Antihistamines Antipsychotics Armodafinil Aubagio Botulinum Toxin Cimzia Cinryze Daliresp Enbrel ESAs Eylea & Lucentis Fentanyl Citrate General Authorization Form Gilenya Growth Hormone Hepatitis C Hospice Humira Hyaluronic Acid Immunosuppressants IVIG & SCIG Lidocaine Lupron Lyrica Memantine Modafinil Neulasta Neupogen Non-Formulary Orencia PAH Agents Prolia Prostaglandin Analog Quantity Limit Remicade Rituxan Simponi Skeletal Muscle Relaxants Stimulants Suboxone Tecfidera Testosterone Tiering Exception Tysabri Xeljanz Zolpidem & Zaleplon Zytiga & Xtandi
