Acute Migraine (copy)
107 kB
|
#10110
|
2006/01/12
|
MIscellaneous Non Preferred
28 kB
|
|
2005/10/05
|
Antifungals (copy)
118 kB
|
#10120
|
2007/09/07
|
Botox
42 kB
|
|
2005/10/05
|
Zofran
32 kB
|
|
2005/10/05
|
Brand Drugs (copy)
109 kB
|
#10220
|
2006/01/13
|
Cox II Inhibitors (copy)
31 kB
|
#10310
|
2006/01/12
|
Dosage Strength
26 kB
|
|
2005/10/05
|
EPO
36 kB
|
|
2005/10/05
|
Raptiva Amevive
28 kB
|
|
2005/10/05
|
Provigil
31 kB
|
|
2005/10/05
|
Erectile Dysfunction
40 kB
|
#10530
|
2005/10/05
|
Flumist (copy)
39 kB
|
#10610
|
2006/01/12
|
Fuzeon
30 kB
|
|
2005/10/05
|
Growth Hormone (copy)
40 kB
|
#10710
|
2007/04/13
|
Growth Hormone
30 kB
|
|
2005/10/05
|
Flumist
36 kB
|
|
2005/10/05
|
Erectile Dysfunction
38 kB
|
|
2005/10/05
|
Miscellaneous Non Preferred (copy)
32 kB
|
#20420
|
2006/01/12
|
Enbrel Remicade
29 kB
|
|
2005/10/05
|
MS Agents
42 kB
|
|
2005/10/05
|
Cox II Inhibitors
34 kB
|
|
2005/07/01
|
Brand PA
52 kB
|
|
2005/10/05
|
Multi Antipsychotic - Clinical PA (copy)
32 kB
|
#20440
|
2006/11/22
|
Antifungals
38 kB
|
|
2005/10/05
|
Acute Migraine
106 kB
|
|
2005/10/05
|
Zofran
34 kB
|
#30810
|
2005/10/05
|
Enbrel Remicade
32 kB
|
#10510
|
2005/10/05
|
Narcotics (copy)
35 kB
|
#20510
|
2005/11/17
|
Sedative Hypnotics (copy)
31 kB
|
#30110
|
2005/11/17
|
Narcotics (copy)
81 kB
|
#20510
|
2007/10/25
|
Neupogen Leukine
34 kB
|
|
2005/10/05
|
Non Sedating Antihistamines
31 kB
|
|
2005/10/05
|
Sedative Hypnotics (copy)
60 kB
|
#30110
|
2006/01/12
|
Narcotics (copy)
76 kB
|
#20510
|
2006/01/12
|
Phosphate Binders
27 kB
|
|
2005/10/05
|
Provigil (copy)
31 kB
|
#20710
|
2006/11/22
|
Brand Drugs (copy)
57 kB
|
#10220
|
2006/01/12
|
Raptiva Amevive (copy)
30 kB
|
#20910
|
2007/01/29
|
Remicade/Kineret (copy)
65 kB
|
#10510
|
2007/06/26
|
Sedative Hypnotics (copy)
62 kB
|
#30110
|
2007/06/12
|
Synagis Respigam (copy)
37 kB
|
#30120
|
2006/11/22
|
Sensipar
29 kB
|
|
2005/10/05
|
Provigil (copy)
33 kB
|
#20710
|
2005/12/05
|
Multi Antipsychotic - Clinical PA (copy)
32 kB
|
#20440
|
2006/11/22
|
Growth Hormone (copy)
33 kB
|
#10710
|
2006/11/22
|
Sedative Hypnotics (copy)
29 kB
|
#30110
|
2007/01/29
|
Subjective Global Assessment (SGA)
28 kB
|
|
2005/10/05
|
Enbrel/Remicade (copy)
33 kB
|
#10510
|
2007/01/29
|
Antifungals (copy)
39 kB
|
#10120
|
2007/01/29
|
Synagis Respigam
34 kB
|
|
2005/10/05
|
Synagis Respigam (copy)
37 kB
|
#30120
|
2007/10/12
|
Narcotics (copy)
37 kB
|
#20510
|
2007/06/12
|
Transition Policy
431 B
|
|
2007/03/14
|
PDP Grandfathering Strategy
459 B
|
|
2007/03/14
|
PDL Dosage Consolidation List_01.29.07
112 kB
|
|
2007/01/29
|
PA Analysis 2007 Standard vs Managed
522 B
|
|
2007/03/14
|
Growth Hormone (copy)
82 kB
|
#10710
|
2007/05/01
|
DUR Board Member List - 03/11/2004
34 kB
|
|
2005/02/28
|
Customer Service Requirements
566 B
|
|
2007/03/14
|
Customer Service Requirements
226 kB
|
|
2007/03/14
|
Coverage Determination Review Process
499 B
|
|
2007/03/14
|
Antifungals (copy)
77 kB
|
#10120
|
2007/04/13
|
Synvisc
34 kB
|
|
2005/10/05
|
Syringe Filling
26 kB
|
|
2005/10/05
|
Vivitrol (copy)
33 kB
|
|
2006/11/22
|
Zofran
34 kB
|
#30810
|
2005/11/04
|
Zyvox
28 kB
|
|
2005/10/05
|
Symlin (copy)
39 kB
|
#301501
|
2007/11/06
|
Sensipar (copy)
32 kB
|
#30115
|
2007/11/06
|
Sedative Hypnotics (copy)
96 kB
|
#30110
|
2007/11/06
|
Remicade/Kineret (copy)
98 kB
|
#10510
|
2007/11/06
|
Raptiva Amevive (copy)
34 kB
|
#20910
|
2007/11/06
|
Provigil (copy)
33 kB
|
#20710
|
2007/11/06
|
Phosphate Binders (copy)
28 kB
|
#20720
|
2007/11/06
|
Non Sedating Antihistamines (copy)
32 kB
|
#20530
|
2007/11/06
|
Multi Antipsychotic - Clinical PA (copy)
34 kB
|
#20440
|
2007/11/06
|
MS Agents (copy)
45 kB
|
#20430
|
2007/11/06
|
Miscellaneous Non Preferred (copy)
29 kB
|
#20420
|
2007/11/06
|
Growth Hormone (copy)
82 kB
|
#10710
|
2007/11/06
|
Four (4) Brand PA Form (copy)
36 kB
|
#10600
|
2007/11/06
|
EPO (copy)
36 kB
|
#10520
|
2007/11/06
|
Dose Consolidation (copy)
33 kB
|
#10420
|
2007/11/06
|
Cox II Inhibitors (copy)
30 kB
|
#10310
|
2007/11/06
|
Brand Drugs (copy)
53 kB
|
#10220
|
2007/11/06
|
Acute Migraine (copy)
161 kB
|
#10110
|
2007/11/06
|
Synagis Respigam (copy)
74 kB
|
#30120
|
2007/11/15
|
Zyvox (copy)
33 kB
|
#30820
|
2008/01/02
|
Oral Anabolic Steroid (copy)
31 kB
|
#20600
|
2008/01/17
|
Growth Hormone (copy)
123 kB
|
#10710
|
2008/01/17
|
Byetta (copy)
33 kB
|
#10230
|
2008/01/02
|
Antifungals (copy)
159 kB
|
#10120
|
2008/01/17
|
Maine Pharmacies
83 kB
|
|
2006/08/29
|
MaineCare MAC List Effective 01.25.2007
160 kB
|
|
2007/01/15
|
Draft PDL for October DUR Meeting
4 MB
|
|
2006/10/06
|
Synvisc (copy)
37 kB
|
#30130
|
2008/02/27
|
Botox - Myobloc (copy)
42 kB
|
#10210
|
2008/02/27
|
MS Agents (copy)
91 kB
|
#20430
|
2008/04/17
|
Acute Migraine
109 kB
|
#10110
|
2008/09/23
|
Narcotics
38 kB
|
#20510
|
2008/09/23
|
Zyvox (copy)
100 kB
|
#30820
|
2008/09/29
|
Vivitrol (copy)
65 kB
|
#3400
|
2008/09/29
|
Syringe Filling (copy)
29 kB
|
#30140
|
2008/09/29
|
Synvisc (copy)
74 kB
|
#30130
|
2008/09/29
|
Synagis Respigam (copy)
113 kB
|
#30120
|
2008/09/29
|
Symlin (copy)
78 kB
|
#301501
|
2008/09/29
|
Subjective Global Assessment (SGA) (copy)
27 kB
|
|
2008/09/29
|
Sensipar (copy)
65 kB
|
#30115
|
2008/09/29
|
Sedative Hypnotics (copy)
129 kB
|
#30110
|
2008/09/29
|
Rheumatoid/Crohns (copy)
34 kB
|
#20900
|
2008/09/29
|
Provigil (copy)
68 kB
|
#20710
|
2008/09/29
|
Oral Anabolic Steroid (copy)
63 kB
|
#20600
|
2008/09/29
|
Ondansetron (copy)
37 kB
|
#20610
|
2008/09/29
|
Non Sedating Antihistamines (copy)
63 kB
|
#20530
|
2008/09/29
|
Neupogen Leukine (copy)
34 kB
|
#20520
|
2008/09/29
|
Narcotics (copy)
160 kB
|
#20510
|
2008/09/29
|
Multi Antipsychotic - Clinical PA (copy)
67 kB
|
#20440
|
2008/09/29
|
MS Agents (copy)
141 kB
|
#20430
|
2008/09/29
|
Miscellaneous Non Preferred (copy)
62 kB
|
#20420
|
2008/09/29
|
MaineCare MAC List Effective 10.25.2007 (copy)
221 kB
|
|
2008/09/26
|
Growth Hormone (copy)
119 kB
|
#10710
|
2008/09/29
|
Fuzeon (copy)
32 kB
|
#10620
|
2008/09/29
|
Four (4) Brand PA Form (copy)
68 kB
|
#10600
|
2008/09/29
|
Flumist (copy)
39 kB
|
#10610
|
2008/09/29
|
EPO (copy)
72 kB
|
#10520
|
2008/09/29
|
Drug Drug Interactions (copy)
31 kB
|
#10400
|
2008/09/29
|
Dose Consolidation (copy)
66 kB
|
#10420
|
2008/09/29
|
Dosage Strength (copy)
29 kB
|
#10410
|
2008/09/29
|
Cox II Inhibitors (copy)
62 kB
|
#10310
|
2008/09/29
|
Byetta (copy)
68 kB
|
#10230
|
2008/09/29
|
Brand Drugs (copy)
109 kB
|
#10220
|
2008/09/29
|
Botox - Myobloc (copy)
87 kB
|
#10210
|
2008/09/29
|
Antifungals (copy)
198 kB
|
#10120
|
2008/09/29
|
Amevive (copy)
65 kB
|
#20910
|
2008/09/29
|
Acute Migraine (copy)
319 kB
|
#10110
|
2008/09/29
|
Synagis Respigam
38 kB
|
|
2008/10/24
|
Synagis Respigam (copy)
39 kB
|
#30120
|
2008/12/12
|
Narcotics (copy)
202 kB
|
#20510
|
2008/12/18
|
Sedative Hypnotics (copy)
163 kB
|
#30110
|
2009/01/06
|
Growth Hormone (copy)
161 kB
|
#10710
|
2009/01/06
|
Acute Migraine (copy)
368 kB
|
#10110
|
2009/01/06
|
Non Sedating Antihistamines (copy)
97 kB
|
#20530
|
2009/05/08
|
Med Watch Form (copy)
268 kB
|
|
2009/05/08
|