| Migraine Quantity Limit |
Amerge (naratriptan), Frova (frovatriptan), Imitrex (sumatriptan) tablets and nasal spray, Onzetra (sumatriptan), Relpax (eletriptan), Tosymra (sumatriptan), Zembrace SymTouch (sumatriptan), Zomig (zolmitriptan) tablets, Zomig-ZMT (zolmitriptan), Axert (almotriptan), Brekiya (dihydroergotamine mesylate) injection, D.H.E. 45 (dihydroergotamine mesylate) injection, Imitrex (sumatriptan) injection, Maxalt (rizatriptan), Maxalt-MLT (rizatriptan), Migranal (dihydroergotamine mesylate), Nurtec ODT (rimegepant sulfate), RizaFilm (rizatriptan), Symbravo (meloxicam/rizatriptan), Treximet (sumatriptan/naproxen), Trudhesa (dihydroergotamine mesylate), Ubrelvy (ubrogepant), Zavzpret (zavegepant), Zomig (zolmitriptan) nasal spray |
| Miplyffa (arimoclomol) |
Miplyffa (arimoclomol) |
| Mitapivat Products |
Aqvesme (mitapivat), Pyrukynd (mitapivat) |
| Modeyso (dordaviprone) |
Modeyso (dordaviprone) |
| Molluscum Contagiosum Agents |
Ycanth (cantharidin solution), Zelsuvmi (berdazimer) topical gel |
| Monoclonal Antibody Agents for Alzheimer's Disease - PA, NF |
Aduhelm (aducanumab-avwa), Kisunla (donanemab-azbt), Leqembi (lecanemab-irmb intravenous solution), Leqembi IQLIK (lecanemab-irmb subcutaneous solution) |
| Mulpleta (lusutrombopag) |
Mulpleta (lusutrombopag) |
| Multiple Sclerosis (MS) Agents - PA, NF |
Aubagio (teriflunomide), Avonex (interferon beta-1a), Bafiertam (monomethyl fumarate), Betaseron (interferon beta-1b), Briumvi (ublituximab-xiiy), Copaxone (glatiramer acetate), Glatopa (glatiramer acetate), Kesimpta (ofatumumab), Mayzent (siponimod), Plegridy (peginterferon beta-1a), Ponvory (ponesimod), Rebif (interferon beta-1a), Vumerity (diroximel fumarate), Lemtrada (alemtuzumab), Mavenclad (cladribine), Ocrevus (ocrelizumab), Ocrevus Zunovo (ocrelizumab), Tascenso ODT (fingolimod) |
| Myalept (metreleptin for injection) |
Myalept (metreleptin for injection) |
| Myobloc (rimabotulinumtoxin B) |
Myobloc (rimabotulinumtoxin B) |
| Myqorzo (aficamten) |
Myqorzo (aficamten) |
| Naglazyme (galsulfase injection) |
Naglazyme (galsulfase injection) |
| Namzaric (memantine/donepezil) |
Namzaric (memantine and donepezil hydrochloride) |
| Nasal Steroids |
Xhance (fluticasone propionate) |
| Nascobal (cyanocobalamin) Spray- Non Formulary |
Nascobal (cyanocobalamin) Spray |
| Natalizumab Products |
Tysabri (natalizumab), Tyruko (natalizumab-sztn) |
| Natural Thyroid Products - PA, NF |
Amerithroid (thyroid), Armour Thyroid (thyroid, porcine), EvexiTHROID (thyroid), Niva Thyroid (thyroid, porcine), NP Thyroid (thyroid), RenThyroid (levothyroxine and liothyronine), Thyroid (thyroid) |
| Nemluvio (nemolizumab-ilto) |
Nemluvio (nemolizumab-ilto) |
| Nereus (tradipitant) |
Nereus (tradipitant) |
| Nerlynx (neratinib) |
Nerlynx (neratinib) |
HEALTHY LIVING