| Document Date: 2012-06-25 14:43:19
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Country United States / / Currency BMD / / Facility Pharmacy Services Subject / / MedicalCondition Osteopenia / leukemia / Idiopathic scoliosis / celiac disease / Inflammatory bowel disease / Cancer / HIV / Thyrotoxicosis / Lymphoma / Malabsorption syndromes / Multiple myeloma / Kidney disease / Ankylosing spondylitis / Female athlete triad / Emphysema / Hyperparathyroidism / Rheumatoid arthritis / biliary cirrhosis / Crohn’s disease / Stroke / Spinal cord injuries / Hyperthyroidism / bone marrow disorders / Premature menopause / Diabetes mellitus / Parkinson’s disease / Diseases / Multiple sclerosis / Broken Osteoporosis / Postpolio syndrome / Eating disorders / osteoporosis / AIDS / Severe liver disease / Thalassemia / Prostate cancer / Lupus / Breast cancer / syndrome / / MedicalTreatment contraception / bypass / Organ transplants / / Organization World Health Organization / National Osteoporosis Foundation / / Position athlete / / Product triad / Femara / Nexium / Reclast / Depo-Provera / Lexapro / Cyclosporine / Prevacid / Dilantin / Medroxyprogesterone acetate / Prilosec / testosterone / Zoladex / FORTEO / Zoloft / vitamin K / vitamin D / Prozac / prednisone / Lupron / Actos / Arimidex / Avandia / Aromasin / /
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Division: Pharmacy Services Subject: Prior Authorization Criteria Original Development Date: Original Effective Date: