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Content with Policies & Guidelines Draft Self-Administered Drug Policies .
Androderm, AndroGel, Fortesta, Natesto, Striant, Testim, testosterone solution, Vogelxo, Jatenzo, Methitest, methyltestosterone capsule, Tlando, Anadrol-50, danazol, Oxandrin, Kyzatrex
Abrilada, Actemra, Amjevita, Bimzelx, Cimzia, Cosentyx, Cyltezo, Enbrel, Entyvio, Hadlima, Hulio, Humira, Hyrimoz/Adalimumab-adaz, Idacio, Kevzara, Kineret, Litfulo, Olumiant, Omvoh, Orencia,...
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Compounded Medications Prior Authorization Program Summary
Policy Number: PH-91004
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Mandatory Generic/Member Pays the Difference Exception Prior Authorization Program...
Genotropin, Humatrope, Ngenla, Norditropin, Nutropin AQ, Omnitrope, Saizen, Serostim, Skytrofa, Sogroya, Zomacton, Zorbtive