Provider
P11-16 New Drug-Related Prior Authorization Criteria: Idiopathic P ulmonary Fibrosis Prior Authorization with Quantity Limit Criteria: Esbriet ® and Ofev ®
Program effective Date: Feb 08, 2016
Program effective Date: Feb 08, 2016
Program effective Date: Sep 25, 2017
Program effective Date: Jul 07, 2016
Program effective Date: Mar 29, 2016
Program effective Date: Oct 27, 2016
Program effective Date: Jun 01, 2016
Program effective Date: Jan 27, 2016
Program effective Date: Feb 08, 2017
Program effective Date: Feb 08, 2016
Program effective Date: Aug 09, 2016