UnitedHealthcare Community Plan’s Clinical Pharmacy Program Guidelines are updated on an ongoing basis by our Pharmacy and Therapeutics Committee. Our changes reflect recent developments in pharmaceutical health care so we’re aligned with national treatment standards.
These guidelines apply to the following plans:
- Arizona AHCCCS Complete Care / Medicaid
- Arizona Developmentally Disabled-Children's Rehabilitative Services (DD-CRS) Program
- Arizona Developmentally Disabled (DD) Program
- Arizona Long Term Care
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Actemra - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Acthar Gel - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Actimmune (interferon gamma-1b) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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ADHD Products - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Afinitor (everolimus) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Afrezza - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Aldurazyme - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Alecensa - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Alfa Interferons - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.01.2018
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Alinia - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Alunbrig (brigatinib) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Alzheimer's Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Ampyra (dalfampridine) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Anthelmintics - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.01.2018
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Anticonvulsants - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Antiemetics - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.15.2019
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Antiglaucoma Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.15.2019
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Antipsoriatic Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Antipsychotics - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Apokyn - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.18.2019
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Aquadeks - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Aralast NP - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.18.2019
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Arcalyst - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Arikayce - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Austedo - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Azole Antifungals - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.29.2018
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Azole Antifungals - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Belbuca / Butrans - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Benlysta - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Benznidazole - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Berinert - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Biltricide - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Bonjesta and Diclegis - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 10.01.2018
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Bosulif - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Braftovi - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Breast Cancer - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.18.2019
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Brilinta / Effient - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Buphenyl - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Cablivi - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Cabometyx - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Calquence - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Caprelsa - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Carbaglu - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Cayston - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Celebrex - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Cesamet, Marinol, Syndros - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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CGRP - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Cholbam - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Cialis for BPH - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Cimzia - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Cinryze - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Ciprodex - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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CMV and Herpes Virus Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.18.2019
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Colcrys - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.18.2019
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Colony Stimulating Factors - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Combination Basal Insulin / GLP-1 Receptor Agonist - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.29.2018
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Combination DPP4-SGLT2 - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.18.2019
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Cometriq (cabocantinib) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Complement Inhibitors (Soliris® & Ultomiris™) -Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Compound Bulk Powders - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Concentrated Insulins - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.25.2018
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Copiktra - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Copper Chelating Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Corlanor - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Cosentyx - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Cotellic - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Crestor - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Cystaran (cysteamine) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Daliresp - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Daraprim - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.12.2019
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Daurismo.docx, Daurismo - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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DDAVP - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.18.2019
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Declomycin - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.18.2019
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Dificid - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Dofetilide - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Doptelet - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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DPP-4 Inhibitors - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Dry Eye Disease - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Duexis and Vimovo - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.16.2019
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Duopa - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Dupixent - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Egrifta - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Elaprase - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.25.2018
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Elidel / Protopic - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.01.2018
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Elmiron - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Emflaza - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Emsam - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Enbrel - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Endari - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Entocort - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Entresto - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Epaned - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Eplerenone - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Erivedge - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Erleada (apalutmide) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Erythropoietic Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Erythropoietic Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Estrogens - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Etoposide - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Eucrisa - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Evzio - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.25.2018
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Exondys 51 - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Fabrazyme - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.25.2018
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Farydak - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Fenofibrate - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Fentanyl IR - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.29.2018
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Firazyr - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Firdapse - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Flexeril - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Flucytosine - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Forteo - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Galafold - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.09.2019
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Gattex - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Gaucher’s Disease Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Gilotrif (afatinib) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Gleevec - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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GLP-1 Agonists - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.01.2018
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Glumetza-Fortamet-Glucophage XR - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Glumetza-Fortamet-Glucophage XR - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Gonadotropin-Releasing Hormone Agonists - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Gralise, Horizant - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Growth Hormone / Growth Stimulating Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.25.2018
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Haegarda - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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HCG - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.31.2018
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Hemangeol - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Hemlibra - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Hemophilia Products - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.25.2019
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Hepatitis B - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Hepatitis C Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.25.2019
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Hetlioz - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.31.2018
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Humira - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Hycamtin - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Ibrance - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.29.2018
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Iclusig - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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ICS.LABA Combination Products - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.31.2018
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Idhifa - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Idiopathic Pulmonary Fibrosis - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Ilaris - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Imbruvica - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Impavido - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.25.2018
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Inderal LA - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.25.2018
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Ingrezza - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Inhaled Corticosteroids - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.01.2019
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Inlyta - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Insulin Pen Needles and Syringes - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Iressa - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Iron Chelators - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Irritable Bowel Syndrome (IBS) Constipation - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Irritable Bowel Syndrome - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Isotretinoin - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Jakafi (ruxolitinib) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Juxtapid - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Jynarque - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.09.2019
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Kalydeco - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.01.2018
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Keveyis - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Kevzara - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Kineret - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Kisqali - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Kisqali Femera Co-Pack - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.21.2018
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Korlym - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Kuvan - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Kynamro - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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LAMA / LABA - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Lenvima - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Leucovorin - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Lidocaine - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Lidocaine Patch - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.25.2018
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Lokelma-Veltassa - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.10.2019
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Long-Acting Opioid Products - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.12.2019
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Lonhala and Yupelri - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.25.2019
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Lonsurf - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Lorbrena.docx, Lorbrena - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Lucemyra - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Lynparza (olaparib) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Lyrica - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Lysteda - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Makena - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Mekinist - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Mektovi - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Mepron - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Migranal - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Mirvaso - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.01.2018
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Mozobil - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Mulpleta - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.09.2019
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Multaq - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Multiple Sclerosis (MS) Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Myalept - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.31.2018
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Myozyme / Lumizyme - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.25.2018
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Mytesi - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Namzaric - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.29.2018
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Natpara - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Nerlynx - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Nexavar - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Ninlaro - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Nityr - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Noctiva and Nocdurna - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Non-Preferred Drugs - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.02.2018
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Non-Solid Dosage Forms - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Northera - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.29.2018
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Nuedexta - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Nuplazid - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.02.2018
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Ocaliva (obeticholic acid) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Odomzo - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Olumiant - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Omega.docx, Omega - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Optivar - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Orencia - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Orfadin - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Orilissa.docx, Orilissa - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Orkambi - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Osphena - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Otezla- Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Overactive Bladder (OAB) Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Oxervate - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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PAH Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Palynziq - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Panretin - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Pediculicides - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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Pomalyst (pomalidomide) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Praluent - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Preferred Drugs - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 10.01.2018
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Prevymis (letermovir) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Procysbi (cysteamine bitartrate) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Progesterone - Non-Oral - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Progesterone, Oral - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Promacta - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Proton Pump Inhibitors (PPI) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.31.2018
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Provigil, Nuvigil.docx, Provigil / Nuvigil - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Pulmonary Arterial Hypertension (PAH) Agents - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.26.2018
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Pulmozyme - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Quantity Limits - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.01.2018
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Ranexa - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.01.2018
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Ravicti - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Rectiv - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Regranex - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Relistor - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Renvela - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Repatha.docx, Repatha - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Revlimid - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Rhofade - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.01.2018
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Rubraca - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan
Last Modified 11.30.2018
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Ruconest - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Rydapt (midostaurin) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Samsca - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Sandostatin - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Selzentry - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.26.2018
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Sensipar - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Serevent Diskus - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.19.2019
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SGLT-2 Inhibitors - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.29.2018
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Short-Acting Opioid Products - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.12.2019
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Signifor - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Siliq- ARIZONA.docx, Siliq - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Simponi- Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Sivextro - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Somavert - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Soritane - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Spinraza - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Sprycel - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Stelara - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Stivarga - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Strensiq - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Sublingual Immunotherapy (SLIT) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Suboxone / Subutex - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.25.2019
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Sucraid - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.20.2019
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Sutent - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.16.2019
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Symdeko - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Symlin - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Synagis (Drug Policy) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.21.2018
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Synribo - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.01.2018
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Tafinlar - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Tagrisso - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Takhzyro - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Taltz- ARIZONA.docx, Taltz - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Talzenna - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Tarceva - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Targretin - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Tavalisse - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Tegsedi.docx, Tegsedi - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Temodar - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Test Strips, Blood Glucose - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Thalomid (thalomide)- Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Tibsovo - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.21.2018
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Tobramycin Inhalation - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.17.2019
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Topical Androgens - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.01.2018
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Topical NSAIDs - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan
Last Modified 08.31.2018
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Topical NSAIDs.docx, Topical NSAIDs - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Topical Retinoid Products - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.25.2019
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Trelegy Ellipta - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Tremfya- ARIZONA.docx, Tremfya - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Tretinoin Capsules - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.20.2019
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Triptans - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Tykerb - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Tymlos - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Uloric - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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UnitedHealth Pharmaceutical Solutions, Tasigna - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Valchlor - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Vancocin - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.26.2018
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Vancomycin - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Vecamyl - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Vemlidy - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Venclexta - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Verzenio - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 06.29.2018
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Vitrakvi.docx, Vitrakvi - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Vizimpro - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Votrient.docx, Votrient - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Xalkori - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Xeljanz / Xeljanz XR - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.01.2018
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Xeljanz and Xeljanz XR - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Xenazine - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Xermelo - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Xifaxan - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.31.2018
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Xolair - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Xopenex Respules - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Xospata - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 04.24.2019
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Xtandi - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Xuriden - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Xyrem - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 09.28.2018
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Yonsa.docx, Yonsa - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 03.31.2019
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Zejula - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Zelboraf - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 05.24.2019
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Zetia - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Zolinza - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019
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Zontivity - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 12.28.2018
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Zortress - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 02.20.2019
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Zydelig - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 11.30.2018
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Zykadia - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 08.31.2018
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Zytiga (abriaterone acetate) - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 07.17.2019
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Zyvox - Clinical Pharmacy Program Guidelines - UnitedHealthcare Community Plan of Arizona
Last Modified 01.30.2019