| Continuous Glucose Monitors, Sensors, and Transmitters - PA, NF |
BIGFOOT UNITY PROGRAM KIT, DEXCOM G6 RECEIVER, DEXCOM G6 SENSOR, DEXCOM G6 TRANSMITTER, DEXCOM G7 15 DAY SENSOR, DEXCOM G7 RECEIVER, DEXCOM G7 SENSOR, ENLITE GLUCOSE SENSOR, EVERSENSE 365 SENSOR/HOLDER, EVERSENSE 365 SMART TRANSMITTER, EVERSENSE E3 SENSOR/HOLDER, EVERSENSE E3 SMART TRANSMITTER, EVERSENSE SENSOR/HOLDER, EVERSENSE SMART TRANSMITTER, FREESTYLE LIBRE 14 DAY/READER/FLASH MONITORING SYSTEM, FREESTYLE LIBRE 14 DAY/SENSOR/FLASH MONITORING SYSTEM, FREESTYLE LIBRE 2 PLUS/SENSOR/FLASH GLUCOSE MONITOR SYSTEM, FREESTYLE LIBRE 2/READER/FLASH GLUCOSE MONITORING SYSTEM, FREESTYLE LIBRE 2/SENSOR/FLASH GLUCOSE MONITORING SYSTEM, FREESTYLE LIBRE 3 PLUS/SENSOR/GLUCOSE MONITORING SYSTEM, FREESTYLE LIBRE 3/READER/FLASH GLUCOSE MONITORING SYSTEM, FREESTYLE LIBRE 3/SENSOR/FLASH GLUCOSE MONITORING SYSTEM, GUARDIAN 4 GLUCOSE SENSOR, GUARDIAN 4 TRANSMITTER KIT, GUARDIAN CONNECT TRANSMITTER, GUARDIAN CONNECT TRANSMITTER KIT, GUARDIAN LINK 3, GUARDIAN LINK 3 TRANSMITTER KIT, GUARDIAN SENSOR (3), GUARDIAN SENSOR 3, MINIMED 630G GUARDIAN PRESS STARTER TRANSMITTER KIT, MINIMED GUARDIAN LINK 3 TRANSMITTER, SIMPLERA SENSOR, SIMPLERA SYNC SENSOR, SIMPLERA SYSTEM |
| Contraceptives for Non-Contraceptive Use |
Contraceptives |
| Copper Chelating Agents - PA, NF |
Cuprimine (penicillamine), Cuvrior (trientine tetrahydrochloride), Syprine (trientine) |
| Cosentyx (secukinumab) - NF |
Cosentyx IV (secukinumab), Cosentyx SC (secukinumab) |
| Cotellic (cobimetinib) |
Cotellic (cobimetinib) |
| Cotellic (cobimetinib) |
Cotellic (cobimetinib) |
| Coverage of Drugs for Off-Label or Non-FDA Approved Indications |
|
| Daliresp (roflumilast) |
Daliresp (roflumilast) |
| Daraprim (pyrimethamine) |
Daraprim (pyrimethamine) |
| Dasatinib products - PA, NF |
Sprycel (dasatinib), Phyrago (dasatinib) |
| DAW Override |
DAW override, Dispense, written |
| Deferasirox products |
Exjade (deferasirox), deferasirox tablet, Jadenu (deferasirox), Jadenu Sprinkle (deferasirox) |
| Deflazacort products - NF |
Brand Emflaza (deflazacort), generic deflazacort |
| Demser (metyrosine) |
Demser (metyrosine) |
| Denosumab 120mg Products - PA, NF |
Xgeva (denosumab), Wyost (Denosumab-bbdz), Osenvelt (denosumab-bmwo), Bomyntra (Denosumab-bnht), Bilprevda (denosumab-nxxp), Xtrenbo (denosumab-qbde), Aukelso (denosumab-kyqq) |
| Denosumab 60mg Products |
Enoby (denosumab-qbde) |
| Denosumab 60mg Products |
Enoby (denosumab-qbde) |
| Diabetic GLP-1's |
Bydureon BCise (exenatide extended-release), Byetta (exenatide injection), Mounjaro (tirzepatide), Ozempic (semaglutide), Rybelsus (semaglutide), Trulicity (dulaglutide), Victoza (liraglutide injection) |
| Diacomit (stiripentol) |
Diacomit (stiripentol) |
| Dibenzyline (phenoxybenzamine) |
Dibenzyline (phenoxybenzamine) |