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Prior authorization
Results: 1240

#	Item
731	Division: Pharmacy Services Subject: Prior Authorization Criteria Original Development Date: Original Effective Date: Add to Reading List Source URL: www.fdhc.state.fl.us Language: English - Date: 2012-08-24 13:56:53 Analgesics Alkenes Antipyretics Propionic acids Non-steroidal anti-inflammatory drugs Butalbital Paracetamol Codeine Ibuprofen Pharmacology Medicine Chemistry
732	VIVITROL.6 Form # 30400 R:10.11 State of Maine Department of Health &Human Services MaineCare/MEDEL Prior Authorization Form Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2012-03-19 13:49:13 Addiction Morphinans Ketones Ethers Phenols Naltrexone Opioid dependence Alcoholism Medical necessity Chemistry Alcohol abuse Organic chemistry
733	OPIATE LIMITS Form #[removed]C: 01.13 State of Maine Department of Health &Human Services MaineCare/MEDEL Prior Authorization Form Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2013-01-17 15:22:32 Morphinans Phenols Nociception Ethers Morphine Opioid Back pain Fibromyalgia Chronic pain Medicine Pain Chemistry
734	Division: Pharmacy Services Subject: Prior Authorization Criteria Original Development Date: Original Effective Date: Add to Reading List Source URL: www.fdhc.state.fl.us Language: English - Date: 2012-10-08 11:20:38 Homocysteine Thiols Homocystinuria Trimethylglycine Chemistry Organic chemistry Alcohols
735	Division: Pharmacy Services Subject: Prior Authorization Criteria Original Development Date: Original Effective Date: Add to Reading List Source URL: www.fdhc.state.fl.us Language: English - Date: 2012-06-25 13:42:39 Growth factors Renal dialysis Hemoglobins Anemias Erythropoietin Epoetin alfa Darbepoetin alfa Thalassemia Chemotherapy Medicine Hematology Erythropoiesis-stimulating agents
736	Division: Pharmacy Services Original Development Date: Original Effective Date: Revision Date: Subject: Prior Authorization Criteria Add to Reading List Source URL: www.fdhc.state.fl.us Language: English - Date: 2012-06-25 14:31:22 Medicine Pharmaceutical drug Osteoporosis Pharmacy Pharmacology Health Osteopathies
737	Division: Pharmacy Services Subject: AUTO PA (Automated Prior Authorization) Original Development Date: Original Effective Date: Add to Reading List Source URL: www.fdhc.state.fl.us - Date: 2012-06-25 14:45:16
738	Client Contract Number – Client Name – MA-PD/PDP Prior Authorization Criteria and Guidelines Acne 5 Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2012-04-02 13:55:27 Attention-deficit hyperactivity disorder Stimulants Nootropics Childhood psychiatric disorders Sleep disorders Methylphenidate Attention deficit hyperactivity disorder Leflunomide Modafinil Medicine Chemistry Organic chemistry
739	Microsoft Word - Prior Authorization Request Form for Retinoid.doc Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2012-04-02 14:34:42 Organic chemistry Tretinoin Acne vulgaris Adapalene Retinoid Clindamycin Benzoyl peroxide Sulfacetamide Rosacea Anti-acne preparations Chemistry Medicine
740	Microsoft Word - Prior Authorization Request Form for Humira.doc Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2012-04-02 14:08:16 Immunology Arthritis Rheumatology Autoimmune diseases Connective tissue diseases Anakinra Adalimumab Rheumatoid arthritis Infliximab Medicine Health Immunosuppressants

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