Part B Pharmacy Policies
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A
- ADAMTS13, recombinant-krhn (Adzynma)
- Abatacept (Orencia®) for Injection for Intravenous Use
- Agalsidase beta (Fabrazyme®) and pegunigalsidase alfa-iwxj (Elfabrio)
- Alemtuzumab_(Lemtrada).pdf
- Algucosidase_Alfa_(Lumizyme),_Avalglucosidase_Alfa-Ngpt_(Nexviazyme),_Cipaglucosidase_Alfa-Atga_(Pombiliti).pdf
- Alpha_1-Antitrypsin_Therapy_(Prolastin-C,_Aralast_NP,_Glassia,_Zemaira).pdf
- Anifrolumab-fnia_(Saphnelo).pdf
- Anifrolumab-fnia_(Saphnelo)_2.pdf
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B
- Belimumab_(Benlysta)_for_Intravenous_Use.pdf
- Botulinum Toxin Agents
- Botulinum_Toxin_Agents_2.pdf
- Burosumab-Twza_(Crysvita).pdf
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C
- CGM Policy
- CGM_Policy_.pdf
- Cerliponase alfa (Brineura®)
- Coagulation_Factors.pdf
- Collagenase_Clostridum_Histolyticum_(Xiaflex),_Collagenase_Clostridium_Histolyticum-Aaes_(Qwo).pdf
- Crizanlizumab-tmca (Adakveo®)
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D
- Denosumab (Prolia®, Xgeva®), Romosozumab-aqqg (Evenity®)
- Dofetilide_(Tikosyn)_Use_in_the_Inpatient_Setting.pdf
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E
- Eculizumab (Soliris) and Related Biosimilars, Ravulizumab-cwvz (Ultomiris)
- Eculizumab_(Soliris)_and_Related_Biosimilars,_Ravulizumab-cwvz_(Ultomiris)_2.pdf
- Efgartigimod-alfa (VyvgartTM) and efgartgimod alfa and hyaluronidase-qvfc (Vyvgart Hytrulo)
- Emapalumab-lzsq_(Gamifant).pdf
- Enteral Nutritional Therapy
- Enteral_Nutritional_Therapy_2.pdf
- Enzyme_Replacement_Therapy_for_Mucopolysaccharidosis_(e.g._Aldurazyme,_Elaprase,_Vimizim,_Naglazyme,_Mepsevii,_etc.).pdf
- Enzyme_Replacement_for_the_Treatment_of_Gaucher's_Disease.pdf
- Eptinezumab_Jjmr_(Vyepti).pdf
- Erythropoeisis_Stimulating_Agents_(ESAs).pdf
- Evinacumab-dgnb_(Evkeeza)_2.pdf
- Exon_Skipping_for_Duchenne_Muscular_Dystrophy_(DMD).pdf
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F
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G
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I
- Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG)
- Inclisiran_(Leqvio).pdf
- Inebilizumab-Cdon_(Uplinza).pdf
- Infliximab_and_Related_Biosimilars.pdf
- Interleukin-5 (IL-5) Antagonist (e.g., Cinqair®, Nucala®) and IL-5 Receptor Antagonist (e.g., Fasenra®)
- Intravenous Ketamine (Ketalar) and Intranasal Esketamine (Spravato)
- Intravenous_Ketamine_(Ketalar)_and_Intranasal_Esketamine_(Spravato)_2.pdf
- Intravitreal_Injection_of_VEGF_Antagonists_and_Related_Biosimilars,_and_Combination_VEGF-Angiopoietin-2_(Ang-2)_Inhibitors.pdf
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L
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M
- Medicare Part B vs. Part D Crossover Drugs
- Mirikizumab-mrkz (Omvoh™) for Intravenous Use
- Monoclonal Antibodies Directed Against Amyloid For The Treatment of Alzheimer Disease
- Monoclonal_Antibodies_Directed_Against_Amyloid_For_The_Treatment_of_Alzheimer_Disease_2.pdf
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N
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O
- Ocrezilumab_(Ocrevus).pdf
- Octreotide Acetate (Sandostatin® LAR Depot)
- Off-Label_Coverage_for_Prescription_Drugs_and-or_Biologics.pdf
- Olipudase_Alfa-Rpcp_(Xenpozyme).pdf
- Omalizumab (Xolair®)
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P
- Patisiran (Onpattro™) and vutrisiran (Amvuttra™)
- Pegloticase_(Krystexxa).pdf
- Pozelimab-Bbfg_(Veopoz).pdf
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R
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S
- Sebelipase_Alfa_(Kanuma).pdf
- Secukinumab (Cosentyx®) for Intravenous Use
- Spesolimab-sbzo (Spevigo)
- Spesolimab-sbzo_(Spevigo)_2.pdf
- Sutimlimab-Jome_(Enjaymo).pdf
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T
- Teplizumab-mzwv (Tzield)
- Teprotumumab_(Tepezza).pdf
- Tezepelumab-Ekko_(Tezspire).pdf
- Tildrakizumab-Asmn_(Ilumya).pdf
- Tocilizumab (Actemra®) and Related Biosimilars for Intravenous Infusion and Subcutaneous Injection
- Tofersen_(Qalsody).pdf
- Total_Parenteral_Nutrition_(TPN),_Intradialytic_Parenteral_Nutrition_(IDPN),_Intraperitoneal_Nutrition_(IPN).pdf
- Treatment_of_Pulmonary_Artery_Hypertension_With_Intravenous,_Subcutaneous,_and_Inhaled_Pharmacologic_Agents.pdf
- Treatments for Complex Regional Pain Syndrome (CRPS)
- Triamcinolone_Acetonide_Extended_Release_Injectable_(Zilretta).pdf
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U
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V
- Vedolizumab (Entyvio®) for intravenous use
- Velmanase_alfa_(Lamzede).pdf
- Voretigene_Neparvovec-Rzyl_(Luxturna).pdf