Políticas de cobertura de farmacia

Resultados de la búsqueda

Fecha de vigenciaPolicy NameReviewed Date
6/16/2021 Abecma® (idecabtagene vicleucel)
4/20/2022
6/16/2021 Abecma® (idecabtagene vicleucel)
4/20/2022
1/1/2023 Abecma® (idecabtagene vicleucel)
9/22/2022
12/12/2018 Abilify MyCite® (aripiprazole tablets with sensor)
3/16/2022
12/12/2018 Abilify MyCite® (aripiprazole tablets with sensor)
3/16/2022
1/1/2021 Abilify® (aripiprazole)
8/17/2022
1/1/2023 Abraxane (nab- paclitaxel)
5/18/2022
1/1/2023 Abraxane (nab) paclitaxel
9/22/2022
1/1/2023 Abraxane (nab) paclitaxel
5/18/2022
1/1/2021 Abraxane (nab-paclitaxel)
11/16/2022
1/1/2021 Abraxane (nab-paclitaxel)
11/16/2022
7/21/2021 Accrufer™ (ferric maltol)
5/18/2022
1/1/2019 Actemra® (tocilizumab) Intravenous
3/16/2022
1/1/2019 Actemra® (tocilizumab) Intravenous
3/16/2022
1/1/2022 Actemra® (tocilizumab) Subcutaneous
3/16/2022
1/1/2022 Actemra® (tocilizumab) Subcutaneous
3/16/2022
1/1/2020 Actemra® IV (tocilizumab)
3/16/2022
1/1/2006 Actimmune® (interferon gamma-1b)
8/17/2022
1/1/2022 Actinic Keratosis Agents
8/17/2022
5/8/2020 Adakveo® (crizanlizumab-tmca)
2/16/2022
4/27/2022 Adbry™ (tralokinumab-ldrm)
4/20/2022
9/1/2011 Adcetris® (brentuximab vedotin)
2/16/2022
1/1/2021 Adempas® (riociguat)
4/20/2022
1/1/2022 ADHD Long Acting Stimulants
11/16/2022
7/27/2022 Adlarity® (donepezil) transdermal patch
7/20/2022
12/15/2021 Aduhelm (aducanumab-avwa)
4/20/2022
4/27/2022 Aduhelm™ (aducanumab-avwa)
4/20/2022
1/1/2020 Aemcolo® (rifamycin)
11/16/2022
1/1/2023 Aemcolo® (rifamycin)
6/15/2022
1/1/2022 Afinitor/Afinitor Disperz (everolimus)
7/20/2022
1/1/2023 Afinitor/Afinitor Disperz (everolimus)
5/18/2022
12/31/2014 Afrezza® (insulin human) Inhalation Powder
3/16/2022
1/1/2017 Aggrenox® (aspirin/dipyridamole)
1/19/2022
5/26/2022 AHCA Continuity of Care
5/19/2022
1/1/2021 Aklief® (trifarotene)
6/15/2022
1/1/2023 Aklief® (trifarotene)
6/15/2022
1/1/2020 Akynzeo (fosnetupitant/netupitant-palonosetron)
6/15/2022
1/1/2013 Aldurazyme® (laronidase)
9/21/2022
1/1/2022 Alecensa (alectinib)
6/15/2022
1/1/2014 Alferon N® (interferon alfa-n3)
3/16/2022
12/20/2017 Aliqopa™ (copanlisib)
8/17/2022
12/9/2020 Alkindi® (hydrocortisone) sprinkle capsule
10/19/2022
1/1/2019 Allergy Ophthalmics
3/16/2022
1/1/2020 Allergy Ophthalmics
5/18/2022
1/1/2019 Aloxi (palonosetron)
8/17/2022
1/1/2016 Alpha-1 Proteinase Inhibitors (Aralast NP®, Glassia®)
10/19/2022
1/1/2021 Alpha-1 Proteinase Inhibitors (Aralast NP®, Glassia®, Zemaira®)
3/16/2022
1/1/2023 Alpha-1 Proteinase Inhibitors (Aralast NP®, Glassia®, Zemaira®)
10/6/2022
1/1/2016 Alpha-1 Proteinase Inhibitors (Prolastin-C®, Zemaira®)
10/19/2022
1/1/2015 Alphagan® P (brimonidine)
7/20/2022
7/20/2017 Alunbrig™ (brigatinib)
8/17/2022
1/1/2019 Amitiza® (lubiprostone)
1/19/2022
1/1/2019 Amitiza® (lubiprostone)
1/19/2022
1/1/2023 Amitiza® (lubiprostone)
5/18/2022
6/16/2021 Amondys 45 (casimersen)
10/19/2022
1/1/2020 Ampyra® (dalfampridine) extended-release tablets
11/16/2022
1/1/2020 Amrix®, Fexmid® (cyclobenzaprine hydrochloride)
4/20/2022
9/28/2022 Amvuttra™ (vutrisiran)
9/21/2022
1/1/2023 Amzeeq (minocycline) topical foam
6/15/2022
1/1/2021 Amzeeq® (minocycline) topical foam
6/15/2022
1/1/2020 Angiotensin Blocking & Renin Inhibitor Agents
6/15/2022
1/1/2022 Angiotensin Blocking Agents
6/15/2022
1/1/2023 Angiotensin Blocking Agents
7/20/2022
1/1/2019 Angiotensin-Calcium Channel Blocking Agents
1/19/2022
1/1/2022 Anticholinergics and Central Nervous System Polypharmacy Agents
8/17/2022
1/1/2020 Antidepressant Agents
11/16/2022
1/1/2019 Antipsychotic Utilization Program
3/16/2022
1/1/2020 Apadaz® (benzhydrocodone and acetaminophen)
4/20/2022
1/1/2022 APOKYN® (apomorphine hydrochloride injection)
3/16/2022
1/1/2020 Aptiom® (eslicarbazepine acetate)
2/16/2022
1/1/2022 Aranesp® (darbepoetin alfa)
11/16/2022
1/1/2023 Aranesp® (darbepoetin alfa)
7/20/2022
4/3/2008 Arcalyst® (rilonacept)
3/16/2022
1/1/2020 Arikayce® (liposomal amikacin for inhalation)
2/16/2022
1/1/2017 Arzerra® (ofatumumab)
3/16/2022
12/11/2019 Asparlas™ (calaspargase pegol-mknl)
11/16/2022
1/1/2019 Asthma Interleukin Inhibitors (Cinqair® , Nucala™, Fasenra®)
9/21/2022
1/1/2013 Atgam® (antithymocyte immune globulin, equine)
7/20/2022
1/1/2022 Aubagio® (teriflunomide)
5/18/2022
1/1/2023 Aubagio® (teriflunomide) tablet
6/15/2022
1/1/2021 Auryxia® (ferric citrate)
3/16/2022
1/1/2022 Auryxia® (ferric citrate)
3/16/2022
1/1/2023 Auryxia® (ferric citrate)
5/18/2022
1/1/2022 Austedo® (deutetrabenazine)
10/19/2022
11/30/2022 Auvelity™ (dextromethorphan and bupropion)
11/16/2022
6/17/2020 Avsola® (infliximab-axxq)
1/19/2022
6/17/2020 Avsola® (infliximab-axxq)
1/19/2022
1/1/2023 Avsola® (infliximab-axxq)
11/16/2022
1/1/2022 Avsola™ (infliximab-axxq)
11/16/2022
3/4/2020 Ayvakit™ (avapritinib)
8/17/2022
10/17/2018 Azedra® (iobenguano I 131)
3/16/2022
1/1/2022 Azilect® (rasagiline)
3/16/2022
1/1/2014 Azopt® (brinzolamide ophthalmic suspension) 1%
5/18/2022
1/1/2019 Azopt® (brinzolamide ophthalmic suspension) 1%
11/16/2022
11/6/2019 Baclofen Products (Fleqsuvy™, generic baclofen oral solution, Ozobax™, Lyvispah™)
7/20/2022
1/1/2023 Bafiertam® (monomethyl fumarate) capsule, delayed release
6/15/2022
1/20/2021 Bafiertam™ (monomethyl fumarate)
5/18/2022
1/1/2022 Balversa™ (erdafitinib)
8/17/2022
1/1/2022 Banzel® (rufinamide)
7/20/2022
1/1/2019 Bavencio® (avelumab)
8/17/2022
7/24/2014 Beleodaq® (belinostat)
2/16/2022
1/1/2020 Bendamustine products (Treanda, Bendeka, Belrapzo)
3/16/2022
1/1/2023 Bendamustine products (Treanda, Bendeka, Belrapzo)
7/20/2022
1/1/2022 Benlysta® (belimumab)
8/17/2022
1/1/2019 Benzodiazepine Limited Days' Supply
6/15/2022
7/27/2022 Beovu® (brolucizumab)
7/20/2022
1/1/2023 Beovu® (brolucizumab)
9/22/2022
1/1/2022 Berinert® (C1 esterase inhibitor, human)
8/17/2022
1/1/2022 Berinert® (C1 esterase inhibitor, human)
8/17/2022
1/1/2019 Besponsa™ (inotuzumab ozogamicin)
2/16/2022
2/16/2022 Besremi (ropeginterferon alfa-2b-njft)
2/16/2022
1/1/2022 Betaseron® (interferon beta-1b)
7/20/2022
1/1/2023 Bevacizumab products
7/20/2022
1/1/2021 Bevacizumab products
6/9/2022
1/1/2022 BiDil® (isosorbide dinitrate/hydralazine)
8/17/2022
1/1/2019 Biguanide Agents
7/20/2022
1/1/2017 Bisphosphonates
1/19/2022
10/14/2020 Blenrep (belantamab mafodotin-blmf)
8/17/2022
1/1/2020 Blincyto® (blinatumomab)
6/15/2022
9/26/2006 Boniva® and generic ibandronate sodium Injection
11/16/2022
1/1/2019 Boniva® and generic ibandronate sodium Injection
11/16/2022
1/1/2022 Bortezomib products (Velcade and Bortezomib for injection)
8/17/2022
1/1/2023 Bortezomib products (Velcade and Bortezomib for injection)
10/19/2022
1/1/2022 Bosentan Products
4/20/2022
1/1/2022 Bosulif® (bosutinib)
5/18/2022
1/1/2022 Bosulif® (bosutinib)
5/18/2022
9/29/2006 Botox® (Botulinum Toxin)
3/16/2022
1/1/2018 Bowel Prep Agents
5/18/2022
1/1/2022 Bowel Prep Agents
9/1/2022
1/1/2023 Bowel Prep Agents
5/18/2022
1/1/2016 BPH Agents
8/11/2022
1/1/2020 Braftovi™ (encorafenib) and Mektovi® (binimetinib)
4/20/2022
3/17/2021 Breyanzi® (lisocabtagene maraleucel)
8/17/2022
1/1/2023 Breyanzi® (lisocabtagene maraleucel)
9/22/2022
4/21/2021 Breyanzi® (lisocabtagene maraleucel)
8/17/2022
9/16/2020 Breztri Aerosphere™ (budesonide/glycopyrrolate/formoterol fumarate)
3/16/2022
2/23/2022 Brimonidine-timolol eye drops (generic Combigan)
2/16/2022
7/19/2017 Brineura™ (cerliponase alfa)
2/16/2022
10/3/2013 Brisdelle® (paroxetine mesylate)
3/16/2022
6/22/2016 Briviact® (brivaracetam)
9/1/2022
5/19/2021 Bronchitol® (mannitol)
3/16/2022
1/1/2022 Brovana (arformoterol)
12/16/2021
1/15/2020 Brukinsa™ (zanubrutinib)
9/21/2022
1/1/2023 Brukinsa™ (zanubrutinib)
9/21/2022
1/15/2020 Budesonide-Formoterol HFA (generic Symbicort)
10/20/2021
1/1/2020 Buprenorphine Containing Products
3/16/2022
1/1/2023 Buprenorphine Containing Products
8/17/2022
1/1/2022 Buprenorphine transdermal patch
1/27/2022
1/1/2022 Bupropion Containing Products (Aplenzin®, Forfivo® XL)
10/19/2022
1/1/2021 Bupropion Containing Products (Aplenzin®, Forfivo® XL, Wellbutrin XL®)
5/18/2022
11/17/2021 Bylvay (odevixibat) capsules
11/16/2022
8/19/2020 Bynfezia Pen™ (octreotide acetate) injection
5/18/2022
6/22/2022 Byooviz™ (ranibizumab-nuna)
6/16/2022
1/1/2021 Bystolic® (nebivolol)
5/18/2022
5/15/2019 Cablivi® (caplacizumab-yhdp)
1/19/2022
1/1/2021 Cabometyx™ (cabozantinib)
10/19/2022
1/1/2022 Cafergot® (ergotamine tartrate/caffeine)
5/18/2022
1/1/2021 Inhibidores del péptido relacionado con el gen de la calcitonina (CGRP)
7/20/2022
9/1/2022 Inhibidores del péptido relacionado con el gen de la calcitonina (CGRP)
8/18/2022
1/1/2021 Calquence® (acalabrutinib)
3/16/2022
6/22/2022 Camcevi (leuprolide mesylate)
6/15/2022
10/26/2022 Camzyos™ (mavacamten)
10/19/2022
3/18/2020 Caplyta® (lumateperone)
3/16/2022
4/28/2011 Caprelsa® (vandetanib)
11/16/2022
11/24/2010 Carbaglu® (carglumic acid)
2/16/2022
1/1/2020 Carbinoxamine 6mg tablet
3/16/2022
9/20/2017 CaroSpir® (spironolactone) oral suspension
2/16/2022
1/1/2022 Carvedilol ER
5/18/2022
4/27/2022 Carvykti™ (ciltacabtagene autoleucel)
4/20/2022
1/1/2023 Carvykti™ (ciltacabtagene autoleucel)
9/22/2022
4/27/2022 Carvykti™ (ciltacabtagene autoleucel)
4/20/2022
1/1/2019 Cayston® (aztreonam inhalation solution)
6/15/2022
9/18/2014 Cerdelga® (eliglustat)
8/17/2022
1/1/2010 Cerezyme® (imiglucerase)
8/17/2022
1/1/2020 Cesamet (nabilone)
6/15/2022
1/1/2023 CFTR Modulators
7/20/2022
1/1/2015 Chenodal™ (chenodiol) tablets
11/16/2022
7/30/2015 Cholbam® (cholic acid)
2/16/2022
1/1/2023 Cholbam® (cholic acid) capsules
10/6/2022
1/1/2021 Cialis® (tadalafil)
2/16/2022
5/25/2022 Cibinqo™ (abrocitinib)
5/18/2022
11/1/2022 Cimerli™ (ranibizumab-eqrn)
10/27/2022
1/1/2020 Cimzia (certolizumab pegol)
5/18/2022
1/1/2022 Cimzia® (certolizumab pegol)
7/20/2022
1/1/2022 Cimzia® (certolizumab pegol)
11/17/2022
1/1/2022 Cinryze® (C1 esterase inhibitor, human)
8/17/2022
1/1/2022 Cinryze® (C1 esterase inhibitor, human)
8/17/2022
1/1/2020 Cinvanti (aprepitant)
6/15/2022
6/16/2021 Clemastine fumarate syrup
4/20/2022
1/1/2020 Clindagel® (clindamycin phosphate gel)
11/16/2022
1/20/2017 Coagadex® (Coagulation Factor X [Human])
1/19/2022
1/1/2021 Colchicine Tablets and Capules
2/16/2022
1/1/2017 Cometriq® (cabozantinib)
12/2/2021
1/1/2017 Compounded Drugs
2/16/2022
1/1/2021 Compounded Medications
8/17/2022
11/11/2020 Conjupri® (levamlodipine)
9/21/2022
1/1/2022 Consensi® (amlodipine-celecoxib)
5/18/2022
1/1/2016 Sistemas de monitoreo continuo de glucosa
5/18/2022
6/3/2020 Contraceptive Medications
3/16/2022
12/12/2018 Copiktra™ (duvelisib)
3/16/2022
1/1/2021 Coreg CR® (carvedilol ER)
5/18/2022
1/20/2017 Corifact® (Factor XIII Concentrate [Human])
1/19/2022
1/1/2022 Corlanor® (ivabradine)
5/18/2022
1/1/2017 Corticosteroid and Long Acting Beta Agonist Combination Inhalers
9/15/2021
1/1/2020 Corticotropin Products
9/1/2022
4/21/2021 Cosela (trilaciclib)
4/20/2022
1/1/2022 Cosentyx® (secukinumab)
1/27/2022
1/1/2016 Cosopt® (dorzolamide and timolol ophthalmic solution)
7/20/2022
1/1/2021 Cotellic® (cobimetinib)
11/16/2022
1/1/2021 Cotellic® (cobimetinib)
11/16/2022
1/1/2006 Medicamentos para tos y resfríos
10/19/2022
5/28/2015 Cresemba® (isavuconazonium sulfate)
8/17/2022
3/7/2013 Crofelemer Products
7/21/2021
1/1/2020 Crotamiton Topical Products
2/16/2022
1/1/2020 Crysvita® (burosumab)
9/21/2022
1/1/2017 Cycloset® (bromocriptine)
2/16/2022
1/1/2013 Cyklokapron® (tranexamic acid)
1/19/2022
1/1/2021 Cyramza™ (ramucirumab)
7/20/2022
5/9/2013 Cysteamine Ophthalmic Products (Cystaran™, Cystadrops®)
11/16/2022
1/1/2013 Cytogam® (cytomegalovirus immune globulin, human)
8/18/2022
2/17/2021 Danyelza® (naxitamab-gqgk)
2/16/2022
2/23/2022 Dartisla ODT (glycopyrrolate)
2/16/2022
1/1/2022 Darzalex Faspro™ (daratumumab and hyaluronidase- fihj)
8/17/2022
1/1/2022 Darzalex® (daratumumab)
8/17/2022
1/16/2019 Daurismo™ (glasdegib)
11/16/2022
1/1/2022 Dayvigo™ (lemborexant)
7/21/2022
1/1/2022 Deferasirox Products
11/10/2022
1/1/2022 Deferasirox Products
6/15/2022
1/1/2023 Deferasirox Products
11/16/2022
1/1/2023 Deferasirox Tablet
8/17/2022
1/1/2022 Defitelio® (defibrotide sodium)
10/19/2022
1/1/2022 Desmopressin Nasal Spray
7/21/2022
1/1/2020 Desvenlafaxine Containing Products
5/18/2022
1/1/2022 Dexchlorpheniramine oral solution
5/18/2022
1/1/2023 Dexilant® (dexlansoprazole)
6/15/2022
1/1/2016 Diabetic Test Strips and Meters
9/21/2022
1/1/2017 Diabetic Test Strips and Meters
9/21/2022
5/15/2019 Diacomit® (stiripentol)
11/16/2022
1/1/2023 Diacomit® (stiripentol)
11/16/2022
1/1/2022 Differin® (adapalene) and Epiduo® (adapalene and benzoyl peroxide)
6/15/2022
1/1/2023 Differin® (adapalene) and Epiduo® (adapalene and benzoyl peroxide)
6/15/2022
1/1/2022 Dihydroergotamine Products
10/19/2022
9/2/2020 Dojolvi™ (triheptanoin) Oral Liquid
7/20/2022
1/1/2021 Dopamine Agonists
9/21/2022
1/1/2023 Dopamine Agonists
9/21/2022
9/26/2018 Doptelet® (Avatrombopag)
5/18/2022
1/1/2021 Doxycycline Antibiotics
7/20/2022
1/1/2020 DPP-IV inhibitors
3/16/2022
1/1/2021 DPP-IV inhibitors
3/16/2022
1/1/2021 DPP-IV, SGLT2 Combination Products
3/16/2022
1/1/2021 DPP-IV, SGLT2 Combination Products
3/16/2022
1/1/2023 DPP-IV, SGLT2 Combination Products
7/20/2022
1/1/2014 Dronabinol (GENERIC)
2/16/2022
1/1/2014 Dronabinol containing products (BRAND)
2/16/2022
1/24/2019 Drug Management Program-Opioid Program
11/3/2022
8/28/2010 Drug Utilization Management and Clinical Edits Tools
2/16/2022
1/1/2015 Duavee® (conjugated estrogens/bazedoxifene tablet)
3/16/2022
1/1/2020 Duexis® (ibuprofen-famotidine)
3/16/2022
1/1/2021 Duexis® (ibuprofen-famotidine) tablet
4/20/2022
10/16/2019 Duloxetine Containing Products
10/19/2022
1/1/2021 Duobrii® (halobetasol propionate and tazarotene)
6/15/2022
1/1/2022 Duopa® (carbidopa and levodopa) enteral suspension
3/16/2022
4/21/2021 Dupixent® (dupilumab) injection
11/16/2022
1/1/2022 Dupixent® (dupilumab) injection
11/16/2022
10/15/2015 Durlaza® (aspirin extended-release)
2/16/2022
8/19/2020 Durysta™ (bimatoprost implant)
4/20/2022
9/29/2006 Dysport® (botulinum toxin)
5/18/2022
1/1/2023 Dysport® (botulinum toxin)
8/17/2022
1/1/2018 Effient® (prasugrel)
10/19/2022
12/16/2010 Egrifta® (tesamorelin acetate)
4/20/2022
9/29/2008 Elaprase® (idursulfase)
11/16/2022
5/22/2012 Elelyso® (taliglucerase alfa)
9/1/2022
4/21/2021 Elepsia™ XR (levetiracetam)
2/16/2022
1/1/2022 Elidel® (pimecrolimus)
4/20/2022
1/1/2020 Eligard® (leuprolide acetate)
11/16/2022
1/1/2012 Elitek® (rasburicase)
2/16/2022
5/15/2019 Elzonris™ (tagraxofusp-erzs)
2/16/2022
1/1/2023 Elzonris™ (tagraxofusp-erzs)
6/15/2022
1/1/2020 Emend IV (fosaprepitant)
6/15/2022
1/1/2008 Emend® Oral (aprepitant)
2/16/2022
1/1/2020 Emflaza® (deflazacort)
11/16/2022
7/21/2021 Empaveli™ (pegcetacoplan)
6/15/2022
1/1/2022 Empliciti (elotuzumab)
8/17/2022
1/1/2022 EMSAM® (selegiline transdermal system)
7/21/2022
1/1/2022 Enbrel® (etanercept)
5/18/2022
11/8/2017 Endari™ (L-glutamine)
2/16/2022
1/1/2023 Enhertu (fam-trastuzumab deruxtecan-nxki)
9/21/2022
2/19/2020 Enhertu  (fam-trastuzumab deruxtecan-nxki)
9/21/2022
7/27/2022 Enjaymo™ (sutimlimab-jome)
7/20/2022
1/20/2021 Enspryng™ (satralizumab-mwge)
11/16/2022
9/28/2022 Entadfi™ (finasteride and tadalafil)
9/21/2022
1/1/2022 Entocort® (budesonide)
5/18/2022
1/1/2018 Entresto® (sacubitril-valsartan)
2/16/2022
1/1/2019 Entyvio® (vedolizumab)
1/19/2022
1/1/2020 Entyvio® (vedolizumab)
1/19/2022
1/1/2022 Entyvio® (vedolizumab)
11/16/2022
1/1/2019 Envarsus XR® (tacrolimus extended-release)
7/20/2022
1/1/2021 Envarsus XR® (tacrolimus extended-release)
7/20/2022
1/1/2021 Epclusa® (sofosbuvir/velpatasvir)
8/17/2022
1/1/2022 Epidiolex® (cannabidiol)
4/20/2022
1/1/2019 EpiPen® and EpiPen Jr® (epinephrine)
1/19/2022
1/1/2023 Eplerenone Products
7/20/2022
1/1/2022 Epoetin Alfa (Epogen, Procrit, Retacrit)
11/16/2022
1/1/2023 Epoetin Alfa (Epogen, Procrit, Retacrit)
11/10/2022
1/1/2021 Epoprostenol Products
6/15/2022
12/15/2021 Eprontia™ (topiramate) oral solution
11/16/2022
1/1/2021 Equetro® (carbamazepine)
8/17/2022
1/1/2021 Erbitux® (cetuximab)
8/17/2022
1/4/2017 Erectile Dysfunction Medications
2/16/2022
2/9/2012 Erivedge® (vismodegib)
1/19/2022
1/1/2022 Erleada™ (apalutamide)
8/18/2021
1/1/2022 Erleada™ (apalutamide)
8/18/2021
1/1/2019 Erwinaze® (asparaginase Erwinia chrysanthemi)
2/16/2022
1/1/2022 Esbriet® (pirfenidone)
8/17/2022
1/1/2023 Esbriet® (pirfenidone)
7/20/2022
1/1/2022 Eucrisa® (crisaborole)
4/20/2022
9/28/2022 Eulexin (flutamide)
9/21/2022
1/1/2023 Eulexin (Flutamide)
6/15/2022
6/19/2019 Evenity™ (romosozumab-aqqg)
4/20/2022
6/19/2019 Evenity™ (romosozumab-aqqg)
4/20/2022
1/1/2023 Evenity™ (romosozumab-aqqg)
5/18/2022
1/1/2021 Evista (raloxifene)
4/20/2022
3/17/2021 Evkeeza™ (evinacumab-dgnb)
2/16/2022
6/1/2016 Evomela (melphalan)
2/16/2022
11/11/2020 Evrysdi™ (risdiplam) Oral Solution
6/15/2022
11/17/2021 Exkivity (mobocertinib)
10/19/2022
1/1/2022 Exondys 51™ (eteplirsen)
4/20/2022
8/18/2021 Exservan™ (riluzole)
8/17/2022
1/1/2022 Eylea® (aflibercept)
11/16/2022
1/1/2023 Eylea® (aflibercept)
9/22/2022
1/20/2021 Eysuvis™ (loteprednol etabonate)
11/16/2022
1/1/2023 Eysuvis™ (loteprednol etabonate)
5/18/2022
1/1/2021 Ezetimibe-Containing Products
5/18/2022
1/1/2012 Fabrazyme® (agalsidase beta)
4/20/2022
1/20/2017 Factor IX Replacement Products (Hemophilia B)
1/19/2022
1/20/2017 Factor VIII Replacement Products (Hemophilia A)
1/19/2022
1/1/2020 Fanapt® (iloperidone)
3/16/2022
1/1/2022 Farxiga® (dapagliflozin)
9/1/2022
1/1/2019 Farydak® (panobinostat)
2/16/2022
1/1/2020 Faslodex® (fulvestrant)
4/20/2022
1/1/2020 FazaClo® (clozapine orally disintegrating tablet) and Versacloz® (clozapine oral solution)
3/16/2022
7/20/2017 FEIBA NF (Anti-Inhibitor Coagulant Complex)
11/16/2022
1/1/2021 Fenoprofen Products
4/20/2022
7/15/2020 Fensolvi® (leuprolide acetate) subcutaneous syringe
4/20/2022
1/1/2022 Ferriprox® (deferiprone)
8/17/2022
1/1/2022 Fetzima® (levomilnacipran)
10/19/2022
1/1/2017 Fibrate Products
2/16/2022
1/1/2020 Fibrate Products
2/16/2022
1/1/2023 Finacea® (azelaic acid) topical foam
9/21/2022
9/2/2020 Fintepla® (fenfluramine)
5/18/2022
1/1/2023 Fintepla® (fenfluramine) Oral Solution
8/17/2022
1/1/2022 Firazyr® (icatibant)
8/17/2022
1/1/2020 Firdapse® (amifampridine) tablets
11/16/2022
1/1/2020 Firmagon® (degarelix)
11/16/2022
1/1/2021 Flector®, Licart™ (diclofenac epolamine patch 1.3%)
9/21/2022
9/28/2022 fluticasone propionate HFA inhaler
9/21/2022
10/29/2009 Folotyn® (pralatrexate)
2/16/2022
1/1/2021 Foot Bath Medications
7/20/2022
1/1/2019 Formulary Tier Exception
2/17/2021
1/1/2019 Forteo® (teriparatide injection)
4/20/2022
1/1/2019 Forteo® (teriparatide injection)
4/20/2022
5/19/2021 Fotivda® (tivozanib)
4/20/2022
2/23/2022 Fyarro (sirolimus protein-bound particles for injectable suspension)
2/16/2022
1/2/2014 Fycompa® (perampanel)
2/16/2022
1/1/2023 Fycompa® (perampanel)
6/15/2022
9/26/2018 Galafold®(migalastat)
7/20/2022
4/23/2019 Gamifant® (emapalumab-lzsg)
2/16/2022
7/15/2015 Gardasil® (human papillomavirus vaccine)
2/16/2022
1/1/2019 Gattex® (teduglutide)
11/16/2022
11/11/2020 Gavreto™ (pralsetinib)
2/16/2022
1/1/2020 Gazyva® (obinutuzumab)
6/15/2022
1/1/2022 Gilenya® (fingolimod)
7/20/2022
1/1/2020 Gilotrif® (afatinib)
3/16/2022
1/20/2021 Gimoti™ (metoclopramide)
11/16/2022
3/18/2020 Givlaari™ (givosiran)
1/19/2022
1/1/2021 Glatiramer Products
9/21/2022
1/1/2020