MedicationCriteriaForm
AddyiDownloadDownload
AfrezzaDownloadDownload
AmpyraDownloadDownload
Androgen & Anabolic SteroidsDownloadDownload
AnticoagulantsDownloadDownload
AntidepressantDownloadDownload
AntiemeticDownloadDownload
Antifungal: Cresemba/Noxafil/VfendDownloadDownload
Anti-Influenza AgentDownloadDownload
Arcalyst/IlarisDownloadDownload
Atopic DermatitisDownloadDownload
Atypical AntipsychoticsDownloadDownload
Biologic ImmunomodulatorsDownloadDownload
Botulinum ToxinsDownloadDownload
Buprenorphine/Buprenorphine Naloxone Opioid DependenceDownloadDownload
CarbagluDownloadDownload
CerdelgaDownloadDownload
Ciclopirox Efinaconazole Itraconazole Tavabrole TerbinafineDownloadDownload
Circadian Rhythm DisorderDownloadDownload
Circadian Rhythm DisorderDownloadDownload
Combination GI ProtectantDownloadDownload
Cresemba Noxafil VfendDownloadDownload
Diclofenac Fluorouracil Cream Imiquimod Cream IngenolDownloadDownload
Doxycycline/MinocyclineDownloadDownload
EgriftaDownloadDownload
EmflazaDownloadDownload
EndariDownloadDownload
ErythropoietinsDownloadDownload
ForteoDownloadDownload
Gabapentin ERDownloadDownload
GattexDownloadDownload
Growth HormoneDownloadDownload
GocovriDownloadDownload
Hepatitis B/Hepatitis C AgentsDownloadDownload
Hepatitis C First Generation Program SummaryDownloadDownload
Hepatitis C Second Generation Program Summary DownloadDownload
Hereditary Angiodema (HAE)DownloadDownload
Homozygous Familial Hypercholesterolemia (HoFH) AgentsDownloadDownload
HP ActharDownloadDownload
Hyperpolarization-Activated Cyclic Nucleotide-Gated (HCN) Channel Blocker (Corlanor)DownloadDownload
Idiopathic Pulmonary Fibrosis (IPF)DownloadDownload
Injectable MethotrexateDownloadDownload
Insomnia AgentsDownloadDownload
Insulin DownloadDownload
Insulin CombinationDownloadDownload
Kalydeco/OrkambiDownloadDownload
KeveyisDownloadDownload
KorlymDownloadDownload
KuvanDownloadDownload
Metformin ERDownloadDownload
Multiple SclerosisDownloadDownload
MyaleptDownloadDownload
NatparaDownloadDownload
Neprilysin InhibitorDownloadDownload
NortheraDownloadDownload
Nuvigil/ProvigilDownloadDownload
OcalivaDownloadDownload
Ophthalmic AntihistamineDownloadDownload
Ophthalmic ImmunomodulatorsDownloadDownload
Opioid AntidoteDownloadDownload
Opioids ERDownloadDownload
Opioids IRDownloadDownload
Oral ImmunotherapyDownloadDownload
Oral NSAIDDownloadDownload
Oral Pulmonary Hypertension (PAH) AgentsDownloadDownload
OtezlaDownloadDownload
Phosphodiesterase type 5 inhibitor (PDE5) AgentsDownloadDownload
PPIDownloadDownload
Post Acute Withdrawal AgentsDownloadDownload
Proprotein Convertase Subtilisin/kexin type 9 (PCSK9) InhibitorsDownloadDownload
Quantity LimitsDownloadDownload
RayosDownloadDownload
RetinoidsDownloadDownload
Selective Serotonin Inverse Agonist (SSIA)DownloadDownload
Self-Administered Oncology AgentsDownloadDownload
StrensiqDownloadDownload
Testosterone AgentsDownloadDownload
Thrombopoietin Receptor AgonistsDownloadDownload
Topical AntibioticsDownloadDownload
Topical LidocaineDownloadDownload
Topical NSAIDDownloadDownload
Transmucosal Immediate Release Fentanyl (TIRF)DownloadDownload
TriptansDownloadDownload
Urate Transporter Inhibitor 1 (URAT1)DownloadDownload
Urea Cycle Disorders AgentsDownloadDownload
VMAT2 InhibitorsDownloadDownload
ViscosupplementsDownloadDownload
Weight LossDownloadDownload
XermeloDownloadDownload
XyremDownloadDownload
ZavescaDownloadDownload