ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Immune Globulins - Medicaid
တချုးတၢ်ဟ့ၣ်စိဟ့ၣ်ကမီၤ
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါနိၣ်၀့ဘၢၣ် 01, 2024
တၢ်ဃုသ့ၣ်ညါတၢ်အစၢ
တၢ်ပာ်ဖျါ 2041 - 2050 လၢ 3685 အစၢတဖၣ်အကျါ
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Bonjesta®, Diclegis® - Commercial
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါနိၣ်၀့ဘၢၣ် 01, 2024
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Bempedoic Acid - Medicaid
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲ အမုၢ်နံၤမုၢ်သီ- လါစဲးပတ့ဘၢၣ် 01, 2024
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Gattex® (teduglutide) - Commercial
တချုးတၢ်ဟ့ၣ်စိဟ့ၣ်ကမီၤ
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါနိၣ်၀့ဘၢၣ် 01, 2024
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Egrifta® (tesamorelin) - Medicaid
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲ အမုၢ်နံၤမုၢ်သီ- လါစဲးပတ့ဘၢၣ် 01, 2024
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Egrifta® (tesamorelin) - Commercial
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲ အမုၢ်နံၤမုၢ်သီ- လါစဲးပတ့ဘၢၣ် 01, 2024
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
BC-COM-PharmProgPolicyNotifctn-Eff-12-1-21.pdf
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
QP76-21 Commercial and MHCP Pharmacy Benefit Exclusion for Uptravi®
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 13, 2021
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
QP77-21 Commercial Pharmacy Benefit Update – Revised Drug-Related Prior Authorization (PA) Requirement Notification – Effective December 1, 2021
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 13, 2021
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
QP82-21 MHCP Pharmacy Benefit Update – New Drug-Related Prior Authorization (PA) with Quantity Limit (QL) Criteria: Accrufer™ (ferric maltol)
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 27, 2021