These policies apply to drugs billed under the medical benefit.

Amyloidosis - Amvuttra UM Medical De-identified

Amyloidosis - Onpattro UM Medical De-Identified

Amyloidosis - Tegsedi UM Medical De-Identified

Botulinum Toxins - Botox UM Medical De-Identified

Botulinum Toxins - Dysport UM Medical De-Identified

Botulinum Toxins - Myobloc UM Medical De-Identified

Botulinum Toxins - Xeomin UM Medical De-Identified

Calcitonin Gene-Related Peptide Inhibitors - Vyepti UM Medical De-identified

Colony Stimulating Factors - Filgrastim Products UM Medical De-identified

Colony Stimulating Factors - Granix UM Medical De-identified

Colony Stimulating Factors - Pegfilgrastim Products UM Medical De-Identified

Colony Stimulating Factors - Rolvedon UM Medical Policy De-Identified

Complement Inhibitors - Soliris UM Medical De-identified

Complement Inhibitors - Ultomiris Intravenous UM Medical De-Identified

Erythropoiesis-Stimulating Agents - Aranesp UM Medical De-Identified

Erythropoiesis-Stimulating Agents - Epoetin Alfa Products UM Medical De-Identified

Erythropoiesis-Stimulating Agents - Mircera UM Medical Policy 

ESA - Epoetin Alfa Products UM Medical De-identified

Gaucher Disease - Enzyme Replacement Therapy - Cerezyme UM Medical De-identified

Gaucher Disease - Enzyme Replacement Therapy - Elelyso UM Medical De-identified

Gaucher Disease - Enzyme Replacement Therapy - Vpriv UM Medical De-identified

GnRH - Implants UM Medical De-identified 

GnRH - Injectable Long-Acting Products UM Medical De-identified 

Gonadotropin-Releasing Hormone Agonists - Central Precocious Puberty UM Medical De-Identified

Gonadotropin-Releasing Hormone Agonists - Injectable Long-Acting Products UM Medical De-Identified

Hematology - Gene Therapy - Zynteglo UM Medical De identified 

Hemophilia - Altuviiio UM Medical De-Identified

Hemophilia - Factor VIII Products UM Medical De-Identified

Hemophilia - Gene Therapy - Hemgenix UM Medical De-Identified 

Hemophilia - Hemlibra UM Medical De-identified

Hepatology - Givlaari UM Medical De-Identified

Hepatology - Panhematin UM Medical De-Identified

Hyaluronic Acid Derivatives Intraarticular UM Medical Policy 

Immune Globulin - Subcutaneous UM Medical De-Identified

Immunologicals - Cinqair UM Medical De-Identified

Immunologicals - Fasenra UM Medical De-Identified

Immunologicals - Nucala UM Medical De-Identified

Immunologicals - Tezspire UM Medical De-Identified

Immunologicals - Xolair UM Medical De-Identified

Inflammatory Conditions - Actemra Intravenous UM Medical De-Identified

Inflammatory Conditions - Cimzia UM Medical De-identified 

Inflammatory Conditions - Entyvio Intravenous UM Medical De-identified

Inflammatory Conditions - Ilumya UM Medical De-identified 

Inflammatory Conditions - Infliximab Products UM Medical De-Identified

Inflammatory Conditions - Orencia Intravenous UM Medical De-Identified

Inflammatory Conditions - Simponi Aria UM Medical De-Identified

Inflammatory Conditions - Skyrizi Intravenous UM Medical De-identified

Inflammatory Conditions - Stelara Intravenous UM Medical De-identified

Iron Replacement - Feraheme UM Medical De-Identified

Iron Replacement - Ferrlecit UM Medical De-Identified

Iron Replacement - INFeD UM Medical De-Identified

Iron Replacement - Injectafer UM Medical De-Identified

Iron Replacement - Monoferric UM Medical De-Identified

Iron Replacement - Venofer UM Medical De-Identified

Makena (Hydroxyprogesterone caproate) UM Medical De-Identified

Multiple Sclerosis - Briumvi UM Medical De-Identified

Multiple Sclerosis - Lemtrada UM Medical De-Identified

Multiple Sclerosis - Ocrevus UM Medical De-Identified

Multiple Sclerosis and Crohn's Disease - Tysabri UM Medical De-Identified

Neurology - Vyvgart UM Medical De-Identified

Oncology (Injectable) - Bevacizumab Products UM Medical De-Identified

Oncology (Injectable) - Herceptin Hylecta UM Medical De-Identified

Oncology (Injectable) - Phesgo UM Medical De-identified

Oncology (Injectable) - Rituxan Hycela UM Medical De-Identified

Oncology (Injectable) - Trastuzumab Products UM Medical De-identified 

Ophthalmology - Luxturna UM Medical De-identified

Ophthalmology - Vascular Endothelial Growth Factor Inhibitors - Beovu UM Medical De-Identified

Ophthalmology - Vascular Endothelial Growth Factor Inhibitors - Eylea UM Medical De-Identified

Ophthalmology - Vascular Endothelial Growth Factor Inhibitors - Ranibizumab Products UM Medical De-Identified

Ophthalmology - Vascular Endothelial Growth Factor Inhibitors - Susvimo UM Medical De-Identified

Ophthalmology - Vascular Endothelial Growth Factor Inhibitors - Vabysmo UM Medical De-Identified

Ophthalmology - VEGF Inhibitors  Eylea UM Medical De-identified

Repository Corticotropin - Acthar Gel UM Medical De-identified 

Rituximab Intravenous Products UM Medical De-identified

Somatostatin Analogs  Lanreotide Products UM Medical De-identified 

Somatostatin Analogs - Sandostatin LAR Depot UM Medical

Spinal Muscular Atrophy - Gene Therapy - Zolgensma - UM Medical De-Identified 

Spinal Muscular Atrophy - Spinraza UM Medical De-Identified

Uplizna UM Medical De-identified