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Prior authorization
Results: 1240

#	Item
831	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: 2014-08-11 12:05:05 Pain Sumatriptan Treximet Medical prescription Almotriptan Migraine Methadone Naproxen Chemistry Triptans Organic chemistry
832	NSANTI.18 Form # 20530 R:05.09 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 13:38:25 Organochlorides Piperidines Schering-Plough Allergology Type 1 hypersensitivity Loratadine Desloratadine Cetirizine Urticaria Chemistry Medicine Organic chemistry
833	Microsoft Word - Prior Authorization Request Form for Betaseron.doc Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2012-04-02 14:09:35 Glatiramer acetate Interferon beta-1a Medical diagnosis Medicine Multiple sclerosis Immune system
834	Prior Authorization Request Form for Forteo (teriparatide) Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2012-04-02 14:06:01 Anatomy Drugs Osteopathies Osteoporosis Teriparatide Raloxifene Bisphosphonate Bone density Bone Eli Lilly and Company Medicine Chemistry
835	Prior Authorization Changes to Outpatient Mental Health Services Add to Reading List Source URL: www.passporthealthplan.com Language: English - Date: 2013-05-10 15:29:36
836	Prior Authorization Request Form for Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2012-04-02 14:03:01 Psychiatry Anorectics Euphoriants Stimulants Dopamine agonists Methylphenidate Attention deficit hyperactivity disorder Amphetamine Dextroamphetamine Pharmacology Medicine Attention-deficit hyperactivity disorder
837	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 14:43:07
838	Microsoft Word - Prior Authorization Request Form for Celebrex.doc Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2012-04-02 14:03:30 Chemistry COX-2 inhibitors Celecoxib Address Fax Aspirin Polyp Medicine Non-steroidal anti-inflammatory drugs Technology
839	ACTM.25 Form #10110 R:7.13 State of Maine Department of Health & Human Services MaineCare/MEDEL Prior Authorization Form Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2013-07-25 08:31:21 Sumatriptan Tab Migraine Q Treximet Aspirin Beverage can Chemistry Triptans Pain Organic chemistry
840	Prior Authorization of Advanced Diagnostic Imaging for Passport Health Plan Provider Orientation Objectives Add to Reading List Source URL: www.passporthealthplan.com Language: English - Date: 2012-09-06 09:39:10 Nuclear medicine Medical diagnosis Nosology Authorization Clinical decision support system Medical imaging Magnetic resonance imaging Medicine Health Health informatics

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