Medical Policies & Clinical UM Guidelines Search

Prescription Drug Documents


The pharmacy clinical criteria for injectable, infused, or implanted prescription drugs and therapies covered under the medical benefit may be accessed at the following websites for commercial plans and certain Medicare/Medicaid markets. Please refer to provider notification for dates associated with implementation of these documents. As of October 1, 2019, implementation of pharmacy clinical criteria will be complete and drug medical policies and clinical UM guidelines will be retired at that time.



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