® (siponimod) tablet
6/15/2022
1/1/2021 Mayzent® (siponimod) tablets
5/18/2022
6/19/2019 Medical Necessity Determinations
10/20/2022
1/1/2023 Medical Necessity Determinations
10/20/2022
12/1/2022 Medical Necessity Determinations
10/20/2022
6/21/2012 Medication Waste
2/16/2022
1/1/2016 Megace® ES (megestrol acetate)
10/19/2022
1/1/2021 Mekinist® (trametinib)
7/20/2022
1/1/2021 Mekinist® (trametinib)
7/20/2022
9/28/2022 Meloxicam oral suspension
9/21/2022
10/11/2012 Member Cost-Share Waiver: Contraceptives
2/16/2022
12/13/2017 Mepsevii™ (vestronidase alfa-vjbk)
9/1/2022
1/1/2020 Metaxalone tablet
4/20/2022
11/23/2022 Methocarbamol tablet
11/16/2022
1/1/2022 Methotrexate Injection (Otrexup®, Rasuvo®)
5/18/2022
1/1/2023 Methotrexate Injection (Otrexup®, Rasuvo®)
5/18/2022
2/27/2014 Methotrexate Injection (Otrexup®, Reditrex®)
5/18/2022
1/1/2023 Methotrexate Injection (Otrexup®, Reditrex®)
5/18/2022
1/1/2022 Mircera® (methoxy polyethylene glycol-epoetin beta)
11/3/2022
1/1/2017 Modafinil
3/16/2022
1/1/2017 Modafinil
3/16/2022
1/1/2020 Molindone hydrochloride
11/16/2022
10/14/2020 Monjuvi® (tafasitamab-cxix)
8/17/2022
1/1/2023 Motegrity® (prucalopride)
5/18/2022
5/22/2019 Motegrity™ (prucalopride)
1/19/2022
1/1/2020 Mozobil® (plerixafor)
4/20/2022
10/17/2018 Mulpleta® (lusutrombopag)
8/17/2022
8/24/2007 Multi-Source Brands
4/20/2022
1/1/2020 Mupirocin Topical Cream
1/19/2022
1/1/2021 Muscle Relaxants
7/20/2022
1/1/2023 Muscle Relaxants
7/20/2022
5/8/2014 Myalept® (metreleptin)
1/19/2022
1/1/2017 Myalept® (metreleptin)
1/19/2022
10/14/2020 Mycapssa® (octreotide) delayed-release capsules
5/18/2022
8/18/2021 Myfembree® (relugolix, estradiol, and norethindrone acetate)
8/18/2022
1/1/2020 Mylotarg® (gemtuzumab ozogamicin)
3/16/2022
9/29/2006 Myobloc® (botulinum toxin)
5/18/2022
1/1/2023 Myobloc® (botulinum toxin)
8/17/2022
1/1/2022 Myrbetriq® and Myrbetriq® Granules (mirabegron)
8/17/2022

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