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Prior authorization
Results: 1240

#	Item
751	Division: Pharmacy Services Subject: Prior Authorization Criteria Original Development Date: Original Effective Date: Add to Reading List Source URL: www.fdhc.state.fl.us - Date: 2012-06-25 14:38:27
752	Division: Pharmacy Services Subject: Prior Authorization Criteria Original Development Date: Original Effective Date: Add to Reading List Source URL: www.fdhc.state.fl.us - Date: 2012-06-25 14:07:32
753	Microsoft Word - Prior Authorization Request Form for Fuzeon.doc Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2012-04-02 14:06:21 Chemistry Antiretroviral drug HIV Zidovudine Enfuvirtide Viral load Retrovirus HIV/AIDS Biology Medicine
754	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: 2012-07-13 11:45:57 Piperidines Morphinans Ketones Alcohols Pharmacology Actiq Fentanyl Abstral Hydromorphone Medicine Chemistry Organic chemistry
755	CCHP Senior Program (HMO[removed]Prior Authorization Drug Requirements Last Updated[removed]FORMULARY DRUG BRAND NAME Add to Reading List Source URL: www.cchphmo.com Language: English - Date: 2014-10-26 01:26:15 Anti-acne preparations Carboxylic acids Retinoids Health Managed care Adapalene Medicare Part D Health maintenance organization Formulary Pharmaceuticals policy Chemistry Medicine
756	Plavix.2 Form # 20715 R:06.13 State of Maine Department of Health & Human Services MaineCare/MEDEL Prior Authorization Form Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2013-06-21 15:19:43 Aging-associated diseases Organofluorides Medical emergencies Antiplatelet drugs Clopidogrel Prodrugs Prasugrel Acute coronary syndrome Myocardial infarction Chemistry Organic chemistry Medicine
757	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: 2012-11-02 09:41:52 Multiple sclerosis Biology Interferon beta-1a Pfizer Autoimmune diseases Antivirals Glatiramer acetate Interferon Teriflunomide Cytokines Immunology Immune system
758	NARC.17 Form # 20510 R:1.13 State of Maine Department of Health & Human Services MaineCare/MEDEL Prior Authorization Form Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2013-09-26 09:23:13 Morphinans Ketones Alcohols Euphoriants Phenols Fentanyl Oxycodone Pain management Methadone Chemistry Organic chemistry Medicine
759	May 16, 2014: Reminder – Lantus Status Changed May 1 On May 1, 2014 the Medicaid Preferred Drug List (PDL) prior authorization criteria for Lantus products on the Medicaid formulary changed to allow it authorized for c Add to Reading List Source URL: www.hhsc.state.tx.us - Date: 2014-05-16 14:58:53
760	ZYV.13 Form # 30820 R:04.11 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 12:57:51 Staphylococcaceae Antibiotic-resistant bacteria Lactobacillales Vancomycin Linezolid Methicillin-resistant Staphylococcus aureus Staphylococcus aureus MRSE Vancomycin-resistant Staphylococcus aureus Bacteria Microbiology Bacterial diseases

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