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- Search for your medicine by name or class
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December 2024
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
November 2024
Additions:
- None
Removals:
- None
Other Updates:
- None
October 2024
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
September 2024
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
August 2024
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
July 2024
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
June 2024
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
May 2024
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
April 2024
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
March 2024
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
February 2024
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
January 2024
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
December 2023
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
November 2023
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
October 2023
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
September 2023
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
August 2023
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
July 2023
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
June 2023
Additions:
- No updates
Removals:
- No updates
Other Updates:
- Mavyret Pellet Pack 50-20 mg (Quantity Level Limit, Removed Prior Authorization)
- Mavyret Tablet 100-40 mg (Quantity Level Limit, Removed Prior Authorization)
- Sofosbuvir-Velpatasvir Tablet 400-100 mg (Quantity Level Limit, Removed Prior Authorization)
May 2023
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
April 2023
Additions:
- No updates
Removals:
- *Calcium Alginate Wound Dressing***
- *Neomycin-Bacitracin-Polymyxin with Lidocaine Ointment 4%***
- *Pediatric Multiple Vitamin with Minerals & C Chewable Tablet**
- *Pediatric Multiple Vitamins with Iron Drops 10 mg/mL**
- Cholecalciferol Drops 10 mcg/0.025 mL (400 Unit/0.025ml)
- Cholecalciferol Drops 125 mcg/ mL (5000 Unit/mL)
- Cholecalciferol Drops 400 Unit/0.028 mL (Per Drop)
- Formaldehyde Solution 10%
- Loperamide Hydrochloride Liquid 1 mg/5 mL (0.2 mg/mL)
- Magnesium Salicylate Tablet 500 mg
- Magnesium Tablet 400 mg
- Phenylephrine-Shark Liver Oil-Mineral oil-Petrolatum Ointment 0.25-3-14-71.9%
- Psyllium Capsule 400 mg
- Psyllium Powder 30%
- Psyllium Powder 30.9%
- Psyllium Powder 33%
- Psyllium Powder 49%
- Uridine Triacetate Oral Granules Packet 10 gm
Other Updates:
- Betamethasone Dipropionate Ointment 0.05% (Quantity Level Limit)
- Fluocinolone Acetonide Cream 0.025% (Quantity Level Limit)
- Fluocinolone Acetonide Ointment 0.025% (Quantity Level Limit)
- Fluconazole Tablet 150 mg (Quantity Level Limit)
- Freestyle 14 Sensor Libre (Quantity Level Limit)
- Freestyle 14 Sensor Libre 2 (Quantity Level Limit)
- Freestyle 14 Sensor Libre 3 (Quantity Level Limit)
- *Pediatric Multiple Vitamins with Fluoride Chewable Tablet 0.25 mg***
- *Pediatric Multiple Vitamins with Fluoride Chewable Tablet 0.5 mg***
- *Pediatric Multiple Vitamins with Fluoride Chewable Tablet 1 mg***
March 2023
Additions:
- Guaifenesin-Codeine Solution 100-6.33 mg/5 mL (Quantity Level Limit, Age Limit)
Removals:
- No updates
Other Updates:
- No updates
February 2023
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
January 2023
Additions:
- No updates
Removals:
- Testosterone Td Gel 40.5 Mg/2.5 GM (1.62%)
Other Updates:
- Testosterone Td Soln 30 Mg/Act (Prior Authorization Required)
- Testosterone Td Gel 25 Mg/2.5gm (1%) (Prior Authorization Required)
- Testosterone Td Gel 50 Mg/5gm (1%) (Prior Authorization Required)
- Testosterone Td Gel 12.5 Mg/Act (1%) (Prior Authorization Required)
- Testosterone Td Gel 20.25 Mg/Act (1.62%) (Prior Authorization Required)
- Testosterone Td Gel 10mg/Act (2%) (Prior Authorization Required)
- Testosterone Cypionate Im Inj In Oil 100 Mg/Ml (Prior Authorization Required)
- Testosterone Cypionate Im Inj In Oil 200 Mg/Ml (Prior Authorization Required)
- Testosterone Enanthate Im Inj In Oil 200 Mg/Ml (Prior Authorization Required)
December 2022
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
November 2022
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
October 2022
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
September 2022
Additions:
- No updates
Removals:
- No updates
Other Updates:
- Ceftriaxone Sodium For Inj 1 Gm (Changed Quantity Level Limit)
- Ceftriaxone Sodium For Inj 2 Gm (Changed Quantity Level Limit)
- Ceftriaxone Sodium For Inj 250 Mg (Changed Quantity Level Limit)
- Ceftriaxone Sodium For Inj 500 Mg (Changed Quantity Level Limit)
August 2022
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
July 2022
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
June 2022
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
May 2022
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
April 2022
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
March 2022
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
February 2022
Additions:
- Levocetirizine 5mg Tablets (Quantity Limit)
- Dexcom G5 Mis Transmit (Quantity Limit)
- Dexcom G6 Mis Transmit (Quantity Limit)
- G5/G4 Plati Mis Sensor (Quantity Limit)
- Dexcom G6 Mis Sensor (Quantity Limit)
- Dexcom G5 Mis Receiver (Quantity Limit)
- Dexcom G6 Mis Receiver (Quantity Limit)
- Freestyle 10 Sen Libre (Quantity Limit)
- Freestyle 10 Reader Libre (Quantity Limit)
- Freestyle 14 Sen Libre (Quantity Limit)
- Freestyle 14 Reader Libre (Quantity Limit)
- Freestyle 14 Sen Libre 2 (Quantity Limit)
- Freestyle 14 Reader Libre 2 (Quantity Limit)
Removals:
- Diphenhydramine elixir
Other Updates:
- Medroxyprogesterone Acetate 150mg/mL Syringe (Quantity Limit updated)
- Diphenhydramine liquid (Quantity Limit updated)
- Promethazine syrup (Quantity Limit updated)
January 2022
Additions:
- No updates
Removals:
- Nozin Nasal Kit Sanitize
- Calcium 600 Tab +D
Other Updates:
- No updates
December 2021
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
November 2021
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
October 2021
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
September 2021
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
August 2021
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
July 2021
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
June 2021
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
May 2021
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
April 2021
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
March 2021
Additions:
- Hizentra Inj 1gm/5ml (Prior Authorization)
- Hizentra Inj 2gm/10ml (Prior Authorization)
- Hizentra Inj 2gm/10ml (Prior Authorization)
- Hizentra Inj 4gm/20ml (Prior Authorization)
- Hizentra Sol 20% (Prior Authorization)
- Hizentra Via 10gm/50m (Prior Authorization)
- Hizentra Via 1gm/5ml (Prior Authorization)
- Immune Globulin (Human) Iv Or Subcutaneous Soln 1 Gm/10 (Prior Authorization)
- Immune Globulin (Human) Iv Or Subcutaneous Soln 10 Gm/1 (Prior Authorization)
- Immune Globulin (Human) Iv Or Subcutaneous Soln 20 Gm/2 (Prior Authorization)
- Immune Globulin (Human) Iv Or Subcutaneous Soln 5 Gm/50 (Prior Authorization)
- Privigen Inj 10grams (Prior Authorization)
- Privigen Inj 40grams (Prior Authorization)
- Privigen Inj 5 Grams (Prior Authorization)
- Privigen Via 20grams (Prior Authorization)
Other Updates:
- Arnuity Elpt Inh 100mcg (Quantity Limit Added)
- Arnuity Elpt Inh 200mcg (Quantity Limit Added)
- Arnuity Elpt Inh 50mcg (Quantity Limit Added)
- Bevespi Aer 9-4.8mcg (Quantity Limit Added)
- Levofloxacin Sol 25mg/Ml (Quantity Limit, Age Limit Added)
- Neomycin-Polymyxin-Dexamethasone Ophth Oint 0.1% (Quantity Limit Added)
- Phenylephrine Hcl Ophth Soln 2.5% (Quantity Limit Added)
- Rabeprazole Tab 20 (Quantity Limit Added)
February 2021
Additions:
- No updates
Removals:
- No updates
Other Updates:
- No updates
January 2021
Removals:
- Ogestrel Tablet 0.5-50mg-mcg
Other Updates:
- Antabuse 250mg, 500mg (Removed Quantity Level Limit)
- Buprenorphine-Naloxone 2-0.5mg, 8-2mg sublingual tablet (Removed Quantity Level Limit)
- Buprenorphine 2mg, 8mg sublingual tablet (Removed Quantity Level Limit)
- Naloxone 0.4mg/mL injection solution (Removed Quantity Level Limit)
- Naloxone 0.4mg/mL injection syringe (Removed Quantity Level Limit)
- Naloxone 1mg/mL injection syringe (Removed Quantity Level Limit)
- Narcan 4mg/actuation nasal spray (Removed Quantity Level Limit)
- Probuphine 74.2mg subdermal implant (Removed Quantity Level Limit)
- Sublocade 100mg/0.5ml, 300mg/1.5ml solution, extended release subcutaneous syringe (Removed Quantity Level Limit)