| Altabax |
New Drug Appeal |
Require Prior Approval |
Prior Approval Required |
| Avinza |
PDL Appeal |
Remain Non-Preferred |
Non-Preferred � PDL Class |
| Azor |
New Drug Initial Review |
Require Prior Approval |
Prior Approval Required |
| Byetta |
New Drug Appeal |
Require Prior Approval |
Prior Approval Required |
| Cerefolin NAC |
New Drug Initial Review |
Require Prior Approval |
Prior Approval Required |
| Depakote ER |
PDL Appeal |
Remain Non-Preferred |
Non-Preferred � PDL Class |
| Exforge |
New Drug Appeal |
Require Prior Approval |
Prior Approval Required |
| Invega |
New Drug Initial Review |
Remove Prior Approval Requirement |
Prior Approval requirement removed |
| Istalol |
PDL Appeal |
Remain Non-Preferred |
Non-Preferred � PDL Class |
| Lantus |
PDL Appeal |
Remain Non-Preferred |
Non-Preferred � PDL Class |
| Natelle |
PDL Appeal |
Remain Non-Preferred |
Non-Preferred � PDL Class |
| Neupro |
New Drug Initial Review |
Remove Prior Approval Requirement |
Prior Approval requirement removed |
| Perforomist |
New Drug Initial Review |
Require Prior Approval |
Prior Approval Required |
| Pylera |
New Drug Appeal |
Remove Prior Approval Requirement |
Prior Approval Required |
| Veramyst |
New Drug Appeal |
Require Prior Approval |
Prior Approval Required |
| Xibrom |
PDL Appeal |
Remain Non-Preferred |
Non-Preferred � PDL Class |
| Xyzal |
New Drug Initial Review |
Require Prior Approval |
Prior Approval Required |
| Zinotic |
New Drug Initial Review |
Require Prior Approval |
Prior Approval Required |
| Zyflo CR |
New Drug Initial Review |
Require Prior Approval |
Prior Approval Required |