requested non-preferred product / chemical entities / treatment of nausea and vomiting associated with cancer / /
MedicalCondition
cancer / Parkinsonism / seizure disorder / seizure / vomiting / AIDS / tinea pedis / nausea / tinea / tinea capitis / MS / Acne / tinea corporis / documented allergy / pain / pityriasis / tinea cruris / /
MedicalTreatment
chemotherapy / /
Organization
BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC DRUG CLASS ANTIMIGRAINE AGENTS / BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC DRUG CLASS PREFERRED AGENTS NON-PREFERRED AGENTS ANALGESICS / BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC DRUG CLASS PREFERRED AGENTS ANTIDEPRESSANTS / BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC DRUG CLASS ANALGESICS / BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC DRUG CLASS ANTIFUNGALS / BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC DRUG CLASS PREFERRED AGENTS ALZHEIMER’S AGENTS NON-PREFERRED AGENTS CHOLINESTERASE INHIBITORS ARICEPT / PA NR / BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC DRUG CLASS ANGIOTENSIN MODULATORS ANTICOAGULANTS / BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC DRUG CLASS PREFERRED AGENTS ANTIEMETICS / BUREAU FOR MEDICAL SERVICES WEST VIRGINIA MEDICAID PREFERRED DRUG LIST WITH PRIOR AUTHORIZATION CRITERIA THERAPEUTIC DRUG CLASS PREFERRED AGENTS NON-PREFERRED AGENTS ACNE AGENTS / /
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