Medical management

Medical prior authorization service list

Medical injectables list

Medical benefit prior authorization form

Medical Policy Drug Documents

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Exception to coverage forms

For new FDA-approved drugs on the market for less than a year.
Pharmacy drug-IL
Pharmacy drug-MO
Medical injectable drug-IL
Medical injectable drug-MO
Medicare injectable drug step B therapy
Medicare pharmacy drug step B therapy

Medicare Prior Part B Authorization list

Medicare Prior Authorization Review when Absent NCD/LCD

Non-covered services