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Prior authorization
Results: 1240

#	Item
811	HOMOZYGOUS FH FORM Form #[removed]R: 12.13 State of Maine Department of Health &Human Services MaineCare/MEDEL Prior Authorization Form Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2014-01-16 12:31:44 Biology Low-density lipoprotein Cholesterol Hypercholesterolemia Statin Health Chemistry Familial hypercholesterolemia
812	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 14:42:30
813	SYMLIN.3 Form # [removed]R:09.08 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 13:47:09 Endocrinology Insulin pump Diabetes management Blood glucose monitoring Anti-diabetic medication Insulin Hypoglycemia Basal Metformin Diabetes Medicine Endocrine system
814	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 14:09:03 Medicine Nephrology Organ failure 4-Aminopyridine Pyridines Renal failure Renal function Creatinine Epileptic seizure Anatomy Biology Renal physiology
815	DOS/MAX.04 Form # 10420 R: 02.11 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 13:24:15 Amines Medicine Withdrawal syndromes Eli Lilly and Company Ropinirole Pharmacology Dose Chemistry
816	RAPAM.12 Form # 20910 R: 12.13 State of Maine Department of Health & Human Services MaineCare/MEDEL Prior Authorization Form Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2014-01-16 12:07:13 Immunology Etanercept Biologic Psoriasis Ustekinumab Alefacept Adalimumab Acitretin Methotrexate Immunosuppressants Medicine Pharmacology
817	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 14:34:49 Rheumatology Organochlorides Febuxostat Nitriles Thiazoles Gout Colchicine Diclofenac Tophus Chemistry Organic chemistry Non-steroidal anti-inflammatory drugs
818	OAS.3 Form # 20600 R:05.08 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 13:39:44 Nutrition Obesity Wasting Body shape HIV/AIDS Medical signs Oxandrolone Cachexia Body mass index Medicine Health Biology
819	FLUM.9 Form # 10610 R:05.11 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 13:29:27 Pharmacology AstraZeneca Influenza vaccines Flu pandemic FluMist MedImmune Influenza Aspirin Fluzone Vaccination Vaccines Medicine
820	FUZ.9 Form # 10620 R:09.08 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 13:31:37 Biology Antiretroviral drug Enfuvirtide Viral load HIV Medical prescription Medical record Zidovudine HIV/AIDS Medicine Health

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