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Prior authorization
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#	Item
961	Oral Enteral Nutrition Worksheet Expedited Prior Authorization (EPA) Request New Request Extension Request (Prior Authorization Number or EPA Number) Add to Reading List Source URL: www.hca.wa.gov Language: English - Date: 2013-03-14 12:10:47 United States Department of Agriculture WIC Medical classification Medical informatics World Health Organization Dietitian International Statistical Classification of Diseases and Related Health Problems Medicine Health Federal assistance in the United States
962	PRIOR AUTHORIZATION POLICY Stelara™ (ustekinumab for subcutaneous [SC] injection – Centocor Ortho Biotech) To Initiate a Coverage Review, Call[removed]For Coverage Under the Medical Benefit, Call[removed] Add to Reading List Source URL: statehealthplan.state.nc.us Language: English - Date: 2014-08-12 13:02:44 Monoclonal antibodies Immunology Centocor Psoriasis Ustekinumab Biologic Adalimumab Etanercept Infliximab Immunosuppressants Medicine Pharmacology
963	Prior Authorization of Power Mobility Devices (PMDs) Demonstration Updated Fact Sheet • The Medicare Fee-for-Service Prior Authorization of Power Mobility Device (PMD) Add to Reading List Source URL: www.cms.gov Language: English - Date: 2014-05-23 14:11:43 Healthcare in the United States Medicare Medicaid Government Wheelchair TRICARE Health United States Federal assistance in the United States Healthcare reform in the United States Presidency of Lyndon B. Johnson
964	PRIOR AUTHORIZATION POLICY Ilaris® (canakinumab for subcutaneous [SC] injection Novartis) To initiate a Coverage Review, Call[removed] Add to Reading List Source URL: statehealthplan.state.nc.us Language: English - Date: 2013-11-01 14:13:13 Immunology Autoinflammatory syndromes Rheumatology Rare diseases Monoclonal antibodies Canakinumab Muckle–Wells syndrome Cryopyrin-associated periodic syndrome Familial cold urticaria Health Medicine Immunosuppressants
965	PRIOR AUTHORIZATION POLICY Aubagio® (teriflunomide tablets Genzyme/Sanofi) To Initiate a Coverage Review, Call[removed] Add to Reading List Source URL: statehealthplan.state.nc.us Language: English - Date: 2014-01-29 12:46:45 Immunosuppressants Medicine Cytokines Autoimmune diseases Anilides Glatiramer acetate Treatment of multiple sclerosis Interferon beta-1a Natalizumab Immunology Immune system Multiple sclerosis
966	PRIOR AUTHORIZATION POLICY Cimzia® (certolizumab pegol for subcutaneous [SC] injection [lyophilized] and SC injection [solution] UCB) To Initiate a Coverage Review, Call[removed]OVERVIEW Add to Reading List Source URL: statehealthplan.state.nc.us Language: English - Date: 2014-01-06 13:47:04 Immunology Autoimmune diseases Arthritis Rheumatology Monoclonal antibodies Certolizumab pegol Etanercept Infliximab Rheumatoid arthritis Medicine Immunosuppressants Health
967	Oral Enteral Nutrition Worksheet Prior Authorization Request TO BE SUBMITTED BY MEDICAL VENDOR OR PHARMACY Fax: [removed]New Request Add to Reading List Source URL: www.hca.wa.gov Language: English - Date: 2013-03-14 12:10:48 Healthcare Common Procedure Coding System Federal assistance in the United States United States Department of Agriculture WIC
968	Medicare Prior Authorization of Power Mobility Devices Demonstration Status Update (posted[removed]The Medicare Prior Authorization of Power Mobility Devices Demonstration was implemented on September 1, 2012 in CA, Add to Reading List Source URL: www.cms.gov Language: English - Date: 2014-01-08 14:44:09 Presidency of Lyndon B. Johnson Authorization Health Government United States Healthcare reform in the United States Federal assistance in the United States Medicare
969	PRIOR AUTHORIZATION POLICY Androgens and Anabolic Steroids To Initiate a Coverage Review, Call[removed]Covered Medications  Add to Reading List Source URL: statehealthplan.state.nc.us Language: English - Date: 2014-09-02 09:27:06 Androgens Testosterone Anabolic steroids Reproductive system Gender transitioning Hypogonadism Hormone replacement therapy Androgen replacement therapy Androgen Medicine Endocrine system Endocrinology
970	GENERAL: TRAVEL AUTHORIZATION: All non-routine travel must be authorized with prior approvals in writing by the head of the department, board, or commission from whose funds the traveler is paid. Add to Reading List Source URL: doa.louisiana.gov Language: English - Date: 2014-07-23 12:52:30 Travel agency Damage waiver Enterprise Holdings Transport Business Travel Car rental Corporate travel management

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