ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
QP58-21 Commercial and MHCP Pharmacy Benefit Exclusion for Vocabria
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲ အမုၢ်နံၤမုၢ်သီ- လါယူၤလံ 14, 2021
တၢ်ဃုသ့ၣ်ညါတၢ်အစၢ
တၢ်ပာ်ဖျါ 2171 - 2180 လၢ 3685 အစၢတဖၣ်အကျါ
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
QP2R1-21 Update for New to Market Medical Drugs: Aducanumab, Casimersen, Evinacumab, Idecabtagene Vicleucel, and Pegunigalsidase Alfa
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါယူၤ 23, 2021
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Special Transportation Ride Request Form
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Common Carrier Ride Request Form
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Special Transportation Ride Request Form - Care Coordinator
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Common Carrier Ride Request Form - Care Coordinator
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Hypoactive Sexual Desire Disorder (HSDD) - Commercial
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါယူၤ 01, 2025
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Hyperhidrosis - Commercial - Effective Date 03/01/2025
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါမာ်ရှး 01, 2025
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Fintepla - Medicaid
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါယူၤ 01, 2025
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Fintepla (fenfluramine) - Commercial
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါယူၤ 01, 2025