| Document Date: 2014-12-18 11:40:48
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Company CVS Caremark / / Facility CVS Caremark Specialty Pharmacy / Contact CVS Caremark Specialty Pharmacy / / IndustryTerm healthcare / / MedicalCondition HIV / HBV / DEFICIENCY / Somatuline Depot1 Somavert1 Increlex1 HEMATOPOIETICS ALCOHOL DEPENDENCY Mozobil Neumega ALLERGIC ASTHMA HEMOPHILIA / / NaturalFeature Limited Distribution channel / / Organization Blue Cross and Blue Shield Association / / / Product Videx EC / Combivir / Humira / Hycamtin / zidovudine / Orencia / Videx / Kineret / Fuzeon / Targretin / Sandimmune / Exjade / leuprolide acetate / TOBI / Apokyn / Sprycel / Gleevec / Enbrel / Neoral / Copaxone / Infergen / Cystagon / Buphenyl / cyclosporine / Sensipar / Tyzeka / Temodar / COPEGUS / Retrovir / Kuvan / Nexavar / ribavirin / Zerit / nevirapine / Tasigna / Forteo / Pegasys / Viramune / gengraf / Vivitrol / Zolinza / Ribasphere / Xeloda / Sandostatin / octreotide acetate / Hepsera / abacavir / Prograf / Rebetol / lamivudine / PegIntron / Ventavis / Lupron / Epivir / Arcalyst / Revlimid / Tracleer / didanosine / Xolair / Actimmune / Rebif / Intron A / Betaseron / Ziagen / Avonex / Letairis / Sutent / Neumega / CellCept / Stimate / Tykerb / Pulmozyme / Revatio / Thalomid / stavudine / sildenafil citrate / tobramycin / Baraclude / / ProvinceOrState Idaho / /
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Specialty Drug List Blue Cross of Idaho regards the following list of medications as specialty drugs. Most specialty drugs require prior authorization from Blue Cross of Idaho for medical necessity. If covered, Blue Cros