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Pharmacy Coverage Policies
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Effective Date
Policy Name
Reviewed Date
6/16/2021
Abecma® (idecabtagene vicleucel)
2/19/2025
6/16/2021
Abecma® (idecabtagene vicleucel)
2/19/2025
1/1/2023
Abecma® (idecabtagene vicleucel)
2/19/2025
7/1/2024
Abecma® (idecabtagene vicleucel)
2/19/2025
1/1/2025
Abilify MyCite (aripiprazole tablets with sensor)
7/16/2025
1/1/2023
Abraxane (nab- paclitaxel)
9/17/2025
1/1/2023
Abraxane (nab-paclitaxel)
11/20/2024
1/1/2023
Abraxane (nab-paclitaxel)
11/20/2024
7/21/2021
Accrufer™ (ferric maltol)
5/15/2024
1/1/2021
Acitretin
7/16/2025
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