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Drug Authorization and Quantity Limits
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Some drugs, and certain amounts of some drugs, require an approval before they can be covered by your patients' benefits.
Obtain approval in advance to help prevent delays at the pharmacy.
To view authorization information for procedures, imaging, and durable medical equipment (DME), please view the medical authorization table.
View important details about authorization
FEP Drug Authorization Table
The drugs listed below require authorization. Click the drug name to see the criteria of the policy.
Submit drug authorization request
All Opioid-related drugs
To find a specific drug more quickly, use the keyboard shortcut. On a PC, press ‘CTRL+‘F’ and on a Mac, press 'Cmd+F' and type in the drug name to search.
Abstral Acanya Aciphex Aciphex Sprinkles Acromegaly Actemra Acthar Gel Actiq Aczone Adakveo Adapalene 0.3% Adcirca Adderall XR Addyi Adempas Admelog Adoxa Adzensys XR-ODT Aerospan Afrezza Aimovig AirDuo (BRAND ONLY) Ajovy Aklief Alinia Almotriptan Alsuma Altreno Alvesco Amphetamine-Dextroamphetamine ER Amzeeq Androderm Androgel Androgel Pump Apidra Aptensio XR Aralast NP Arazlo Armodafanil ArmonAir Asceniv Atralin Aubagio Avita Avonex Avsola Axert Axiron Azelex Banzel Baraclude solution Beconase AQ Belsomra Benzaclin Benzoyl Peroxide/Clindamycin Berinert Betaseron Bivigam Botox Breztri Aerosphere Budesonide/Formoterol Fumarate Inhalation Caplyta Carac Cream Carimune NF Carospir Cerdelga
Cerezyme Cimzia Cinryze Cinqair Clindamycin Foam Clindamycin phosphate/tretinoin topical Compounded Drug Products Concerta Condylox Gel Copaxone Corlanor Oral Solution Cosentyx Cotempla XR Crysvita Cutaquiq Cuvitru Cuvposa Cystic Fibrosis Daklinza Daytrana Dayvigo Descovy Desvenlafaxine ER Desvenlafaxine Fumarate ER Dexedrine Dexilant Dexmethylphenidate ER Dextroamphetamine ER Diacomit Differin 0.3% Dojolvi Doryx Doxycycline delayed release Doxycycline Hyclate delayed release tablet Drizalma Sprinkles Duac Dulera Dupixent Durolane Dyanavel XR Dymista Dysport Edluar Elelyso Emflaza Emgality Emtriva Enbrel Enspryng Entresto Entyvio Epaned Epclusa Epidiolex Epiduo Forte Epoprostenol Esbriet Esomeprazole Strontium Eucrisa Euflexxa Evekeo Evekeo ODT Evenity Evoclin Evrysdi Extavia Fasenra Fentanyl Lozenge Fentora Fetzima Finacea 15% foam Firazyr Firvanq Flebogamma Flector Flolan FloLipid Flovent Flunisolide Nasal Solution Fluoroplex Fluorouracil 0.5% Cream Fluvoxamine Maleate ER Focalin XR Forteo Fortesta Frova Frovatriptan Galafold Gammagard Gammaked Gammaplex Gamunex C Gel-One Gelsyn-3 Genotropin Genvisc 850 Gilenya Givlaari Glassia Glatopa Gloperba Glucose Test Strips Gocovri Granix Grastek Harvoni Haegarda Hetlioz Hizentra Humalog Humalog Mix 50/50 Humalog Mix 75/25 Humatrope Humira Humulin 70/30 Humulin N Humulin R-100 Hyalgan Hymovis Hyqvia Ilumya Inbrija Increlex Inflectra Infliximab Ingrezza Ingrezza Intermezzo Invokamet Invokamet XR Invokana Isturisa Itraconazole Ivermectin Ixifi Jentadueto Jublia Juxtapid Jynarque Kalbitor Kalydeco Kazano Kerydin Kesimpta Kevzara Khedezla Kineret Kombiglyze ER Korlym Koselugo Krystexxa Kynamro Kynmobi Lantus Lartruvo Lemtrada Letairis Leukine Lucemyra Luvox CR Luxturna Lyrica solution Lyumjev Mavenclad Mavyret Mayzent Metadate CD Metadate ER Methitest Methylphenidate CD Methylphenidate ER Methyltestosterone Minocycline ER Mirapex ER Mirvaso Modafinil Mometasone Nasal Spray Monovisc Motegrity Movantik Mycapssa Mydayis Myobloc Naprosyn suspension Naproxen suspension Nasonex Natesto Nayzilam Nesina Neuac Neulasta Neulasta Onpro Neupogen Neupro Nexium Capsules Nexium Packets Nexletol Nexlizet Norditropin Nourianz Nucala Nurtec ODT Nutropin Nutropin AQ Nuvigil Ocaliva Ocrevus Octagam Odactra Ofev Olumiant Olysio Omnaris Omnitrope Onexton Onfi Ongentys Onglyza Onmel Onpattro Onsolis Opdivo Opsumit Oracea Oralair Orencia Orenitram Orilissa Orkambi Orthovisc Oseni Osmolex ER Otezla Oxbryta Oxervate Ozobax Palforzia Palynziq Patanase Panzyga Pazeo Pegasys Pennsaid 2% solution Pexeva Picato Plegridy Pradaxa Praluent Prevacid Solutabs Prilosec Packets Pristiq Privigen Prolastin-C Protonix Packets Provigil Pulmicort Flexhaler Purixan Qbrelis Qnasl Qnasl Child Qtern QuilliChew ER Quillivant XR Rabeprazole Radicava Ragwitek Raloxifene Ravicti Rebif Reblozyl Relistor Relpax Remicade Remodulin Renflexis Repatha Requip XL Retin A Micro Retin-A Revatio Rexulti Reyvow Rhofade Rinvoq Riomet Riomet ER Ritalin LA Rituxan Rituxan Hycela Ropinirole ER Rozerem Ruconest Ruxience Ruzurgi Rytary Saizen Samsca Savaysa Scenesse Secuado Segluromet Semglee Serostim Signifor LAR Sildenafil Silenor Siliq Simponi Simponi Aria Simvastatin Oral Suspension Skyrizi Sodium Hyaluronate Soliris Solodyn Soltamox Somavert Soolantra Sotylize Sovaldi Spinraza Sporanox Spravato Steglatro Steglujan Stelara Strensiq Striant Subsys Sumavel Dosepro Sunosi Supartz Symdeko Sympazan Symproic Synagis Syndros Synojoynt Synvisc Synvisc-One Takhzyro Taltz Talzenna Tamoxifen Tanzeum Tasmar Tavalisse Tecfidera Tegsedi Tepezza Teriparatide Testim Testosterone Gel 1% Testosterone Gel Pump 1% Tolak Tolsura Tolvaptan Tosymra Toujeo Tracleer Tradjenta Tremfya Tretin-X Tretinoin Micronized topical Tretinoin topical Treximet Trikafta Triluron Trintellix Trivisc Trulicity Truxima Turalio Tymlos Tysabri Tyvaso Ubrelvy Ultomiris Uptravi Valtoco Vancocin Vancomycin Veklury Veletri Veltin Ventavis Veramyst Veregen Ointment Vesicare Viekira Pak Viibryd Viread Visco-3 Vogelxo Vosevi VPRIV Vraylar Vumerity Vyepti Vyndamax Vyndaqel Vyvanse Wakix Xadago Xatmep Xcopri Xeljanz Xeljanz XR Xembify Xeomin Xiaflex Ximino Xolair Xyosted Xyrem Xywav Yervoy Zavesca Zecuity Zelapar Zelnorm Zemaira Zepatier Zerviate Zetonna Ziana Zilxi Zolgensma Zolpimist Zomacton Zomig Nasal Spray Zorbtive Zulresso Zyclara
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