Drug Criteria
Abecma Criteria
[
119.2 kB
]
Added 5/7/2021
Abilify Mycite Criteria
[
125.6 kB
]
Updated 7/18/2023
Abstral/Actiq/Fentora/Lazanda/Onsolis/Subsys Criteria
[
333.5 kB
]
Updated 03/2018
Abstral/Actiq/Fentora/Lazanda/Onsolis/Subsys PA Form
[
1 MB
]
Updated 1/3/2025
Adakveo Criteria
[
74.6 kB
]
Updated 1/24/2024
Adbry Criteria
[
125.1 kB
]
Updated 2/8/2024
Adlarity Criteria
[
113.4 kB
]
Added 11/15/2022
Aduhelm Criteria
[
198.3 kB
]
Updated 10/2/2023
Adult High Dose Antipsychotic Criteria
[
134.1 kB
]
Updated 1/24/2024
Adult High Dose Antipsychotic PA Form
[
634.1 kB
]
Updated 1/3/2025
Adzynma Criteria
[
208.4 kB
]
Updated 3/11/2024
Aemcolo Criteria
[
150.6 kB
]
Added 3/13/2023
Afrezza Criteria
[
183.1 kB
]
Updated10/2/2023
Agamree Criteria
[
115.1 kB
]
Added 7/1/2024
Albumin PA Form
[
1.1 MB
]
Updated 1/3/2025
Alinia Criteria
[
138.3 kB
]
Updated 6/16/2022
Amifampridine Criteria
[
121 kB
]
Updated 7/19/2023
Amlodipine (NORLIQVA® and KATERZIA®) oral solution/suspension Criteria
[
143.5 kB
]
Added 3/13/2023
Amondys 45 Criteria
[
150.9 kB
]
Updated 4/14/2023
Anti-Parkinson’s Agents for “Off” Episodes
[
156.6 kB
]
Updated 7/28/2022
Antidepressants (Age < 6 years) PA Form
[
1.4 MB
]
Updated 1/3/2025
Antipsychotic (Age <6) PA Form
[
1.4 MB
]
Updated 1/3/2025
Antipsychotic (Age 6 to <18) PA Form
[
1.9 MB
]
Updated 1/3/2025
Antipsychotic Non-Preferred Criteria
[
145.5 kB
]
Updated 1/24/2024
Antipsychotic Polypharmacy Criteria
[
383 kB
]
Added 7/7/2020
Aplenzin
[
300.6 kB
]
New 6/5/2015
Arikayce Criteria
[
117.4 kB
]
Added 4/30/2021
Automated Prior Authorizations and Bypass Lists
[
1.8 MB
]
Updated 2/13/2025
Auvelity Criteria
[
174.1 kB
]
Added 6/27/2023
Benlysta Criteria
[
148.8 kB
]
Updated 12/29/2021
Besremi Criteria
[
138 kB
]
Updated 9/8/2022
Bile Salts Agents Criteria
[
146.3 kB
]
Added 1/7/2022
Blincyto Criteria
[
70.2 kB
]
Added 6/16/2022
Boniva Injection Criteria
[
181.5 kB
]
Updated 1/24/2024
Botulinum Criteria
[
113.7 kB
]
Updated 1/31/2024
Brexafemme Criteria
[
114.2 kB
]
Added 11/15/2022
Breyanzi Criteria
[
161.6 kB
]
Updated 10/14/2022
Brineura Criteria
[
155 kB
]
Added 1/27/2023
Brisdelle Criteria
[
295.9 kB
]
Updated 2/28/2018
Bronchitol Criteria
[
118.3 kB
]
Added 4/30/2021
Buprenorphine Agents for Pain
[
75.6 kB
]
Updated 11/30/2023
Butalbital Criteria
[
100.9 kB
]
Updated 4/22/2022
Camzyos Criteria
[
178 kB
]
Added 10/14/2022
Carbaglu Critieria
[
168.1 kB
]
Updated 9/17/2021
Carvykti Criteria
[
177.1 kB
]
Added 6/16/2022
Casgevy Criteria
[
151.4 kB
]
Added 8/14/2024
Cayston Criteria
[
300.3 kB
]
Updated 2/24/2015
Ceprotin Criteria
[
295.1 kB
]
Updated 11/16/2015
Cerdelga Criteria
[
125.1 kB
]
Updated 2/9/2024
Cerezyme Criteria
[
137.5 kB
]
Updated 6/16/2022
Chantix Criteria
[
112.4 kB
]
Updated 1/21/2022
Chemet Criteria
[
145.7 kB
]
Updated 6/27/2023
Chorionic Gonadotropin Criteria
[
194.8 kB
]
Updated 11/16/2015
Cibinqo Criteria
[
146 kB
]
Updated 10/2/2023
CII-V Edit Override Criteria
[
175.9 kB
]
Updated April 4, 2024
Cinqair Criteria
[
147.9 kB
]
Updated 8/9/2022
Cinryze Criteria
[
322 kB
]
Added 4/12/2019
Cobenfy Criteria
[
118 kB
]
Added 10/11/2024
Colchicine Agents Criteria
[
140.3 kB
]
Added 4/22/2022
Colony Stimulating Factors Criteria
[
189.7 kB
]
Added 1/3/2025
Colony Stimulating Factors Form
[
1.3 MB
]
Updated 1/3/2025
Concomitant Drug Therapy Criteria
[
364.4 kB
]
Added 7/7/2020
Constipation Agents
[
154.7 kB
]
Updated 12/20/2024
Corlanor Criteria
[
131.2 kB
]
Updated 1/24/2024
Cough and Cold Antitussive Medications Criteria
[
70.6 kB
]
Updated 4/21/2021
Cresemba Criteria
[
142.6 kB
]
Added 11/13/2024
Crysvita Criteria
[
98 kB
]
Updated 7/1/2024
Cubicin Criteria
[
281 kB
]
Updated 10/3/2019
Cyanocobalamin Criteria
[
23.5 kB
]
Updated 4/22/2022
Cyramza Criteria
[
344.3 kB
]
Updated 6/14/2019
Cytokines and CAM Antagonists Criteria
[
256.4 kB
]
Updated 11/13/2024
Cytogam PA Form
[
1 MB
]
Updated 1/3/2025
Daliresp Criteria
[
190.7 kB
]
Added 6/27/2018
Dalvance Criteria
[
75.9 kB
]
Updated 12/10/2021
Daraprim Criteria
[
119.1 kB
]
Updated 12/29/2021
Daybue Criteria
[
189.3 kB
]
Updated 11/08/2023
Diacomit Criteria
[
138.3 kB
]
Updated 10/14/2022
Dibenzyline Criteria
[
135.9 kB
]
Updated 7/7/2022
Dificid Criteria
[
148.4 kB
]
Updated 6/22/2022
Dojolvi Criteria
[
126.9 kB
]
Added 10/29/2020
Dupixent Criteria
[
176.1 kB
]
Updated 11/13/2024
Duvyzat Criteria
[
159.2 kB
]
Added 1/21/2025
Elfabrio Criteria
[
120.8 kB
]
Added 2/27/2024
Elmiron Criteria
[
182 kB
]
Updated 11/16/2015
Emflaza Criteria
[
229.2 kB
]
Updated 6/28/2019
Empaveli Criteria
[
148.4 kB
]
Added 9/21/2021
Enjaymo Criteria
[
117 kB
]
Updated 10/2/2023
Enspryng Criteria
[
143.3 kB
]
Added 9/2/2020
Entadfi Criteria
[
179 kB
]
Added 5/5/2023
Epaned Criteria
[
197.9 kB
]
Updated 1/24/2024
Erwinaze and Rylaze Criteria
[
142.6 kB
]
Updated 4/12/2024
Erythropoeisis Stimulating Agents Criteria
[
235.4 kB
]
Updated 1/24/2024
Erythropoeisis Stimulating Agents Form
[
1 MB
]
Updated 1/3/2025
Esbriet Criteria
[
339.7 kB
]
Updated 5/19/2020
Evenity Criteria
[
151.1 kB
]
Updated 5/8/2024
Evrysdi Criteria
[
150.7 kB
]
Updated 10/14/2022
Exjade Criteria
[
170 kB
]
Updated 10/15/2021
Exondys 51 Criteria
[
152.7 kB
]
Updated 3/31/2022
Exondys PA Form
[
1 MB
]
Updated 1/3/2025
Fabhalta Criteria
[
145.5 kB
]
Added 2/28/2024
Fasenra Criteria
[
185.5 kB
]
Updated 8/19/2024
Ferriprox Criteria
[
159.8 kB
]
Updated 3/11/2022
Fetzima Criteria
[
338.1 kB
]
Updated 6/15/2016
Filspari Criteria
[
161.3 kB
]
Added 1/26/2024
Filsuvez Criteria
[
123.9 kB
]
Added 9/19/2024
Fintepla Criteria
[
122.1 kB
]
Updated 6/16/2022
Firvanq Criteria
[
69.9 kB
]
Updated 6/16/2022
Fleqsuvy Criteria
[
172.6 kB
]
Added 7/8/2022
Forteo Criteria
[
160.2 kB
]
Updated 12/20/2024
Fuzeon PA Form
[
1 MB
]
Updated 1/3/2025
Galafold Criteria
[
397.5 kB
]
Added 1/18/2019
Gamifant Criteria
[
69.2 kB
]
Added 9/25/2020
Gattex Criteria
[
334 kB
]
Updated 6/3/2019
Gemtesa Criteria
[
121.7 kB
]
Added 2/27/2024
Gimoti Criteria
[
112.4 kB
]
Added 8/4/2021
Givlaari Criteria
[
145.7 kB
]
Added 8/4/2021
H.P. Acthar Gel Criteria
[
143.5 kB
]
Updated 3/11/2022
Haegarda Criteria
[
119 kB
]
Updated 10/30/2020
Hemady Criteria
[
114.1 kB
]
Added 8/4/2021
Hemangeol Criteria
[
173.8 kB
]
Updated 1/27/2023
Hepatitis C Agents Criteria
[
117.6 kB
]
Updated 3/13/2023
Hepatitis C Agents Form
[
1.9 MB
]
Updated 1/3/2025
Hetlioz Criteria
[
188.6 kB
]
Updated 1/13/2022
HIV Auto PA Form
[
144.1 kB
]
Updated 12/7/2021
HIV Diagnosis Verification or Prophylaxis of HIV Form
[
1.4 MB
]
Updated 1/3/2025
Human Growth Hormone Criteria
[
288.9 kB
]
Updated 8/19/2024
Human Growth Hormone PA Form
[
1.4 MB
]
Updated 1/3/2025
Hyftor Criteria
[
171.4 kB
]
Added 5/2/2023
Hyperlipidemia Agents Criteria
[
250.5 kB
]
Updated 11/7/2024
Ibsrela Criteria
[
122.6 kB
]
Added 2/27/2024
iDose TR Criteria
[
141.1 kB
]
Added 8/19/2024
Ileal Bile Acid Transporter Inhibitor Agents Criteria
[
151 kB
]
Updated 7/10/2024
Imcivree Criteria
[
147.6 kB
]
Added 4/30/2024
Immune Globulin Criteria
[
421.8 kB
]
Updated 10/11/2024
Increlex PA Form
[
1.3 MB
]
Updated 1/3/2025
Injectable and Intravenous Iron Agents Criteria
[
176.8 kB
]
Updated 12/20/2024
Isturisa Criteria
[
122 kB
]
Added 6/9/2021
Joenja Criteria
[
132 kB
]
Updated 4/9/2024
Kadcyla Criteria
[
144.9 kB
]
Updated 10/14/2022
Kalbitor Criteria
[
224.4 kB
]
Added 3/20/2020
Kalydeco Critieria
[
176.2 kB
]
Updated 9/9/2024
Kanuma Criteria
[
69.8 kB
]
Added 3/30/2022
Kapvay Critieria
[
319.3 kB
]
Updated 11/19/2015
Kepivance Critieria
[
42.9 kB
]
Updated 9/8/2022
Kerendia Criteria
[
143.2 kB
]
Added 12/10/2021
Kimmtrak Criteria
[
135.9 kB
]
Added 6/16/2022
Korlym Criteria
[
115.2 kB
]
Updated 7/7/2022
Krystexxa Criteria
[
140 kB
]
Updated 10/14/2022
Kymriah Criteria
[
165.3 kB
]
Updated 10/14/2022
Lacrisert Criteria
[
156.7 kB
]
Updated 7/7/2022
Lampit Criteria
[
120.8 kB
]
Updated 1/24/2024
Lamzede Criteria
[
92.9 kB
]
Added 1/26/2024
Leqembi Criteria
[
189.3 kB
]
Added 6/15/2023
Lioresal/Gablofen Criteria
[
143.3 kB
]
Updated 7/7/2022
Livtencity Criteria
[
117.2 kB
]
Added 3/30/2022
Long Acting Beta 2 Agonists Criteria
[
135.5 kB
]
Updated 7/9/2021
Long Acting Stimulants in Children Criteria
[
114 kB
]
Updated 5/11/2023
Lucemyra Criteria
[
118 kB
]
Added 1/11/2021
Lumryz Criteria
[
172.9 kB
]
Added 1/26/2024
Lupkynis Criteria
[
152.2 kB
]
Added 6/9/2021
Luxturna Criteria
[
378.4 kB
]
Added 3/27/2018
Lybalvi Criteria
[
186.9 kB
]
Updated 11/15/2024
Lyfgenia Criteria
[
151.7 kB
]
Added 8/14/2024
Marinol Criteria
[
180.9 kB
]
Updated 6/8/2016
Methadone Criteria
[
510.7 kB
]
Update 3/15/2018
Miscellaneous Drug Criteria
[
123 kB
]
Updated 6/27/2023
Miscellaneous Pharmacy Prior Authorization Requests
[
897.7 kB
]
Updated 1/3/2025
Mounjaro Criteria
[
142.9 kB
]
Updated 4/26/2024
Mozobil Criteria
[
308.1 kB
]
Updated 11/6/2017
Mucopolysaccharidosis Agents Criteria
[
154.7 kB
]
Added 3/13/2023
Multi Source Brand Drug PA Form
[
992.3 kB
]
Updated 1/3/2025
Multiple Sclerosis Oral Agents Criteria
[
146.3 kB
]
Updated 2/5/2024
Myalept Criteria
[
119.9 kB
]
Updated 4/12/2024
Myfembree Criteria
[
142.9 kB
]
Updated 4/13/2023
Myrbetriq Criteria
[
145.1 kB
]
Added 2/27/2024
Mytesi Criteria
[
183.1 kB
]
Added 11/20/2020
Namenda XR Criteria
[
123.8 kB
]
Updated 1/24/2024
Natacyn Criteria
[
292.6 kB
]
Neupro Criteria
[
441 kB
]
Updated 11/19/2015
Nucala Criteria
[
166.8 kB
]
Updated 8/9/2022
Nuplazid Criteria
[
290.8 kB
]
Updated 8/8/2018
Octreotides & Related Agents Criteria
[
159.3 kB
]
Added 1/19/2022
Ofev Criteria
[
140.7 kB
]
Updated 7/1/2024
Off Label Use Criteria
[
93.1 kB
]
Updated 6/27/2023
Olpruva Criteria
[
182.6 kB
]
Updated 8/19/2024
Opioid PA Form
[
547.5 kB
]
Updated 1/3/2025
Opzelura Criteria
[
144.3 kB
]
Updated 9/19/2024
Oralair
[
135.5 kB
]
Added 2/1/2022
Oral Oncology Criteria
[
496.3 kB
]
Updated 11/13/2024
Oral Oncology PA Form
[
1.3 MB
]
Updated 1/3/2025
Orfadin/Nityr (Nitisinone) PA Form
[
1.3 MB
]
Updated 1/16/2025
Oriahnn Criteria
[
136.5 kB
]
Added 9/21/2020
Orilissa Criteria
[
324.1 kB
]
Added 1/18/2019
Oritavancin Criteria
[
156.1 kB
]
Updated 1/27/2023
Orkambi Criteria
[
158.7 kB
]
Updated 5/11/2023
Orladeyo Criteria
[
111.2 kB
]
Added 4/2/2021
Ortikos Criteria
[
134.6 kB
]
Added 8/4/2021
Otrexup Criteria
[
197.1 kB
]
Added 7/27/2016
Overactive Bladder Agents Criteria
[
74.6 kB
]
Updated 3/26/2024
Oxalosis Agents Criteria
[
186 kB
]
Updated 7/1/2024
Oxandrin Criteria
[
127.4 kB
]
Updated 12/22/2016
Oxbryta Criteria
[
123 kB
]
Updated 8/14/2024
Palforzia Criteria
[
165.5 kB
]
Updated 11/12/2021
Panretin PA Form
[
1.3 MB
]
Updated 1/3/2025
Pheburane Criteria
[
70.8 kB
]
Updated 11/14/2024
Phenylketonuria Treatments Criteria
[
90.9 kB
]
Added 3/13/2023
Pompe Disease Agents
[
143.9 kB
]
Added 12/10/2021
Prevymis Criteria
[
149.6 kB
]
Updated 1/24/2024
ProCentra Criteria
[
127.2 kB
]
Updated 7/18/2023
Proleukin PA Form
[
1.3 MB
]
Updated 1/3/2025
Prolia Criteria
[
174.5 kB
]
Updated 1/24/2024
Proton Pump Inhibitors
[
488.3 kB
]
Added 7/11/2016
Pulmonary Hypertension Agent Criteria
[
168.8 kB
]
Updated 11/13/2024
Pyrukynd Criteria
[
141.3 kB
]
Added 6/16/2022
Qalsody Criteria
[
161.2 kB
]
Added 1/26/2024
Qutenza Criteria
[
144 kB
]
Added 11/13/2024
Radicava/Radicava ORS Criteria
[
151.1 kB
]
Added 10/14/2022
Rasuvo Criteria
[
197.2 kB
]
Added 7/27/2016
Ravicti Criteria
[
85.3 kB
]
Updated 8/19/2024
Reblozyl Criteria
[
379.7 kB
]
Added 7/10/2020
Recorlev Criteria
[
115.6 kB
]
Added 6/16/2022
Rectiv Criteria
[
353.2 kB
]
Regranex Criteria
[
227 kB
]
Updated 11/6/2018
Relyvrio Criteria
[
148.1 kB
]
Added 5/11/2023
Revcovi Criteria
[
88.7 kB
]
Added 1/7/2022
Reyvow Criteria
[
135.1 kB
]
Added 10/29/2021
Rezdiffra Criteria
[
181.4 kB
]
Added 9/19/2024
Rezurock Criteria
[
115.3 kB
]
Added 12/17/2021
Rinvoq ER Criteria
[
127.4 kB
]
Updated 11/13/2024
Ruconest Criteria
[
321.4 kB
]
Added 4/12/2019
Sancuso Criteria
[
195.2 kB
]
Updated 1/15/2015
Saphnelo Criteria
[
115.9 kB
]
Added 12/17/2021
Saphris Criteria
[
147.5 kB
]
Updated 1/24/2024
Sedative Hypnotic Criteria
[
115.1 kB
]
Updated 11/13/2024
Selzentry PA Form
[
966.2 kB
]
Updated 1/3/2025
Serostim PA Form
[
1 MB
]
Updated 1/16/2025
Sirturo Criteria
[
120.4 kB
]
Updated 9/8/2022
Skyclarys Criteria
[
187.2 kB
]
Updated 5/8/2024
Sodium-Glucose Co-Transporter (SGLT-2) Inhibitor Agents
[
160.3 kB
]
Updated 9/9/2024
Soliris Criteria
[
80.6 kB
]
Updated 6/10/2021
Soma PA Form
[
1.5 MB
]
Updated 1/3/2025
Spinraza Criteria
[
158.2 kB
]
Updated 4/23/2021
Spinraza PA Form
[
1 MB
]
Updated 1/3/2025
Spravato Criteria
[
180.8 kB
]
Updated 8/11/2020
Stimulants and Strattera (<6 years of age) PA Form
[
1.1 MB
]
Updated 1/3/2025
Sunosi Criteria
[
123.6 kB
]
Updated 6/27/2023
Supprelin LA Criteria
[
94.8 kB
]
Updated 7/7/2022
Supprelin LA PA Form
[
532.2 kB
]
Updated 1/3/2025
Symdeko Criteria
[
312.1 kB
]
Updated 9/17/2021
Synagis Criteria
[
446 kB
]
Updated 4/3/2020
Synagis - All Florida Regions Combined PA Form
[
1.4 MB
]
Updated 1/3/2025
Synagis - Weight Change PA Form
[
1 MB
]
Updated 1/3/2025
Synribo Criteria
[
300.3 kB
]
Updated 11/23/2015
Takhzyro Criteria
[
119.8 kB
]
Updated 1/24/2024
Tarpeyo Criteria
[
121.7 kB
]
Updated 9/13/2022
Tavneos Criteria
[
167.8 kB
]
Added 3/30/2022
Tecartus Criteria
[
69.3 kB
]
Updated 3/11/2022
Tepezza Criteria
[
123 kB
]
Updated 12/20/2024
Testosterone Criteria
[
215.7 kB
]
Updated 5/8/2024
Tezspire Criteria
[
146.1 kB
]
Updated 8/19/2024
Thrombopoiesis Stimulating Agents Criteria
[
161.4 kB
]
Updated 7/18/2023
Tolvaptan Criteria
[
190.2 kB
]
Updated 8/19/2024
Toujeo Criteria
[
178.3 kB
]
Added 8/27/2024
Transthyretin Mediated Amyloidosis Agents Criteria
[
125.2 kB
]
Updated 10/14/2022
Trikafta Criteria
[
190.9 kB
]
Updated 8/19/2024
Trudhesa Criteria
[
148.2 kB
]
Updated 5/6/2022
Tygacil Criteria
[
78.6 kB
]
Updated 7/7/2022
Tymlos Criteria
[
149.8 kB
]
Updated 1/24/2024
Tzield Criteria
[
152.3 kB
]
Added 3/28/2023
Ultomiris Criteria
[
171.1 kB
]
Updated 5/8/2024
Uplizna Criteria
[
146.5 kB
]
Added 9/2/2020
Vecamyl Criteria
[
312.4 kB
]
Updated 3/14/2018
Veozah Criteria
[
172.1 kB
]
Added 8/27/2024
Veregen Criteria
[
120.3 kB
]
Updated 7/7/2022
Verkazia Criteria
[
142.7 kB
]
Added 11/15/2022
Verquvo Criteria
[
127.8 kB
]
Updated 1/24/2024
Vfend PA Form
[
1.1 MB
]
Updated 1/3/2025
Vibativ Criteria
[
146.2 kB
]
Updated 7/7/2022
Viberzi Criteria
[
192.5 kB
]
Added 4/5/2018
Viltepso Criteria
[
149.8 kB
]
Updated 4/14/2023
Vijoice Criteria
[
117.2 kB
]
Updated 7/1/2024
Vivjoa Criteria
[
105.1 kB
]
Added 1/29/2024
Voquezna Criteria
[
115.2 kB
]
Added 5/10/2024
Vowst Criteria
[
159.8 kB
]
Added 1/29/2024
Voxzogo Criteria
[
142.7 kB
]
Updated 12/28/2023
Voydeya Criteria
[
146.8 kB
]
Added 1/21/2025
Vpriv Criteria
[
333 kB
]
Added 1/18/2019
Vtama Criteria
[
138.3 kB
]
Updated 5/8/2024
Vyepti Criteria
[
143.2 kB
]
Updated 10/29/2021
Vyjuvek Criteria
[
159.4 kB
]
Added 9/19/2024
Vyondys 53 Criteria
[
97.3 kB
]
Updated 3/31/2022
Vyvgart Criteria
[
117.7 kB
]
Added 3/30/2022
Wakix Criteria
[
142.4 kB
]
Updated 6/27/2023
Xenazine Criteria
[
213.1 kB
]
Updated 7/16/2018
Xenpozyme Criteria
[
128.8 kB
]
Added 11/15/2022
Xermelo Criteria
[
247.4 kB
]
Added 12/21/2017
Xgeva Criteria
[
146.8 kB
]
Updated 4/15/2024
Xiaflex Criteria
[
185.4 kB
]
Added 6/16/2022
Xifaxan Criteria
[
358.7 kB
]
Updated 11/23/2015
Xphozah Criteria
[
121.3 kB
]
Added 5/10/2024
Xolair Criteria
[
171.9 kB
]
Updated 9/19/2024
Xolremdi Criteria
[
124.8 kB
]
Added 1/21/2025
Xopenex Criteria
[
38.1 kB
]
Updated 2/9/2024
Xyrem Criteria
[
163.2 kB
]
Updated 11/24/2020
Xywav Criteria
[
137.3 kB
]
Updated 10/23/2024
Ycanth Criteria
[
202.4 kB
]
Added 5/10/2024
Yescarta Criteria
[
71.6 kB
]
Updated 6/16/2022
Zavzpret Criteria
[
156.2 kB
]
Added 2/9/2024
Zeposia Criteria
[
146.9 kB
]
Updated 4/5/2023
Zokinvy Criteria
[
146.6 kB
]
Added 8/4/2021
Zolgensma Criteria
[
152 kB
]
Updated 1/24/2024
Zortress Criteria
[
83.1 kB
]
Updated 9/8/2022
Zoryve Criteria
[
146.6 kB
]
Added 5/10/2024
Ztalmy Criteria
[
154.3 kB
]
Added 1/29/2024
Zulresso Criteria
[
145.7 kB
]
Updated 10/14/2022
Zurzuvae Criteria
[
156.1 kB
]
Added 7/2/2024
Zyprexa Relprevv
[
170.9 kB
]
Updated 1/24/2024
