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Your 2021 Premium Standard Formulary
A medication may be excluded from coverage under your pharmacy benefit when it works the same as or similar to another prescription or over-the-counter (OTC)
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Methods for Evaluating the Opioid Analgesic Risk
Dec 11, 2020 DuragesicTM (fentanyl) agents, Suboxone/Subutex, and DemerolTM will be denied for chronic deterrent form for which there is an FDA-approved
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AHCCCS Fee-For-Service Program Acute Care/LTC Drug
The OptumRx-AHCCCS Prior Authorization Request Form is available on the AHCCCS website at BUPRENORPHINE HCL-NALOXONE HCL DIHYDRATE FILM. SUBOXONE FILM. Brand
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