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Clinical Review Prior Authorization Rx (CRPA)
Clinical Review Prior Authorization Rx (CRPA)
abatacept, Absorica, Acanya, Aciphex, Aclaro, Acticlate, Active-Pac/Gabapentin, acyclovir buccal tab, acyclovir/hydrocortisone, Addyi, Adzenys, Agoneaze, Alphaquin, amlodipine/olmesartan/HCTZ, amlodipine/olmesartine, amlodipine/telmisartan, amlopipine/atorvastatin, Ammonium Lactate lotion, amoxicillin trihydrate ER, amphetamine ER suspension, Ampyra, Amrix, anakinra, Androgel, Android, Androxy, Anodyne LPT, apremilast, Aptiom, Arcalyst, Astagraf XL, Austedo, Auvi-Q, Avage, Axiron, azelastine/fluticasone combination spray, balsalazide tablet, BPO/clindamycin Combo gel, Bonjesta, Brisdelle, Briviact, budesonide ER, budesonide rectal foam, calcipotriene/betamethasone suspension, calcipotriene/betamethasone topical foam, Capxib Kit, Carac, carbidopa/levodopa, carglumic Acid, carisoprodol 250mg, chlorzoxazone, clindamycin/BPO, clindamycin/tretinoin gel, clindamycin/tretinoin, clobazam, clonidine ER, Cosmetic Drugs, Cotempla XR ODT, crofelemer, Cuprimine, Cuvposa, cyclobenzaprine 10mg and topical liniment gel, cyclobenzaprine 7.5mg, cyclobenzaprine Comfort Pac, Cyclo/Gaba Pak, Cyclobenzaprinepax, Cyproheptadine dosecup,Cystaran, cysteamine Ophthalmic drops, Cysteamine Oral capsule, gastro-resistant, dalfampridine, DDS Premium Pak, DermacinRx DPN, DermacinRx Pak, Dermacin Pak PHN, DermasilkRx SDS, Dermawerx Kit, desonide ointment/cream, dexamethasone dose pak, dextromethorphan/quinidine, Diclegis, diclofenac 3% gel, Diclopak, Diclopr, Dithol, donepezil/memantine, doxycycline hyclate, doxylamine/pyridoxine, droxidopa, Dupixent, dutasteride/tamsulosin, Duzallo, Dyanavel XR, Dymista, efinaconazole solution, Egrifta, Eldopaque, Eldoquin, Ellzia Pak, eltrombopag, Emflaza, Empricaine, EmVerm, enalapril 1mg/1ml solution, Endari, Enstilar, Envarsus XR, Epaned, Epiquin, Esbriet, eslicarbazepine acetate, Esomeprazole, Esomep-EZS kit, Strontium, Exforge HCT, Exforge, Extavia, Fabior, Fexmid, Finasteride 1mg, First-Testosterone, Flexepax, Flexipak, flibanserin, fluorouracil 0.5% cream, Fortesta, Gabapentin enacarbil ER, gabapentin ER, Gaba-V Kit, Gattex, Genadur, Giazo, glycopyrrolate, Gocovri, golimumab, Gonitro, Gralise, Granix, Halobetasol ointment, Halonate Kit, Halonate Pac, Hetlioz, Horizant, hydroquinone, Impavido, Increlex, Inflammation Reduction Pack, inflammatral, Ingrezza, Interferon Beta-1b, isotretinoin, itraconazole, ivabradine, ivacaftor, Jublia, Juxtapid, Jynarque, Kalydeco, Kerydin, Keveyis, Korlym, Kuvan, Kynamro, Lamisil Oral Granules, Latisse, lesinurad/allopurinol, levomilnacipran, Lexitral, Lexixryl kit, Lidocaine-Tetracaine Cream, Lidopac 5% ointment, Lido-Prilo Caine Pak, Lidotrans 5 Paks, Lidoxib Kit, Liprozonepak, Lisinopril, Locort, lomitapide, Loprox Kit, Lorvatus Kit, Lorzone, lumacaftor/ivacaftor, Lustra, Lyrica CR, Mecasermin, Medolor Pak, Melpaque, Melquin, Mesalamine Rectal enema, suspension kit, Methitest, methotrexate injection, methotrexate injection, methotrexate tab, methylphenidate chewable, methylphenidate ER, methylphenidate ER suspension, methyltestosterone, metreleptin, miconazole buccal, mifepristone, Migranow, Minocin Pak, minocycline ER, mipomersen, Mirvaso, Morgidox Kits (not capsules), Moxatag, Myalept, Mytesi, Namzaric ER, Natesto, Natpara, Nava, Neupogen, Neupro, Neurcaine, nintedanib, nitroglycerin, Nitromist, Northera, Nortriptyline dosecup,Nudiclo (Solupak and Tabpak), Nuedexta, Nuplazid, Nuquin, Nyata Kit, O3D3 System, Obeticholic Acid, Ocaliva, Ofev, Omega-3/D-3 Kit, Onexton, Onmel, Oravig, Orilissa, Orkambi, Osmolex, Otrexup, oxcarbazepine ER, Oxsoralen lotion, Oxtellar XR, Paingo KFT Cream Kit, palcipotriene foam, paliperidone, parathyroid hormone, paroxetine 7.5mg, pasireotide, pegvisomant, penicillamine, phentermine disintegrating tablet, PHN, pirfenidone, Pliaglis, prednisone tab, gastro resistant, PrevidolRx Pak, Prilolid, Procysbi, Promacta, Propecia, Qbrelis, Qualaquin, Qudexy XR, Quillichew ER, Quillivant XR, quinine capsule, rabeprazole sprinkles, Rasuvo, Rayos, Recombinant, Refissa, Renova, rh-IGF-1, Rhofade, Rhuematrex, rilonacept, rotigotine patch, Rowasa Kit, RRB Pak, Rytary, Sabril, SanadermRx Skin Repair, sapropterin, secukinumab, Signifor SC, Sitavig, Sivextro, SmartRx Pak, sodium oxybate, Solaraze, Solodyn, Soma 250mg, Somavert, Sorilux, sotalol solution, Sotylize, Spritam, Striant, sumatriptan, Suprenza, Symdeko, Syndros, Syprine, Taclonex Scalp, Tac Pak, tacrolimus ER, tacrolomus ER24H, tasimelteon, tavaborole,Tavalisse, tazarotene foam, teduglutide, terbinafine, tesamorelin inject, Testim, Testosterone gel, Testosterone Products, Testred, tetrabenazine, Ticalast Kit, Ticanase, Ticaspray, timothy grass pollen allergen extract, tocilizumab, tofacitinib ER, tofacitinib, topiramate ER capsule, Tretinoin Emollient, Cream 0.05%, Tretin-X .0375%, Tri-Luma, Trokendi XR, Uceris Foam, Uceris Tablets, Ultravate-X, Vaniqa, Veltin, vigabatrin, Viibryd, vilazodone, Vogelxo, Vopat MDS Kit, vorapaxar, vortioxetine, Whytederm Pak, Xatmep, Xeljanz, Xerese, Xhance, Ximino, Xryliderm Kit, Xrylix Pak, Xyrem, Zecuity, Zelapar, Ziana, Zontivity, ZRM Paks, Zurampic

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