| Daurismo (glasdegib) |
Daurismo (glasdegib) |
| Dasatinib products - PA, NF |
Sprycel (dasatinib), Phyrago (dasatinib) |
| Daraprim (pyrimethamine) |
Daraprim (pyrimethamine) |
| Daliresp (roflumilast) |
Daliresp (roflumilast) |
| Crysvita (burosumab-twza) |
Crysvita (burosumab-twza) |
| Crinone Gel 8% Quantity Limit |
Crinone Gel 8% |
| Crenessity (crinecerfont) |
Crenessity (crinecerfont) |
| Coverage of Drugs for Off-Label or Non-FDA Approved Indications |
|
| Cotellic (cobimetinib) |
Cotellic (cobimetinib) |
| Cosentyx (secukinumab) - PA, NF |
Cosentyx IV (secukinumab), Cosentyx SC (secukinumab) |
| Cosela (trilaciclib) - PA, NF |
Cosela (trilaciclib) |
| Copper Chelating Agents - PA, NF |
Cuprimine (penicillamine), Depen (penicillamine), Cuvrior (trientine tetrahydrochloride), Syprine (trientine) |
| Copiktra (duvelisib) |
Copiktra (duvelisib) |
| Contraceptives for Non-Contraceptive Use |
Contraceptives |
| Continuous Glucose Monitors, Sensors, Transmitters, and Components - PA, NF |
*CONTINUOUS BLOOD GLUCOSE SYSTEM RECEIVER***, *CONTINUOUS BLOOD GLUCOSE SYSTEM SENSOR***, *CONTINUOUS BLOOD GLUCOSE SYSTEM TRANSMITTER***, BIGFOOT UNITY PROGRAM KIT, DEXCOM G6 RECEIVER, DEXCOM G6 SENSOR, DEXCOM G6 TRANSMITTER, DEXCOM G7 15 DAY SENSOR, DEXCOM G7 RECEIVER, DEXCOM G7 SENSOR, 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/GLUCOSE MONITORING SYSTEM, FREESTYLE LIBRE 3/SENSOR/GLUCOSE MONITORING SYSTEM |
| Constipation Agents |
Amitiza (lubiprostone), Linzess (linaclotide), Motegrity (prucalopride), Movantik (naloxegol), Relistor (methylnaltrexone bromide) injection, Relistor (methylnaltrexone bromide) tablet, Symproic (naldemedine), Trulance (plecanatide) |
| Compounded Drugs |
Acyclovir 5% Topical Ointment, Arthrotec, Bulk powders, Cambia, Compound, COMPOUNDED DRUGS, Compounds, Cutivate, Diclofenac bulk powder, Diclofenac Ophthalmic Solution, Diclofenac tablets, Doxepin 5% Topical Cream, Dyloject, Elocon, Flector, Flurbiprofen bulk powder, Flurbiprofen tablets, Fluticasone bulk powder, Gabapentin bulk powder, Gralise, Horizant, Ketalar, Ketamine bulk powder, Ketoprofen bulk powder, Ketoprofen capsules, Ketoprofen extended-release capsules, Levocetirizine bulk powder, Mometasone powder, Neurontin, Ocufen, Pennsaid, Prudoxin 5% Topical Cream, Rexaphenac, Solaraze, Voltaren, Xyzal, Zipsor Liquid Filled Capsules, Zonalon 5% Topical Cream, Zorvolex Oral Capsules, Zovirax 5% Topical Ointment |
| Commercial MEDLIMIT CDUR Criteria |
cumulative, MED, MEE, morphine, opioid |
| Cometriq (cabozantinib) |
Cometriq (cabozantinib) |
| Colony-Stimulating Factors (CSFs) - PA, NF |
Armlupeg (pegfilgrastim-unne), Fulphila (pegfilgrastim-jmdb, G-CSF), Nyvepria (pegfilgrastim-apgf, G-CSF), Granix (tbo-filgrastim, G-CSF), Leukine (sargramostim, GM-CSF), Neulasta, Neulasta Onpro (pegfilgrastim, G-CSF), Fylnetra (pegfilgrastim-pbbk), Stimufend (pegfilgrastim-fpgk), Ziextenzo (pegfilgrastim-bmez, G-CSF), Neupogen (filgrastim, G-CSF), Nypozi (filgrastim-txid), Nivestym (filgrastim-aafi, G-CSF), Zarxio (filgrastim-sndz, G-CSF), Releuko (filgrastim-ayow), Rolvedon (eflapegrastim-xnst), Ryzneuta (efbemalenograstim alfa-vuxw), Udenyca (pegfilgrastim-cbqv, G-CSF) |
HEALTHY LIVING