-
Jadenu® (deferasirox) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 01.14.2021
,
-
Abilify MyCite (aripiprazole tablet with sensor) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Absorica (isotretinoin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Abstral (fentanyl sublingual tablets) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Abstral (fentanyl) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Actemra (tocilizumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Actemra® (tocilizumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Acthar Gel® (Repository corticotropin injection) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Acthar Gel®(repository corticotropin injection) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Actimmune® (interferon gamma-1b) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Actiq (brand only) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Actiq (fentanyl) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Adcirca® (tadalafil) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Adcirca® (tadalafil) - Prior Authorization/Notification - UnitedHealthcare Commercial Plan
Last Published 08.17.2020
,
-
Adderall (amphetamine-dextroamphetamine mixed salts) and Adderall XR (amphetamine-dextroamphetamine mixed salts, extended release) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Addyi (flibanserin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 02.26.2020
,
-
Adempas® (riociguat) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Adempas® (riociguat) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Adhansia XR (methylphenidate extended-release) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Adlyxin (lixisenatide) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Adynovate - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.09.2020
,
-
Adynovate (antihemophilic factor [recombinant], pegylated) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Adzenys XR-ODT (amphetamine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Afinitor (everolimus) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Afrezza (insulin, human) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Afstyla - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.09.2020
,
-
Afstyla [Antihemophilic Factor (Recombinant), single chain] - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Aimovig (erenumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Aimovig (erenumab) Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Ajovy (fremanezumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Ajovy (fremanezumab) Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Aklief® (trifarotene) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Albenza (albendazole) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Albuterol tablets - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Alcensa Prior Authorization Notification
Last Published 01.14.2021
,
-
Altreno® (tretinoin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Alunbrig™ (brigatinib) Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Amitiza (lubiprostone) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Amitiza® (lubiprostone) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.25.2020
,
-
Ampyra® (dalfampridine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Amzeeq (minocycline 4% topical foam) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Androderm - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.08.2021
,
-
Androgel (topical androgens) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Annovera - PA_Notification - UnitedHealthcare Commerical Plans
Last Published 01.14.2021
,
-
Aptensio XR (methylphenidate extended-release) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Aptiom (eslicarbazepine acetate) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Aptiom (eslicarbazepine) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Arcalyst®(rilonacept) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Arikayce® (amikacin liposome inhalation suspension) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Arikayce® (amikacin liposome inhalation suspension) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Arymo ER (morphine sulfate extended-release) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Atralin™ (retinoic) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Aubagio® (teriflunomide) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Austedo® (deutetrabenazine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Austedo® (deutetrabenazine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Avinza (morphine sulfate extended-release capsules) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Avita® (retinoic) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Avonex® (interferon β-1a) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Axiron (topical androgens) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Ayvakit (avapritinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
,
-
Ayvakit (avapritinib) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Balversa® (erdafitinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Banzel (rufinamide) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Belbuca (buprenorphine hydrochloride film) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Belviq - CA, MD, & NY Regulatory Program Weight Loss - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 12.04.2019
-
Belviq XR (lorcaserin extended-release) - CA, MD, & NY Regulatory Program Weight Loss - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 12.04.2019
-
Benlysta® (belimumab) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Benznidazole - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
,
-
Benzphetamine - CA, MD, & NY Regulatory Program Weight Loss - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 12.04.2019
-
Berinert® (C1 esterase inhibitor [human]) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Berinert® (C1 esterase inhibitor, human) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Betaseron® (interferon β-1b) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Bethkis®(tobramycin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Bonjesta - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2018
-
Bosulif® (bosutinib) Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Braftovi™ (encorafenib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Briviact (brivaracetam) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Briviact (brivaracetam) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Brukinsa™ (zanubrutinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Bunavail and Suboxone Prior Authorization/Notification – UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Butrans (buprenorphine patch, extended-release) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Bydureon (exenatide extended-release) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 01.14.2021
,
-
Bydureon BCise (exenatide extended-release) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 01.08.2021
,
-
Byetta (exenatide) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Cablivi® (caplacizumab-yhdp) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Cabometyx (cabozantinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Calquence® (acalabrutinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Caplyta (lumateperone) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Caplyta (lumateperone) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Caprelsa® (vandetanib) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Carbaglu™ (carglumic acid) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Cardiovascular Disease Prevention - Prior Authorization - UnitedHealthcare Commercial Plans
Last Published 06.29.2020
,
-
Carospir (spironolactone) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Cayston®(aztreonam solution for inhalation) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Cequa™ (cyclosporine 0.09% ophthalmic solution) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Cequa™ (cyclosporine 0.09% ophthalmic solution) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.02.2020
Cequa,
-
Cerdelga® (eliglustat) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Cetrotide® (cetrorelix acetate) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Cetrotide® (cetrorelix acetate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Chantix (varenicline) – Tobacco Cessation (Applies to KY Fully Insured) – Supply Limit Override - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Chantix (varenicline) – Tobacco Cessation (Applies to NJ Fully Insured) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Chantix (varenicline) – Tobacco Cessation - Prior Authorization - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
Chantix (varenicline), Nicotrol Inhaler (nicotine inhalationsystem), and Nicotrol NS (nicotine nasal spray),
-
Cholbam™ (cholic acid) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Cimzia® (certolizumab) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Cimzia® (certolizumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Cinryze® (C1 esterase inhibitor, human) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Cinryze® (C1 esterase inhibitor, human) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Clomid (clomiphene citrate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Colchicine tablet (Colcrys authorized generic) - Prior Authorization/Excluded Drug - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Cometriq® (cabozantinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Compounds and Bulk Powders - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
-
Concerta (methylphenidate extended-release) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Continuous Glucose Monitoring - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
,
-
Continuous Glucose Monitors - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
,
-
Contrave (naltrexone and bupropion) - CA, MD, & NY Regulatory Program Weight Loss - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 12.04.2019
-
Copaxone® (glatiramer acetate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Copiktra® (duvelisib)- Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Corlanor® (ivabradine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Cosentyx™ (secukinumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Cosentyx™ (secukinumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Cotellic® (cobimetinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Cotempla XR-ODT (methylphenidate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Cystadrops (cysteamine) ophthalmic solution - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Cystaran® (cysteamine) ophthalmic solution - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 01.14.2021
,
-
Daliresp® (roflumilast) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Daraprim® (pyrimethamine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Daurismo™ (glasdegib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Daytrana (methyphenidate transdermal) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Depakote and Depakote ER (multisource brand/modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Depo-Pervera - PA_Notification - UnitedHealthcare Commerical Plans
Last Published 01.14.2021
,
-
Descovy® (emtricitabine/tenofovir alafenamide) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.31.2020
,
-
Desoxyn (methamphetamine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Devices - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Dexedrine (dextroamphetamine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Diabetic Meters and Test Strips Prior Authorization/Notification - UnitedHealthcare Commerical Plans
Last Published 12.09.2020
-
Diacomit (stiripentol) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Diclegis (doxylamine/pyridoxine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.26.2019
-
Diethylpropion - CA, MD, & NY Regulatory Program Weight Loss - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 12.04.2019
-
Differin® (adapalene) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Dojolvi™ (triheptanoin) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.09.2020
-
Dojolvi™ (triheptanoin) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.09.2020
-
Dolophine (methadone) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Doptelet (avatrombopag) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Drizalma Sprinkle (duloxetine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
,
-
Duopa (carbidopa/levodopa) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Dupixent® (dupilumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Dupixent® (dupilumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Duragesic (fentanyl transdermal) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Duzallo (lesinurad/allopurinol) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.26.2019
-
Dyanavel XR (amphetamine extended-release) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Egrifta® (tesamorelin for injection) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Eloctate [antihemophilic factor (recombinant), Fc fusion protein] - PA-Medical Necessity - UnitedHealth Commerical Plans
Last Published 12.09.2020
-
Eloctate® (antihemophilic factor recomninant, Fc fusion protein) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Emflaza® (deflazacort) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Emflaza® (deflazacort) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Emgality (galcanezumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Emgality (galcanezumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Emverm (mebendazole) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Enbrel (etanercept) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Enbrel® (etanercept) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.08.2021
,
-
Endari (L-glutamine Powder for Solution) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Endometrin® (progesterone vaginal insert) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.22.2021
,
-
Enspryng™ (satralizumab) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.09.2020
-
Enspryng™ (satralizumab) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.09.2020
-
Entresto (valsartan-sacubitril) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Entresto (valsartan-sacubitril) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Epaned (enalapril) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Epclusa (sofosbuvir/velpatasvir) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Epclusa (sofosbuvir/velpatasvir) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Epidiolex (cannabidiol) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Epidiolex (cannabidiol) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Ergomar (ergotamine) Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Erivedge® (vismodegib) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Erleada ® (apalutamide) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Esbriet® (pirfenidone) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Esbriet® (pirfenidone) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Esperoct (antihemophilic factor [recombinant], glycopegylated-exei) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.09.2020
-
Esperoct (antihemophilic factor [recombinant], glycopegylatedexei) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
,
-
Evekeo (amphetamine sulfate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Evekeo ODT (amphetamine sulfate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.30.2019
-
Evrysdi™ (risdiplam) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Evrysdi™ (risdiplam) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Evzio (naloxone hydrochloride) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Exalgo (hydromorphone extended-release) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Exforge - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Exjade® (deferasirox) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Extavia® (interferon β-1b) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Ezallor Sprinkle (rosuvastatin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
,
-
Fabior (tazarotene) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Farydak (panobinostat) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Fasenra® (benralizumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Fasenra™ (benralizumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
-
Felbatol (multisource brand/modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Fentanyl citrate powder - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Fentanyl Transdermal - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Fentora (fentanyl buccal tablet) - Prior Authorization / Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 02.14.2020
,
-
Fentora (fentanyl buccal tablet) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Ferriprox® (deferiprone) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Fintepla (fenfluramine) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Fintepla (fenfluramine)- PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Firazyr (icatibant) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Firazyr® (icatibant) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Firdapse® (amifampridine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Firdapse® (amifampridine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
FIRST™-ProgesteroneVGS (progesterone vaginal suppository compounding kit) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.22.2021
,
-
Flolipid (simvastatin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Focalin (dexmethylphenidate) and Focalin XR (dexmethylphenidate extended-release) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Follistim® AQ (follitropin beta) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Follistim® AQ (follitropin beta) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Fortamet (metformin extended-release, brand and generic) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.26.2019
-
Forteo™ (teriparatide) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Fortesta (topical andogens) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Fycompa (perampanel) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Fycompa (perampanel) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 01.08.2021
,
-
Galafold™ (migalastat) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Ganirelix Acetate - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Gattex® (teduglutide [rDNA origin]) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Genotropin® (somatropin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Genotropin® (somatropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Gilenya®(fingolimod) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Gilotrif® (afatinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Glatopa™ (glatiramer acetate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Gleevec® (imatinib mesylate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Gloperba (colchicine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
,
-
Glucophage XR (metformin extended-release, brand only) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.26.2019
-
Glumetza (metformin extended-release, brand and generic) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.26.2019
-
Gonal-f (follitropin alfa) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Gonal-f RFF (follitropin alfa) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Gonal-f™ (follitropin alfa)/Gonal-f™ RFF (follitropin alfa) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Gonococcal Ophthalmia Neonatorum Prevention - Prior Authorization/Regulatory - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Grastek (sublingual immunotherapy) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Grastek (sublingual Immunotherapy) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Haegarda (C1 esterase inhibitor Subcutaneous, human) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Haegarda - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Harvoni (ledipasvir/sofosbuvir) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Harvoni® (ledipasvir/sofosbuvir) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Health Care Reform Breast Cancer Prevention Copay Reduction Tamoxifen - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Health Care Reform Breast Cancer Prevention Copay Reduction-generic Aromatase Inhibitors (NY Only) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.23.2020
,
-
Hemlibra® (emicizumab-kxwh) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.09.2020
,
-
Hemlibra® (emicizumab-kxwh)- Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Hetlioz (tasimelteon) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Hetlioz® (tasimelteon) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
HIV Medications with Pre-exposure Prophylaxis (PrEP) Use Zero Dollar Cost Share for California - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.07.2021
,
-
HIV Pre-exposure Prophylaxis (PrEP) Zero Dollar Cost Share – generic tenofovir disoproxil fumarate 300 mg - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
HIV Pre-Exposure Prophylaxis Zero Dollar Cost Share-tenofovir- NY Only- Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.23.2020
,
-
Humatrope® (somatropin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Humatrope® (somatropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Humira (adalimumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Humira® (adalimumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Hycamtin® (topotecan hydrochloride) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Hysingla ER (hydrocodone extended-release) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Ibrance® (palbociclib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Ibsrela (tenapanor) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 02.26.2020
,
-
Ibsrela (tenapanor) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.25.2020
,
-
Iclusig® (ponatinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Idhifa® (enasidenib) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Ilumya™ (tildrakizumab-asmn) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Ilumya™ (tildrakizumab-asmn) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Imbruvica® (ibrutinib) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Inbrija® (levodopa inhalation powder) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Inbrija™ (levodopa inhalation powder) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Increlex (mecasermin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 02.26.2020
,
-
Increlex® (mecasermin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
Human Growth Hormone: Somatropin (Genotropin®*,Humatrope®*, Norditropin®*, NordiFlex®*, Nutropin AQ®,Nutropin AQ® NuSpin™, Omnitrope®*, Saizen®*, Zomacton®*,Zorbtive®, and Serostim®)Growth Stimulating Products : Mecasermin (Increlex®),
-
Infertility Medications (applies to Hawaii) - Prior Authorization/Regulatory - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Ingrezza® (valbenazine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Ingrezza® (valbenazine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Inlyta® (axitinib) - PA-Notification - UnitedHealthcare Commerial Plans
Last Published 12.01.2020
-
Inrebic® (fedratinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Interim New Product Criteria - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Intron-A (interferon alpha-2b) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Invokana (canagliflozin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Iressa® (gefitinib) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Isturisa® (osilodrostat) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Ixinity (coagulation factor IX recombinant) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Jakafi™ (ruxolitinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Jatenzo (testosterone) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Jivi (antihemophilic factor [recombinant], PEGylated-aucl) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.08.2020
-
Jivi (antihemophilic factor [recombinant], PEGylated-aucl) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Jornay PM (methylphenidate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Jublia (efinaconazole) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Juxtapid® (lomitapide) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Juxtapid™ (lomitapide) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Jynarque™ (tolvaptan) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Kadian (morphine sulfate sustained-release capsule) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Kalydeco® (ivacaftor) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Kalydeco®(ivacaftor) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Katerzia (amlodipine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 05.14.2020
,
-
Keppra and Keppra XR (multisource brand/modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Kerydin (tavaborole) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Keveyis® (dichlorphenamide) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Kevzara® (sarilumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Kevzara®(sarilumab) Injection - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Kineret® (anakinra) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Kisqali Femara Co-Pack PA/Notification
Last Published 01.14.2021
,
-
Kisqali® Femara® Co-Pack (ribociclib/letrozole) Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.26.2019
-
Kitabis® Pak (tobramycin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Korlym® (mifepristone) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Koselugo™ (selumetinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Kuvan® (sapropterin dihydrochloride) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Lamictal and Lamictal XR (multisource brand/modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Lamictal ODT (brand and generic) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Lazanda (fentanyl nasal spray) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Lazanda (fentanyl nasal spray) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Lenvima™ (lenvatinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Letairis® (ambrisentan) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Letairis® (ambrisentan) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
leuprolide acetate - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Levemir (insulin detemir) - Prior Authorization - UnitedHealthcare Commercial Plans
Last Published 10.05.2020
,
-
Lidocaine patch (Lidoderm) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Lokelma (sodium zirconium cyclosilicate) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Lonhala Magnair (glycopyrrolate nebulized solution) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Lonsurf (trifluridine/tipiracil) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Lorbrena (lorlatinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.25.2020
,
-
Lotronex* (alosetron)- Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Lovaza® (omega-3-acid ethyl esters) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Lucemyra (lofexidine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Lynparza™ (olaparib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Lyrica - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Mavenclad® (cladribine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Mavyret™ (glecaprevir/pibrentasvir) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Mavyret™ (glecaprevir/pibrentasvir) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Mayzent® (siponimod) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Mekinist® (trametinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Mektovi™ (binimetinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Menopur® (menotropins) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Menopur® (menotropins) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Metadate (methylphenidate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
Adderall* (amphetamine-dextroamphetamine mixed salts),Adderall XR (amphetamine-dextroamphetamine mixed saltsextended-release), Aptensio XR* (methylphenidate extendedrelease),Adzenys XR-ODT (amphetamine)*, Concerta(methylphenidate extended-release*), Cotempla XR-ODT*(methylphenidate), Daytrana* (methyphenidate transdermal),Desoxyn (methamphetamine), Dexedrine (dextroamphetamine),Dyanavel XR* (amphetamine extended-release), Evekeo(amphetamine sulfate)*, Focalin (dexmethylphenidate), FocalinXR* (dexmethylphenidate extended-release), Jornay PM(methylphenidate)*, Metadate (methylphenidate), Metadate CD(methylphenidate extended-release*), Methylin(methylphenidate), Methylin ER (methylphenidate extendedrelease),Mydayis* (dextroamphetamine-amphetamine mixedsalts), Procentra (dextroamphetamine), QuilliChew ER*(methylphenidate extended-release), Quillivant XR*(methylphenidate extended-release), Ritalin (methylphenidate),Ritalin SR (methylphenidate extended-release), Ritalin LA*(methylphenidate extended-release), Vyvanse(lisdexamfetamine), Zenzedi*(dextroamphetamine),
-
Metadate CD (methylphenidate extended release) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Methylin and Methylin ER (methylphenidate extended-release) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Migranal Nasal Spray (dihydroergotamine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Minocycline extended-release tablet (generic Solodyn) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Minolira (minocycline extended-release tablet) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Mirvaso (brimonidine gel) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Morphabond ER (morphine sulfate extended-release) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Morphine Sulfate (generic MS Contin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Motegrity (prucalopride) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Motegrity (prucalopride) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.25.2020
,
-
Movantik (naloxegol) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Movantik (naloxegol) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.25.2020
,
-
MS Contin (long-acting opioid analgesic) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Mulpleta® (lusutrombopag) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Multaq (dronedarone) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Myalept (metreleptin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Myalept® (metreleptin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Mydayis (dextroamphetamine-amphetamine mixed salts) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Mysoline (multisource brand/modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Mytesi™ (crofelemer) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Naprosyn (naproxen) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Natesto (topical androgens) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Natpara® (parathyroid hormone analog) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Natpara® (parathyroid hormone analog) - PA-Notification - UnitedHealthcare Commerial Plans
Last Published 12.01.2020
-
Nayzilam (midazolam) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Nerlynx® (neratinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Neurontin (multisource brand/modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
New & Therapeutic Equivalent Medications - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.07.2021
-
New & Therapeutic Equivalent Medications Excluded Drug - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.07.2021
-
Nexavar® (sorafenib tosylate) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Nexium (esomeprazole) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Nexletol (bempedoic acid) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Nexlizet (bempedoic acid/ezetimibe) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Nicotine Gum / Lozenge / Patch - Prior Authorization - UnitedHealthcare Commercial Plans
Last Published 03.12.2019
-
Nicotine Gum/Lozenge/Patch - Tobacco Cessation (Applies to KY Fully Insured) - Supply Limit Override - UnitedHealthcare Commercial Plans
Last Published 10.22.2020
,
-
Nicotine Gum/Lozenge/Patch - Tobacco Cessation (Applies to NJ Fully Insured) - UnitedHealthcare Commercial Plans
Last Published 10.22.2020
,
-
Nicotrol Inhaler (nicotine inhalation system) - Tobacco Cessation (Applies to KY Fully Insured) - Supply Limit Override - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Nicotrol Inhaler (nicotine inhalation system) - Tobacco Cessation (Applies to NJ Fully Insured) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Nicotrol Inhaler (nicotine inhalation system) – Tobacco Cessation - Prior Authorization - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Nicotrol NS (nicotine nasal spray) – Tobacco Cessation (Applies to KY Fully Insured) – Supply Limit Override - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Nicotrol NS (nicotine nasal spray) – Tobacco Cessation (Applies to NJ Fully Insured) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Nicotrol NS (nicotine nasal spray) – Tobacco Cessation - Prior Authorization - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Ninlaro® (ixazomib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Nityr™ (nitisinone) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Nocdurna (desmopressin acetate) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Noctiva (desmopressin acetate) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Non-Formulary Copay Adjustment Notification (applies to New Jersey) - Prior Authorization/Regulatory - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
,
-
NordiFlex® (somatropin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
NordiFlex® (somatropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Norditropin (somatropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Norditropin® (somatropin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Northera (droxidopa) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Nourianz (istradefylline) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 02.26.2020
,
-
Novarel® (chorionic gonadotropin)- Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Nubeqa® (darolutamide) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Nucala® (mepolizumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Nucala® (mepolizumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Nucynta ER (tapentadol extended-release) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Nuedexta (dextromethorphan/quinidine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Nuedexta (dextromethorphan/quinidine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Nuplazid (pimavanserin tartrate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Nurtec ODT (rimegepant) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 11.01.2020
,
-
Nurtec ODT (rimegepant)- Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Nutropin AQ® NuSpin™ (somatropin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Nutropin AQ® NuSpin™ (somatropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Nutropin®, Nutropin AQ® (somatropin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Nutropin®, Nutropin AQ® (somatropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
NuvaRing - PA_Notification - UnitedHealthcare Commerical Plans
Last Published 01.14.2021
,
-
Nuvigil (armodafinil) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Ocaliva (obeticholic acid) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Ocaliva (obeticholic acid) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Odactra (sublingual immunotherapy) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Odactra (sublingual immunotherapy) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Odomzo® (sonidegib) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Ofev® (nintedanib) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Ofev® (nintedanib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Olumiant® (baricitinib) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Olumiant® - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Omnitrope® (somatropin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Omnitrope® (somatropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Onfi (clobazam), Sabril (vigabatrin) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Onfi - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Opana ER (oxymorphone extended-release) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Opioid Containing Cough & Cold Medicines PA/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Opsumit® (macitentan) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.29.2020
-
Opsumit® (macitentan) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Oral Oncology Agents - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Oralair (sublingual immunotherapy) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Oralair (sublingual immunotherapy) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Orencia (abatacept) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Orencia® (abatacept) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Orenitram™ (treprostinil) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.29.2020
-
Orenitram™ (treprostinil) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Orfadin® (nitisinone) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Oriahnn (elagolix and estradiol/norethindrone) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Orilissa (elagolix) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Orkambi™ (lumacaftor/ivacaftor) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Orkambi™ (lumacaftor/ivacaftor) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.26.2019
-
OrthoEvra - PA_Notification - UnitedHealthcare Commerical Plans
Last Published 01.14.2021
,
-
Osphena (ospemifene) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 07.09.2020
-
Otezla® (apremilast) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Ovidrel® (choriogonadotropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Oxbryta™ (voxelotor) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Oxbryta™ (voxelotor) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Oxervate (cenegermin-bkbj) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Oxervate™ (cenegermin-bkbj) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Oxistat (oxiconazole) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.26.2019
-
Oxtellar (multisource brand-modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
OxyContin (oxycodone controlled-release) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Ozempic (semaglutide) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Ozobax (baclofen) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
,
-
Palforzia [Peanut (Arachis hypogaea) Allergen Powder-dnfp] - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
,
-
Palforzia [Peanut (Arachis hypogaea) Allergen Powder-dnfp] - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Palynziq™ - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Palynziq™ (pegvaliase-pqpz) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
PEG-Intron® (peginterferon alfa-2b) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Pegasys® (peginterferon alfa-2a) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Pemazyre™ (pemigatini) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Phendimetrazine - CA, MD, & NY Regulatory Program Weight Loss - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 12.05.2019
-
Phentermine - CA, MD, & NY Regulatory Program Weight Loss - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 12.05.2019
-
Phexxi (lactic acid, citric acid, and potassium bitartrate) vaginal gel - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.08.2020
-
Piqray® (alpelisib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Plegridy™ (peginterferon)- Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Pomalyst® (pomalidomide) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Praluent (alirocumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Praluent™ (alirocumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
,
-
Pregnyl® (chorionic gonadotropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Prevacid SoluTab (lansoprazole) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Prevymis™ (letermovir) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Procentra (dextroamphetamine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Procysbi® (cysteamine bitartrate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Progesterone bulk powder - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 12.09.2020
,
-
Promacta® (eltrombopag) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Provigil (modafanil) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Prudoxin (doxepin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Pulmozyme® (dornase alfa) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Purixan (mercaptopurine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.29.2019
-
Qbrelis (lisinopril) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Qinlock™ (ripretinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Qsymia (phentermine, topiramate extended-release) - CA, MD, & NY Regulatory Program Weight Loss - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 12.05.2019
-
Qudexy XR (multisource brand/modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
QuilliChew ER (methylphenidate extended-release) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Quillivant XR (methylphenidate extendedrelease) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Ragwitek (sublingual immunotherapy) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Ragwitek (sublingual immunotherapy) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Ravicti™ (glycerol phenylbutyrate oral liquid) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Ravicti™ (glycerol phenylbutyrate oral liquid) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Rebif® (interferon β-1a) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Regranex® (becaplermin gel) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Relistor (methylnaltrexone bromide) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Repatha™ (evolocumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
,
-
Repatha™ (evolocumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Restasis (cyclosporine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Retin-A® (tretinoin) / Retin-A Micro® (tretinoin microspheres) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Revatio® (sildenafil citrate) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.29.2020
-
Revatio® Solution (sildenafil citrate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Revlimid (lenalidomide) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 07.29.2019
-
Rexulti (brexpiprazole) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Reyvow (lasmiditan) - Prior Authorization - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Reyvow (lasmiditan) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Reyvow (lasmiditan) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Rhofade (oxymetazoline cream) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Rinvoq™ (upadacitinib) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Rinvoq™ (upadacitinib) extended-release tablets - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Ritalin (methylphenidate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Ritalin LA (methylphenidate extended-release) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Ritalin SR (methylphenidate extended-release) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Rozlytrek™ (entrectinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Rubraca® (rucaparib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Ruconest (C1 esterase inhibitor recombinant) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 09.26.2019
-
Ruconest® (C1 esterase inhibitor [recombinant]) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Rukobia (fostemsavir) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Ruzurgi® (amifampridine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Rybelsus (semaglutide) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Rydapt™ (midostaurin) Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Sabril (vigabatrin) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Saizen® (somatropin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Saizen® (somatropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Samsca (tolvaptan) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
-
Sandostatin® (octreotide acetate) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Saxenda (liraglutide) - CA, MD, & NY Regulatory Program Weight Loss - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 12.05.2019
-
Selzentry® (maraviroc) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Sensipar (cinacalcet) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Serostim® (somatropin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Serostim® (somatropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Signifor® (pasireotide diaspartate) - PA-Notification - UnitedHealth Commerical Plans
Last Published 12.01.2020
-
Siliq (brodalumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Siliq™ (brodalumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Simponi® (golimumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Simponi® (golimumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Skyrizi™ (risankizumab-rzaa) injection - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Skyrizi™ (risankizumab-rzaa) injection - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Slynd (drospirenone) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Sodium Phenylbutyrate (Buphenyl) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.25.2020
-
Solaraze (diclofenac 3% gel) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Solodyn (generic minocycline extended-release tablet) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Somavert® (pegvisomant) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Somavert®(pegvisomant) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Sotylize (sotalol) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Sovaldi® (sofosbuvir) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Sovaldi® (sofosbuvir) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Spravato™ (esketamine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Spravato™ (esketamine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Spritam (multisource brand-modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Sprycel® (dasatinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Sprycel®(dasatinib) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Stelara™ (ustekinumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Stelara™ (ustekinumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 12.04.2019
-
Stendra (avanafil) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
,
-
Stivarga® (regorafenib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Strensiq® (asfotase alfa) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Strensiq™ (asfotase alfa) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Striant (topical androgens) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Subsys (fentanyl sublingual spray) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Subsys (fentanyl sublingual spray) - Prior Notification/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.29.2020
-
Sucraid (sacrosidase) oral solution - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Sucraid (sacrosidase) oral solution - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.25.2020
,
-
Sunosi™ (solriamfetol) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Sunosi™ (solriamfetol) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Sutent® (sunitinib malate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Sylatron™ (peginterferon alfa-2b) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Symdeko (texacaftor / ivacaftor) Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Symdeko® (tezacaftor/ivacaftor) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
,
-
Sympazan (clobazam)* - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
,
-
Symproic (maldemedine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.25.2020
,
-
Syndros (dronabinol) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Synribo® (omacetaxine)- Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Syprine (trientine hydrochloride) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Tabrecta™ (capmatinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Tafinlar® (dabrafenib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
-
Tagrisso™ (osimertinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Takhzyro™ (lanadelumab-flyo) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
-
Takhzyro™ (lanadelumab-flyo) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.29.2020
-
Taltz (ixekizumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Taltz™ (ixekizumab) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Talzenna™ (talazoparib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.25.2020
,
-
Tarceva® (erlotinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
Tasigna® (nilotinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
-
TavalisseTM (fostamatinib) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
-
Tazorac (tazarotene) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Tazorac® (tazarotene) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Tazverik™ (tazemetostat)- Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
,
-
Tecfidera™ (dimethyl fumarate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
,
-
Technivie (ombitasvir, paritaprevir, ritonavir tablets) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.29.2019
-
Tegsedi - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.29.2019
-
Tegsedi™ (inotersen) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.29.2020
-
Temodar PA/Notification
Last Published 01.14.2021
,
-
Testim (topical androgens) - Pror Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Testosterone - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 05.01.2019
-
Tetrabenazine (Xenazine®) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.25.2020
,
-
Thalomid® (thalidomide) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
,
-
Tibsovo® (ivosidenib) Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
-
Tiglutik (riluzole) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
Tirosint-Sol (levothyroxine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
-
TOBI™ Nebulizer Solution and TOBI® Podhaler™ (tobramycin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
-
Topamax (multisource brand-modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Tracleer® (bosentan) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.29.2020
-
Tracleer® (bosentan) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
,
-
Tremfya® (guselkumab) - PA-Notification - UnitedHealthcare Commercial Plans
Last Published 12.01.2020
-
Tremfya® (guselkumab) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.08.2021
,
-
Trikafta - Prior Authorization/Medical Necessity Medication - UnitedHealthcare Commercial Plans
Last Published 11.25.2019
-
Trikafta - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.25.2019
-
Trileptal (multisource brand-modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Trintellix (vortioxetine) - Prior Authorization - UnitedHealthcare Commercial Plans
Last Published 08.10.2018
-
Trokendi XR (multisource brand-modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
,
-
Trulance (plecanatide) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.25.2020
,
-
Trulance (plecanatide) Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 02.26.2020
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Trulicity (dulaglutide) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
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Tukysa™ (tucatinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
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Turalio™ (pexidartinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
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Twirla - PA_Notification - UnitedHealthcare Commerical Plans
Last Published 01.14.2021
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Tykerb® (lapatinib) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
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Tymlos™ (abaloparatide) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
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Tyvaso® (treprostinil) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.29.2020
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Tyvaso® (treprostinil) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
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Ubrelvy (ubrogepant) - Prior Authorization - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
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Ubrelvy (ubrogepant) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
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Ubrelvy (ubrogepant) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
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Uptravi® (selexipag) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.29.2020
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Uptravi® (selexipag) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
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Valchlor® gel for topical use (mechlorethamine) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
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Valtoco (diazepam) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
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Vanatol LQ (butalbital, acetaminophen and caffeine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
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Vascepa® (icosapent ethyl) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.08.2021
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Vascepa® (icosapent ethyl) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
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Vecamyl (mecamylamine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
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Veltassa (patiromer) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
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Venclexta™ (venetoclax) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Ventavis (iloprost) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
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Ventavis® (iloprost) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.29.2020
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Vermox (mebendazole) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Verzenio® (abemaciclib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
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Viberzi (eluxadoline) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
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Victoza (liraglutide) - PA-Notification - UnitedHealthcare Commercial Plans
Last Published 12.31.2020
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Viekira Pak (ombitasvir, paritaprevir, ritonavir, dasabuvir tablets) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
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Viekira Pak (ombitasvir, paritaprevir, ritonavir, dasabuvir tablets) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 05.06.2019
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Vimpat (lacosamide) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
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Vimpat (lacosamide) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
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Vitrakvi® (larotrectinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
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Vizimpro® (dacomitinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
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Vogelxo (topical androgens) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
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Vosevi™ (sofosbuvir, velpatasvir, and voxilaprevir) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 02.26.2020
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Vosevi™ (sofosbuvir, velpatasvir, and voxilaprevir) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
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Votrient™ (pazopanib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
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Vumerity™ (diroximel fumarate - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
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Vumerity™ (diroximel fumarate) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
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Vyleesi (bremelanotide) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 01.29.2020
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Vyndamax™ (tafamidis) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
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Vyndamax™ (tafamidis)- Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
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Vyndaqel® (tafamidis meglumine) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
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Vyndaqel® (tafamidis meglumine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
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Vyvanse (lisdexamfetamine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
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Wakix® (pitolisant) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
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Wakix® (pitolisant) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
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Xalkori® (crizotinib)- Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
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Xatmep (methotrexate) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
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Xcopri (cenobamate) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
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Xcopri (cenobamate) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.31.2020
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Xeljanz®/Xeljanz® XR (tofacitinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
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Xeljanz®/Xeljanz® XR/Xeljanz® Oral Solution (tofacitinib) - PA_Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 01.06.2021
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Xenical (orlistat) - CA, MD, & NY Regulatory Program Weight Loss - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 12.05.2019
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Xermelo™ (telotristat ethyl) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
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Xifaxan (rifaximin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Xiidra (lifitegrast 5% ophthalmic solution) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Xiidra®(lifitegrast 5% ophthalmic solution) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Ximino (minocycline extended-release capsule) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
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Xospata® (gilteritinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
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Xpovio™ (selinexor) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 01.28.2020
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Xtampza ER (oxycodone extended-release) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Xtandi® (enzalutamide) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
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Xuriden® (uridine triacetate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
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Xyntha (antihemophilic factor [recombinant]) - PA-Medical Necessity - UnitedHealthcare Commerical Plans
Last Published 12.09.2020
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Xyosted - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
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Xyrem® (sodium oxybate) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
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Xyrem® (sodium oxybate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
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Yonsa (abiraterone acetate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.16.2020
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Yupelri (revefenacin inhalation solution) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
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Zegerid (omeprazole, sodium bicarbonate) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 04.17.2020
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Zejula™ (niraparib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
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Zelboraf™ (vemurafenib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.01.2020
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Zelnorm (tegaserod) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 02.26.2020
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Zelnorm (tegaserod) - Prior Authorization/Notification - UnitedHealthcare Commercial
Last Published 02.25.2020
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Zenzedi (dextroamphetamine) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 11.01.2020
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Zepatier (elbasvir, grazoprevir) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Zepatier (elbasvir, grazoprevir) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 04.30.2019
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Zohydro ER (hydrocodone extended-release) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Zomacton® (somatropin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Zomacton® (somatropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Zonalon (doxepin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 03.30.2020
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Zonegran (multisource brand-modified release anticonvulsants) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 10.01.2020
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Zorbtive® (somatropin) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Zorbtive® (somatropin) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Zovirax Ointment (acyclovir) - Prior Authorization/Medical Necessity - UnitedHealthcare Commercial Plans
Last Published 11.26.2019
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ZTLido - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 06.12.2020
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Zurampic (lesinurad) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 02.27.2019
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Zydelig® (idelalisib) - PA-Notification - UnitedHealthcare Commerical Plans
Last Published 12.01.2020
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Zykadia™ (ceritinib) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.17.2020
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Zytiga™ (abiraterone acetate) - Prior Authorization/Notification - UnitedHealthcare Commercial Plans
Last Published 08.01.2020
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