ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
GLP-1 (glucagon-like peptide-1) Agonists - Commercial
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 01, 2025
တၢ်ဃုသ့ၣ်ညါတၢ်အစၢ
တၢ်ပာ်ဖျါ 3821 - 3830 လၢ 4029 အစၢတဖၣ်အကျါ
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Hepatitis C Direct Acting Antivirals - Commercial
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 01, 2025
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Dipeptidyl Peptidase-4 (DPP-4) Inhibitors and Combinations - Commercial
Step Therapy, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 01, 2025
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Insulin Pumps - Medicaid
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 01, 2025
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Formulary Exception - Standard Guidelines - Medicaid
Formulary Exception
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 01, 2025
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Interleukin (IL) -1 Inhibitors - Commercial
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 01, 2025
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Immune Globulins - Medicaid
တချုးတၢ်ဟ့ၣ်စိဟ့ၣ်ကမီၤ
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 01, 2025
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Hyperpolarization-Activated Cyclic Nucleotide-Gated (HCN) Channel Blocker (Corlanor) - Commercial
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 01, 2025
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Droxia and Siklos - Medicaid
တချုးတၢ်ဟ့ၣ်စိဟ့ၣ်ကမီၤ
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 01, 2025
ကသံၣ်ကသီပှၤဟ့ၣ်မၤစၢၤတၢ်
Hereditary Angioedema - Commercial
Prior Authorization, Quantity Limit
တၢ်ရဲၣ်တၢ်ကျဲၤစးထီၣ်မူ၀ဲအမုၢ်နံၤမုၢ်သီ- လါအီးကထိဘၢၣ် 01, 2025