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Clinical & Payment Policies | Ambetter de Magnolia Health
Políticas clínicas y de pago
Clinical Policies
Clinical policies are one set of guidelines used to assist in administering health plan benefits, either by prior authorization or payment rules. They include but are not limited to policies relating to evolving medical technologies and procedures, as well as pharmacy policies. Clinical policies help identify whether services are medically necessary based on information found in generally accepted standards of medical practice; peer-reviewed medical literature; government agency/program approval status; evidence-based guidelines and positions of leading national health professional organizations; views of physicians practicing in relevant clinical areas affected by the policy; and other available clinical information.
All policies found in the Magnolia Health Clinical Policy Manual apply to Magnolia Health members. Policies in the Magnolia Health Clinical Policy Manual may have either a Magnolia Health or a “Centene” heading. Magnolia Health utilizes InterQual® criteria for those medical technologies, procedures or pharmaceutical treatments for which a Magnolia Health clinical policy does not exist. InterQual is a nationally recognized evidence-based decision support tool. You may access the InterQual® SmartSheet(s)™ for Adult and Pediatric procedures, durable medical equipment and imaging procedures by logging into the secure provider portal or by calling Magnolia Health. In addition, Magnolia Health may from time to time delegate utilization management of specific services; in such circumstances, the delegated vendor’s guidelines may also be used to support medical necessity and other coverage determinations. Other non-clinical policies (e.g., payment policies) or contract terms may further determine whether a technology, procedure or treatment that is not addressed in the Clinical Policy Manuals or InterQual®criteria is payable by Magnolia Health.
If you have any questions regarding these policies, please contact Member Services and ask to be directed to the Medical Management department.
- 25-hydroxyvitamin D Testing in Children and Adolescents (CP.MP.157) (PDF)
- 30-Day Readmission (PDF)
- 340B Drug Payment Reduction (PDF)
- Clean Claim Reviews (CC.PI.04) (PDF)
- Concert Infectious Disease: Dermatologic Testing 2025.1 (CG.CP.MP.03) (PDF) Effective Date: 6/1/2024
- Concert Infectious Disease: Gastroenterologic Testing 2025.1 (CG.CP.MP.04) (PDF) Effective Date: 6/1/2024
- Concert Infectious Disease: Genitourinary Testing 2025.1 (CG.CP.MP.07) (PDF) Effective Date: 6/1/2024
- Concert Infectious Disease: Multisystem Testing 2025.1 (CG.CP.MP.02) (PDF) Effective Date: 6/1/2024
- Concert Infectious Disease: Primary Care & Preventative Testing 2025.1 (CG.CP.MP.05) (PDF) Effective Date: 6/1/2024
- Concert Infectious Disease: Respiratory Testing V2025.1 (CG.CP.MP.01) (PDF) Effective Date: 6/1/2024
- Concert Infectious Disease: Vector-borne and Tropical Diseases Testing 2025.1 (CG.CP.MP.06) (PDF) Effective Date: 6/1/2024
- Concert Laboratory Payment Policy (CG.CC.PP.01) (PDF) Effective Date: 6/1/2024
- Cost to Charge Adjustments on Clean Claim Reviews (CC.PI.06) (PDF)
- Digital EEG Spike Analysis (CP.MP.105) (PDF)
- E&M Services Billed with Treatment Room Revenue Codes (CC.PP.071) (PDF)
- Endometrial Ablation (CP.MP.106) (PDF)
- Genetic and Molecular Testing Services (CG.PP.551) (PDF)
- Genetic and Molecular Testing Services Version A (CG.PP.551A) (PDF)
- Leveling of Care: Emergency Department Evaluation and Management Overcoding for Professional Services (CC.PP.076 ) (PDF)
- Leveling of Care: Evaluation and Management Overcoding (PDF)
- Leveling of ER (PDF)
- Newborn Inpatient Stays (PDF)
- Non-Emergent ER Services (PDF)
- Non-Obstetrical Pelvic and Transvaginal Ultrasounds (PDF)
- Optum Comprehensive Payment Integrity (CPI) (CC.PP.074) (PDF)
- Physician's Consultation Services (PDF)
- Place of Service Mismatch (PDF)
- Problem Oriented Visits and Prentative Visits (PDF)
- Problem Oriented Visits with Surgical Procedures (PDF)
- Skilled Nursing Facility Leveling (CC.PP.206) (PDF)
- Ultrasound in Pregnancy (CP.MP.38) (PDF)
- Unbundling Adjustments on Clean Claim Reviews (CC.PI.10) (PDF)
- Urine Specimen Validity Testing (PDF)
- Urodynamic Testing (CP.MP.98) (PDF)
- Wheelchair Seating (CP.MP.99) (PDF)
Payment Policies
Health care claims payment policies are guidelines used to assist in administering payment rules based on generally accepted principles of correct coding. They are used to help identify whether health care services are correctly coded for reimbursement. Each payment rule is sourced by a generally accepted coding principle. They include, but are not limited to claims processing guidelines referenced by the Centers for Medicare and Medicaid Services (CMS), Publication 100-04, Claims Processing Manual for physicians/non-physician practitioners, the CMS National Correct Coding Initiative policy manual (procedure-to-procedure coding combination edits and medically unlikely edits), Current Procedural Technology guidance published by the American Medical Association (AMA) for reporting medical procedures and services, health plan clinical policies based on the appropriateness of health care and medical necessity, and at times state-specific claims reimbursement guidance.
All policies found in the Magnolia Health Payment Policy Manual apply with respect to Magnolia Health members. Policies in the Magnolia Health Payment Policy Manual may have either a Magnolia Health or a “Centene” heading. In addition, Magnolia Health may from time to time employ a vendor that applies payment policies to specific services; in such circumstances, the vendor’s guidelines may also be used to determine whether a service has been correctly coded. Other policies (e.g., clinical policies) or contract terms may further determine whether a technology, procedure or treatment that is not addressed in the Payment Policy Manual is payable by Magnolia Health.
If you have any questions regarding these policies, please contact Member Services and ask to be directed to the Medical Management department.
- 25-hydroxyvitamin D Testing in Children and Adolescents (CP.MP.157) (PDF)
- 30-Day Readmission (PDF)
- 340B Drug Payment Reduction (PDF)
- Clean Claim Reviews (CC.PI.04) (PDF)
- Concert Infectious Disease: Dermatologic Testing 2025.1 (CG.CP.MP.03) (PDF) Effective Date: 4/1/2026
- Concert Infectious Disease: Gastroenterologic Testing 2025.1 (CG.CP.MP.04) (PDF) Effective Date: 4/1/2026
- Concert Infectious Disease: Genitourinary Testing 2025.1 (CG.CP.MP.07) (PDF) Effective Date: 4/1/2026
- Concert Infectious Disease: Multisystem Testing 2025.1 (CG.CP.MP.02) (PDF) Effective Date: 4/1/2026
- Concert Infectious Disease: Primary Care & Preventative Testing 2025.1 (CG.CP.MP.05) (PDF) Effective Date: 4/1/2026
- Concert Infectious Disease: Respiratory Testing V2025.1 (CG.CP.MP.01) (PDF) Effective Date: 4/1/2026
- Concert Infectious Disease: Vector-borne and Tropical Diseases Testing 2025.1 (CG.CP.MP.06) (PDF) Effective Date: 4/1/2026
- Concert Laboratory Payment Policy (CG.CC.PP.01) (PDF) Effective Date: 4/1/2026
- Cost to Charge Adjustments on Clean Claim Reviews (CC.PI.06) (PDF)
- Digital EEG Spike Analysis (CP.MP.105) (PDF)
- E&M Services Billed with Treatment Room Revenue Codes (CC.PP.071) (PDF)
- Endometrial Ablation (CP.MP.106) (PDF)
- Genetic and Molecular Testing Services Version A (CG.PP.551A) (PDF) Effective Date: 4/1/2026
- Leveling of Care: Emergency Department Evaluation and Management Overcoding for Professional Services (CC.PP.076 ) (PDF)
- Leveling of Care: Evaluation and Management Overcoding (PDF)
- Leveling of ER (PDF)
- Newborn Inpatient Stays (PDF)
- Non-Emergent ER Services (PDF)
- Non-Obstetrical Pelvic and Transvaginal Ultrasounds (PDF)
- Optum Comprehensive Payment Integrity (CPI) (CC.PP.074) (PDF)
- Physician's Consultation Services (PDF)
- Place of Service Mismatch (PDF)
- Problem Oriented Visits and Prentative Visits (PDF)
- Problem Oriented Visits with Surgical Procedures (PDF)
- Skilled Nursing Facility Leveling (CC.PP.206) (PDF)
- Ultrasound in Pregnancy (CP.MP.38) (PDF)
- Unbundling Adjustments on Clean Claim Reviews (CC.PI.10) (PDF)
- Urine Specimen Validity Testing (PDF)
- Urodynamic Testing (CP.MP.98) (PDF)
- Wheelchair Seating (CP.MP.99) (PDF)
Pharmacy and Biopharmacy Policies
- Abaloparatide (Tymlos) (CP.PHAR.345) (PDF)
- Abemaciclib (Verzenio) (CP.PHAR.355) (PDF)
- Abiraterone (Zytiga, Yonsa) (CP.PHAR.84) (PDF)
- AbobotulinumtoxinA (Dysport) (CP.PHAR.230) (PDF)
- Abrocitinib (Cibinqo) (CP.PCH.57) (PDF)
- Abrocitinib (Cibinqo) (CP.PHAR.578) (PDF)
- Acalabrutinib (Calquence) (CP.PHAR.366) (PDF)
- Aceclidine (Vizz) (CP.PMN.302) (PDF)
- Acoltremon (Tryptyr) (CP.PHAR.739) (PDF)
- Acoramidis (Attruby) (CP.PHAR.683) (PDF)
- Acyclovir Buccal Tablet (Sitavig) (CP.PMN.210) (PDF)
- Adagrasib (Krazati) (CP.PHAR.605) (PDF)
- ADAMTS13, Recombinant-krhn (Adzynma) (CP.PHAR.635) (PDF)
- Adefovir (Hepsera) (CP.PHAR.142) (PDF)
- Ado-Trastuzumab Emtansine (Kadcyla) (CP.PHAR.229) (PDF)
- Aducanumab-avwa (Aduhelm) (CP.PHAR.468) (PDF)
- Afamelanotide (Scenesse) (CP.PHAR.444) (PDF)
- Afamitresgene Autoleucel (Tecelra) (CP.PHAR.678) (PDF)
- Afatinib (Gilotrif) (CP.PHAR.298) (PDF)
- Aflibercept (Eylea, Eylea HD, Opuviz, Yesafili, Ahzantive, Enzeevu, Pavblu) (CP.PHAR.184) (PDF)
- Aficamten (Myqorzo) (CP.PHAR.766) (PDF)
- Agalsidase Beta (Fabrazyme) (CP.PHAR.158) (PDF)
- Age Limit Override (HIM.PA.177) (PDF)
- Alectinib (Alecensa) (CP.PHAR.369) (PDF)
- Alemtuzumab (Lemtrada) (CP.PHAR.243) (PDF)
- Alendronate (Binosto, Fosamax Plus D) (CP.PMN.88) (PDF)
- Alglucosidase Alfa (Lumizyme) (CP.PHAR.160) (PDF)
- Allogeneic Cultured Keratinocytes and Dermal Fibroblasts in Murine Collagen-dsat (StrataGraft) (CP.PHAR.562) (PDF)
- Allogenic Processed Thymus Tissue-agdc (Rethymic) (CP.PHAR.563) (PDF)
- Alpelisib (Piqray, Vijoice) (CP.PHAR.430) (PDF)
- Alpha1-Proteinase Inhibitors (Aralast NP, Glassia, Prolastin-C, Zemaira) (CP.PHAR.94) (PDF)
- Amantadine ER (Gocovri, Osmolex ER) (CP.PMN.89) (PDF)
- Ambrisentan (Letairis) (CP.PHAR.190) (PDF)
- Amifampridine (Firdapse) (CP.PHAR.411) (PDF)
- Amikacin (Arikayce) (CP.PHAR.401) (PDF)
- Amisulpride (Barhemsys) (CP.PMN.236) (PDF)
- Amivantamab-vmjw (Rybrevant) (CP.PHAR.544) (PDF)
- Anifrolumab-fnia (Saphnelo) (CP.PHAR.551) (PDF)
- Anti-Inhibitor Coagulant Complex, Human (Feiba) (CP.PHAR.217) (PDF)
- Anitocabtagene autoleucel (KITE-772)_PEPP (CP.PHAR.769_PEPP) (PDF)
- Antithrombin III (ATryn, Thrombate III) (CP.PHAR.564) (PDF)
- Antithymocyte Globulin (Atgam, Thymoglobulin) (CP.PHAR.506) (PDF)
- Apalutamide (Erleada) (CP.PCH.45) (PDF)
- Apitegromab (SRK-015)_PEPP (CP.PHAR.737_PEPP) (PDF)
- Apomorphine (Apokyn, Kynmobi) (CP.PHAR.488) (PDF)
- Aprepitant (Aponvie, Emend, Cinvanti), Fosaprepitant (Emend for injection, Focinvez) (CP.PMN.19) (PDF)
- Aprocitentan (Tryvio) (CP.PHAR.676) (PDF)
- Aripiprazole Long-Acting Injections (Abilify Maintena, Abilify Asimtufii, Aristada, Aristada Initio) (CP.PHAR.290) (PDF)
- Aripiprazole Orally Disintegrating Tablet, Oral Film (Opipza) (CP.PMN.300) (PDF)
- Armodafinil (Nuvigil) (CP.PMN.35) (PDF)
- Asciminib (Scemblix) (CP.PHAR.565) (PDF)
- Arimoclomol (Miplyffa) (CP.PHAR.510) (PDF)
- Asenapine (Saphris, Secuado) (CP.PMN.15) (PDF)
- Asfotase Alfa (Strensiq) (CP.PHAR.328) (PDF)
- Aspirin/Dipyridamole (Aggrenox) (CP.PMN.20) (PDF)
- Ataluren (Translarna)_PEPP (CP.PHAR.710_PEPP) (PDF)
- Atezolizumab (Tecentriq) (CP.PHAR.235) (PDF)
- Atidarsagene autotemcel (Lenmeldy) (CP.PHAR.602) (PDF)
- Atogepant (Qulipta) (CP.PHAR.566) (PDF)
- Atrasentan (Vanrafia) (CP.PHAR.727) (PDF)
- Avacincaptad Pegol (Izervay) (CP.PHAR.641) (PDF)
- Avacopan (Tavneos) (CP.PHAR.515) (PDF)
- Avalglucosidase Alfa-ngpt (Nexviazyme) (CP.PHAR.521) (PDF)
- Avapritinib (Ayvakit) (CP.PHAR.454) (PDF)
- Avatrombopag (Doptelet) (CP.PHAR.130) (PDF)
- Avelumab (Bavencio) (CP.PHAR.333) (PDF)
- Avutometinib, Defactinib (Avmapki Fakzynja Co-Pack) (CP.PHAR.731) (PDF)
- Axatilimab-csfr (Niktimvo) (CP.PHAR.691) (PDF)
- Axicabtagene Ciloleucel (Yescarta) (CP.PHAR.362) (PDF)
- Axitinib (Inlyta) (CP.PHAR.100) (PDF)
- Azacitidine (Onureg, Vidaza) (CP.PHAR.387) (PDF)
- Azelaic Acid (Finacea Topical Gel/Foam) (HIM.PA.119) (PDF)
- Aztreonam (Cayston) (CP.PHAR.209) (PDF)
- Baclofen (Fleqsuvy, Gablofen, Lioresal, Lyvispah, Ozobax) (CP.PHAR.149) (PDF)
- Baloxavir Marboxil (Xofluza) (CP.PMN.185) (PDF)
- Bedaquiline (Sirturo) (CP.PMN.212) (PDF)
- Belantamab Mafodotin-blmf (Blenrep) (CP.PHAR.469) (PDF)
- Belatacept (Nulojix) (CP.PHAR.201) (PDF)
- Belimumab (Benlysta) (CP.PHAR.88) (PDF)
- Belinostat (Beleodaq) (CP.PHAR.311) (PDF)
- Belumosudil (Rezurock) (CP.PHAR.552) (PDF)
- Belzutifan (Welireg) (CP.PHAR.553) (PDF)
- Bempedoic Acid (Nexletol), Bempedoic Acid/Ezetimibe (Nexlizet) (CP.PMN.237) (PDF)
- Bendamustine (Belrapzo, Bendeka, Treanda, Vivimusta) (CP.PHAR.307) (PDF)
- Benralizumab (Fasenra) (HIM.PA.SP70) (PDF)
- Benznidazole (CP.PMN.90) (PDF)
- Berdazimer (Zelsuvmi) (CP.PMN.293) (PDF)
- Beremagene geperpavec-svdt (Vyjuvek) (CP.PHAR.592) (PDF)
- Berotralstat (Orladeyo) (HIM.PA.169) (PDF)
- Betaine (Cystadane) (CP.PHAR.143) (PDF)
- Betamethasone Dipropionate Spray (Sernivo) (CP.PMN.182) (PDF)
- Betibeglogene Autotemcel (Zynteglo) (CP.PHAR.545) (PDF)
- Bevacizumab (Alymsys, Avastin, Avzivi, Jobevne Mvasi, Vegzelma, Zirabev) (CP.PHAR.93) (PDF)
- Bexarotene (Targretin Capsules, Gel) (CP.PHAR.75) (PDF)
- Bezlotoxumab (Zinplava) (CP.PHAR.300) (PDF)
- Bimatoprost Implant (Durysta) (CP.PHAR.486) (PDF)
- Binimetinib (Mektovi) (CP.PHAR.50) (PDF)
- Biologic and Non-biologic DMARDs (HIM.PA.SP60) (PDF)
- Birch Triterpenes (Filsuvez) (CP.PHAR.669) (PDF)
- Bitopertin (CP.PHAR.758_PEPP) (PDF)
- Blinatumomab (Blincyto) (CP.PHAR.312) (PDF)
- Bortezomib (Velcade) (CP.PHAR.410) (PDF)
- Bosentan (Tracleer) (CP.PHAR.191) (PDF)
- Bosutinib (Bosulif) (CP.PHAR.105) (PDF)
- Brand Name Override and Non-Formulary Medications (HIM.PA.103) (PDF)
- Brensocatib (Brinsupri) (CP.PMN.303) (PDF)
- Brentuximab Vedotin (Adcetris) (CP.PHAR.303) (PDF)
- Brexanolone (Zulresso) (CP.PHAR.417) (PDF)
- Brexpiprazole (Rexulti) (CP.PMN.68) (PDF)
- Brexucabtagene Autoleucel (Tecartus) (CP.PHAR.472) (PDF)
- Brigatinib (Alunbrig) (CP.PHAR.342) (PDF)
- Brimonidine Tartrate (Mirvaso) (CP.PMN.192) (PDF)
- Brivaracetam (Briviact) (CP.PMN.297) (PDF)
- Brolucizumab-dbll (Beovu) (CP.PHAR.445) (PDF)
- Budesonide (Eohilia, Uceris) (CP.PMN.294) (PDF)
- Budesonide (Tarpeyo) (CP.PHAR.572) (PDF)
- Bulevirtide (Hepcludex)_PEPP (CP.PHAR.589_PEPP) (PDF)
- Buprenorphine Injection (Sublocade, Brixadi) (CP.PHAR.289) (PDF)
- Buprenorphine/Naloxone (Suboxone, Zubsolv) (CP.PMN.81) (PDF)
- Bupropion/Naltrexone (Contrave) (CP.PCH.12) (PDF)
- Burosumab-twza (Crysvita) (CP.PHAR.11) (PDF)
- Butorphanol Nasal Spray (HIM.PA.46) (PDF)
- C1 Esterase Inhibitors (Berinert, Cinryze, Haegarda, Ruconest) (HIM.PA.170) (PDF)
- Cabazitaxel (Jevtana) (CP.PHAR.316) (PDF)
- Cabotegravir (Apretude), Cabotegravir/Rilpivirine (Cabenuva) (CP.PHAR.573) (PDF)
- Cabozantinib (Cabometyx, Cometriq) (CP.PHAR.111) (PDF)
- Calcifediol (Rayaldee) (CP.PMN.76) (PDF)
- Calcipotriene/Betamethasone Dipropionate Foam (Enstilar) (CP.PMN.181) (PDF)
- Canakinumab (Ilaris) (CP.PHAR.246) (PDF)
- Cannabidiol (Epidiolex) (CP.PMN.164) (PDF)
- Capecitabine (Xeloda) (CP.PHAR.60) (PDF)
- Capivasertib (Truqap) (CP.PHAR.663) (PDF)
- Caplacizumab-yhdp (Cablivi) (CP.PHAR.416) (PDF)
- Capmatinib (Tabrecta) (CP.PHAR.494) (PDF)
- Carbetocin_PEPP (CP.PHAR.546_PEPP) (PDF)
- Carbidopa/Levodopa ER Capsules (Rytary), Enteral Suspension (Duopa), IR Tablets (Dhivy) (CP.PMN.238) (PDF)
- Carfilzomib (Kyprolis) (CP.PHAR.309) (PDF)
- Carglumic Acid (Carbaglu) (CP.PHAR.206) (PDF)
- Cariprazine (Vraylar) (CP.PMN.91) (PDF)
- Casimersen (Amondys 45) (CP.PHAR.470) (PDF)
- Celecoxib (Celebrex, Elyxyb) (CP.PMN.122) (PDF)
- Cemiplimab-rwlc (Libtayo) (CP.PHAR.397) (PDF)
- Cenegermin-bkbj (Oxervate) (CP.PMN.186) (PDF)
- Cenobamate (Xcopri) (CP.PMN.231) (PDF)
- Ceritinib (Zykadia) (PDF) (CP.PHAR.349)
- Cerliponase Alfa (Brineura) (CP.PHAR.338) (PDF)
- Cetuximab (Erbitux) (CP.PHAR.317) (PDF)
- Chenodiol (Chenodal) (CP.PMN.239) (PDF)
- Chlorambucil (Leukeran) (CP.PHAR.554) (PDF)
- Chloramphenicol Sodium Succinate (CP.PHAR.388) (PDF)
- Cholic Acid (Cholbam) (CP.PHAR.390) (PDF)
- Ciclopirox Topical Solution 8% (CP.PMN.24) (PDF)
- Ciltacabtagene Autoleucel (Carvykti) (CP.PHAR.533) (PDF)
- Cinacalcet (Sensipar) (CP.PHAR.61) (PDF)
- Cipaglucosidase Alfa-atga + Miglustat (Pombiliti + Opfolda) (CP.PHAR.567) (PDF)
- Ciprofloxacin/Fluocinolone (Otovel) (CP.PMN.249) (PDF)
- Cladribine (Mavenclad) (CP.PHAR.422) (PDF)
- Clascoterone (Winlevi) (CP.PMN.257) (PDF)
- Clemidsogene Lanparvovec (RGX-121)_PEPP (CP.PHAR.734_PEPP) (PDF)
- Clesrovimab-cfor (Enflonsia) ( CP.PHAR.741) (PDF)
- Clobazam (Onfi, Sympazan) (CP.PMN.54) (PDF)
- CNS Stimulants (CP.PMN.92) (PDF)
- Cobimetinib (Cotellic) (CP.PHAR.380) (PDF)
- Colchicine (Colcrys, Lodoco) (CP.PMN.123) (PDF)
- Colesevelam (Welchol) (CP.PMN.250) (PDF)
- Collagenase Clostridium Histolyticum (Xiaflex) (CP.PHAR.82) (PDF)
- Colonoscopy Preparation Products (CP.PCH.43) (PDF)
- Compounded Medications (CP.PMN.280) (PDF)
- Concizumab (Alhemo) (CP.PHAR.625) (PDF)
- Conjugated Estrogens/Bazedoxifene (Duavee) (CP.PMN.258) (PDF)
- Continuous Glucose Monitors (CP.PMN.214) (PDF)
- Copper Histidinate (CUTX-101)_PEPP (CP.PHAR.714_PEPP) (PDF)
- Corticosteroids for Ophthalmic Injection (Dextenza, Iluvien, Ozurdex, Retisert, Xipere, Yutiq) (CP.PHAR.385) (PDF)
- Cosibelimab-Ipdl (Unloxcyt) (CP.PHAR.711) (PDF)
- Cosyntropin (Cortrosyn) (CP.PHAR.203) (PDF)
- Crinecerfont (Crenessity) (CP.PHAR.692) (PDF)
- Crisaborole (Eucrisa) (CP.PMN.110) (PDF)
- Crizanlizumab-tmca (Adakveo) (CP.PHAR.449) (PDF)
- Crizotinib (Xalkori) (CP.PHAR.90) (PDF)
- Crovalimab (PiaSky) (CP.PHAR.664) (PDF)
- Cyclosporine (Cequa, Restasis, Verkazia, Vevye) (CP.PMN.48) (PDF)
- Cysteamine Ophthalmic (Cystaran, Cystadrops) (CP.PMN.130) (PDF)
- Cysteamine oral (Cystagon, Procysbi) (CP.PHAR.155) (PDF)
- Cytomegalovirus Immune Globulin (CytoGam) (CP.PHAR.277) (PDF)
- Dabrafenib (Tafinlar) (CP.PHAR.239) (PDF)
- Dacomitinib (Vizimpro) (CP.PHAR.399) (PDF)
- Dalfampridine (Ampyra) (CP.PHAR.248) (PDF)
- Dalteparin (Fragmin) (CP.PHAR.225) (PDF)
- Danicopan (Voydeya) (CP.PHAR.665) (PDF)
- Dapsone (Aczone Gel) (CP.PCH.32) (PDF)
- Daptomycin (Cubicin, Cubicin RF, Dapzura RT) (CP.PHAR.351) (PDF)
- Daratumumab (Darzalex), Daratumumab/Hyaluronidase-fihj (Darzalex Faspro) (CP.PHAR.310) (PDF)
- Darbepoetin Alfa (Aranesp) (CP.PHAR.236) (PDF)
- Darolutamide (Nubeqa) (CP.PHAR.435) (PDF)
- Dasabuvir/Ombitasvir/Paritaprevir/Ritonavir (Viekira Pak) (HIM.PA.SP61) (PDF)
- Dasatinib (Sprycel, Phyrago) (CP.PHAR.72) (PDF)
- Dasiglucagon (ZP4207)_PEPP (CP.PHAR.642_PEPP) (PDF)
- Datopotamab deruxtecan-dlnk (Datroway) (CP.PHAR.715) (PDF)
- Daunorubicin/Cytarabine (Vyxeos) (CP.PHAR.352) (PDF)
- DaxibotulinumtoxinA-lanm (Daxxify) (CP.PHAR.651) (PDF)
- DB-OTO (DB-OTO)_PEPP (CP.PHAR.757_PEPP) (PDF)
- Decitabine/Cedazuridine (Inqovi) (CP.PHAR.479) (PDF)
- Deferasirox (Exjade, Jadenu) (CP.PHAR.145) (PDF)
- Deferiprone (Ferriprox) (CP.PHAR.147) (PDF)
- Deferoxamine (Desferal) (CP.PHAR.146) (PDF)
- Deflazacort (Emflaza) (CP.PHAR.331) (PDF)
- Degarelix Acetate (Firmagon) (CP.PHAR.170) (PDF)
- Delafloxacin (Baxdela) (CP.PMN.115) (PDF)
- Delandistrogene moxeparvovec-rokl (Elevidys) (CP.PCH.56) (PDF)
- Delgocitinib (Anzupgo) (CP.PHAR.744) (PDF)
- Denileukin Diftitox-cxdl (Lymphir) (CP.PHAR.693) (PDF)
- Denosumab (Prolia, Xgeva) (CP.PHAR.58) (PDF)
- Depemokimab-ulaa (Exdensur) (HIM.PA.179) (PDF)
- Deramiocel (CAP-1002)_PEPP (CP.PHAR.716_PEPP) (PDF)
- Desmopressin Acetate (DDAVP, Stimate, Nocdurna) (CP.PHAR.214) (PDF)
- Deutetrabenazine (Austedo) (CP.PCH.42) (PDF)
- Dexrazoxane (Totect) (CP.PHAR.418) (PDF)
- Dextromethorphan/Bupropion (Auvelity) (CP.PMN.284) (PDF)
- Dextromethorphan-Quinidine (Nuedexta) (CP.PMN.93) (PDF)
- Diazepam Nasal Spray (Valtoco) (CP.PMN.216) (PDF)
- Diazoxide Choline (Vykat XR) (CP.PHAR.701) (PDF)
- Dichlorphenamide (Keveyis) (CP.PMN.261) (PDF)
- Diclofenac (Cambia, Flector, Licart, Pennsaid, Solaraze, Zipsor, Zorvolex) (CP.PCH.28) (PDF)
- Dimethyl Fumarate (Tecfidera), Diroximel Fumarate (Vumerity), Monomethyl Fumarate (Bafiertam) (CP.PHAR.249) (PDF)
- Dipeptidyl Peptidase-4 (DPP-4) Inhibitors (HIM.PA.58) (PDF)
- Dolasetron (Anzemet) (CP.PMN.141) (PDF)
- Donanemab-azbt (Kisunla) (CP.PHAR.594) (PDF)
- Donidalorsen (Dawnzera) (CP.PHAR.717) (PDF)
- Dordaviprone (Modeyso) (CP.PHAR.745) (PDF)
- Dornase Alfa (Pulmozyme) (CP.PHAR.212) (PDF)
- Dostarlimab-gxly (Jemperli) (CP.PHAR.540) (PDF)
- Doxecitine and doxribtimine (Kygevvi) (CP.PHAR.738) (PDF)
- Doxepin (Silenor, Prudoxin, Zonalon) (HIM.PA.147) (PDF)
- Doxycycline Hyclate (Acticlate, Doryx), Doxycycline (Oracea) (CP.PMN.79) (PDF)
- Dupilumab (Dupixent) (HIM.PA.SP69) (PDF)
- Durvalumab (Imfinzi) (CP.PHAR.339) (PDF)
- Dutasteride (Avodart), Dutasteride/Tamsulosin (Jalyn) (CP.PMN.128) (PDF)
- Duvelisib (Copiktra) (CP.PHAR.400) (PDF)
- Ecallantide (Kalbitor) (CP.PHAR.177) (PDF)
- Eculizumab (Soliris) (CP.PHAR.97) (PDF)
- Edaravone (Radicava, Radivaca ORS) (CP.PHAR.343) (PDF)
- Efgartigimod Alfa-fcab, Efgartigimod/Hyaluronidase-qvfc (Vyvgart, Vyvgart Hytrulo) (CP.PHAR.555) (PDF)
- Efinaconazole (Jublia) (CP.PMN.25) (PDF)
- Eflornithine (Iwilfin) (CP.PHAR.670) (PDF)
- Elacestrant (Orserdu) (CP.PHAR.623) (PDF)
- Eladocagene Exuparvovec-tneq (Kebilidi) (CP.PHAR.595) (PDF)
- Elafibranor (Iqirvo) (CP.PHAR.688) (PDF)
- Elagolix (Orilissa), Elagolix/Estradiol/Norethinedrone (Oriahnn) (CP.PHAR.136) (PDF)
- Elamipretide (Forzinity) (CP.PHAR.680) (PDF)
- Elapegademase-lvlr (Revcovi) (CP.PHAR.419) (PDF)
- Elbasvir/Grazoprevir (Zepatier) (HIM.PA.SP62) (PDF)
- Elexacaftor/Ivacaftor/Tezacaftor; Ivacaftor (Trikafta) (CP.PHAR.440) (PDF)
- Eliglustat (Cerdelga) (CP.PHAR.153) (PDF)
- Elinzanetant (Lynkuet) (CP.PMN.304) (PDF)
- Elivaldogene Autotemcel (Skysona) (CP.PHAR.556) (PDF)
- Elosulfase Alfa (Vimizim) (CP.PHAR.162) (PDF)
- Elotuzumab (Empliciti) (CP.PHAR.308) (PDF)
- Elranatamab-bcmm (Elrexfio) (CP.PHAR.652) (PDF)
- Eltrombopag (Alvaiz, Promacta) (CP.PHAR.180) (PDF)
- Eluxadoline (Viberzi) (CP.PMN.170) (PDF)
- Emapalumab-lzsg (Gamifant) (CP.PHAR.402) (PDF)
- Emicizumab-kxwh (Hemlibra) (CP.PHAR.370) (PDF)
- Emtricitabine/Tenofovir Alafenamide (Descovy) (PDF)
- Enasidenib (Idhifa) (CP.PHAR.363) (PDF)
- Encorafenib (Braftovi) (CP.PHAR.127) (PDF)
- Enfortumab Vedotin-ejfv (Padcev) (CP.PHAR.455) (PDF)
- Enfuvirtide (Fuzeon) (CP.PHAR.41) (PDF)
- Enoxaparin (Lovenox) (CP.PHAR.224) (PDF)
- Ensartinib (Ensacove) (CP.PHAR.712) (PDF)
- Entecavir (Baraclude) (HIM.PA.08) (PDF)
- Entrectinib (Rozlytrek) (CP.PHAR.441) (PDF)
- Enzalutamide (Xtandi) (CP.PHAR.106) (PDF)
- Epcoritamab-bysp (Epkinly) (CP.PHAR.634) (PDF)
- Epinephrine (Epipen, Epipen Jr, Neffy, Auvi-Q) (CP.PCH.55) (PDF)
- Eplontersen (Wainua) (CP.PHAR.633) (PDF)
- Epoetin Alfa (Epogen, Procrit), Epoetin Alfa-epbx (Retacrit) (CP.PHAR.237) (PDF)
- Epoprostenol (Flolan, Veletri) (CP.PHAR.192) (PDF)
- Eptinezumab-jjmr (Vyepti) (HIM.PA.SP64) (PDF)
- Erdafitinib (Balversa) (CP.PHAR.423) (PDF)
- Erenumab-aooe (Aimovig) (HIM.PA.SP65) (PDF)
- Eribulin Mesylate (Halaven) (CP.PHAR.318) (PDF)
- Erlotinib (Tarceva) (CP.PHAR.74) (PDF)
- Erwinia Asparaginase (Rylaze) (CP.PHAR.301) (PDF)
- Esketamine (Spravato) (CP.PMN.199) (PDF)
- Esomeprazole-Naproxen (Vimovo) (CP.PMN.117) (PDF)
- Estradiol Vaginal Ring (Femring) (CP.PMN.263) (PDF)
- Etelcalcetide (Parsabiv) (CP.PHAR.379) (PDF)
- Eteplirsen (Exondys 51) (CP.PHAR.288) (PDF)
- Etranacogene Dezaparvovec-drlb (Hemgenix) (CP.PHAR.580) (PDF)
- Etripamil (Cardamyst) (CP.PMN.306) (PDF)
- Etuvetidigene Autotemcel (Waskyra) (CP.PHAR.735) (PDF)
- Everolimus (Afinitor, Afinitor Disperz, Zortress) (CP.PHAR.63) (PDF)
- Evinacumab-dgnb (Evkeeza) (HIM.PA.166) (PDF)
- Evolocumab (Repatha) (HIM.PA.156) (PDF)
- Exagamglogene Autotemcel (Casgevy) (CP.PHAR.603) (PDF)
- Factor IX (Human, Recombinant) (CP.PHAR.218) (PDF)
- Factor IX Complex, Human (Profilnine) (CP.PHAR.219) (PDF)
- Factor VIIa, Recombinant (NovoSeven RT, SevenFact) (CP.PHAR.220) (PDF)
- Factor VIII (Human, Recombinant) (CP.PHAR.215) (PDF)
- Factor VIII/von Willebrand Factor Complex (Human – Alphanate, Humate-P, Wilate); von Willebrand Factor (Recombinant – Vonvendi) (CP.PHAR.216) (PDF)
- Factor XIII A-Subunit, Recombinant (Tretten) (CP.PHAR.222) (PDF)
- Factor XIII, Human (Corifact) (CP.PHAR.221) (PDF)
- Famotidine-Ibuprofen (Duexis) (CP.PMN.120) (PDF)
- Fam-Trastuzumab Deruxtecan-nxki (Enhertu) (CP.PHAR.456) (PDF)
- Faricimab-svoa (Vabysmo) (CP.PHAR.581) (PDF)
- Febuxostat (Uloric) (CP.PMN.57) (PDF)
- Fecal Microbiota Spores, Live-brpk (Vowst) (CP.PHAR.632) (PDF)
- Fecal Microbiota, Live-jslm (Rebyota) (CP.PHAR.613) (PDF)
- Fedratinib (Inrebic) (CP.PHAR.442) (PDF)
- Fenfluramine (Fintepla) (CP.PMN.246) (PDF)
- Fentanyl IR (Actiq, Fentora, Lazanda, Subsys) (CP.PMN.127) (PDF)
- Ferric Carboxymaltose (Injectafer) (CP.PHAR.234) (PDF)
- Ferric Derisomaltose (Monoferric) (CP.PHAR.480) (PDF)
- Ferric Maltol (Accrufer)Ferric Maltol (Accrufer) (CP.PMN.213) (PDF)
- Ferumoxytol (Feraheme) (CP.PHAR.165) (PDF)
- Fezolinetant (Veozah) (CP.PMN.289) (PDF)
- Fibrinogen Concentrate [Human] (Fibryga, RiaSTAP) (CP.PHAR.526) (PDF)
- Fidanacogene Elaparvovec-dzkt (Beqvez) (CP.PHAR.643) (PDF)
- Filgrastim (Neupogen), Filgrastim-sndz (Zarxio), Tbo-filgrastim (Granix), Filgrastim-aafi (Nivestym), Filgrastim-ayow (Releuko) (CP.PHAR.297) (PDF)
- Finerenone (Kerendia) (CP.PMN.266) (PDF)
- Fingolimod (Gilenya, Tascenso ODT) (CP.PHAR.251) (PDF)
- Fitusiran (Qfitlia) (CP.PHAR.706) (PDF)
- Flibanserin (Addyi) (CP.PHAR.446) (PDF)
- Fluorouracil Cream (Tolak) (CP.PMN.165) (PDF)
- Fluticasone Propionate (Xhance) (CP.PMN.95) (PDF)
- Fondaparinux (Arixtra) (CP.PHAR.226) (PDF)
- Fosdenopterin (Nulibry) (CP.PHAR.471) (PDF)
- Fostamatinib (Tavalisse) (CP.PHAR.24) (PDF)
- Fostemsavir (Rukobia) (CP.PHAR.516) (PDF)
- Fremanezumab-vfrm (Ajovy) (HIM.PA.SP66) (PDF)
- Fruquintinib (Fruzaqla) (CP.PHAR.666) (PDF)
- Fulvestrant (Faslodex Injection) (CP.PHAR.424) (PDF)
- Furosemide (Furoscix) (CP.PHAR.608) (PDF)
- Futibatinib (Lytgobi) (CP.PHAR.604) (PDF)
- Gabapentin ER (Gralise, Horizant) (CP.PMN.240) (PDF)
- Galcanezumab-gnlm (Emgality) (HIM.PA.SP67) (PDF)
- Galsulfase (Naglazyme) (CP.PHAR.161) (PDF)
- Ganaxolone (Ztalmy) (CP.PMN.278) (PDF)
- Garadacimab (Andembry) (CP.PHAR.673) (PDF)
- Gefitinib (Iressa) (CP.PHAR.68) (PDF)
- Gemcitabine Intravesical System (Inlexzo) (CP.PHAR.753) (PDF)
- Gemtuzumab Ozogamicin (Mylotarg) (CP.PHAR.358) (PDF)
- Gilteritinib (Xospata) (CP.PHAR.412) (PDF)
- Givinostat (Duvyzat) (CP.PHAR.644) (PDF)
- Givosiran (Givlaari) (CP.PHAR.457) (PDF)
- Glasdegib (Daurismo) (CP.PHAR.413) (PDF)
- Glatiramer Acetate (Copaxone, Glatopa) (CP.PHAR.252) (PDF)
- Glaucoma Agents (CP.PMN.286) (PDF)
- Glecaprevir/Pibrentasvir (Mavyret) (HIM.PA.SP36) (PDF)
- Glepaglutide (ZP1848)_PEPP (CP.PHAR.694_PEPP) (PDF)
- Glofitamab-gxbm (Columvi) (CP.PHAR.636) (PDF)
- GLP-1 receptor agonists_PEPP (HIM.PA.53_PEPP) (PDF)
- Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists (CP.PMN.183_PEPP) (PDF)
- Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists (HIM.PA.53)(PDF)
- Glycerol Phenylbutyrate (Ravicti) (CP.PHAR.207) (PDF)
- Golodirsen (Vyondys 53) (CP.PHAR.453) (PDF)
- Goserelin Acetate (Zoladex) (CP.PHAR.171) (PDF)
- Govorestat (AT-007)_PEPP (CP.PHAR.681_PEPP) (PDF)
- Granisetron (Sancuso, Sustol) (CP.PMN.74) (PDF)
- Halcinonide (Halog) (HIM.PA.20) (PDF)
- Halobetasol Propionate (Bryhali, Lexette, Ultravate) (CP.PMN.180) (PDF)
- Halobetasol Propionate/Tazarotene (Duobrii) (CP.PMN.208) (PDF)
- Hematopoietic Stem and Progenitor Cells, High-Purity Regulatory T-Cells, and Conventional T-Cells (Orca-T)_PEPP (CP.PHAR.770_PEPP) (PDF)
- Hemin (Panhematin) (CP.PHAR.181) (PDF)
- Histrelin Acetate (Vantas, Supprelin LA) (CP.PHAR.172) (PDF)
- House Dust Mite Allergen Extract (Odactra) (CP.PMN.111) (PDF)
- Human Growth Hormone (Somapacitan, Somatrogon, Somatropin) (HIM.PA.161) (PDF)
- Hyaluronate Derivatives (CP.PHAR.05) (PDF)
- Hydroxyurea (Siklos) (CP.PMN.193) (PDF)
- Ibalizumab-uiyk (Trogarzo) (CP.PHAR.378) (PDF)
- Ibandronate Injection (Boniva) (CP.PHAR.189) (PDF)
- Ibrutinib (Imbruvica) (CP.PHAR.126) (PDF)
- Ibuprofen/Famotidine (Duexis) (CP.PMN.120) (PDF)
- Icatibant (Firazyr) (CP.PHAR.178) (PDF)
- Icosapent Ethyl (Vascepa) (CP.PMN.187) (PDF)
- Idebenone_PEPP (CP.PHAR.752_PEPP) (PDF)
- Idecabtagene Vicleucel (Abecma) (CP.PHAR.481) (PDF)
- Idelalisib (Zydelig) (CP.PHAR.133) (PDF)
- Idursulfase (Elaprase) (CP.PHAR.156) (PDF)
- Ifezuntirgene Inilparvovec (AMT-130)_PEPP (CP.PHAR.761_PEPP) (PDF)
- Iloperidone (Fanapt) (CP.PMN.32) (PDF)
- Iloprost (Ventavis) (CP.PHAR.193) (PDF)
- Imatinib (Gleevec) (CP.PHAR.65) (PDF)
- Imetelstat (Rytelo) (CP.PHAR.690) (PDF)
- Imiglucerase (Cerezyme) (CP.PHAR.154) (PDF)
- Imlunestrant (Inluriyo) (CP.PHAR.754) (PDF)
- Immune Globulins (HIM.PA.178) (PDF)
- Inavolisib (Itovebi) (CP.PHAR.702) (PDF)
- Inclisiran (Leqvio) (CP.PHAR.568) (PDF)
- IncobotulinumtoxinA (Xeomin) (CP.PHAR.231) (PDF)
- Inebilizumab-cdon (Uplizna) (CP.PHAR.458) (PDF)
- Infertility and Fertility Preservation (CP.PHAR.131) (PDF)
- Infigratinib (Truseltiq) (CP.PHAR.547) (PDF)
- Inhaled Agents for Asthma and COPD (HIM.PA.153) (PDF)
- Inotersen (Tegsedi) (CP.PHAR.405) (PDF)
- Inotuzumab Ozogamicin (Besponsa) (CP.PHAR.359) (PDF)
- Insulin Delivery Systems (V-Go, Omnipod, InPen) (CP.PHAR.534) (PDF)
- Insulin detemir (Levemir) (HIM.PA.171) (PDF)
- Insulin Glargine (Rezvoglar, Semglee, Toujeo) (HIM.PA.09) (PDF)
- Interferon Beta-1a (Avonex, Rebif) (CP.PHAR.255) (PDF)
- Interferon Gamma- 1b (Actimmune) (CP.PHAR.52) (PDF)
- Ipilimumab (Yervoy) (CP.PHAR.319) (PDF)
- Iptacopan (Fabhalta) (CP.PHAR.656) (PDF)
- Irinotecan Liposome (Onivyde) (CP.PHAR.304) (PDF)
- Isatuximab-irfc (Sarclisa) (CP.PHAR.482) (PDF)
- Isavuconazonium (Cresemba) (CP.PMN.154) (PDF)
- Isotretinoin (Absorica, Absorica LD, Amnesteem, Claravis, Myorisan, Zenatane) (CP.PMN.143) (PDF)
- Istradefylline (Nourianz) (CP.PMN.217) (PDF)
- Itraconazole (Sporanox, Tolsura) (CP.PMN.124) (PDF)
- Ivabradine (Corlanor) (CP.PMN.70) (PDF)
- Ivacaftor (Kalydeco) (CP.PHAR.210) (PDF)
- Ivermectin (Stromectol, Sklice) (CP.PMN.269) (PDF)
- Ivosidenib (Tibsovo) (CP.PHAR.137) (PDF)
- Ixazomib (Ninlaro) (CP.PHAR.302) (PDF)
- Ketamine (Ketalar) (CP.PMN.296) (PDF)
- Ketorolac Nasal Spray (Sprix) (CP.PMN.282) (PDF)
- Lanadelumab-fylo (Takhzyro) (HIM.PA.172) (PDF)
- Lanreotide (Somatuline Depot and Unbranded) (CP.PHAR.391) (PDF)
- Lapatinib (Tykerb) (CP.PHAR.79) (PDF)
- Laronidase (Aldurazyme) (CP.PHAR.152) (PDF)
- Larotrectinib (Vitrakvi) (CP.PHAR.414) (PDF)
- Lasmiditan (Reyvow) (CP.PMN.218) (PDF)
- Lazertinib (Lazcluze) (CP.PHAR.695) (PDF)
- Lebrikizumab (Ebglyss) (CP.PCH.58) (PDF)
- Lebrikizumab (Ebglyss) (CP.PHAR.704) (PDF)
- Lecanemab-irmb (Leqembi) (CP.PHAR.596) (PDF)
- Ledipasvir/Sofosbuvir (Harvoni) (HIM.PA.SP3) (PDF)
- Lefamulin (Xenleta) (CP.PMN.219) (PDF)
- Lenacapavir (Sunlenca) (CP.PHAR.622) (PDF)
- Lenalidomide (Revlimid) (CP.PHAR.71) (PDF)
- Leniolisib (Joenja) (CP.PHAR.597) (PDF)
- Lenvatinib (Lenvima) (CP.PHAR.138) (PDF)
- Lerodalcibep-liga (Lerochol) (CP.PHAR.768) (PDF)
- Letermovir (Prevymis) (CP.PHAR.367) (PDF)
- Leucovorin Injection (CP.PHAR.393) (PDF)
- Leuprolide Acetate (Eligard, Fensolvi, Lupaneta Pack, Lupron Depot, Lupron Depot-Ped), Leuprolide mesylate (Camcevi) (CP.PCH.53) (PDF)
- Levacetylleucine (Aqneursa) (CP.PHAR.682) (PDF)
- Levodopa Inhalation Powder (Inbrija) (CP.PMN.267) (PDF)
- Levoketoconazole (Recorlev) (CP.PMN.275) (PDF)
- Levoleucovorin (Fusilev, Khapzory) (CP.PHAR.151) (PDF)
- Levomilnacipran (Fetzima) (HIM.PA.125) (PDF)
- L-glutamine (Endari) (CP.PMN.116) (PDF)
- Lidocaine Transdermal (Lidoderm, ZTlido) (CP.PMN.08) (PDF)
- Lifileucel (Amtagvi) (CP.PHAR.598) (PDF)
- Lifitegrast (Xiidra) (CP.PMN.73) (PDF)
- Linezolid (Zyvox) (CP.PMN.27) (PDF)
- Linvoseltamab-gcpt (Lynozyfic) (CP.PHAR.743) (PDF)
- Lisocabtagene Maraleucel (Breyanzi) (CP.PHAR.483) (PDF)
- Lofexidine (Lucemyra) (CP.PMN.152) (PDF)
- Lomustine (Gleostine) (CP.PHAR.507) (PDF)
- Lonafarnib (Zokinvy) (CP.PHAR.499) (PDF)
- Loncastuximab Tesirine-lpyl (Zynlonta) (CP.PHAR.539) (PDF)
- Lorlatinib (Lorbrena) (CP.PHAR.406) (PDF)
- Loteprednol etabonate (Eysuvis) (CP.PMN.260) (PDF)
- Lotilaner (Xdemvy) (CP.PMN.291) (PDF)
- Lovotibeglogene Autotemcel (Lyfgenia) (PDF)
- Lubiprostone (Amitiza) (CP.PMN.142) (PDF)
- Luliconazole Cream (Luzu) (CP.PMN.166) (PDF)
- Lumacaftor/Ivacaftor (Orkambi) (CP.PHAR.213) (PDF)
- Lumasiran (Oxlumo) (CP.PHAR.473) (PDF)
- Lumateperone (Caplyta) (CP.PMN.232) (PDF)
- Lurbinectedin (Zepzelca) (CP.PHAR.500) (PDF)
- Luspatercept-aamt (Reblozyl) (CP.PHAR.450) (PDF)
- Lusutrombopag (Mulpleta) (CP.PHAR.407) (PDF)
- Lutetium Lu 177 Dotatate (Lutathera) (CP.PHAR.384) (PDF)
- Lutetium Lu 177 vipivotide tetraxetan (Pluvicto) (CP.PHAR.582) (PDF)
- Macitentan (Opsumit) (CP.PHAR.194) (PDF)
- Mannitol (Bronchitol) (CP.PHAR.518) (PDF)
- Maralixibat (Livmarli) (CP.PHAR.543) (PDF)
- Margetuximab-cmkb (Margenza) (CP.PHAR.522) (PDF)
- Maribavir (Livtencity) (CP.PMN.271) (PDF)
- Marnetegragene Autotemcel (Kresladi)_PEPP (CP.PHAR.599_PEPP) (PDF)
- Marstacimab-hncq (Hympavzi) (CP.PHAR.674) (PDF)
- Mavacamten (Camzyos) (CP.PMN.272) (PDF)
- Mavorixafor (Xolremdi) (CP.PHAR.679) (PDF)
- Mecamylamine (Vecamyl) (CP.PMN.136) (PDF)
- Mecasermin (Increlex) (CP.PHAR.150) (PDF)
- Mechlorethamine Gel (Valchlor) (CP.PHAR.381) (PDF)
- Megestrol Acetate (Megace ES) (CP.PMN.179) (PDF)
- Melphalan (Hepzato) (CP.PHAR.653) (PDF)
- Memantine ER (Namenda XR), Memantine/Donepezil (Namzaric) (CP.PCH.30) (PDF)
- Mercaptopurine (Purixan) (CP.PHAR.447) (PDF)
- Mesenchymal Stem Cell-NTF Cells (NurOwn)_PEPP (CP.PHAR.637_PEPP) (PDF)
- Metformin ER (Fortamet, Glumetza) (CP.PMN.72) (PDF)
- Methotrexate (Otrexup, Rasuvo, Xatmep, Reditrex, Jylamvo (CP.PHAR.134) (PDF)
- Methoxsalen (Uvadex) (HIM.PA.17) (PDF)
- Methoxy Polyethylene Glycol-Epoetin Beta (Mircera) (CP.PHAR.238) (PDF)
- Methylnaltrexone Bromide (Relistor) (CP.PMN.169) (PDF)
- Metoclopramide (Gimoti) (CP.PMN.252) (PDF)
- Metreleptin (Myalept) (CP.PHAR.425) (PDF)
- Midazolam (Nayzilam) (CP.PMN.211) (PDF)
- Midostaurin (Rydapt) (CP.PHAR.344) (PDF)
- Mifepristone (Korlym) (CP.PHAR.101) (PDF)
- Migalastat (Galafold) (CP.PHAR.394) (PDF)
- Miglustat (Zavesca) (CP.PHAR.164) (PDF)
- Milnacipran (Savella) (CP.PMN.125) (PDF)
- Minocycline ER (Solodyn, Ximino, Minolira), Microspheres (Arestin), Foam (Zilxi) (CP.PMN.80) (PDF)
- Mirdametinib (Gomekli) (CP.PHAR.718) (PDF)
- Mirvetuximab soravatansine-gynx (Elahere) (CP.PHAR.617) (PDF)
- Mitapivat (Pyrukynd) (CP.PHAR.558) (PDF)
- Mitomycin for Pyelocalyceal Solution (Jelmyto) (PDF)
- Mitoxantrone (CP.PHAR.258) (PDF)
- Mobocertinib (Exkivity) (CP.PHAR.559) (PDF)
- Modafinil (Provigil) (CP.PMN.39) (PDF)
- Mogamulizumab-kpkc (Poteligeo) (CP.PHAR.139) (PDF)
- Momelotinib (Ojjaara) (CP.PHAR.654) (PDF)
- Mometasone Furoate (Sinuva) (CP.PHAR.448) (PDF)
- Mosunetuzumab-axgb (Lunsumio) (CP.PHAR.618) (PDF)
- Motixafortide (Aphexda) (CP.PHAR.655) (PDF)
- Moxetumomab pasudotox-tdfk (Lumoxiti) (PDF)
- Mozafancogene Autotemcel (RP-L102)_PEPP (CP.PHAR.719_PEPP) (PDF)
- Nabumetone Double-Strength (Relafen DS) (CP.PMN.287) (PDF)
- Nadofaragene Firadenovec-vncg (Adstiladrin) (CP.PHAR.461) (PDF)
- Nafarelin Acetate (Synarel) (CP.PHAR.174) (PDF)
- Naldemedine (Symproic) (CP.PMN.112) (PDF)
- Nalmefene (Opvee) (CP.PHAR.638) (PDF)
- Naloxegol (Movantik) (HIM.PA.167) (PDF)
- Naltrexone (Vivitrol) (CP.PHAR.96) (PDF)
- Naproxen Oral Suspension (Naprosyn) (HIM.PA.130) (PDF)
- Naproxen/Esomeprazole (Vimovo) (CP.PMN.117) (PDF)
- Narsoplimab (Yartemlea) (CP.PHAR.527) (PDF)
- Natalizumab (Tysabri, Tyruko) (CP.PHAR.259) (PDF)
- Navepegritide (TransCon CNP)_PEPP (CP.PHAR.746_PEPP) (PDF)
- Naxitamab-gqgk (Danyelza) (CP.PHAR.523) (PDF)
- Necitumumab (Portrazza) (CP.PHAR.320) (PDF)
- Nedosiran (Rivfloza) (CP.PHAR.619) (PDF)
- Nemolizumab-ilto (Nemluvio) (CP.PCH.59) (PDF)
- Nemolizumab-ito (Nemluvio) (CP.PHAR.703) (PDF)
- Neomycin/Fluocinolone Cream (Neo-Synalar) (CP.PMN.167) (PDF)
- Nerandomilast (Jascayd) (CP.PHAR.759) (PDF)
- Neratinib (Nerlynx) (CP.PHAR.365) (PDF)
- Netupitant and Palonosetron (Akynzeo), Fosnetupitant and Palonosetron (Akynzeo IV) (CP.PMN.158) (PDF)
- Nifurtimox (Lampit) (CP.PMN.256) (PDF)
- Nilotinib (Tasigna) (CP.PHAR.76) (PDF)
- Nintedanib (Ofev) (CP.PCH.54 ) (PDF)
- Nipocalimab-aahu (Imaavy) (CP.PHAR.720) (PDF)
- Niraparib (Zejula) (CP.PHAR.408) (PDF)
- Niraparib and Abiraterone Acetate (Akeega) (CP.PHAR.645) (PDF)
- Nirmatrelvir and Ritonavir (Paxlovid) (CP.PMN.288) (PDF)
- Nirogacestat (Ogsiveo) (CP.PHAR.671) (PDF)
- Nirsevimab-alip (Beyfortus) (CP.PHAR.614) (PDF)
- Nitazoxanide (Alinia) (HIM.PA.152) (PDF)
- Nitisinone (Nityr, Orfadin) (CP.PHAR.132) (PDF)
- Nivolumab, Nivolumab Hyaluronidase-nvhy (Opdivo, Opdivo Qvantig) (CP.PHAR.121) (PDF)
- Nivolumab and Relatlimab-rmbw (Opdualag) (CP.PHAR.588) (PDF)
- No Coverage Criteria, Recent Label Changes Pending Clinical Policy Update (HIM.PA.33) (PDF)
- Nogapendekin alfa inbakicept-pmln (Anktiva) (CP.PHAR.684) (PDF)
- Non-Calcium Phosphate Binders (CP.PMN.04) (PDF)
- Non-Formulary and Formulary Contraceptives (HIM.PA.100) (PDF)
- Non-Formulary Test Strips (HIM.PA.34) (PDF)
- Nucala (HIM.PA.175) (PDF)
- Nusinersen (Spinraza) (CP.PHAR.327) (PDF)
- Obecabtagene autoleucel (Aucatzyl) (CP.PHAR.675) (PDF)
- Obeticholic Acid (Ocaliva) (CP.PHAR.287) (PDF)
- Obinutuzumab (Gazyva) (CP.PHAR.305) (PDF)
- Ocrelizumab (Ocrevus) (CP.PHAR.335) (PDF)
- Octreotide Acetate (Sandostatin, Sandostatin LAR Depot, Mycapssa) (PDF)
- Odevixibat (Bylvay) (CP.PHAR.528) (PDF)
- Ofatumumab (Arzerra, Kesimpta) (CP.PHAR.306) (PDF)
- Off-Label Drug Use (HIM.PA.154) (PDF)
- Olanzapine Long-Acting Injection (Zyprexa Relprevv) (CP.PHAR.292) (PDF)
- Olanzapine/Samidorphan (Lybalvi) (CP.PMN.265) (PDF)
- Olaparib (Lynparza) (CP.PHAR.360) (PDF)
- Olezarsen (Tryngolza) (CP.PHAR.689) (PDF)
- Olezarsen (Tryngolza)_PEPP (CP.PHAR.689_PEPP) (PDF)
- Olipudase Alfa-rpcp (Xenpozyme) (CP.PHAR.586) (PDF)
- Olutasidenib (Rezlidhia) (CP.PHAR.615) (PDF)
- Omacetaxine (Synribo) (CP.PHAR.108) (PDF)
- Omadacycline (Nuzyra) (CP.PMN.188) (PDF)
- Omalizumab (Xolair, Omlyclo) (CP.PCH.49) (PDF)
- Omaveloxolone (Skyclarys) (CP.PHAR.590) (PDF)
- OnabotulinumtoxinA (Botox) (CP.PHAR.232) (PDF)
- Onasemnogene Abeparvovec (Zolgensma) (CP.PHAR.421) (PDF)
- Ophthalmic Corticosteroids (HIM.PA.03) (PDF)
- Ophthalmic Riboflavin (Photrexa, Photrexa Viscous) (CP.PHAR.536) (PDF)
- Opicapone (Ongentys) (CP.PMN.245) (PDF)
- Opioid Analgesics* (HIM.PA.139) (PDF)
- Osilodrostat (Isturisa) (CP.PHAR.487) (PDF)
- Osimertinib (Tagrisso) (CP.PHAR.294) (PDF)
- Ospemifene (Osphena) (CP.PMN.168) (PDF)
- Overactive Bladder Agents (CP.PMN.198) (PDF)
- Oxymetazoline (Rhofade, Upneeq) (CP.PMN.86) (PDF)
- Ozanimod (Zeposia) (CP.PHAR.462) (PDF)
- Ozenoxacin (Xepi) (CP.PMN.119) (PDF)
- Paclitaxel, Protein-Bound (Abraxane) (CP.PHAR.176) (PDF)
- Pacritinib (Vonjo) (CP.PHAR.583) (PDF)
- Palbociclib (Ibrance) (HIM.PA.173) (PDF)
- Paliperidone Long-Acting Injections (Invega Hafyera, Invega Sustenna, Invega Trinza) (CP.PHAR.291) (PDF)
- Palivizumab (Synagis) (CP.PHAR.16) (PDF)
- Palopegteriparatide (Yorvipath) (CP.PHAR.696) (PDF)
- Palovarotene (Sohonos) (CP.PHAR.548) (PDF)
- Paltusotide (Palsonify) (CP.PHAR.755) (PDF)
- Pancrelipase (Creon, Pancreaze, Pertzye, Viokace, Zenpep) (CP.PCH.44) (PDF)
- Panitumumab (Vectibix) (CP.PHAR.321) (PDF)
- Parathyroid Hormone (Natpara) (CP.PHAR.282) (PDF)
- Paricalcitol Injection (Zemplar) (CP.PHAR.270) (PDF)
- Pariglasgene Brecaparvovec (DTX401)_PEPP (CP.PHAR.762_PEPP) (PDF)
- Pasireotide (Signifor, Signifor LAR) (PDF)
- Patiromer (Veltassa) (CP.PMN.205) (PDF)
- Patisiran (Onpattro) (CP.PHAR.395) (PDF)
- Pazopanib (Votrient) (CP.PHAR.81) (PDF)
- Peanut Allergen Powder-dnfp (Palforzia) (CP.PMN.220) (PDF)
- Pegaspargase (Oncaspar), Calaspargase Pegol-mknl (Asparlas) (CP.PHAR.353) (PDF)
- Pegcetacoplan (Empaveli, Syfovre) (CP.PHAR.524) (PDF)
- Pegfilgrastim (Neulasta, Neulasta Onpro), Pegfilgrastim-jmdb, Pegfilgrastim-pbbk, Pegfilgrastim-apgf, Eflapegrastim-xnst, Efbemalenograstim alfa-vuxw, Pegfilgrastim-fpgk, Pegfilgrastim-cbqv, Pegfilgrastim-bmez (CP.PHAR.296) (PDF)
- Peginterferon Alfa-2a (Pegasys) (CP.PHAR.89) (PDF)
- Peginterferon Beta-1a (Plegridy) (CP.PHAR.271) (PDF)
- Pegloticase (Krystexxa) (CP.PHAR.115) (PDF)
- Pegunigalsidase Alfa-iwxj (Elfabrio) (CP.PHAR.512) (PDF)
- Pegvaliase-pqpz (Palynziq) (CP.PHAR.140) (PDF)
- Pegvisomant (Somavert) (CP.PHAR.389) (PDF)
- Pegzilarginase-nbln (Loargys) (CP.PHAR.587) (PDF)
- Pembrolizumab (Keytruda) (CP.PHAR.322) (PDF)
- Pemetrexed (Alimta, Pemfexy) (CP.PHAR.368) (PDF)
- Pemigatinib (Pemazyre) (CP.PHAR.496) (PDF)
- Penicillamine (Cuprimine) (CP.PCH.09) (PDF)
- Penpulimab-kcqx (CP.PHAR.732) (PDF)
- Perampanel (Fycompa) (CP.PMN.156) (PDF)
- Perfluorohexyloctane (Miebo) (CP.PMN.290) (PDF)
- Pertuzumab (Perjeta) (CP.PHAR.227) (PDF)
- Pertuzumab/Trastuzumab/Hyaluronidase-zzxf (Phesgo) (CP.PHAR.501) (PDF)
- Pexidartinib (Turalio) (CP.PHAR.436) (PDF)
- Phendimetrazine (CP.PCH.47) (PDF)
- Phentermine (Adipex-P, Lomaira) (CP.PCH.13) (PDF)
- Pilocarpine (Qlosi, Vuity) (CP.PMN.270) (PDF)
- Pimavanserin (Nuplazid) (CP.PMN.140) (PDF)
- Pirfenidone (Esbriet) (CP.PHAR.286) (PDF)
- Pirtobrutinib (Jaypirca) (CP.PHAR.620) (PDF)
- Pitolisant (Wakix) (CP.PMN.221) (PDF)
- Plasminogen, Human-tvmh (Ryplazim) (PDF)
- Plecanatide (Trulance) (CP.PMN.87) (PDF)
- Plerixafor (Mozobil) (CP.PHAR.323) (PDF)
- Plozasiran (Redemplo) (CP.PHAR.721) (PDF)
- Polatuzumab Vedotin-piiq (Polivy) (CP.PHAR.433) (PDF)
- Pomalidomide (Pomalyst) (CP.PHAR.116) (PDF)
- Ponatinib (Iclusig) (CP.PHAR.112) (PDF)
- Ponesimod (Ponvory) (CP.PHAR.537) (PDF)
- Potassium Chloride for Oral Solution (Klor-Con Powder) (HIM.PA.143) (PDF)
- Pozelimab-bbfg (Veopoz) (CP.PHAR.626) (PDF)
- Prademagene Zamikeracel (Zevaskyn) (CP.PHAR.609) (PDF)
- Pralatrexate (Folotyn) (CP.PHAR.313) (PDF)
- Pramlintide (Symlin) (CP.PMN.129) (PDF)
- Prasterone (Intrarosa) (CP.PMN.99) (PDF)
- Pregabalin (Lyrica, Lyrica CR) (CP.PMN.33) (PDF)
- Pretomanid (CP.PMN.222) (PDF)
- Progesterone (Crinone, Endometrin, Milprosa) (CP.PMN.243) (PDF)
- Propranolol HCl Oral Solution (Hemangeol) (CP.PCH.51) (PDF)
- Protein C Concentrate, Human (Ceprotin) (CP.PHAR.330) (PDF)
- Prucalopride (Motegrity) (HIM.PA.159) (PDF)
- Pyrimethamine (Daraprim) (CP.PMN.44) (PDF)
- Quantity Limit Override and Dose Optimization (CP.PMN.59) (PDF)
- Quetiapine Extended-Release (Seroquel XR) (PDF)
- Quinine Sulfate (Qualaquin) (CP.PMN.262) (PDF)
- Quizartinib (Vanflyta) (CP.PHAR.646) (PDF)
- Ramucirumab (Cyramza) (CP.PHAR.119) (PDF)
- Ranibizumab (Byooviz, Cimerli, Lucentis, Susvimo) (CP.PHAR.186) (PDF)
- Rasagiline (Azilect) (HIM.PA.89) (PDF)
- Ravulizumab-cwvz (Ultomiris) (CP.PHAR.415) (PDF)
- Rebisufligene Etisparvovec (UX111)_PEPP (CP.PHAR.722_PEPP) (PDF)
- Regorafenib (Stivarga) (CP.PHAR.107) (PDF)
- Relacorilant_PEPP (CP.PHAR.736_PEPP) (PDF)
- Relugolix (Orgovyx), Relugolix/Estradiol/Norethinedrone (Myfembree) (CP.PHAR.529) (PDF)
- Remestemcel-L (Ryoncil) (CP.PHAR.474) (PDF)
- Remibrutinib (Rhapsido) (CP.PHAR.756) (PDF)
- Repository Corticotropin Injection (H.P. Acthar Gel, Purified Cortrophin Gel) (HIM.PA.168) (PDF)
- Repotrectinib (Augtyro) (CP.PHAR.667) (PDF)
- Reslizumab (Cinqair) (CP.PHAR.223) (PDF)
- Resmetirom (Rezdiffra) (CP.PHAR.647) (PDF)
- Retifanlimab-dlwr (Zynyz) (CP.PHAR.629) (PDF)
- Revakinagene Taroretcel-lwey (Encelto) (CP.PHAR.697) (PDF)
- Revumenib (Revuforj) (CP.PHAR.707) (PDF)
- Rexlemestrocel-L (Revascor)_PEPP (CP.PHAR.728_PEPP) (PDF)
- Ribavirin (Rebetol, Ribasphere) (CP.PHAR.141) (PDF)
- Ribociclib (Kisqali), Ribociclib/Letrozole (Kisqali Femara) (CP.PHAR.334) (PDF)
- Rifabutin (Mycobutin) (CP.PMN.223) (PDF)
- ifamycin (Aemcolo) (CP.PMN.196) (PDF)
- Rifaximin (Xifaxan) (CP.PMN.47) (PDF)
- Rilonacept (Arcalyst) (CP.PHAR.266) (PDF)
- Rilzabrutinib (Wayrilz) (CP.PHAR.751) (PDF)
- RimabotulinumtoxinB (Myobloc) (CP.PHAR.233) (PDF)
- Rimegepant (Nurtec ODT) (CP.PHAR.490) (PDF)
- Riociguat (Adempas) (CP.PHAR.195) (PDF)
- Ripretinib (Qinlock) (CP.PHAR.502) (PDF)
- Risdiplam (Evrysdi) (CP.PHAR.477) (PDF)
- Risedronate (Actonel, Atelvia) (CP.PMN.100) (PDF)
- Risperidone Long-Acting Injection (Perseris, Risperdal Consta, Rykindo, Uzedy) (CP.PHAR.293) (PDF)
- Rituximab (Rituxan), Rituximab-arrx (Riabni), Rituximab-pvvr (Ruxience), Rituximab-abbs (Truxima), Rituximab-Hyaluronidase (Rituxan Hycela) (CP.PHAR.260) (PDF)
- Roflumilast (Daliresp, Zoryve) (CP.PMN.46) (PDF)
- Rolapitant (Varubi) (CP.PMN.102) (PDF)
- Romidepsin (Istodax) (CP.PHAR.314) (PDF)
- Romiplostim (Nplate) (CP.PHAR.179) (PDF)
- Romosozumab-aqqg (Evenity) (CP.PHAR.428) (PDF)
- Ropeginterferon Alfa-2b-njft (BESREMi) (CP.PHAR.570) (PDF)
- Rozanolixizumab-noli (Rystiggo) (CP.PHAR.648) (PDF)
- Rucaparib (Rubraca) (CP.PHAR.350) (PDF)
- Rufinamide (Banzel) (CP.PMN.157) (PDF)
- Ruxolitinib (Jakafi, Opzelura) (CP.PHAR.98) (PDF)
- Sacituzumab Govitecan-hziy (Trodelvy) (CP.PHAR.475) (PDF)
- Safinamide (Xadago) (CP.PMN.113) (PDF)
- Sapropterin Dihydrochloride (Kuvan, Javygtor) (CP.PHAR.43) (PDF)
- Sarecycline (Seysara) (CP.PMN.189) (PDF)
- Sargramostim (Leukine) (CP.PHAR.295) (PDF)
- Satralizumab-mwge (Enspryng) (CP.PHAR.463) (PDF)
- Sebelipase Alfa (Kanuma) (CP.PHAR.159) (PDF)
- Sebetralstat (Ekterly) (CP.PHAR.723) (PDF)
- Secnidazole (Solosec) (CP.PMN.103) (PDF)
- Seladelpar (Livdelzi) (CP.PHAR.698) (PDF)
- Selexipag (Uptravi) (CP.PHAR.196) (PDF)
- Selinexor (Xpovio) (CP.PHAR.431) (PDF)
- Selpercatinib (Retevmo) (CP.PHAR.478) (PDF)
- Selumetinib (Koselugo) (CP.PHAR.464) (PDF)
- Semaglutide (Wegovy) (CP.PMN.295) (PDF)
- Semaglutide (Wegovy, NN9932)_PEPP (CP.PMN.295_PEPP) (PDF)
- Sepiapterin (Sephience) (CP.PHAR.708) (PDF)
- Setmelanotide (Imcivree) (CP.PHAR.491) (PDF)
- Setmelanotide (Imcivree)_PEPP (CP.PHAR.491_PEPP) (PDF)
- Sevabertinib (Hyrnuo) (CP.PHAR.764) (PDF)
- Short Ragweed Pollen Allergen Extract (Ragwitek) (CP.PMN.83) (PDF)
- Sildenafil (Revatio, Liqrev) (CP.PHAR.197) (PDF)
- Sildenafil for ED (Viagra) (CP.PCH.07) (PDF)
- Siltuximab (Sylvant) (CP.PHAR.329) (PDF)
- Siponimod (Mayzent) (CP.PHAR.427) (PDF)
- Sirolimus-Pegadricase (NASP)_PEPP (CP.PHAR.760_PEPP) (PDF)
- Sirolimus Protein-Bound Particles (Fyarro), Topical Gel (Hyftor) (CP.PHAR.574) (PDF)
- Sodium Dichloroacetate (SL-1009)_PEPP (CP.PHAR.724_PEPP) (PDF)
- Sodium Oxybate (Xyrem, Lumryz) and Calcium, Magnesium, Potassium, and Sodium Oxybate (Xywav) (CP.PMN.42) (PDF)
- Sodium Phenylbutyrate (Buphenyl, Pheburane, Olpruva) (CP.PHAR.208) (PDF)
- Sodium Phenylbutyrate/Taurursodiol (Relyvrio) (CP.PHAR.584) (PDF)
- Sodium Thiosulfate (Pedmark) (CP.PHAR.610) (PDF)
- Sodium Zirconium Cyclosilicate (Lokelma) (CP.PMN.163) (PDF)
- Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitors (HIM.PA.91) (PDF)
- Sofosbuvir (Sovaldi) (HIM.PA.SP2) (PDF)
- Sofosbuvir/Velpatasvir (Epclusa) (HIM.PA.SP1) (PDF)
- Sofosbuvir/Velpatasvir/Voxilaprevir (Vosevi) (HIM.PA.SP63) (PDF)
- Solriamfetol (Sunosi) (CP.PMN.209) (PDF)
- Sonidegib (Odomzo) (CP.PHAR.272) (PDF)
- Sonpiretigene Isteparvovec (MCO 010)_PEPP (CP.PHAR.749_PEPP) (PDF)
- Sorafenib (Nexavar) (CP.PHAR.69) (PDF)
- Sotatercept (Winrevair) (CP.PHAR.657) (PDF)
- Sotorasib (Lumakras) (CP.PHAR.549) (PDF)
- Sparsentan (Filspari) (CP.PHAR.631) (PDF)
- Spesolimab-sbzo (Spevigo) (CP.PHAR.606) (PDF)
- Spinosad (Natroba) (HIM.PA.134) (PDF)
- Step Therapy (HIM.PA.109) (PDF)
- Stiripentol (Diacomit) (CP.PMN.184) (PDF)
- Sunitinib (Sutent) (CP.PHAR.73) (PDF)
- Sunvozertinib (Zegfrovy) (CP.PHAR.742) (PDF)
- Sutimlimab-jome (Enjaymo) (CP.PHAR.503) (PDF)
- Suvorexant (Belsomra) (CP.PMN.109) (PDF)
- Sweet Vernal, Orchard, Perennial Rye, Timothy, and Kentucky Blue Grass Mixed Pollens Allergen Extract (Oralair) (CP.PMN.85) (PDF)
- Suzetrigine (Journavx) (CP.PMN.301) (PDF)
- Tabelecleucel (Tab-cel)_PEPP (CP.PHAR.747_PEPP) (PDF)
- Tadalafil (Adcirca, Alyq, Tadliq) (CP.PHAR.198) (PDF)
- Tadalafil BPH - ED (Cialis) (CP.PMN.132) (PDF)
- Tafamidis (Vyndaqel, Vyndamax) (CP.PHAR.432) (PDF)
- Tafasitamab-cxix (Monjuvi) (CP.PHAR.508) (PDF)
- Talazoparib (Talzenna) (CP.PHAR.409) (PDF)
- Taletrectinib (Ibtrozi) (CP.PHAR.740) (PDF)
- Taliglucerase Alfa (Elelyso) (CP.PHAR.157) (PDF)
- Talimogene laherepvec (Imlygic) (CP.PHAR.542) (PDF)
- Talquetamab-tgvs (Talvey) (CP.PHAR.649) (PDF)
- Tapinarof (Vtama) (CP.PMN.283) (PDF)
- Tarlatamab-dlle (Imdelltra) (CP.PHAR.685) (PDF)
- Tasimelteon (Hetlioz, Hetlioz LQ) (CP.PMN.104) (PDF)
- Tavaborole (Kerydin) (CP.PMN.105) (PDF)
- Tazarotene (Arazlo, Fabior, Tazorac) (CP.PMN.244) (PDF)
- Tazemetostat (Tazverik) (CP.PHAR.452) (PDF)
- Tebentafusp-tebn (Kimmtrak) (CP.PHAR.575) (PDF)
- Teclistamab-cqyv (Tecvayli) (CP.PHAR.611) (PDF)
- Tedizolid (Sivextro) (CP.PMN.62) (PDF)
- Teduglutide (Gattex) (CP.PHAR.114) (PDF)
- Telisotuzumab Vedotin-tllv (Emrelis) (CP.PHAR.733) (PDF)
- Telotristat Ethyl (Xermelo) (CP.PHAR.337) (PDF)
- Temozolomide (Temodar) (CP.PHAR.77) (PDF)
- Temsirolimus (Torisel) (CP.PHAR.324) (PDF)
- Tenapanor (Ibsrela, Xphozah) (CP.PMN.224) (PDF)
- Tenofovir Alafenamide Fumarate (Vemlidy) (CP.PMN.268) (PDF)
- Teplizumab-mzwv (Tzield) (CP.PHAR.492) (PDF)
- Teplizumab-mzwv (Tzield) (CP.PHAR.492_PEPP) (PDF)
- Tepotinib (Tepmetko) (CP.PHAR.530) (PDF)
- Teprotumumab (Tepezza) (CP.PHAR.465) (PDF)
- Teriflunomide (Aubagio) (CP.PCH.40) (PDF)
- Teriparatide (Forteo, Bonsity) (CP.PHAR.188) (PDF)
- Tesamorelin (Egrifta SV, Egrifta WR) (CP.PHAR.109) (PDF)
- Testosterone (Androderm) (HIM.PA.87) (PDF)
- Testosterone (Testopel, Jatenzo, Kyzatrex, Tlando) (CP.PHAR.354) (PDF)
- Tetrabenazine (Xenazine) (CP.PHAR.92) (PDF)
- Tezacaftor/Ivacaftor; Ivacaftor (Symdeko) (CP.PHAR.377) (PDF)
- Tezepelumab-ekko (Tezspire) (CP.PHAR.576) (PDF)
- Tezepelumab (Tezspire) (HIM.PA.176) (PDF)
- Thalidomide (Thalomid) (CP.PHAR.78) (PDF)
- Thioguanine (Tabloid) (CP.PHAR.437) (PDF)
- Thyrotropin Alfa (Thyrogen) (CP.PHAR.95) (PDF)
- Timothy Grass Pollen Allergen Extract (Grastek) (CP.PMN.84)(PDF)
- Tiopronin Delayed-Release (Thiola EC) (CP.PHAR.725) (PDF)
- Tirzepatide (Zepbound) (CP.PMN.298) (PDF)
- Tisagenlecleucel (Kymriah) (CP.PHAR.361) (PDF)
- Tislelizumab-jsgr (Tevimbra) (CP.PHAR.687) (PDF)
- Tisotumab Vedotin-tftv (Tivdak) (CP.PHAR.561) (PDF)
- Tividenofusp Alfa (DNL310)_PEPP (CP.PHAR.748_PEPP) (PDF)
- Tivozanib (Fotivda) (CP.PHAR.538) (PDF)
- Tobramycin (Bethkis, Kitabis Pak, TOBI, TOBI Podhaler) (CP.PHAR.211) (PDF)
- Tofersen (Qalsody) (CP.PHAR.591) (PDF)
- Tolvaptan (Jynarque, Samsca) (CP.PHAR.27) (PDF)
- Topical Acne Treatment (HIM.PA.71) (PDF)
- Topical Immunomodulators (CP.PMN.107) (PDF)
- Topiramate Extended-Release (Qudexy XR, Trokendi XR) (CP.PMN.281) (PDF)
- Topotecan (Hycamtin) (CP.PHAR.64) (PDF)
- Toripalimab-tpzi (Loqtorzi) (CP.PHAR.668) (PDF)
- Tovorafenib (Ojemda) (CP.PHAR.686) (PDF)
- Trabectedin (Yondelis) (CP.PHAR.204) (PDF)
- Tralokinumab-ldrm (Adbry) (CP.PCH.60) (PDF)
- Tralokinumab-ldrm (Adbry) (CP.PHAR.577) (PDF)
- Trametinib (Mekinist) (CP.PHAR.240) (PDF)
- Trastuzumab/Biosimilars, Trastuzumab-Hyaluronidase (CP.PHAR.228) (PDF)
- Travoprost Implant (iDose TR) (CP.PHAR.672) (PDF)
- Tremelimumab-actl (Imjudo) (CP.PHAR.612) (PDF)
- Treprostinil (Orenitram, Remodulin, Tyvaso, Tyvaso DPI) (CP.PHAR.199) (PDF)
- Triamcinolone ER Injection (Zilretta) (CP.PHAR.371) (PDF)
- Triclabendazole (Egaten) (CP.PMN.207) (PDF)
- Trientine (Cuvrior, Syprine) (CP.PHAR.438) (PDF)
- Trifarotene (Aklief) (CP.PMN.225) (PDF)
- Trifluridine/Tipiracil (Lonsurf) (CP.PHAR.383) (PDF)
- Triheptanoin (Dojolvi) (CP.PHAR.509) (PDF)
- Triptorelin Pamoate (Trelstar, Triptodur) (CP.PHAR.175) (PDF)
- Trofinetide (Daybue) (CP.PHAR.600) (PDF)
- Troriluzole (BHV-4157)_PEPP (CP.PHAR.639_PEPP) (PDF)
- Tucatinib (Tukysa) (CP.PHAR.497) (PDF)
- Ublituximab-xiiy (Briumvi) (CP.PHAR.621) (PDF)
- Udenafil_PEPP (CP.PHAR.557_PEPP) (PDF)
- Ulcer Therapy Products (CP.PMN.277) (PDF)
- Uridine Triacetate (Vistogard) (HIM.PA.SP55) (PDF)
- Vadadustat (Vafseo) (CP.PHAR.677) (PDF)
- Valbenazine (Ingrezza, Ingrezza Sprinkle) (CP.PHAR.340) (PDF)
- Valganciclovir (Valcyte) (CP.PCH.06) (PDF)
- Valoctocogene Roxaparvovec-rvox (Roctavian) (CP.PHAR.466) (PDF)
- Valrubicin (Valstar) (CP.PHAR.439) (PDF)
- Vamorolone (Agamree) (CP.PHAR.659) (PDF)
- Vandetanib (Caprelsa) (CP.PHAR.80) (PDF)
- Vanzacaftor/Tezacaftor/Deutivacaftor (Alyftrek) (CP.PHAR.700) (PDF)
- Varenicline (Tyrvaya) (CP.PMN.273) (PDF)
- Vatiquinone (PTC743)_PEPP (CP.PHAR.729_PEPP) (PDF)
- Velaglucerase Alfa (VPRIV) (CP.PHAR.163) (PDF)
- Velmanase Alfa-tycv (Lamzede) (CP.PHAR.601) (PDF)
- Vemurafenib (Zelboraf) (CP.PHAR.91) (PDF)
- Venetoclax (Venclexta) (CP.PHAR.129) (PDF)
- Verteporfin (Visudyne) (CP.PHAR.187) (PDF)
- Vestronidase Alfa-vjbk (Mepsevii) (CP.PHAR.374) (PDF)
- Vigabatrin (Sabril) (CP.PHAR.169) (PDF)
- Viloxazine (Qelbree) (CP.PMN.264) (PDF)
- Viltolarsen (Viltepso) (CP.PHAR.484) (PDF)
- Vimseltinib (Romvimza) (CP.PHAR.726) (PDF)
- Vismodegib (Erivedge) (CP.PHAR.273) (PDF)
- Voclosporin (Lupkynis) (CP.PHAR.504) (PDF)
- Vorapaxar (Zontivity) (HIM.PA.146) (PDF)
- Vorasidenib (Voranigo) (CP.PHAR.699) (PDF)
- Voretigene Neparvovec-rzyl (Luxturna) (CP.PHAR.372) (PDF)
- Vorinostat (Zolinza) (CP.PHAR.83) (PDF)
- Vortioxetine (Trintellix) (CP.PMN.65) (PDF)
- Vosoritide (Voxzogo) (CP.PHAR.525) (PDF)
- Voxelotor (Oxbryta) (CP.PHAR.451) (PDF)
- Vutrisiran (Amvuttra) (CP.PHAR.550) (PDF)
- Xanomeline-trospium chloride (Cobenfy) (CP.PMN.299) (PDF)
- Zanidatamab-hrii (Ziihera) (CP.PHAR.709) (PDF)
- Zanubrutinib (Brukinsa) (CP.PHAR.467) (PDF)
- Zavegepant (Zavzpret) (CP.PHAR.630) (PDF)
- Zenocutuzumab-zbco (Bizengri) (CP.PHAR.713) (PDF)
- Ziftomenib (Komzifti) (CP.PHAR.765) (PDF)
- Zilganersen (ION373)_PEPP (CP.PHAR.763_PEPP) (PDF)
- Zilucoplan (Zilbrysq) (CP.PHAR.616) (PDF)
- Ziv-aflibercept (Zaltrap) (CP.PHAR.325) (PDF)
- Zolbetuximab-clzb (Vyloy) (CP.PHAR.705) (PDF)
- Zoledronic Acid (Reclast) (CP.PHAR.59) (PDF)
- Zongertinib (Hernexeos) (CP.PHAR.750) (PDF)
- Zopapogene Imadenovec (Papzimeos) (CP.PHAR.730) (PDF)
- Zuranolone (Zurzuvae) (CP.PHAR.650) (PDF)