Housecall Newsletter - ConnectiCare
Housecall Newsletter - ConnectiCare
Housecall Newsletter - ConnectiCare
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Benlysta<br />
Signifor<br />
Xtandi<br />
Follistim AQ<br />
Berinert<br />
Soliris<br />
Zelboraf<br />
Ganirelix<br />
Botox (botulinium toxin<br />
type A)<br />
Cayston<br />
Cerezyme<br />
Cinryze<br />
Egrifta<br />
Elaprase<br />
Exjade<br />
Fabrazyme<br />
Fentora<br />
Firazyr<br />
Folotyn<br />
Gattex<br />
Ilaris<br />
IVIG (Immuneglobulin)<br />
Jakafi<br />
Jetrea<br />
Kalbitor<br />
Kalydeco<br />
Krystexxa<br />
Kuvan<br />
Lucentis<br />
Macugen<br />
Naglazyme<br />
Nplate<br />
Nulojix<br />
Onsolis<br />
Orfadin<br />
Prolastin<br />
Prolia<br />
Promacta<br />
Reclast<br />
Riastap<br />
Synagis<br />
Thyrogen<br />
Xenazine<br />
Xolair<br />
Zyrem<br />
Zavesca<br />
Zemaira<br />
ORAL ONCOLOGY<br />
AGENTS INCLUDING:<br />
Afinitor<br />
Bosulif<br />
Caprelsa<br />
Cometriq<br />
Erivedge<br />
Gleevec<br />
Hycamtin<br />
Iclusig<br />
Inlyta<br />
Iressa<br />
Nexavar<br />
Oforta<br />
Revlimid<br />
Sprycel<br />
Stivarga<br />
Sutent<br />
Tarceva<br />
Tasigna<br />
Temodar<br />
Thalomid<br />
Tykerb<br />
Votrient<br />
Xalkori<br />
Xeloda<br />
Zolinza<br />
Zortress<br />
Zytiga<br />
PSORIASIS/RHEUMATOID<br />
ARTHRITIS/CROHN’S<br />
DISEASE TREATMENTS<br />
INCLUDING:<br />
Actemra<br />
Amevive<br />
Cimzia<br />
Enbrel<br />
Humira<br />
Orencia<br />
Remicade<br />
Rituxan RA<br />
Simponi<br />
Stelara<br />
Xeljanz<br />
PULMONARY<br />
HYPERTENSION DRUGS<br />
INCLUDING:<br />
Adcirca<br />
Flolan<br />
Letairis<br />
Remodulin<br />
Revatio<br />
Tracleer<br />
Tyvaso<br />
Ventavis<br />
INFERTILITY DRUGS<br />
INCLUDING:<br />
Bravelle<br />
Cetrotide<br />
Chorionic Gonadotropin (HCG)<br />
Gonal-F<br />
Luveris<br />
Makena<br />
Menopur<br />
Novarel<br />
Ovidrel<br />
Pregnyl<br />
Repronex<br />
VISCOSUPPLEMENTS<br />
INCLUDING:<br />
Euflexxa<br />
Gel-One<br />
Hyalgan<br />
Orthovisc<br />
Supartz<br />
Synvisc<br />
Synvisc One<br />
Except for these changes<br />
to the lists of services,<br />
equipment, supplies,<br />
and drugs that require<br />
Pre-Authorization or<br />
Pre-Certification as described<br />
in your Member Document,<br />
and your Prescription Drug<br />
Rider, your Plan, including<br />
any other Riders, remains<br />
unchanged.<br />
CCI/INSERT 01 (1/2014)<br />
15
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