WebC. Changes to the Highmark Core Formulary D. Changes to the Highmark National Select Formulary E. Updates to the Pharmacy Utilization Management Programs 1. Prior Authorization Program 2. Managed Prescription Drug Coverage (MRxC) Program 3. Formulary Program 4. Quantity Level Limit (QLL) Programs. Section II. Highmark … WebDec 22, 2024 · Highmark Wholecare (Medicaid Primary) 004336 MCAIDADV RX2338 Highmark Wholecare (Medicaid Secondary to Medicare) 012114 MCAIDADV RX2338 Highmark Wholecare (Medicaid Secondary to Commercial Insurance) 013089 MCAIDADV RX2338: Keystone First Community Health Choices: 019595: 07630000: N/A: Keystone …
Published on February 3, 2024 Section I. Highmark …
WebHighmark Wholecare Pharmacy Division Phone 800-392-1147 Fax 888-245-2049 . Effective 1/9/2024 . b. Has a history of one of the following: i. Failure to achieve goal LDL-C or percentage reduction of LDL-C while adherent to treatment with maximally tolerated doses of 2 different high-intensity statins for ≥3 consecutive months each, ii. Web2024 Custom Drug List This list is current as of 08/17/22 Trade Name Dosage Form Strength Tier Drug Description Budesonide *generic equivalent of how is hemp produced
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